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E-consults are structured electronic encounters that a primary care provider initiates with an internal specialist to answer a clinical question about a patient without needing the patient to be seen by a specialist. E-consults have expanded the reach of our specialists, improved patient experience with greater access, and helped our PCPs manage complex visits with multiple issues.
Prescription renewal protocols
Atrius Health has partnered with Healthfinch to automate the refill process through designed protocols and internal refill coordinator support. These standard refill protocols and electronic workflows remove a significant share of manual prescription renewals and greatly reduce the work burden.
Atrius Health’s revenue cycle operations have been the top performing across the Epic community for the past two years. This means that the work you do is reliably attributed to you faster. Billing and coding coaches are available for support, and behind-the-scenes tools help ensure that providers are billing appropriately.
IT SWAT teams
Members of the Epic clinical applications optimization team spend a 2-week period with practices to roll out new features, tweak existing features, and retrain on key features such as click-saving widescreen mode, time-saving electronic prescribing, and improved chart review functionality. Over 85% of providers agree that SWAT events were beneficial to their work and have observed measurable improvements to practice efficiency.
Documentation assistance with Haiku and Dragon
Atrius Health has a number of technology solutions to assist with patient visit documentation work, most notably Dragon voice-recognition and transcription software to document notes or perform certain actions in the EHR. Providers can also document from home using the Dragon-Haiku (the Epic phone app) integration to reduce time spent in the office.
Although InBasket messages enable easy access to care advice for patients, managing the volume of InBasket work can be overwhelming. At Atrius Health, we routinely incorporate system-wide initiatives to reduce this burden. Targeting the highest InBasket volume areas, recent initiatives included automatic prescription renewal protocols, automatic routing and patient notification of normal results, and thinning the InBasket of “FYI” messages as a result of CC charts or document scans.
Prescription Monitoring Program Integration
Atrius Health was among the first in Massachusetts to create an electronic interface with the state’s Prescription Monitoring Program, allowing for navigation to the web page, sign-in, and patient look-up, all to be performed in a single click.
Predictive analytics at the point of care
Atrius Health has led the industry in the pragmatic application of predictive models to improve the care of our patients, using algorithms that analyze over 100 variables to flag and inform care teams of patients who are at highest risk of hospitalization. We then employ standard workflows to initiate proactive outreach and care.
Having been on Epic for 25 years, Atrius Health has developed a number of homegrown decision support tools to save providers time and make it easier to provide the right care. SmartRx’s are decision aids for over 80 common prescribing scenarios such as acne, conjunctivitis, ADHD, asthma, atrial fibrillation, COPD, depression, hepatitis C, hypertension, insomnia, migraine, and skin infections, and orders can be placed straight from the SmartRx. SmartLabs helps with the workup of common diagnostic scenarios. There are over 40 scenarios represented as SmartLabs including abnormal LFTs, anemia, hypercoagulability, viral hepatitides, and dementia.
Registries and Safety Nets
A hallmark of Atrius Health’s system of care has been an emphasis on reliable EHR data to help manage care for populations and prevent patients from falling through the cracks of the healthcare system. We use Epic registries (including COPD, CHF, opioid, asthma, and more) to pull together relevant information about selected populations and facilitate management through efforts like roster reviews. Providers and Population Health Managers alike use these rosters to arrange follow-ups and close care gaps. Safety nets are algorithms that flag patients who have missed important screenings or not gotten the appropriate follow ups and in effect automate the roster review follow-up process.
Natural Language Processing (NLP)
NLP is a technology that allows a computer to “read” clinical notes, effectively “unlocking” the information in the freetext clinical notes of the EMR for analysis and decision support. Atrius Health is a “heavy user” of NLP given its ability to extract meaningful concepts and guide population health activities. Future work with this technology aims to cull out the social and behavioral aspects of health that are major contributors to health outcomes.
Web Portals and Information Exchange
Our providers and care teams generate real-time rosters of their hospitalized patients; use standards-based exchange networks to access notes, labs, and other results from over 1,600 hospitals and 37,000 physician practices throughout the country; use bidirectional electronic health record portals with over 15 local preferred hospitals; access via electronic interfaces the state-based immunization registry and Prescription Monitoring Program for safe opioid prescribing; and send to and receive from patients’ preferred pharmacies electronic prescription requests.
MyHealth is Atrius Health’s patient portal which is connected to Epic. Due to extensive patient outreach, Atrius Health has among the highest patient activation rates in the nation at 70% of patients with active accounts, and MyHealth has become a common platform to care for our patients.
Atrius Health is piloting in internal medicine a technology-enabled team that abstracts a patient’s chart before their first visit. The goal is to populate the medical record with a problem list, medications, allergies, and immunizations, allowing providers to focus on the content of the visit and not the clerical work of populating the chart.
Atrius Health offers comprehensive, continuous care through a combination of in-person and telehealth offerings matched to patient preference and clinical appropriateness. As an early adopter of telehealth technologies, Atrius Health has for several years been recognized for robust teledermatology and e-consult programs. Additional initiatives have included urgent care evaluations for select low-acuity conditions for adults, psychotherapy, developmental and behavioral pediatrics, and routine prenatal care video visits for women with low-risk pregnancy.
In 2020, extensive prior experience with video visit technology integrated with our Epic electronic health record enabled the rapid and robust expansion of video visit capacity as part of the organizational response to the COVID-19 pandemic. This allowed our patients to access to the vast majority of clinical services during a time when physical distancing was critical. Beyond COVID-19, Atrius Health believes telehealth will remain an important part of our care model, allowing greater choice for our patients for how and where they can connect with their clinical care teams.
In 2017, Atrius Health launched a hospital at home pilot in collaboration with Medically Home Group. The medication, monitoring and treatment that patients would normally receive in a hospital is provided in the patients home. Atrius Health physicians, nurse practitioners and its VNA Care nurses work as a team to remotely monitor biometrics, video-conference with patients and their families, and coordinate care services in the home. The program is active practice-wide and has served Atrius Health patients with conditions such as heart failure, COPD, pneumonia and respiratory infections.
Patient Appointment Reminders & Fast Pass
Access to care for our patients is one of our practice’s highest priorities, and we have adopted a number of technologies to make it easier for our patients to get the care they need. Appointment text reminders are sent to patients 3 days before their appointment, decreasing no show rates by 20%. More recently, we launched Epic’s Fast Pass, technology that determines if an appointment time is available sooner than originally scheduled and notifies the patient electronically. Patients who use Fast Pass have on average found an appointment that is 60 days sooner than originally scheduled.