Reliant Medical Group, formerly known as Fallon Clinic, includes more than 260 physicians, offering a number of services in primary care and more than 30 specialties. In 2011, Reliant was recognized for its twelve Level 3 National Committee for Quality Assurance (NCQA) PCMH sites, and has achieved MU Stage 1 for two consecutive years. Reliant is an affiliate of Atrius Health, an organization consisting of six non-profit community groups dedicated to providing patients in central Massachusetts with timely, efficient quality care, and is part of the Atrius Pioneer Accountable Care Organization (ACO).
Reliant built a “hassle-free HIE” that automates the transmission of health information from one EHR system to the next in a matter of seconds. This network consists of many components, but the Massachusetts State HIE—known as The Massachusetts Health Information Highway (The HIway) provides the infrastructure to transmit messages via Direct.
Reliant Medical Group’s preparation process for MU Stage 2 have led to impactful discoveries and more efficient and realistic practice workflows. Reliant was able to:
- Identify physicians with the largest volume of outside referrals and developed strategies to reduce those numbers (including providing high volume specialists with EHR access)
- Establish efficient workflows for automating the emergency department referral process
- Simplify connections to the Health Information Service Provider (HISP) from the Reliant EHR system via an interface engine or LAND device
Using these strategies, more than 99% of Reliant’s providers satisfy the Transitions of Care (TOC) measure.
Reliant recommends the following best practices:
- Determine what your practice can automate or complete electronically
- Determine what workflows or tasks can be completed without involving a doctor
- Analyze your referral patterns to determine the number of referrals occurring and why
- Work with providers receiving your patients to learn their capabilities
- Use a good interface engine and EHR system
- Convene a community of providers to discuss the referral process and options for receiving referrals.
Moving forward, Reliant has developed a process and framework for care transitions to meet MU Stage 2. These steps and recommendations consist of the following:
• Define a transition and a referral
• Analyze the referral pattern of patients directed outside of the organization
• Determine the workflows on both the receiving and sending sides
• Identify what information comes from the EHR
• Determine if electronic transmissions can be automated
• Use the paper workflow for referrals not captured electronically