How Cloud-Based EHR Implementations Support Primary Care Delivery

The implementation of a cloud-based EHR system has helped a primary care company scale its business while promoting positive patient experiences.

CareTeam operates an enhanced primary care model for employer-sponsored health plans. Unlike traditional fee-for-service primary care, CareTeam gets paid on a fixed-fee basis to manage a population.

“Our model is particularly focused on outcomes, quality, and accessibility more than a traditional primary care model,” Scott Parks, president and co-founder of CareTeam, told EHRIntelligence in an interview.

The organization operates onsite primary care health centers, as well as what it calls “near site” health centers which are close to employer locations. Parks said there are also some environments where CareTeam operates shared multi-employer primary care centers.

About three and a half years ago, CareTeam implemented a cloud-based EHR system from athenahealth.

Parks noted that when he and CareTeam’s CEO researched potential EHR vendors, they were looking for a cloud-based system that would allow them to scale their business.

“We have to be prepared to put primary care clinics up in any environment—urban, rural, any state—depending on where our employer clients lead us, so picking a solution that was cloud-based was principally important for us to scale our business nationally,” Parks explained.

“Our business would really suffer if we had to worry about server rooms and onsite EHR support specialists,” he added. “We really needed something that could be centrally managed where we could effectively take a router, a Wi-Fi signal, and a laptop and operate a cloud-based EHR system.”

Parks said that the cloud-based EHR system’s open API framework was also a selling point for CareTeam.

“We're super sensitive to being able to make sure other tech systems can integrate and talk to the athenaOne platform,” he said.

CareTeam’s chief medical officer was involved in the purchasing decision from an EHR usability and patient engagement standpoint, Parks explained.

“He was very impressed with athena's usability from a clinical perspective and the relative reduction in number of clicks to get similar workflows done,” Parks said. “Ultimately, it's the easiest EHR for our clinical staff to operate, which is really important because we believe that the EHR product should serve the clinician and not the other way around.”

CareTeam’s chief medical officer also focused on ensuring the new system would support a positive patient experience.

“Patient satisfaction is so critical in our business model, which is based on providing high-quality care and an incredible patient experience. He was really sensitive to the patient experience and how we manage patients across the care continuum,” Parks said.

Parks noted that the value of strong patient engagement will continue to increase.

“Engagement with patients and the tools that facilitate clinical engagement with patients matters a lot and will matter more as we go into the future of care delivery.”

athenaCommunicator, the EHR vendor’s patient engagement tool, allows providers to send communications out to patients within the EHR workflow. Parks noted that CareTeam leveraged athenaCommunicator heavily during the COVID-19 pandemic, as well as athenahealth’s integrated telehealth solution.

“When the pandemic was at its height, athenahealth rolled out an integrated telehealth product, which was so critical for continuing to provide care through different means,” Parks said. “Now patients can get care when they need it through the means they need it, not just a traditional office visit.”

Like many healthcare organizations, CareTeam experienced a boom in telehealth visits during COVID-19. CareTeam’s virtual encounters a year before the pandemic accounted for about 1 percent of total visits; Parks said that grew to 42 percent of total visits during the COVID-19 pandemic.

He emphasized the value of athenahealth’s telehealth solution for continuing primary care delivery during a time when office visits were not possible.

“We wouldn't have been able to do that if we didn't have an integrated telehealth product,” he said. “Primary care for us was able to continue despite shutdowns and restrictions because of that telehealth product. We were ready to continue to manage a patient's care plan, despite not even being able to potentially see them as frequently in an office setting.”

The pandemic has also accelerated adoption of whole-patient care models due to more urgency around treating underlying conditions and understanding patients’ lifestyle choices that affect care. These factors include exercise, nutrition, muscle and movement-based issues, and behavioral health challenges. 

“What we're finding in advanced primary care models is that providing great primary care is important, but you also have to consider a person's whole health, which may include social determinants of health,” Parks said.

An athenahealth surveying tool has helped CareTeam survey patients about certain items associated with their social determinants of health as well as mental health.

“We've begun integrating virtual and onsite behavioral health specialists into some of our practice settings, as well as lifestyle coaching, health coaching, and nutrition counseling,” he noted. “So now, our clinical teams can really provide for the whole health needs of our population and the athenaOne product gives us the collaboration across those different disciplines to do that in a coordinated way.”

CareTeam’s behavioral health and nutritionist counseling services saw increased utilization during the pandemic, and the company as a whole experienced a 98 percent patient satisfaction rate. 

Additionally, CareTeam’s relationship with athenahealth recently expanded in a unique way.

Parks noted that this summer, CareTeam opened an onsite primary care health center at athenahealth’s Watertown, Massachusetts headquarters.

“athenahealth is practicing what they preach, which is really cool to see,” he said. “It's a new initiative, but an exciting one.”