Bon Secours working to transform practice
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The medical group within the larger system, based in Richmond, Va., has been live on its EMR for three years, a time period during which it has strategically grown, doubling its physician roster to 420. The group also has been engaged in an ambulatory reengineering project to create an advanced medical home and aggressively promote use of its patient portal. Although Fortini is proud that Bon Secours has more than 50,000 activated users across Virginia, he pointed out that that figure represents only about 10 percent of the organization’s total patient population. “Our growth plan is to increase that number dramatically.”
To reengineer its practice, Bon Secours created the role of nurse navigator—its term for case manager. “We’re trying our darnedest to coordinate services across all transitions of care.” And, while that effort is underway, Fortini also is trying to justify the expense of the nurse navigators through demonstration of return on investment and down-sized risk management of measures like value-based purchasing and 30-day readmission rates.
Bon Secours recently contracted with Cigna in an arrangement that allows for care coordination to help underwrite the expense of the nurse navigator. The overall goal is to “take healthcare out of physician offices and facilities and back into homes,” said Fortini. “We want to deliver healthcare where people live.”
Fortini discussed three levers in play to help “bend the cost curve.” First is the creative use of human resources. Bon Secours is using advanced practice clinicians more aggressively and elevating RNs as new providers of care. The facility wants to have RNs “doing the absolute most allowed by the board of nursing” to effectively manage the patient population. Bon Secours also recently hired a doctor of pharmacology for its medical home team because medication reconciliation is such an important factor in managing patients. That person also serves as a resource to physicians prescribing the medications.
Second is the use of technology. Fortini said he thinks there is a huge market for online physician visits because so many patients have access issues. Bon Secours mantra is “healthcare without walls” so telemonitoring is another way to achieve this objective. “We want to bring healthcare delivery to the patient, not the other way around.”
The third lever is wrapping the first two up in unique delivery systems, including the development of a team approach and modifying those teams to target specific populations, such as the geriatric populations who ultimately will be the highest utilizers of care.
Beth Walsh,
Editor
Editor Beth earned a bachelor’s degree in journalism and master’s in health communication. She has worked in hospital, academic and publishing settings over the past 20 years. Beth joined TriMed in 2005, as editor of CMIO and Clinical Innovation + Technology. When not covering all things related to health IT, she spends time with her husband and three children.