Case Studies
The Comox Medical Clinic is starting to reap big dividends from a 180-degree shift in its business plan focus
May 2009
Back in 2005, a group of physicians in Comox considered fine-tuning their business doctor skills. So they grabbed their stethoscopes and got to work. What they did sounds a lot like a typical check-up: they listened, observed, and then they determined an appropriate set of diagnostic tests to uncover suspected health issues.
Four years ago, the Comox physicians determined that the best course of recovery and preventive care was the transition from paper to electronic medical records. Since then, the shift in the business game plan has fired the clinic's fortunes. It hits you as soon as you walk in the door: classy decor, diffused light, spacious rooms. The clinic has 12 examination rooms, all identical. They are used by whichever physicians happen to be working that day and this means that they can always be in use, maximizing space in the clinic building. The ergonomics of the rooms facilitate excellent interaction with the patients and the EMR. There are two large "offices" at either end of the clinic where the clinic's eight full time physicians have their workstations. In a busy clinic such as the one in Comox this allows for ongoing interaction among the physicians during the day, something often lost in a "typical" clinic design where a physician has his own "office" and exam rooms.
The physicians have monthly business meetings. One of them is designated as "lead" for a specified time by the others, and they rotate this periodically.
Dr. Mel Petreman, PITO Local Physician Champion, who has been working with the physicians in Comox for a long time, says that he is "impressed" by the extent to which the clinic has reaped the awards after implementing the EMR-based system.
"The physicians share different responsibilities such as developing specialized templates with their EMR and then teaching the others - highest and best use of an EMR product I have ever had the pleasure to see," Dr. Petreman says.
"They do chronic disease management using tools in their EMR and track all of their chronic disease patients to ensure they are being treated according to treatment protocols and that they get paid appropriately for their work."
The clinic is humming with record patient visits and happy physicians making more money since they switched to electronic medical records.
"We made the transition in just one weekend, four years ago," Dr. Rickard Potter-Cogan says. "Since then, the expenses have fallen and the EMR-based system has paid for itself. We get lab results electronically from the hospital and, overall, we offer more efficient and timely patient care."
The paperless system has also improved the patient - physician communication. Thanks to the EMR, the patients with chronic diseases can easily see the lab results, the effects of their treatments and their overall health progress, causing them to get involved in their own medical care and sometimes change their health behaviour. "Our patients have never expressed privacy concerns; on the contrary, they are aware of the benefits of the computerized system, they are confident that the information in their records is up-to-date and they appreciate this patient-centred system; we now have more time to spend discussing the patients' concerns because we spend less time looking for information. Since we adopted the EMR, we manage the clinic more efficiently and we provide a higher level of service," Dr. Potter-Cogan says.
Finally, just like good business doctors, the physicians at the Comox medical clinic make sure that they always follow up to ensure that the course of care for their clinic business is working as it should. If needed, the business manager makes changes in "treatment", and the "patient", that is, the clinic, is monitored until a clean bill of health is achieved.