Dialing up care takes down hypertension
Primary care doctors at Arch Health Partners, a 90-physician multi-specialty practice affiliated with Palomar Health, recently ramped up care of patients with hypertension – with promising results.
Providers at AHP focused on the numbers like never before as they employed a team approach and Web-based population health management technology from Dallas-based Phytel. The result: In less than six months, most doctors moved from 62 percent of patients who had their blood pressure under control to 66 percent. The number is continuing to inch up.
Dennis Mamaril, MD, did even better. His patients went from 62 percent with their hypertension in check to 82 percent. He gives much of the credit to the Phytel platform, which helped keep patients – and physicians – focused on results.
As Mamaril tells it, over the past five to six years, the primary care docs made efforts to keep track of the progress – or lack thereof – of patients with chronic diseases, such as hypertension, diabetes and heart disease.
"A lot of things were done manually in regards to capturing this population's hypertension, diabetes, other chronic diseases," Mamaril said. It was labor intensive, he added, and involved poring over ICD-10 codes and reports, taking up many hours of valuable time.
Mamaril and his colleagues knew there had to be a better way.
Once they automated the process, it freed up hours of tedious research and provided the doctors with an immediate view of how each patients was faring.
"Number one, it helps us capture our hypertension patients and form a hypertension registry," Mamaril said.
Today, the doctors and other medical staff have the information they need at hand. If a patient is not up to snuff, they will receive a call – from the doctor or a team member – asking him or her to come in for an office visit.
Patients whose hypertension is not in check are scheduled to come in on a regular basis, every two weeks, to recheck, to make sure everything is tolerated, to make sure the blood pressures are good. Doctors suggest lifestyle changes, such as losing weight, or curbing alcohol intake, and they are on the lookout for other contributing factors.
The physicians also learn from one another.
"The great thing about Phytel is not only can they look up their own patient population," Mamaril noted, "but they can actually look at other doctors and how they're doing. They could ask their colleagues how they're doing, what they're doing right. They can share that information, that wisdom with their practice as well."
[See also: KLAS gives Phytel top score for population health.]
In Mamaril's view, the greater focus on results that AHP doctors have been able to achieve is making a huge difference for patients.
"I think it comes down definitely to some engagement," he said, much more engagement than we're used to."
In addition to adopting new technology, AHP has also adopted a team approach to tackling chronic disease. They've included a pharmacist and a licensed vocational nurse on board. Both can consult with patients with high blood pressure. Some of the blood pressure readings can be taken by nurses or pharmacists, and can free up time for the doctors and other patients as well.
"It's really a little bit of a team approach," Mamaril said, "but it's personalized care in terms of looking at these high-risk patients. I think that's the way medicine should be right now.
"It's working in the right direction, and it is also being sustained."