The changes taking place in health care today can be daunting to practices of every size, but at Fish River Rural Health (FRRH) located in Eagle Lake and Fort Kent [Aroostook County], transforming the way care is delivered is being met more with enthusiasm than trepidation.  As members of Maine Primary Care Association Patient Centered Primary Care Collaborative (PCPCC) and the federal government’s Health Disparities Collaborative, FRRH’s two MD’s and two PA’s are constantly looking for ways to improve their practice.  

Despite already having special recognition for cardiology care, diabetes care, office systems and electronic health records, FRRH strives for the next level of quality.  With the goal of being designated a Patient Centered Medical Home (PCMH) in the next three years, FRRH has begun working on making their practices more accessible, comprehensive, coordinated and effective.  Targeting areas outlined by the PCPCC, FRRH is working to improve follow up processes with patients, tracking of health outcomes and goals, case management, and meaningful use of their electronic health record system.  

Major transformations like these can be incredibly stressful to providers and office staff, but at FRRH there is a team approach that makes even the most significant changes manageable.  According to Norman Fournier, the Executive Director of the practice, the key to successfully implementing change lies in widespread staff involvement.   From the very beginning, Mr. Fournier makes sure that his staff is comfortable with the changes they’re trying to make, and that they understand why they are making them before proceeding.  It’s not an easy task to garner support for changes that more often than not increase the administrative staff’s workload, but there’s a common understanding that when doctors are freed up to spend more time with patients the level of care improves.  Keeping everyone invested in the mission to provide better health care, and maintaining open lines of communication are two of the most important factors for being successful.

Another hesitation many practices face is the potential cost of improvement efforts.  Keeping a practice afloat with a large Medicare and Medicaid population can be difficult for even the most skilled administrators, but adding the cost of an EHR system, staff time, and other tools necessary to deliver high quality care can be overwhelming.  Luckily, help exists in a number of places for practices like FRRH.  FRRH has recently applied to participate in the Centers for Medicare and Medicaid Services (CMS) in their Federally Qualified Health Center’s Advance Primary Care Practice Demonstration.  If selected, FRRH would receive financial assistance in the form of an $18 per Medicare Fee for Service beneficiary quarterly care management payment.  Also, the Health Resources and Services Administration (HRSA) have recently announced that they will be awarding $35,000 to each Federally Qualified Health Center like FRRH for Quality Improvement and Patient-Centered Medical Home Development.  Whatever the costs, though, Mr. Fournier sees the changes as an investment in the practice’s future.  As the push to put more quality systems in place picks up steam, FRRH’s livelihood depends on its ability to stay competitive.

Pushback is natural whenever there is an attempt to change business-as-usual procedures, but it’s important to keep practices like FRRH in mind as change marches on.  The movement of healthcare towards patient-centeredness and quality improvement is not only inevitable, it is the way to improve healthcare and meet the challenges of the future.