As part of the public hospital system’s transformation strategy to improve and expand primary care, NYC Health + Hospitals announced outcomes of a primary care pilot at NYC Health + Hospitals/Bellevue. The hospital has significantly reduced patient wait times for appointments in its Adult Primary Care Clinic and improved continuity of care, ensuring that a patient is likely to see the same primary care physician (PCP) at each visit. The average time a new patient has to wait for an appointment is now 14 days, down from 52 days, and the wait time for a revisit is now less than week. At the same time, the continuity rate between patients and their PCPs improved from 69.9 percent to 87.1 percent. Bellevue was able to accomplish such improvements by working directly with NYC Health + Hospitals’ Manhattan Call Center, developing scripts that emphasized continuity between patients and PCPs, and transitioning to EPIC, an electronic medical record system, which allows patients to request appointments through its MyChart patient portal. NYC Health + Hospitals/Bellevue’s Adult Primary Care Clinic provides care to approximately 30,000 patients.
'These improvements reflect our health system’s focus on increasing timely access to primary care services and our responsiveness to the community we serve,' said William Hicks, CEO of NYC Health + Hospitals/Bellevue. 'By streamlining processes and strengthening relationships, we’re enabling New Yorkers to access the care they need to live healthier lives.'
In July 2019, other NYC Health + Hospital ambulatory care practices have begun to adopt this new system. These efforts build on NYC Health + Hospitals’ transformation strategy to improve patient experience and expand access to primary care services. Further, these changes create the infrastructure needed to support the additional patients who will seek care through the public health system as NYC Care launches. NYC Care is a new health care option for New Yorkers who are unable to afford or are ineligible for health insurance. The program will guarantee access to a primary care doctor, specialty care, coordinated services, and other services that people with health insurance are accustomed to. NYC Care launches on August 1, 2019 in the Bronx.
'We are proud to offer our patients greatly improved access with wait times that have been cut by more than half in one of the busiest primary care practices in the City. Now our patients can be seen when they want to be seen, ensuring they have the best possible experience receiving care from us,' said Ted Long, MD, MHS, Vice President for Ambulatory Care at NYC Health + Hospitals. 'And equally important, our patients now can trust that they will see their own provider at nearly every visit, which is how we build out long-term therapeutic relationships with our patients.'
'The continuity of the relationship between patient and provider and access to care are the backbone of high-quality primary care,' said Andrew B. Wallach, MD, FACP, Clinical Chief for Ambulatory Care at NYC Health + Hospitals and the Clinical Director of Ambulatory Care at NYC Health + Hospitals/Bellevue. 'As we improve access and become more efficient as a system, we will make more visits available for patients who really do need to see a provider.'
'Prompt access to primary care is critical to avoiding more dangerous and expensive complications down the line,' said Assembly Member Richard N. Gottfried, Chair of the Assembly Health Committee. 'And patients benefit from building trust by consistently seeing the same primary care practitioners. This pilot program shows that it can be done, and I look forward to NYC Health + Hospitals continuing to improve access to primary care.'
'It is encouraging to see the outcome of the NYC Health + Hospitals/Bellevue primary care pilot,' said Council Member Keith Powers. 'I applaud their success in significantly reducing wait times and increasing continuity rates among nearly 30,000 patients and their doctors. This is a step in the right direction towards ensuring all New Yorkers have access to basic health care.'
'In the past, when my doctor said I would like to see you in three months, I didn’t see him before six months because I could not get an appointment. So this is a big improvement for me and I’m really happy about it,' said Hyacinth Peart, a NYC Health + Hospitals/Bellevue patient since 1999.
The Adult Primary Care Clinic at NYC Health + Hospitals/Bellevue implemented patient-centered scheduling in August 2018. The clinic worked closely with NYC Health + Hospitals’ Manhattan Contact Center, where patients call to get an appointment, to develop call scripts that emphasized continuity between patients and their Primary Care Providers. The clinic re-designed its appointment templates to match the new scripts. If a patient needs to see their provider urgently and he or she is not available, they are offered an appointment with a nurse practitioner or physician’s assistant on their regular provider’s team. Previously, the call center agents used a script that focused on scheduling the patient in the next available slot, even if it wasn’t with the patient’s PCP. Thus, the patient was booked with another PCP rather than their regular doctor.
NYC Health + Hospitals/Bellevue’s recent transition to the EPIC electronic medical record system has further enhanced the improvements by providing the ability for patients to request appointments through its MyChart patient portal. Preliminary data show that the improvements will have other positive impacts on the hospital’s operations, such as a decrease in less-acute patients presenting to the ED, and patients will be less likely to have unnecessary tests ordered. Clinical outcomes will also be positively impacted, such as patients experiencing better glucose and blood pressure control.
Under the leadership of Dr. Long, the public health care system has undertaken a five-prong transformation strategy to improve the patient experience in ambulatory care. Launched in early summer 2018, the plan focuses on five pillars of work: improved continuity between patients and their PCPs, patient-centered scheduling, improved clinic efficiencies, enhanced revenue collection, and the spread of electronic consults (eConsults).
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