When Gloria Rojas walks into her doctor’s office at Open Door Family Medical Center in Ossining with a bad cold, it’s not only about treating her minor respiratory infection. Her pre-visit planning document, viewed on the doctor’s computer, spells out the gaps in her preventive healthcare. At the age of 52 and with diabetes, she learns that she is overdue for her diabetes lab tests and foot and eye exams, and that it’s also time for a mammogram and a pap smear.
“Using technology and data helps us better meet the needs of our patients,” said Denise Egan, Vice President, Clinical Business Intelligence at the federally qualified healthcare center. “We can see the gaps in their care and recommend needed services. If a colorectal screening is due, and they just came in for the flu, we can address that need. We use technology to track and contact patients who have missed appointments, which has always been a problem but one that has become much more prevalent since the pandemic.”
Things have come a long way, said Egan, from the time she first started working at Open Door in 2003 while getting her Master’s degree in Public Health. Years later, she returned to the organization to launch its clinical business intelligence department.
“We’ve since built our own data warehouse so we can control what data elements are pulled from the electronic medical record,” she said. “Then we built the structure and framework so that any time, for example, a clinical quality measure gets updated by the federal government, we can put it one place to control it in all of our different reports.”
At one time, she said, there were only paper records and preparing reports was time consuming and often inaccurate. “This led to inconsistencies with data depending largely on who pulled the report,” she said, “And, often, it meant different outcomes. We wanted to get the same answers regardless of who pulled the report.”
Open Door has long placed a premium on healthcare technology and its use of data, having twice received the prestigious Davies Community Health Organization Award from the Healthcare Information and Management Systems Society (HIMSS). The HIMSS award, the highest global recognition for successful implementation of information technology in the health care sector, was given in recognition of Open’s Door’s impressive improvements in asthma care at its School-Based Health Centers and for advancements in colorectal screening at its community health centers.
At a time when many patients don’t answer phone calls from numbers they don’t recognize, technology has helped Open Door reach more patients through their text messaging platform. They use it both to confirm appointments and for broader outreach campaigns, such as encouraging vaccinations. It’s also a way to remind patients of the benefits of its electronic patient portal and help them learn to access it. This outreach has resulted in portal use increasing from about 12 percent to nearly 30 percent, said Egan.
Data registries that keep track of patients with different chronic diseases – such as diabetes, asthma, and cardiovascular disease – help Open Door educate patients on the different services available and remind them about lab tests and medication. These registries, said Egan, make it easier for care teams to manage their patients by consolidating patient information into one place.
“For patients with diabetes, for example, our clinicians can see if they’ve had a regular eye exam or an A1C test,” said Egan. “And, if their A1C is greater than 9, which indicates uncontrolled diabetes, we can provide intervention and direct them to a patient advocate who can provide additional education.”
Open Door technology also gives clinicians a scorecard that shows how they rank among each other in different quality measures – for primary care physicians, for example, there are 18 different quality measures, including breast cancer screenings, hypertension management, diabetes control, and vaccinations.
“This provides full transparency,” said Egan. “It shows discrepancies between sites and how clinicians are performing in relation to each other. It allows them to learn from each other which helps everyone to continually improve.”
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