Care Org Taps EHR Integration to Improve FQHC Clinical Workflows

Alliance Chicago (AC), a health center-controlled network and practice-based research network, recently announced that it will deploy an EHR integration to federally qualified health centers (FQHCs) across the country in efforts to streamline clinical workflows.

Fred Rachman, MD, the CEO and founder of AC, noted that due to the multi-purpose nature of EHRs, there are a lot of factors independent of clinician workflows that have been driving EHR development.

For instance, Rachman noted that the EHR is a legal document, a billing document, as well as a document to report quality measure requirements to CMS.

“There are a lot of people in line for what they want out of the electronic health record in addition to clinicians,” he told EHRIntelligence in an interview. “Our focus has been on how to facilitate the iterative development of health information technology and clinical practice.”

Rachman, who is a pediatrician himself, explained that ease of access to pertinent patient health information is a key factor in clinician EHR satisfaction.

“We as clinicians really want a tool that is going to help us easily and effectively assemble all the information that we need at the time when we're trying to make a decision with and for our patients,” he said.

“Certainly, we all know that we have to do those things,” he noted. “We have to document for medical-legal purposes, we have to create a historic record, we have to create the documents that are needed for billing, and we have to comply with regulatory requirements.”

However, Rachman said that the reason clinicians come into the exam room every day is to help patients and deliver the best possible care.

“If we can improve the way health information technology can be applied in order to accomplish that goal, clinicians can really feel it's helping them do that,” he explained. “We will really be able to move the needle.”

In efforts to help improve clinician workflows towards this goal, AC has partnered with health IT vendor Wellsheet to deploy its predictive workflow productivity platform.

The tool uses Fast Healthcare Interoperability Resources (FHIR) application programming interfaces (APIs) and can pull and prioritize key patient data from multiple data sources.

“We want to use it as a tool that we can import and facilitate guidance for decision making that adheres to best current clinical practice,” Rachman said. “To really use that kind of evidence, we need data that is coming not only from within the EMR, but from other sources.”

AC chose to offer Wellsheet with athenaOne, athenahealth’s cloud-based suite of EHR, revenue cycle management, and patient engagement products.

Historically, AC has used another athenahealth product, athenaPractice.

“A strong point of that application was that it allowed us to actually author and create content within the application,” Rachman explained. “However, we've been searching for an additional and a modern platform, and we really flagged athenaOne as being one that stands out. It certainly has a lot of characteristics to its interface that are desirable for clinicians.”

“At the same time, we saw opportunities to enhance the way it functions with regard to our ability to easily import evidence-based guidelines and deliver that to our clinicians,” he added. “Using Wellsheet to add that onto the strengths of athenaOne seemed like an obvious advantage to us. We think the combo can be awesome.”

Rachman noted that as a group of FQHCs, AC thinks of clinicians broadly; not just medical providers, but mental health providers, social service providers, and dental providers.

He said that the integrated EHR offering will help support the aggregation of comprehensive information related to all of those disciplines to help support care coordination and clinician satisfaction.

“We've had a big focus on trying to understand what the factors are that lead to clinician burnout and what might enhance resiliency,” Rachman said.

He explained that AC has been part of KLAS Research’s Arch Collaborative, a large initiative across multiple health centers that aims to improve EHR usability and mitigate clinician burnout.

“What we know from the Arch Collaborative is that one of the things that helps clinicians is a degree to which they can personalize an electronic health record,” Rachman said. “This additional way that we are working together with clinicians to customize views and the way information is presented is a way we could really take a leap forward in that arena.”

“One of the other things that we know about clinician satisfaction and burnout is that team-based care and the way that we can help the entire care team feel part of a group is a big contributor to morale,” he added.

Rachman said AC’s vision is to use the health IT to design workflows that are useful to physicians as well as the broader healthcare team. He noted that the partnership is in the beginning stages.

“We executed our contract and we've got our teams working on how to begin,” he said. “We have an integration and then we want to select our first prototype set of views. We'd like those to be particularly impactful so we can kind of ignite people on both sides and get everyone excited about the work ahead.”

He noted that AC is currently working on securing its first pilot site for the integrated offering.

“We want to work with a couple of health centers so that we're not building it totally in a laboratory, we're building it with the input of actual users,” he stated.

Rachman emphasized that AC is excited to leverage the predictive workflow tool as a primary and preventative care organization, as a lot of the health IT’s users have historically been in specialty or hospital healthcare settings.

“We want to really be partners that can help extend that into primary and preventive care where we think a lot of the action in healthcare actually is,” he said.