Integrated EMR Program Putting the Brakes on Readmissions and Medication Errors.

Sophisticated Program Reigns in Readmissions and Medication Errors

Participating practices performed a post-hospitalization visit and medication reconciliation within 30 days 300% more frequently than non-pilot primary care physicians. Furthermore, over 90% of the post-discharge visits occurred in the critical first 14-day period.

Working with Elation Health, an electronic health records vendor, agilon health created a new program, enabled through an integrated workflow with the provider’s EHR, to notify MDX Hawai’i PCPs when their patients are discharged from the hospital.  The new initiative reminds physicians to promptly see post-discharge patients for follow-up exams, which can help prevent hospital readmissions.  Preliminary results of a pilot study using the new integration reveal physicians who participated had a patient readmission rate 31% less than the rest of the market during the same time period.

The study, which was rolled out in September 2018, involved 54 primary care physicians who received notifications pushed by MDX Hawai’i into their electronic health records when their Medicare Advantage members were discharged from the hospital. The majority of physicians were then able to see patients for follow-up appointments and medication reconciliations within two weeks post-discharge.

Research shows that patients who visit PCPs 14 days post-discharge have a lower chance of readmissions and reactions to their medications. The national average of patients having medication errors post-discharge is 50%.

The preliminary results showed over 90% of the post-discharge visits occurred in the critical first 14-day period. All physicians involved in the study performed a post-hospitalization visit and medication reconciliation within 30 days — 300% more frequently than non-pilot primary care physicians. Following this successful pilot, the program is being expanded to more than 100 primary care physicians within the MDX Hawai’i network.

Physician Burnout? Not at Pioneer Network Physicians!

New Survey Shows Job Satisfaction is High for Pioneer Network Physicians.


At a time when substantial numbers of primary care physicians are disgruntled about their work environment and physician burnout reaches an all-time high, Pioneer Network Physicians in Akron, Ohio, have a very different story to tell. In a recent survey, Pioneer received a Net Promoter Score (NPS) of 76 across its physician partners.  Considered the industry standard, NPS is an index that quantifies customer’s overall satisfaction with a company’s product or service. A score of 50 or above is considered excellent.

Using questions from a respected occupational burnout measurement tool, agilon health collaborated with Pioneer physician management to develop the survey.  Results showed 82% of the responding physicians at Pioneer Network Physicians felt professionally satisfied at least several times per week. These results are strikingly different from overall industry physician satisfaction, which reflect burnout rates ranging from 30 to 65% across specialties, with the highest rates incurred by physicians at the front lines of care, such as emergency medicine and primary care.

Click here to see the summary report.

COPC’s Extensive Care Center Provides In-depth Care to Patients with Acute/Chronic conditions

Through its Extensive Care Center, Central Ohio Primary Care (COPC) Physicians Group is putting the “care” back in health care. Patients with acute or chronic health conditions who require in-depth treatment—but not an emergency room visit—can get more comprehensive care in a more enjoyable setting.

And much of what they need is time.

The Extensive Care Center offers patients the chance to spend an hour or two with a board-certified physician or nurse practitioner and receive thorough treatment in an outpatient setting. In the past, patients with conditions such as cellulitis, gastroenteritis or hypertension have gone to the ER and some have been hospitalized, putting them at greater risk of contracting infections.  Now they have access to a non-emergency facility that offers intravenous fluids/medications and other treatment and delivery methods usually only available in hospitals.  The Center’s healthcare team also provides longer patient monitoring and next-day follow-up to ensure the patient’s condition has improved.  In addition, the medical team communicates directly with the patient’s primary care physician about the visit, and all treatment and medication notes are sent to the provider.