Case Study Urgent Care Center of Alameda
California-based Urgent Care Center of Alameda is a user of CareRemote and its telecardiology service is being driven forward with the aid of our service. We spoke to Beau Ascarrunz, the Practice Manager about how Urgent Care Center of Alameda implements CareRemote in their clinic. Beau has over 20 years of experience in the clinical realm and her feedback was very insightful to us.
The Urgent Care Center of Alameda Story
Urgent Care Center of Alameda is an urgent care clinic that has a firm grip on the patient experience. They are dedicated to providing high-quality care that is personalized, compassionate and timely. Serving not only the community of Alameda but also the surrounding San Francisco Bay Area with urgent care needs, occupational medicine, immigration physicals, travel medicine and workers comp to name of few of their many services. Their patient population is composed of adults, seniors, and children ages 5 & up. Urgent Care Center of Alameda is open Monday through Friday, 9 am to 7 pm and Saturdays from 10 am to 3 pm.
Services are extensive ranging from basic physicals and checkups to treatment of illnesses and infections to injury care and repair At Urgent Care Center of Alameda health care providers are prepared for almost anything. It helps to have the Alameda Fire Department next door, but good triage and quick assessments are made throughout the day by an excellent clinical team that relies on strong communication, teamwork, and compassion for all patients.
Urgent Care Center of Alameda is a growing urgent care center and it is expanding its patient base. But how do they manage cardiology cases?
- Urgent Care Center of Alameda uses CareRemote for:
- EKG management of routine and STAT interpretations
- Credentialing of Cardiologists
- Quality and Auditing
- Ongoing improvement
- They have benefitted from implementing CareRemote by:
- Reducing referrals to hospitals and ERs
- Cardiological expertise for patient presenting with cardiac events
- Streamlined and managed to schedule for EKG interpretations
- More accurate clinical decision making with cardiac patients
- Lower Costs of Healthcare Delivery
- Low Turnaround time
- Lower Readmission Rates
They had a difficult time finding cardiologists who could read their EKG’s. “So many around have merged with larger groups and I found it difficult to connect to any provider in a group” Beau explains. Their intention was to set up a high-quality cardiac service line that would provide patient with more added value inpatient services through the use of cardiology expertise. Beau explained, how the clinic uses a thorough and stringent process for vetting potential specialty partners. She mentioned that they searched for a provider, however, the search required resources that are costly.
Following weeks of phone calls, online searches and, talking to other providers we decided to consider a managed service that could handle everything for us.
“There were not any available providers that were flexible in meeting our facilities needs. CareRemote made this possible”
Adding the Service Line to the Clinic
As patient volume increases for this popular clinic the variety of case presentation increases. Additional support is needed to handle patients in need of care. More importantly, the service line needed to be organized while allowing staff to allocate resources to other areas of care.
“The services seemed to fit exactly what we needed.” CareRemote made it all seem very easy and I trusted them to go ahead and move forward.” CareRemote is unique in that they offer a turnkey solution for facilities seeking to implement a cardiac service line. Particularly, the initial costs were low, the service has a reputation of being reliable so we could depend on them with our patient population. We liked the fact that CareRemote has clinical and business expertise in this field. Coordination of care can be another issue and the service is an integrated service where credentialing, screening, quality, malpractice, scheduling, training was done for us. With all of the complexities around adding a cardiac service line, we had a solution.
Discover how they found out about us and how we solved the problem
“We heard about CareRemote by a word of mouth referral. Electrocardiography (ECG) is a useful diagnostic tool in the diagnosis and management of ischaemic heart disease and cardiac arrhythmia, and its availability in the urgent care setting is now common.” Routine availability of ECG at the primary care level can facilitate early referrals to secondary care while reducing unnecessary referrals where appropriate. Telecardiology has been in use in one form or another for just over a century and has multiple applications.
We believe that recent advances in telecardiology provide an accurate, convenient and cost-effective solution for ECG testing in the primary care setting. The availability of both ECG equipment and interpretational skills are not universal at the primary care level. Obtaining rapid, accurate ECG reports with specialist input remains a challenge.
