In the world of medicine, primary care is where people come face-to-face with their doctors and nurses. Done right, it's where doctors catch their patients' health problems early, and where people with ailments such as diabetes learn to keep their chronic condition under control.
But there's little research into how primary care can deliver the best results without costing an arm and a leg, according to Dr. David Lynch, medical director and vice president for clinical process improvement at Family Care Network, a doctors' group with 11 clinics in Whatcom County.
To fill that gap in knowledge, the Robert Wood Johnson Foundation of Princeton, N.J., has begun a project to identify and learn from cutting-edge providers of primary care across the country. From about 400 outfits that made the initial cut, 30 made the final list for close study.
Family Care Network is one of those 30, and experts with the foundation visited last week to learn more about the network.
"Family Care Network has a long history of being innovative," said Larry Mauksch, who teaches in the Department of Family Medicine at the University of Washington and advises the network on ways to get better. "They're way ahead of the curve."
What the foundation learns has national implications. Under the federal health care law signed by President Obama, millions more people will have medical coverage. That flood of new patients could create a major logjam if the health care system doesn't become more efficient.
At the same time, spreading the gospel about better ways to work with people who have long-term ailments is vital because more than 75 percent of health-care costs in the U.S. is due to chronic conditions, according to the Centers for Disease Control and Prevention.
"We spend way too much in this country," said Dr. Rodney Anderson, who works at Family Health Associates in Bellingham, one of the clinics under the Family Care Network umbrella. "The system is going to implode because it's so inefficient and so costly."
Programs at the network that intrigued the foundation include its use of electronic records, a team approach to patient care, and special efforts to help people with chronic diseases.
The network has used electronic records for nearly a decade. While the information that's gathered remains consistent, doctors can pick their hardware, because flexibility is valued at the network. Some doctors use laptops, some prefer iPads, and some have computers with large screens so patients can watch. Patients' medical information is stored on secure servers and can be retrieved regardless of what type of computer is used.
The network also has a secure website through which patients can send information about their health and confer with a medical professional.
There's similar flexibility when it comes to patient care. At Family Health Associates, for example, Anderson teams up with a nurse when he examines a patient. The nurse starts by checking the patient's medical record and vital signs. When Anderson arrives, he checks out the patient while the nurse documents the visit in the patient's record. That way, Anderson can focus squarely on the patient, then move on to the next patient while the nurse handles follow-up details.
Teamwork also means using employees in new ways to help people with chronic diseases, said Dr. Bertha Safford, who practices at Ferndale Family Medical Center and is medical director of quality performance for the network.
For example, the network has someone who works full-time making sure patients with diabetes stay on schedule for their checkups. For patients on blood-thinning medication, the network uses a speedy arrangement in which nurses check on the patients, assess their blood tests and adjust their medication, all during one visit. Such arrangements require planning and coordination.
"What patients care about is that they get their needs met," Safford said. "Most of this is unseen by the patient."
But not unnoticed by the folks at the foundation.
Contact Dean Kahn at firstname.lastname@example.org or 360-715-2291.
Reach DEAN KAHN at email@example.com or call 715-2291.