The Patient Centered Medical Home (PCMH) is the cornerstone of Primary Care delivery in Health Services. Empanelment is the linkage between a patient and their Provider-led PCMH team. Medi-Cal Managed Care members assigned to Health Services are empaneled in Health Services automatically. However, we care for hundreds of thousands more patients than those assigned to us by the Health Plans. Some see us exclusively for specialty, episodic or emergency care, but a significant number of these patients are part of the residually uninsured who have significant chronic illness. They deserve high quality continuity primary care.
Among the many reasons to choose a career in Health Services is the commitment to care for all Los Angeles County residents without regard to insurance status. Thus, a process to empanel County-responsible patients was developed to promote health equity; empaneled patients are treated equally whether or not they are insured. The approach was first developed as a paper-based process, then matured into a stand-alone application. In early 2020 (remember life before COVID-19?), Dr. Christina Ghaly posed a straightforward question, “This should be in ORCHID, why can’t it be so”?
Not one to retreat from a challenge to develop something that has heretofore not been done in Health Services, the aptly named Research and Innovation division of Population Health Management, working with Cerner and Health Services IT, set out to design and build an application fully integrated with ORCHID user interaction, while seamlessly leveraging the workflow automation of the non-ORCHID, stand-alone empanelment application.
The new integrated functionality is found in PowerChart and FirstNet under the “Primary Care Information” tab. It combines Health Plan Assignment and Health Services Empanelment information and provides a fully electronic mechanism for new empanelment requests for county-responsible patients directly in ORCHID. It takes just a few clicks, just as it should be. No separate portal, no repeat submissions by different people, no paper, no faxing, no lost requests. Everything is tracked, status updates are automatic, and you can be notified when the patient has a PCMH to call their own. Special populations are handled with aplomb. Those living with HIV, physical disability, homelessness or dually diagnosed with physical and mental illness can request a medical home with specialized services well suited for that patient.
This is just the start. Version 2.0 is already in the development queue with integration of the Care Manager and an even faster “one-click” express empanelment. Have an idea of what you want to see in version 3.0 beyond integration of the My Health LA population? Let us know and we might be able to make it so for you, too.