Innovation at Stitches Acute Care Center
By Dan Surdam, MD & Amy Surdam, FNP
“At Stitches Acute Care Center, we believe in advancing healthcare through innovation.”
At Stitches Acute Care Center, we believe in advancing healthcare through innovation. In fact, it’s one of our core values and in our mission statement. We strive to “mend our patient’s health with compassion and empathy, utilizing best practices and innovation, while collaborating with our patients to enhance their physical, mental and spiritual health. By leveraging innovation with an engaged and empowered health care team we will transform how care is delivered by increasing accessibility, affordability, and convenience to the communities we serve.”
Over the last several years we have strategically implemented several innovations, all with the common goal of better patient care and a better environment for our providers to work in. A few of these solutions are:
- Zip Pass.
On our website, patients are able to reserve their spot in line through zip pass. Our patients are important to us and we know that their time and resources are valuable. We want to ensure each visit is smooth, seamless, and hassle-free. Our Zip Pass service allows patients to check in online from their computer or device and reserve their place in line in the event that there multiple patients at the clinic when he/she arrives.
- Electronic Registration.
There is nothing more annoying to a patient than completing a ton of paperwork when he or she first arrives at a healthcare clinic. We’ve tried to simplify this by providing our forms electronically through our website so patients can complete them prior to their arrival and bring them to the visit.
In the next month, we will be taking this a step further by integrating these online registration forms with our electronic health records. All patients will be able to complete their registration process electronically either from home or in the clinic. This online registration will assist our clinic in having more complete records, provide more efficiency for our staff so they can focus on the patients more instead of paperwork, and allow established patients a quicker check process.
Medicine has changed in the last twenty years. We used to take care of patients, write or dictate a few notes about the visit, and then move on to the next patient. Most of our time was spent taking care of patients. Which is what we want to do!
Introduce electronic health records (EHR). With so many boxes to check and places to enter data, we have found ourselves taking care of a computer instead of our patients. This shift has been disheartening for many clinicians and has taken some of the joy away from the practice of medicine.
To combat this, several years ago we implemented scribes. Scribes assist our providers with documentation so the provider can take care of the patient. Basically, the scribe enters the room with the provider and documents the interview and exam findings, diagnosis, and treatment plan. Anything discussed with the patient during the exam is recorded in real time by the scribe. At the end of the visit, the provider simply reviews the chart for accuracy, prescribes any necessary medication and then completes the chart.
We have found that by utilizing scribes our providers are not only more efficient but also much happier which inevitable leads to happier patients. We also feel we are contributing to the education and mentorship of young people wanting to get into medicine as many of our scribes are students or new to the industry.
As many urgent care centers do, we offer onsite x-rays that our providers interpret and use to guide diagnosis. With the advancement of technology and the internet, we are able to send our x-rays to radiologists for immediate over reads. What this means for our patients is that any time an x-ray is taken, a radiologist will also review the x-ray within minutes and provide feedback. It’s like having a second opinion on every imaging study.
- Online Bill Pay.
No one likes paying a bill so we’ve tried to make it as painless as possible. Patients can simply go to our website and pay for their visit should there be an outstanding balance. No more stamps to lick or envelopes to address. With just a few clicks, this task is complete.
- Social Media,
Like many businesses, we attempt to have a strong social media presence through Facebook, Instagram, Twitter, and Linked In. Our posts are focused on current issues, the communities we serve, and offering our followers insights into what we provide. Our social media strategy involves posting regularly and only relevant, positive content.
While not technology driven, memberships are an innovative approach to healthcare that we began offering in August 2018. StitchesCare is a simple, transparent, low-cost monthly membership that allows our members to visit our clinics in Laramie, Cheyenne, or virtually through telemedicine, seven days a week when they need or want to be seen, at no additional cost. This program was started after we realized most of our patients have very high deductible insurance plans or could not afford insurance. This membership program is modeled after direct primary care.
Flu shots, sports physicals, annual exams, annual basic lab work, and telemedicine visits are all included in memberships. We can provide acute care, primary care, and chronic care management. If an x-ray, other lab work, or a procedure is needed, the patient is merely responsible for our clinic’s cost, which is substantially less than one would pay if he or she weren’t a member. We can also dispense medication from our clinics, and our members may receive their prescription medication at wholesale pricing.
This approach to healthcare takes out the middleman and passes the savings directly to our members. We also believe we are increasing access to healthcare and providing a great relationship between patients and providers. We believe that increased engagement, increased emphasis on wellness and prevention will help patients become healthiest and ultimately control excessive healthcare expenses by preventing catastrophic events.
StitchesCare is not health insurance. We like to think of it as health assurance. With our StitchesCare Membership Program members will never pay a deductible, co-pay, or co-insurance with us ever again. At Stitches, we can take care of typically 80% of healthcare needs.
