1. From Solo Family Physician to a Patient-Centered Medical Home
Robert L. Smith, MD, MS
Finger Lakes Family Care
Canandaigua, NY

2. My Workflow Before Becoming a Medical Home
Redundant and inefficient processes
Paper charting
Inability to search your patient population
Increased wait times
Staff and patient frustration
Dictation delays

4. Dispelling the myth of the solo physician
Solo practice percentage: 1986, 44% , 18%.
All-inclusive nature of the Marcus Welby, MD character is personified by the Medical Home practice model.
Solo practice physicians can have a modern lifestyle in the day and age of hospitalist and team based care.
Personalized care can still be the foundation of primary care.
Implementation of EMR systems can be done affordably.
Availability and access to care is paramount to overall cost saving within health systems.

5. Making “The Leap Of Faith” from the traditional office to a Patient-Centered Medical Home

6. Our Journey to a Level 3 Medical Home
Feb 2006, Finger Lakes Family Care founded using Amazing Charts as the electronic medical record and Updox for document management. (0 patients and a sq ft office)
March 2006, 1st Nurse Practitioner joins practice.
July 2009, Invited to become a charter practice of the Rochester Medical Home Initiative.
September 2009, 2nd Nurse Practitioner joins practice.

7. Our Journey Continued …
May 2010, Migrated to our state-of-the-art offices in Canandaigua. (4000 patients and a 3400 sq ft office)
June 2010, Received Level I PCMH-NCQA certification.
Nov 2010, Received Level III PCMH-NCQA certification.
2011 and beyond: Virtual Visits, Patient Portal, Group Visits, etc.

8. Our Practice Model 1 full-time MD and 2 part-time FNPs
2 providers daily working as a team
2 LPNs
1 RN Care Manager
1 Clinical Assistant
3 Clerical Associates
Provider to staff ratio: 1:3.5

9. Our New Medical Home Workflow
Efficient charting and clerical tasks
Charts are available to multiple people simultaneously
Open Access Scheduling and “Quick Sick” Visits
Increased staff and patient satisfaction
Improved efficiency = increased revenues
Examples of EHR, Population Based Management, Patient Portal, Virtual Care, and Social Media to follow.

10. EHR and Document Management

11. Population Based Data Analysis

12. EHR Reporting

14. Social Media

15. Virtual Care

16. Being available to patients whenever they want and how you want!
Next Steps
Creation of a Patient-Centered Medical Community
Increased proportion of virtual care visits
Increased online services via our Patient Portal
Increased revenue directly from patients
Hybrid Concierge Model
Being available to patients whenever they want and how you want!

17. To Be Continued …