CSHP on the move: Practice changing office, care model

Next month, the doctors, nurses, technicians and staff at Colorado Springs Health Partners’ 45-year-old medical offices downtown will pack up the moving trucks and head to a new home at the Union Medical Campus at Union Boulevard and Fillmore Street. 

While patients at the multispecialty clinic will certainly notice the new digs, what’s going on behind the scenes at CSHP could prove to be a lot more important than a change of address.
CSHP, the state’s largest physician-owned, multispecialty practice, is changing the way it provides health care. The new model is called a “patient-centered medical home.” It’s a concept that tries to make health care at once more efficient and more effective — at once cheaper and better.

“The new mantra of coordinating care is doing the right thing at the right time for the patient,” said Debbie Chandler, CSHP’s CEO.

There are a number of factors pushing changes to health care: skyrocketing costs, technology and health care reform. The patient-centered medical home is supposed to be the spearhead for putting best practices into effect.

“We’re heavily involved in basically every aspect of trying to position ourselves for the future of health care,” said Dr. Dennis Schneider, CSHP’s chief medical officer. “At least from our perspective, the patient-centered medical home is the vehicle to get us there.”

Although the name is a mouthful, a lot of what goes into a patient-centered medical home is pretty straightforward stuff: Doctors and staff members talk to one another so that as a patient goes from primary care to specialist to lab to the hospital, everyone knows that patient’s condition, his or her history, what tests have been done and, later, the outcomes of that care.

Traditionally, medicine was done in silos, Schneider said, with primary care and specialists communicating disjointedly.

“This is symptomatic of the system right now, it’s fragmented,” he said. “That’s what’s costing extra cost and difficulty.”

The key innovation in overcoming that fragmentation is electronic medical records. CSHP has spent $3 million in the past two years in switching to electronic records. The old office building, at 209 S. Nevada Ave., has a huge storage space for paper records, Chandler said. The new offices on Union have almost none.

“The new space is actually a little smaller than the old space, but it’s more efficient,” Chandler said. “It really flows very differently than it did downtown.”

CSHP sold the old building on Nevada five years ago and has since leased it back while it worked to find more-modern accommodations. The practice had originally planned to build a $30 million facility on 45 acres it bought near Centennial Boulevard and Fillmore, but shelved those plans in favor of leasing 63,000 square feet of space on Union. CSHP now plans to sell most of the Centennial land, but keep some for future expansion.

As part of the transition, CSHP has moved all of its scheduling to a central call center, located in one of its old offices, now cleared out, at Lehman Drive and Academy Boulevard. It’s more efficient and more cost-effective, Chandler said.

“You take all those services out of the offices and it frees up clinical space,” she said. “Clinical space is expensive.”

In place of schedulers, the new offices have a checkout desk, where whatever follow-up care that may be needed is coordinated for patients.

“The patients love it,” said Joan Compton, CSHP’s director of primary care services and its point person on the medical home movement.

Electronic records can be a much more powerful tool than simply moving information around and improving scheduling. They allow caregivers to closely track quality, check that best practices and protocols are followed and eliminate duplication.

“A unified EMR (electronic medical record) allows the data to be collected in one spot,” Schneider said. “It’s getting a little easier to actually define quality.”

Jeff Ahrendsen, vice president at the local health care-insurance consulting firm Benefit Resources, said efficiency in health care equates to better care.

“It’s a good idea,” he said. “Money aside, the whole point here is to make somebody healthier.”

Part of that process, however, is re-educating doctors and patients.

“When the whole system is used to saying, ‘More is better,’ you can see where the struggle will be when you say, ‘No, you don’t need an MRI because your back hurts,’” Schneider said.
John Suits, director of government relations at Memorial Health System, said the medical home model at CSHP has the potential to reduce the burden on Memorial’s crowded emergency rooms.

“Let’s take diabetes, let’s take congestive heart failure,” Suits said. “In the medical home model, if that patient is being seen and consulted on a regular basis, you would hope that by better management of their disease, there would be less need for them to seek the emergency room.”

Keep patients out of the hospital and you save money, which can be reallocated to providing the primary care and case management that prevented that hospital visit in the first place.
“Prevent one hospital admission, that could be $20,000, easy,” Schneider said. “That buys you a lot of case management.”

Eventually, CSHP plans to have health coaches working with patients to coordinate their care and help them manage their own health and wellness.

“On our side, we’re trying to bundle all the care and make the patient the center,” she said.

What remains to be seen, however, is how Medicare and insurance companies and health care reform align the payments and procedures to shift the payment structure for health care from a traditional fee-for-service model to the medical home model that focuses on preventive care. Another hurdle is getting CSHP’s electronic records to talk to the computer systems at Memorial and Penrose-St. Francis Health Services, or other providers.

“We believe in it strongly enough that we’re willing to put resources in it,” Schneider said. “Is it a leap of faith? Yeah, at this point.”

“It’s a lot different than what we’ve done for 50 years,” Chandler said. “You have to have a belief and a vision and a plan, and I think we have all that.”

CSHP by the numbers
Colorado Springs Health Partners:
Founded: 1946
Physicians: 102
Specialties: 23
Total employees: 625
Locations: 10
Patients: 50,000