For example, one study found that many primary care professionals assessed were unable to diagnose atrial fibrillation. The lack of reliable ECG testing and reporting under these circumstances may mean that some cardiac conditions are being missed. There are several reasons for having reliable ECG testing at the primary care level. Although the majority of patients with acute coronary syndrome present to secondary care, some may present to their GP.
Under these circumstances, ECG testing is a mandatory and reliable interpretation of the result may inform not just the diagnosis, but also the need for urgent referral. This is of particular importance for atypical presentations. From the perspective of diagnosing and managing cardiac disease, opportunistic screening programmes may detect ECG changes such as atrial fibrillation or left ventricular hypertrophy in high-risk individuals with conditions such as hypertension and dyslipidemia.
It may also aid the early detection of silent myocardial ischemia in specific patient groups at high risk of coronary artery disease, e.g. diabetics or patients with chronic kidney disease.
Implementation was rougher than it needed to be. Having been through much more complicated implementations and deployments. Getting setup to begin was a bit of a challenge for us. Trainers were not familiarized with how the client would be using the service and went through the process a few times before finally getting it all sorted. Customer service saved the “sale”, it was close, but response time was fast and everyone was polite. In whole, the implementation did not affect our workflow and once we were setup the service went smoothly.
Rural hospitals face unique challenges such as the lack of patient volume required to justify specializes in multiple modalities and often times the unwillingness of physicians to relocate to remote communities.
Many times the high fixed costs associated with bringing specialists in-house is cost prohibitive for smaller medical facilities, such as Critical Access Hospitals. Typically, these organizations are forced to have diagnostic exams read by local specialists and family practice physicians which presents challenges in terms of study turnaround time, pricing, and patient referral pressures.
Ultimately, the result is diminished patient care and lost revenue for these medical facilities.
CareRemote provides medical facilities with direct access to specialists for diagnostic exam interpretations and clinical consultations using video technology. This scalable solution can be utilized by hospitals as needed such as 24/7, during peak periods, after hours, or during times when in-house specialists are on vacation.
How did we help you reach goals and solve the problem? Providers feel much more confident knowing a cardiologist is “on-hand” for STAT results. As a manager, my concerns with regards to liability have also been resolved. Thank you!
Taking it the next level
We’d like to see the Urgent Care Center of Alameda continue to improve. In urgent care settings, there’s a lot of opportunities to reduce costs and increase revenue. CareRemote can be used to record a face-to-face patient visit. Our platform can be used to follow-up with new and existing patients. Giving urgent care centers this multi-dimensional aspect of care will allow them to expand the patient base with insurers, employers, and patients that may live outside a 3-5 mile radius of UC.
CareRemote will work with Urgent Care Center of Alameda to provide specialist care.
Use Case: The Patient appears with rash
- urgent care setting
- can see a CareRemote specialist
- no waiting for weeks for a visit or follow-up
Use Case: Patient with CHF Urgent Care setting to home
- the patient can be monitored at home (reducing costs for insurers)
- patient education and patient status updates for improved compliance
- reports are provided to the center via a report and this is added to the patient’s file
- re-admissions are avoided (i.e. $2000 per day x 3 days average per patient)
Example Models for Urgent Care Centers
- Urgent care gets paid from walk-in and/or membership fees (PMPM)
- CareRemote specialist gets paid fee-for-service on a schedule (paid by insurers, employers/TPAs or patient)
- CareRemote gets paid a share of Urgent Care PMPM and a $0.50 per minute billable consult.
In summary, the urgent care group takes care of drop-ins, sells memberships, extends services into homes for follow-ups and repeat visits and offers/manages referrals. There is a lot of opportunity in healthcare at this time.
Urgent Care facilities can benefit from portable personal EHR accessible anytime with a doctor on demand from home or while traveling. Other benefits include the ability for an immediate specialty consultation.
We’re working to make things better for patients and to improve the quality of care while reducing inefficiencies.
Pro-tip: CareRemote can you assist you with the services that we have mentioned. Contact us for more information.
We’d like to thank Urgent Care Center of Alameda for the feedback and a successful collaboration. If you are local to Alameda, CA. pay them a visit.