Similarly, The Iowa Clinic in Des Moines wanted to ensure that its patients were receiving appropriate follow-up care and screening services. "Even though we were putting an EMR in place, it didn't really have the right components to make sure we were reaching out and following up on certain aspects as it relates to the delivery of care," says CEO Ed Brown. "Phytel appeared to be at the time one of the solutions to that," he says, adding that some colleagues were having positive experiences using the technology.
The Clinic, which is an independent, physician-owned, multispecialty practice with 135 physicians serving more than 400,000 patients annually, started using the system with its internal medicine, cardiology, and OB patients. For internal medicine, the group focused on congestive heart failure, diabetes, hypertension, physical exam, and mammogram, says Julie Sanders, director of quality. "For cardiology it was very similar protocols as far as disease states, and we look at heart failure, hypertension, and coronary artery disease. For OB, we reached out to those [patients] who have not had the HPV vaccine, [those with] abnormal pap smears, and those who needed a wellness screening.
"We have definitely had patients come in who have been delinquent for care," says Sanders, who was somewhat skeptical at first regarding how many patients were really out of compliance and in need of this type of outreach.
Riverside chose 50 primary care doctors to test the technology, based on physician capacity, says Frazier. The health system didn't want to reach out to a patient for follow-up care with a physician who was extremely busy and would be unavailable for three to six months, he explains.