Mellman Medical is an Internal Medicine practice serving adolescents and adults in El Segundo, California. The practice consists of one physician, Dr. Michael Mellman, and PA, Rebecca Pestle who combined have fifty years of clinical experience. Dr. Mellman has also served as a team physician for several of the LA area professional sports teams since the 1980’s. Dr. Mellman and staff have used Centricity PM and EMR since 2007.
Being a primary care practice Mellman Medical has a”healthy” population of Medicare patients, many of whom are affected by chronic care medical issues. With the introduction of Chronic Care Management (CCM) by CMS in 2015, Dr. Mellman opted to implement a CCM workflow into his practice to enhance patient care and to generate additional revenue. Payment for CCM services offers an opportunity to be compensated for the non-face-to-face work that the practice provides, to effectively manage the Medicare patients with multiple chronic conditions.
Initially the practice chose to work with a third party company that provided CCM services. Unfortunately, the patients resisted discussing their medical care with nurses and medical assistants who were unfamiliar with them and the practice, and from a revenue perspective it wasn’t cost prohibitive. On top of that the company was located on the east coast and calls to patients sometimes occurred outside of “office hours”.
Because of this Dr. Mellman decided to bring the CCM effort in house, and create the necessary forms in Centricity EMR. Initially the custom forms and content allowed the staff to integrate CCM into their daily workflow, but the practice struggled to meet the billing requirements (minimum 20minute calls) and they didn’t feel they were enhancing the healthcare provider-patient relationship. Mellman Medical wanted a comprehensive and interactive solution that documents and helps manage the patients’ chronic illnesses, captures data, records events and billing in Centricity EMR.
Ultimately, Dr. Mellman chose to co-develop an iPhone/ iPad app (now called called MedVu) that would allow patients to interact with the practice, provide test results, and advise the practice of patient issues. While using MedVu app the patient is prompted to answer questions consistent with monitoring their chronic problems. The information gathered is then transmitted into Centricity EMR and results are reported and evaluated by the practice. All irregular responses, unexpected responses, abnormal responses are then flagged and escalated to the provider for further action and instructions.
Mellman Medical can now proactively work with patients to validate the severity of their symptoms, and recommend action prior to further deterioration of the illness or undesired event.
Patient activities are documented, consolidated and billed accordingly at the end of the month. “The success of implementing a team-based CCM process has exceeded our expectations in many ways: there is fully documented interaction with patients to substantiate, satisfy, and exceed all billing requirements, and CCM is now a revenue producing line of business established and recurring within the practice”said Dr. Mellman. The clinical staff is also focused on quality and capturing the MACRA data is captured outside of regular office visits.
“The patient and provider experience is much more satisfying, important and meaningful, which is what every patient and provider desires. The patient and staff acceptance has been very positive and we have introduced the MedVu app to non-CCM patients with the same practice healthcare efficiency goals as with the CCM patients. We are thrilled to see it unifying and enhancing the patient care workflow throughout the practice”said Dr. Mellman.