Fair Haven Use of Microsoft Products

Since 1971, the Fair Haven Community Health Center has been providing comprehensive primary healthcare to residents of the low-income Fair Haven community in New Haven, CT. Over 95% of the primarily Latino patient population at Fair Haven is living below 200% of the federal poverty level. More than 43% of adults lack any form of health insurance. These patients suffer from a wide range of chronic illnesses, including diabetes, heart disease, and chronic kidney disease. The Clinic uses a wide range of Microsoft products such as Windows XP, which allows us to connect to the local hospitals, as well as Microsoft Office Products to write grant proposals in Word and track patients in Excel. Most significantly, for the past 8 years, Fair Haven has employed the Patient Electronic Care System (PECS), a Microsoft SQL based chronic disease and health maintenance registry that allows the clinic to store and access health information for each patient. By using PECS, clinicians at Fair Haven can provide patient specific care to each resident of Fair Haven as well as manage the community’s health as a whole. PECS has allowed Fair Haven to optimize the delivery of its mission and increase the effectiveness of the organization. In order to assess and manage a patient’s health, a clinician gathers a variety of discrete information, ranging from weight and blood pressure to lab values and test results. In a standard medical record, this information is located on several different documents, requiring the clinician to spend time looking through the chart instead of interacting with the patient. At Fair Haven, PECS compiles and stores all of these values about each patient in a Microsoft SQL database, and a summary form displaying these values is generated and printed for each patient visit. Clinicians thus receive an overall snapshot of the patient’s health by simply opening the medical record, and they can spend the rest of the visit engaging in meaningful interactions with the patient about their health. In addition to indicating previous values, the clinical progress form alerts clinicians when patients are due for certain tests or screenings. These alerts are based not only on demographics, but also on the patient’s history and previous test results. For example, experts recommend that diabetics have an annual eye exam. At Fair Haven, “eye exam” would be highlighted in red on the PECS form of a diabetic patient who had not had one in at least one year. This reminder prompts the clinician to schedule the eye exam as well as any other upcoming tests or screenings that are highlighted. By presenting the clinician with a detailed analysis of the patient’s health, PECS ensures that clinicians address major health concerns for every patient who walks in the door. The PECS database also provides a powerful tool for the clinic to extend healthcare into the community. In addition to the main office, Fair Haven operates five School Based Health Centers as well as a clinic at Bella Vista, a housing complex for the elderly. These satellite sites ensure that healthcare is accessible to members of the community who cannot come to the Clinic’s main site for an appointment. In order to deliver high quality primary health care, clinicians at these satellite sites access PECS remotely by using a Microsoft terminal server. Remote access allows clinicians to utilize the robust patient histories stored in PECS as well as the powerful reminders system. Also, PECS links satellite clinics to promote continuity of care. Clinicians at either the main clinic or satellite sites can view up-to-date, previous office notes and visits, preventing the duplication of services. In addition to supporting personalized primary health care, PECS allows Fair Haven to assess and manage the population of the community at large. PECS can use the information stored in the SQL database to produce reports that reflect the health status of our entire population as well as subpopulations of patients. Medical providers can analyze their own patients by, for example, determining their patients’ average HbA1c, a test used to monitor diabetes, or by determining the percentage of the their patients who are maintaining a target blood pressure. These reporting capabilities also empower Fair Haven to assess the clinic’s performance at a national level. As an active member of the Health Disparities Collaboratives (HDC), a nationwide organization of community health centers that focuses on quality improvement for the underserved, the clinic generates and shares reports on the status of chronic diseases such as diabetes and depression in Fair Haven’s population. Reports collected by the HDC allow Fair Haven to compare its performance to other clinics in the country. Recently, Fair Haven was one of the 25 health centers selected from a group of 600 to be recognized for its consistent quality reporting. The Clinic has been invited to present its experience with data-driven health care to HRSA and the NIH. These reports generated by PECS directly impact patient care at Fair Haven. Individual providers use reports to identify trends in measures such as HbA1c levels in their diabetic patients and tailor their care to promote improvement by, for example, encouraging patients to improve their diet and exercise. Assessments of the entire patient population allow the clinic to promote prevention and disease management throughout the community. For example, PECS can generate a report that identifies all of the clinic’s female patients over 40 who have not had a mammogram in one year. The clinic’s Cancer Screening Director then contacts each patient on the list to arrange a screening. PECS reports also help the clinic procure funding for a wide variety of initiatives. As a Federally Qualified Health Center (FQHC) serving an underserved population, Fair Haven relies on grants to fund a wide range of services and outreach efforts. Recently, the clinic received an $800,000 grant to fund the Diabetes Prevention Project (DPP), which allows the health center to apply a major NIH study to prevent diabetes. The grant proposal included information identifying the large number of patients who are at-risk or who have pre-diabetics in the clinic’s population, a statistic generated by PECS that demonstrates the need for the services the DPP will provide. PECS allows Fair Haven to quantify information about patients in order to improve the Clinic’s funding opportunities. Overall, PECS has allowed the Fair Haven Community Health Center to effectively deliver its mission throughout the community. The SQL database and Microsoft terminal server ensure that clinicians provide the high quality primary care that is integral to the clinic’s mission. Additionally, it has allowed the clinic to track and procure funding for all of its programming, which further optimize the effectiveness of the clinic’s mission.