April 2008

PAMF Senior Director of Quality and Planning Tomas Moran and his staff began working with the Ravenswood Family Health Center (RFHC) in 2004 to help the East Palo Alto community clinic identify ways to improve its quality care processes, particularly in disease management. What started as a collaborative relationship between two local health care providers is enabling safety-net clinics throughout the country to provide better care to uninsured and other vulnerable patients.

Moran and his team began by observing RFHC and assessing its organizational strengths and needs for more than a year. "It was important for us to look at what they needed and then respond to that instead of coming in and saying, 'Here’s what you need to do'," he said.

According to RFHC CEO Luisa Buada, R.N., MPH, the clinic needed help organizing all of the information it collects on patients so that it could use that data to better keep track of its patients’ health and provide them with better care through improved management of chronic diseases. Demonstrating this ability to use data to improve patients’ care, particularly those with chronic diseases, is also crucial for clinics like RFHC that rely on grants and other funding to provide patients with these needed services.

"In order to continue receiving this funding, Ravenswood needs to track patient outcomes and report quality measures," said Moran. "One of the best ways to do this is to implement advanced information technologies."

The advanced information technology that Moran helped RFHC implement is called Solutions, a software program that he developed for the PAMF clinic. It is so successful as a disease registry and population health management program that other clinics have adopted it, too. The software has been implemented at community clinics from Santa Cruz and Watsonville to as far away as New York City. Last year, the Oregon Community Health Information Network chose to implement the software throughout its statewide network of 150 safety-net clinics, and the Northern Sierra Rural Health Network is also considering using Solutions.

"Although we began by working with Ravenswood, we realized that we could transfer our knowledge and share our technological expertise with community clinics across the country," said Moran. "This is a very real example of how PAMF is working to ease disparities in the health care system and improve care for patients in our communities and beyond."

It is the transferring of knowledge that is key, said Moran, as it helps RFHC stretch the resources it has a lot further. Some of these resources were made possible by PAMF and its physicians. As part of its collaboration with Ravenswood, PAMF and its physicians contributed $750,000, which allowed RFHC to hire three staff members to support quality and operations improvement.

Looking forward, PAMF has launched a campaign to fund and help install an electronic health record (EHR) at RFHC and two other safety-net clinics in local communities: the Mayview Clinic and the Opportunity Center’s day clinic. This is no small feat. Although the federal government has said it would like EHRs at all U.S. health care facilities by 2013, there are no plans to carry out this task at safety-net clinics.

"Installing an EHR and teaching the RFHC team how to use it is a gift that no other organization can give," said Moran. “Having used EHRs since 1999, we’re one of the most experienced organizations. Our philosophy has been, 'Let’s work alongside you and give you the tools and teach you what we know.' We’re not just giving money; we’re giving our knowledge and our time, which is consistent with our philosophy as a not-for-profit organization."

PAMF’s Education Division has also assisted in the partnership, teaching RFHC staff how to establish education classes for prenatal care and diabetes management.

Like any true partnership, PAMF is learning an incredible amount from RFHC, too.

"Because Ravenswood is used to making the most out of limited resources, it knows how to efficiently use the tools it already has to improve care," said Moran. "By working with them, we’ve learned how to make better use of the resources we have. Having this kind of collaborative relationship is a breath of fresh air and helps ensure our patients receive the highest quality care possible."