‘Good health is good business'

CareTeam is a rapidly growing primary care company that partners with employers to operate on-site, near-site, and shared-site clinics. Their approach benefits both companies and their employees, as employers often save on insurance plan costs and the workforce can schedule more convenient appointments that are longer in duration than traditional primary care visits. These sessions focus on enhanced personal care; besides sick visits and annual wellness exams, each on-site caregiver is also a certified health coach who focuses on personalized preventative care plans. COVID-19 also fastforwarded plans to enhance nutrition and behavioral health counseling. CareTeam’s rapid expansion and model that encourages patient engagement require an EHR that is quick to install, easy to train on, and supports ongoing communication between caregivers and employees.

Fast implementation promotes growing to scale

Having worked in the healthcare private sector previously, president and co-founder Scott Parks said he used “just about every EHR system on the planet.” So when it came time to determine the best option for CareTeam, he opted for a cloud-based solution that he knew could be implemented and his workforce trained on quickly.

“We run clinics all over the nation, all standalone, all in different geographies. And when we launch them, having a web-based model for an electronic health records system is critical — the fact that we can basically go, take a laptop and a WiFi connection, and with a router, we’re practicing medicine,” Parks said. “It’s a huge benefit for a business like ours, which is scaling nationally, quickly.” This growth continued even through COVID-19, with four new clinics opening “virtually seamlessly” during the pandemic – including one at athenahealth’s headquarters.

Matt Theodore, CareTeam Director of Operations, said athenahealth’s “very intuitive” system can be “up and running from day one,” thanks to a simple implementation process. “With almost minimal effort in training, not only are providers doing a good job in taking care of patients, but accurately and effectively documenting those visits as well,” he said. Incorporating new clinicians is fast and easy, too — they can be added via a new log-in instead of purchasing an additional license like other traditional EHR vendors.

Unlike other EHRs, which can require on-site IT staff to help physically install frequent updates, athenahealth’s cloud-based service means employer clinics don’t need to have specialists service their systems — updates are made remotely in real-time, which saves on hiring additional employees.

Easy reporting boosts performance

A single, connected network is also imperative for CareTeam’s business model, say Parks and Theodore. The ease of accessing and parsing crucial data quickly and remotely across myriad locations and clinicians gives them instant visibility into both individual practice management and overall business performance.

“The analytics that we get out of the practice management reporting is critical,” said Parks. “Are we delivering on our value proposition of making quality healthcare accessible and affordable? Are we collecting discrete data points that are actionable and reportable back to our employer clients? That’s where athena is super helpful and super important.”

This is crucial to CareTeam’s success because they are, for example, able to pinpoint which employer clinics are helping close more care gaps or are having successful patient outreach campaigns. CareTeam tracks discrete appointment-level and utilization detail, bio-marker data, preventive and disease specific health data, patient satisfaction data, and demographic data, among other metrics. It’s redacted of personal health information (PHI), and is then fed back to their clients’ reporting. CareTeam can then share best practices across their organization.

It’s all part of a strategy that includes a more longitudinal view of healthcare. “The best way to prevent rising healthcare costs is to keep people healthy,” said Parks. “People who invest in our solution fundamentally believe that good health is good business.”

Proper tools to support patient engagement

In addition to phone calls, CareTeam employs multiple outreach and communication options. It’s part of what Parks describes as a “technology-enabled primary care experience” that includes tools like text messaging with options to send appointment reminders, for instance. The user-friendly patient portal offers options to connect with clinicians and self-scheduling that directly populates athenahealth’s EHR. CareTeam’s culture of inspiring engagement in one’s own health outcomes – including training employees to encourage patients to use communication tools – has led to a patient portal adoption rate that’s 63 percent higher than the athenahealth network best practice rate.

Supporting patient-clinician interaction complements CareTeam’s business model, which includes longer appointment times than traditional primary care facilities. In turn, on-site nurse practitioners (or in some cases, physicians) can address employees’ emotional and physical needs with more comprehensive exams and dialogue, and draft personalized care-gap plans. All CareTeam clinicians have health coaching training, too, supporting ongoing, relationship-driven engagement in addition to technological engagement. “For example, it’s easy to diagnose and manage someone with diabetes. Medication management, A1C monitoring, and a variety of in-person exams are critical to manage a diabetic care plan,” said Parks. “But it’s really hard to treat the actual physical disease if we don’t address fundamental lifestyle factors like exercise, nutrition, muscle- and movement-based issues, or even underlying behavioral health challenges.”

Some of those issues have been exacerbated by the pandemic, which has been a catalyst in the “evolution” of CareTeam’s whole-patient model, says Parks. In the past two years, CareTeam has rounded out its staff with behavioral health specialists at its clinics and added both on-site and virtual nutrition counseling. “Utilization and adoption rates for those services have been incredible,” he said. “Most of our clinicians are at 100% appointment capacity.”

The right care, no matter what the setting

CareTeam’s on-site model largely connects more rural communities that face barriers to quality healthcare with easily accessible resources. But COVID-19 changed how CareTeam delivers its “technology-enabled primary care experience.”

Virtual encounters accounted for just 1.2% of total visits in April 2019, but grew to 42.3% across CareTeam’s network in April 2020. While that number has since declined with their customers’ returns to the office, Parks sees telehealth as an elemental supplement to the CareTeam model. For chronic disease management and prevention, maintaining a relationship in-person is “motivational.” But for reviewing lab results and acute visits, giving patients options is essential, Parks said. CareTeam is actively researching how they can incorporate virtual annual patient assessments; mail-order, self-administered lab tests; and follow-up preventive telehealth appointments.

No matter where services are delivered, CareTeam’s virtual care solution of choice is athenaTelehealth, he said. The benefits are two-fold: clinicians are able to launch video visits easily within the EHR without disrupting their workflow, and patients have a simplified experience compared to CareTeam’s previous vendor. Prior to adopting the embedded solution, patients had to schedule their appointments in a separate, nonproprietary portal.

An open ecosystem offers essential flexibility

Having the right documentation in the right place at the most crucial times is critical to treating patients. CareTeam says athenahealth’s open architecture allows them the flexibility to use additional tools easily, like those available through the Marketplace. In particular, their Marketplace population health management tool has been a “critical” connection with the EHR, said Parks.

What he calls a “one-stop shop” that differentiates CareTeam’s setup from other EHRs means registration information from athenaNet populates in the app, with no toggling or additional sign-on required by the clinician. By using a third-party claims group and internal clinical data, the population health app provides a “total picture of the patient’s health status and health risk profile,” said Parks. Care coordinators can then perform outreach or offer care measures during appointments that are beyond the limited symptom-specific scope of why many patients schedule time with clinicians. Data is surfaced to provide a better overall patient profile for improved care coordination.