Remotely Healthy

History of the Organization

In 1993 concerned community members and agencies troubled by the absence of accessible, affordable and appropriate health services for the poor, uninsured and homeless on Maui established the Community Clinic of Maui, Inc. (CCM). Volunteer physicians from the community provided primary care services in a homeless shelter in Pu‘unene for one year and then, with assistance from the state, a new facility at a homeless center in Wailuku was opened and staffed with a full-time nurse practitioner. In 1998 a third clinic was opened in Lahaina. Today, CCM employs eight physicians, two family nurse practitioner, one dentist and seven behavioral health staff serving some 8,000 individuals annually.

CCM is a non-profit 501(c)3 community health center (CHC), funded in part by grants from the federal government and deemed a federally qualified health center (FQHC). By law FQHCs serve the working poor, uninsured, and high-risk populations. CCM is governed by a volunteer board, the majority of whom are consumers, as well as persons from the community at large proficient in areas of health care, finance, management, marketing, human resources and legal affairs.

Who We Serve

As opposed to the island as a whole, CCM patients are more likely to be impoverished, homeless, speak a language other than English, have lower rates of literacy, and hold culturally divergent views of health care.

In 2008 CCM served 8,013 individuals via 26,612 encounters.

Of these:

· 98% were below 200% of Federal Poverty Level;

· 46% were uninsured;

· 39% were publicly insured (Medicaid and Medicare); and

· 11% were homeless.

Impact of Microsoft Donations

With the Microsoft donation of Windows Server Enterprise Edition, Small Business Server, and Terminal Services, CCM has been able to increase effective communication between staff members and between each of its three sites to ensure full access to patient information from all locations. The ability to remotely access patient information allows CCM to standardize care using a clinical case management database and create an avenue for effective population management and identification of quality initiative areas, which is a functional priority at a community health center. Access to timely and sufficient data is vital to supporting the delivery of quality care in an efficient manner.

In 2005 CCM first established remote connectivity via terminal services when space that housed billing and administrative staffs was lost to a new student housing development. These staffs were relocated to a building a mile away. Wireless access was not an option because of signal blockage by tall buildings that, due to proximity to an airport, could not be remedied by antenna height. Locating staffs at the remote site rather than in the clinic facility afforded sufficient space to serve an additional 500 medical patients.

In 2009, CCM instituted high-speed cable connections between three sites. All patient intake and clinical services functions are processed via remote connections to both the practice management and electronic health record systems housed on servers located at the billing/administration site.

Implementation of terminal services via high-speed point-to-point lines enabled CCM to launch a dental practice in a mobile van via remote connectivity as well. Housing the electronic dental record and practice management system offsite ensures adequate space in the mobile van to treat over 2,000 underserved individuals including children, pregnant women and chronically ill patients with no access to dental care. Additional space in the van is provided by the use of digital imaging equipment supported by the remote server as well.

SharePoint services on the Small Business Server allow CCM to create an internal company Web site that employees use to share documents, initiate discussions, schedule vacations, create calendars for various shared rooms, and share real-time information across the company. This reduced the need to print and post on a bulletin board or circulate through the company utilizing a sign-off list. The ability to provide employees with shared access to policies and procedures, workflow documents, a variety of HR self-service forms, and report technical or maintenance issues has increased productivity and increased awareness of our various policies and procedures.

The products obtained through Microsoft Software Donation Programs have afforded CCM access to cutting edge technologies and operating platforms that we could not have procured without limiting or reducing patient services. These products have allowed CCM to improve responsiveness to patients, accountability to funders and regulators, and to increase access to medical and dental care in our community.