June 9, 2006 | The two-story Family Medical Center on Jack Stephens Drive might be overlooked with three towering University of Arkansas for Medical Sciences (UAMS) institutes surrounding it.
But what makes it stand out is the ambitious work of its leaders, which has led to innovations felt across the campus since at least 1997.
The Family Medical Center has renewed its commitment to UAMS employees by dedicating additional time for a doctor to see them, said Geoffrey Goldsmith, M.D., M.P.H., chairman of the UAMS Department of Family and Preventive Medicine, which has overall responsibility for the clinic.
While all of the family medicine doctors are available for UAMS employees, Edna Taniegra, M.D., now devotes most of her day to UAMS employees.
“It’s our policy to try to see people the same day that they request an appointment, realizing that there might be extreme circumstances when it would be too difficult,” said Jamie Howard, M.D., medical director of the Family Medical Center.
Taniegra, who used to split her time with other administrative duties, now spends 80 percent of her time seeing patients.
The clinic is available to employees who may have other primary care physicians but who need to see a doctor quickly and are willing to pay the higher copay, Howard said.
“Of course we certainly would love for them to choose one of our doctors as their primary care physician,” she said.
The clinic accepts patients of all ages and provides care ranging from pediatrics to geriatrics, including routine low-risk obstetrics services. Patients have 24-hour phone access to a Family Medical Clinic physician. The clinic also has a nutritionist available for life-style consulting and a tobacco cessation counselor to help people kick the habit.
In 1997 the Family Medical Center was years ahead of the curve when it chose an electronic medical records program called Centricity (formerly Logician), a program now familiar to many UAMS clinics.
“Basically we’re paperless; we don’t have any paper patient charts at all,” Howard said.
The Institute on Aging decided to use Centricity in 2000 after learning of its benefits to the Family Medical Center. That seemed to get the ball rolling, and the program has begun to catch on among other UAMS clinics. One of the clinic’s faculty members, David Nelsen, M.D., now assists Charles Smith, M.D., executive associate dean for Clinical Affairs and medical director for UAMS Medical Center, in helping the other clinics around campus convert to Centricity.
The electronic medical records, which can be shared by physicians at different locations who may see the same patient, tell them what they need to know about a patient’s medical care history and why the patient has been referred to them.
Use of the program also allows data collection that someday will pay off for clinics that want to deliver the highest quality care, Howard said. The data shows whether patients with a chronic illness like diabetes, for example, are getting the treatment and tests necessary to keep their disease under control. Medicare and others like Qual Choice now have pilot programs in which they measure the quality of care and reward the best clinics with higher reimbursements, she said.
Just as important and even more costly is the effort clinics make to seek out patients to ensure that their diseases are being managed as well as possible.
“These are all things that are part of a process called care management, especially chronic care management,” Howard said. The chronic care model takes a more proactive, organized approach to delivering care to people with illnesses like coronary disease, congestive heart failure, diabetes or asthma.
The Family Medical Center tracks its patients through Centricity and routinely sends letters to encourage patients to follow up on treatments recommended by their doctors.
“It would difficult if not impossible to do this with a paper chart,” Howard said.