First site! Institute for Family Health, based in New York City.
I spent my first day at Sidney Hilman Family Practice Center, shadowing 3 clinicians and flow staff. Pictures are below, click on any to see as a photo album.
I started the day shadowing flow staff (medical assistants) to see how patients are roomed and brought into the practice. They do something I have not seen in my practice, which is assess patient’s learning ability for every new patient, prior to the provider entering the room. They do this via a template that they fill out with the patient. Something I heard a medical assistant tell a patient that I really liked: “Have a nice visit…” – this seemed to be nice stage setting for a good interaction.
This is a very busy family practice (as one might expect), with 8 exam rooms in this practice, typically shared by 3-4 providers a time. Each room has a workstation and a printer, and some of the images are of an “exam room of the future,” designed by Steelcase furniture as a proof of concept for the group. I was interested to see that the medical assistants here are trained in and do phlebotomy, to assist their laboratory services in times of need. This seems to make things convenient for patients. The practice is nearly paperless.
This group does not yet have Web-based access for their patients to the electronic health record. However, they are on a very current release of the record they are using, and there is good proficiency with the record by the providers here. I was impressed that during patient encounters, the EHR was not perceived or looked to as an impediment to providing care. Dr. Calman enjoys using after visit summaries; the other providers are not as consistent in using these at this time. At the same time, there is a lot of patient education going on, including literacy-appropriate conversations about needed care. The group is working with clinical decision support in the exam room and uses it to be inclusive of preventive care. Much of this decision support is based on the Take Care New York program, that IFH is leading in implementing within their EHR.
The Institute for Family Health now includes medical centers in the Hudson Valley which are newly acquired. At the current time, then, there is a priority on bringing these sites live with the enterprise EHR, which is happening now.
Tomorrow: Shadowing at another medical center, learning more about the enterprise EHR system