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ABC Healthcare is a primary care practice. It is located in a remote, rural area and was founded by Dr. Phalange. When establishing ABC Healthcare, Dr. Phalange's goal was to apply engineering principles to healthcare systems and standardized care to optimize the doctor/patient relationship. ABC Healthcare is comprised of 30% pediatric patients, 30% 18-39 year old patients, 30% 40 to 64 year old patients and 10% of the patients are over 65. The clinic is most often visited by patients between the ages of 40 to 64 years of age with chronic diseases. The practice has gained 30 to 35 new patients per month since it has opened.

The practice employs two physicians, one nurse practitioner and one administrative staff person. In order to deliver care that meets the needs of his patients, Dr. Phalange built an innovative practice that focuses on eliminating barriers between patient and provider. The care provider is often the only person the patients come in contact with when they visit the clinic. As part of the relationship-building strategy, the provider collects all patient information, demographics, insurance, and vitals. By design, there is no receptionist and the patient rarely, if ever, interacts with the administrative staff other than to support the provider in billing or scheduling if needed.

All appointments are made through the ABC website or by calling the provider directly. To eliminate messaging error and delay all calls go directly to voicemail where they are automatically transcribed to text and preserved in a .wav file and emailed to the appropriate provider. The request is addressed and the patient is contacted within 90 minutes. There is a physician directly available by cell 24 hours daily.

The waiting room is technologically advanced and computer terminals allow patients to sign in and schedule appointments. The practice is streamlined and has little overhead. The practice does not offer lab test or immunizations. The use of technology enables the practice to run efficiently with fewer support staff. The entire office team participates in any experiments with new technologies. If a new system is not effective or efficient, it is discarded. Not all patients enjoy the use of technology, but overall, the patients seem to be adapting. ABC Healthcare relies almost completely on EMR. The EMR software used is an inexpensive, off the shelf produce. One drawback is the software does not interact well with outside systems.

•Based on what you have learned about healthcare systems and healthcare technologies, what do you see as the strengths and weaknesses of this practice?

•What makes this practice unique?

•What aspects of this practice make it appealing to patients? Unappealing to patients?

•What issues do you see that will impact this practice?

•Are they easily fixed, or will the issues cause the practice to fail?

•How has the focus on technology in this office hindered or helped this practice?

•What short term and long term outcomes do you see related to this practice?

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