Membership only covers care at our Stitches location or virtually with a Stitches provider, and will not cover events that require surgery at the hospital or if they have a catastrophic event, which is why we strongly recommend having a high deductible insurance plan or cost-sharing plan to accompany the membership. At this time, membership programs cannot be utilized if a patient has Medicare as we still contract with Medicare. Company cafeteria plans or HRA plans can be used to pay membership fees. Federal legislation is being considered to allow HSA accounts to fund membership fees, and ultimately allowing membership fees to be used toward health insurance deductibles.
The cost per month is transparent and very reasonable. We charge a $199 registration fee for families and couples, and a $99 registration fee for individuals.
Per month the breakdown is:
Family of four: $199
Parent and child: $119
Individual over 26 years old: $99
Individual 18-26 years old: $39
Each additional child in a family of four or parent and child plan: $29
If a patient commits to a six-month membership, he or she will receive a 20% discount each month. When patients make this commitment to their health, we want to make a commitment to the patient as well with a lower price.
Perhaps our biggest push for innovation thus far has been the implementation of telemedicine. We rolled out this service to Wyoming in early 2017 through a HIPAA compliant, third-party platform that allows patients to access our local providers through our website. At any time that we are open (including evenings and weekends), patients can access our website with their smartphone, tablet, or computer, select our telemedicine to start your visit now button, read a consent and enter a virtual waiting room. Within moments, our receptionist will greet the patient, verify identity by capturing a photo of their driver license and collect payment (the patient enters his or her own credit card info via a pop-up screen on their end) or insurance information. The patient will be placed back into the virtual waiting room for a few moments until the provider is ready for the visit. A few conditions that can be treated through telemedicine include rashes, UTI’s, cough, colds, prescription refills, back pain, mental health conditions, and pink eye. Once the provider makes a diagnosis, prescriptions are electronically sent to the pharmacy.
This entire process typically takes less than ten minutes and is extremely effective for both the patient and provider. In particular, parents with small children or elderly who might struggle to physically come into the clinic might find this alternate approach for treatment convenient. Employees at work could receive care in a matter of minutes instead of leaving work for hours. People who live in remote areas of Wyoming can also utilize this service enabling them to have access to care where they otherwise would not have had access.
At Stitches, we can treat any patient physically in Wyoming. Which means a patient in Saratoga or Lusk could utilize a telemedicine visit instead of the emergency department for non-acute care. Shifting non-emergent patient visits to telemedicine visits instead of the emergency department will save the patient, insurance companies, and taxpayers significant amounts of money.
Finally, if we find we cannot treat the patient through a telemedicine visit, the virtual visit payment will be applied to their in-person visits at one of our locations.
In the summer of 2018, we added a mobile component to our telemedicine. We converted a RV into a Mobile Medicine clinic and have a technician drive it around the state. In various cities, our technician meets patients who need complex physicals and with the technician’s assistance, one of our physicians conducts these physicals through telemedicine. This allows the patient and the physician to maximize their time by eliminating travel time.
Our next steps with telemedicine are to further our reach throughout Wyoming, making this a more accessible and accepted way of receiving care. Currently, our physical locations include Cheyenne and Laramie. We are excited to roll out Stitches Instacare in Casper, Laramie, Sheridan, Pinedale, and Kemmerer by the end of 2019 in all of the Wyoming Ridley’s Family Market pharmacies. At Stitches Instacare we are able to offer advanced telemedicine visits with the use of peripherals to listen to the heart and lungs and otoscopes to look in the ears and throat. We are also able to conduct a variety of point of care lab tests including strep, flu, and rsv.
- Our Commitment to Wyoming
As healthcare leaders, we feel it is important to help others succeed. We are committed to helping advance telemedicine and healthcare access in Wyoming through various methods and strategies.
As Breakthrough 307 Investors we actively participate in entrepreneur investments paying close attention to healthcare related opportunities. To date, Breakthrough 307 has invested in two healthcare related companies based in Wyoming. Tray Pacer (a sterile processing company) and Nitrome Bioscience (a company committed to decreasing neurodegenerative diseases with nitration enzyme). We look forward to participating in more healthcare related endeavors.
Recently, we aligned ourselves with The Array School of Technology and Design. This alignment was a strategic maneuver to ensure we have the necessary resources to navigate technology advances. We also want to assist other healthcare industry partners in obtaining those resources as well. We are working through what this will look like in the future and are excited to share more when we can.
Thank you for allowing us to share our innovative approaches with you. We look forward to expanding on these tactics! Feel free to contact us for more information or questions at firstname.lastname@example.org or email@example.com.