For our latest Four Questions Series, we sat down with Shelly Kent, care manager at Perrysburg Family Physicians, LLC., an independent family practice located in Perrysburg, Ohio. Perrysburg has five affiliated physicians within its practice who provide care to over 6,600 patients. As a participant in Track 2 of CMS’ CPC+ model, Perrysburg Family Physicians is focused on improving care outcomes for patients while reducing overall care costs.
PatientPing became Bamboo Health in 2021.
Can you tell us about your role at Perrysburg Family Physicians?
As a care manager at Perrysburg Family Physicians, my main focus is to monitor patients who are admitted to or discharged from hospital settings. Most of my day is spent trying to determine where patients have gone to receive care so that I’m able to facilitate appointments with their PCPs.
What are some of the care coordination challenges your organization has faced in the last few years?
Being unable to monitor patient hospital care events was a huge challenge for us. We used to receive weekly lists from two surrounding hospitals which included information on our patient events, but this meant that we only knew about them after they occurred. Additionally, if patients received care at other surrounding hospitals, we had no way of knowing unless the patient or someone from that hospital informed us directly. This made it hard to facilitate follow-ups for patients with our physicians post-discharge, as well as ensure that patients were receiving the services and support that they needed.
Additionally, when we did receive lists from hospitals, we had to spend a lot of time and effort on our end to find the information that was valuable for us. We had to weed through ER, admission, and care summaries.
How have you overcome these challenges?
PatientPing (Pings) has played a huge role in helping us monitor patient events in both hospital and SNF settings. Each day, I’m able to log into PatientPing (Pings) and see all of our patients who have been admitted to or discharged from a hospital or SNF. With this real-time information, I’m able to intervene and follow up with patients post-discharge to ensure appointments are made with our physicians, and that our physicians are in-the-know on these events. PatientPing (Pings) has improved our communication with hospitals, SNFs, and patients, while also allowing us to provide seamless transitions for our patients.
What results have you seen since implementing Pings?
PatientPing (Pings) has completely changed how we provide follow-up services to our patients. Since implementation, we have increased our hospital follow-up rates from 1.65% in 2017 to 90% in 2018, and 26% to 80% for our ER follow-ups. Additionally, I am now able to monitor all of these care events in PatientPing (Pings) as opposed to having each one of our physicians review this information. This has helped improve workflows, time management and overall outcomes.
Thanks so much, Shelly!
