DEPARTMENT NAME TEXAS CHILDREN S EMPLOYEE MEDICAL CLINIC THE NEW VALUE IN EMPLOYER HEALTH CENTERS & SERVICES Julie Griffith, Manager, Employee Medical Clinic and Wellness Houston Business Coalition on Health May 10, 2016
EMPLOYEE DEPARTMENT MEDICAL NAME CLINIC ABOUT TEXAS CHILDREN'S Mission: To create a healthier future for children and women throughout our global community by leading in patient care, education and research. Employees: 11,700 employees, 1,300 physicians U.S. News & World Report #4 Best Children s Hospitals Honor Roll 2015-2016 Consistently rank in the Top 10 Places to Work in Houston by the Houston Business Journal 2 AMPLIFY UNITY 1 EMBRACE FREEDOM 4 3 LEAD TIRELESSLY LIVE COMPASSIONATELY
EMPLOYEE DEPARTMENT MEDICAL NAME CLINIC EMPLOYEE MEDICAL CLINIC RATIONALE Health care costs continued to increase over time (14.4% projected trend from 2009 2012) Point of Service Utilization: ER visits up 6% (cost up 49%) Specialist visits 1,473 per 1,000 members Primary care office visits: 1,893 per 1,000 members 47% of the employee population had at least one chronic condition Build upon established Occupational Health services Competitive advantage in attracting and retaining employees
EMPLOYEE DEPARTMENT MEDICAL NAME CLINIC EMPLOYEE MEDICAL CLINIC SERVICES Self-managed by Texas Children s Full spectrum primary, acute and urgent care In clinic lab draws and rapid tests Specialty care referrals Chronic condition management Live Well with Diabetes Healthy Heart Programs Health Coaching Nutrition consultations Tobacco cessation On-site Physical Therapy Mental Health and EAP Services e-health Pilot with TCP practice Clinic Information Hours of Operation: Mon, Wed, Thu, Fri: 7:30 a.m. - 4:30 p.m. Tue: 6:30 a.m. 3:30 p.m. Same day appointment availability Available to TCH employees on first day of employment $10 co-pay for TCH plan members Externally hosted and confidential electronic medical record
EMPLOYEE MEDICAL CLINIC & WELL-BEING STAFF Physician Nurse Practioner/ Certified Diabetes Educator 2 Medical Assistants Health Coach Dietitian/ Certified Diabetes Educator (Contract 10hr/wk) Employee Medical Clinic & Wellness Manager Employee Medical Clinic Coordinator (Front Desk) Physical Therapist Wellness Program Coordinator Well-Being Assistant
EMPLOYEE MEDICAL CLINIC MILESTONES Employee Medical Clinic Proposed Clinic Implementation EMR Vendor Summit Relocate Employee Health to Main Campus Clinic Soft Launch 1/30/2012 Grand Opening & Employee Open House 2/14/2012 4 Exam Rooms 1 Physician, 1 Midlevel Provider Well-Being Work Group formation Introduced Physical Therapy Introduced Nutrition consultations Adjusted clinic operating hours 2009-2011 2012 2013 2014 2015 2016 Chronic Condition Management Programs for diabetes and hypertension Conducted health coaching pilot programs e-health Pilot Program at 1 TCP practice Adult vaccination promotion Press Ganey survey Patient Centered Medical Home Focus Lab draws in clinic EAP counselling and stress management
PATIENT DATA 17,977 Total Patient Visits 5,643 Unique Patients 19 Average Patients per Day 82% Female 43 Average Age 92.3 Average Customer Satisfaction 98% of patients are on Texas Children s Medical Plan
PATIENT VISITS EMPLOYEE DEPARTMENT MEDICAL HEALTH NAME CLINIC & WELLNESS PATIENT VISITS New Patients Total 380 PATIENT VOLUME PER MONTH (FY16 YTD) 390 315 446 417 456 411 2,786 4,144 4,406 2,815 2,376 1,751 1,329 1,124 449 718 FY 2012 FY 2013 FY 2014 FY 2015 FY 2016 YTD OCT NOV DEC JAN FEB MAR APR
CLINIC DATA & OUTCOMES Top 5 Diagnoses 1. Upper Respiratory Infection 2. Urinary Tract Infection 3. Hypertension 4. Allergic Rhinitis 5. Bronchitis 9 8 7 6 Live Well with Diabetes Participant A1C Outcomes [VALU E] [VALUE ] Pre Program A1C Average Post Program High Impact Patient Cases Cancer identifications Assessment and transportation of stroke patient Stabilization of patient with life threatening anaphylactic reaction Critical BP/glucose values Health Coaching Participant Outcomes Reduced or no longer need medication due to health improvement 6% Improved medication adherence 12% Reduced stress level 56% Improved energy level 63% Length of sleep 27% Quality of sleep 58% Increased physical activity Improved eating habits 87% 90% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
WELL-BEING PROGRAMS
NEXT STEPS 2016 2017 Population Health Dashboard Provide medical services to other Texas Children s locations Launch Total Well-Being Portal Renovate 5 th exam room Evaluate/Replace Electronic Medical Record Targeted interventions and care coordination Expand e-health to additional TCP Practices Build internal and vendor supporting Health Coaching programs Provider access to expanded patient history/data Financial Impact Review Expand behavioral health Considering renaming Employee Medical Clinic
CHALLENGES & TAKEAWAYS Challenges: Takeaways: Reporting and analytics Lack of sophisticated technology/patient portal Provider turnover Marketing and educational materials Privacy and confidentiality Hire great providers Same day appointment availability Reduced co-pay and payroll deduction Offer comprehensive services Keep clinic highly visible Keep wait times low Accessible, pleasant and comfortable
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