Some of my earliest childhood memories are of me accompanying my father on weekend house calls. My father was a primary care physician (family
practitioner), although in those days they were called “GPs” or general practitioners. On Saturday mornings, at age 6 or 7, I would have the privilege of
carrying his black bag up the walkway to a home where he was making a house call. Once inside, I would wait patiently—usually in the kitchen eating some
sort of treat—while he tended to a patient somewhere else in the house. (Clearly, HIPAA was not an issue in those days….) I remember those frequent
Saturday morning rituals vividly, even today, and those early memories still shape my view of what it means to practice medicine. The patient-centered
values imbued in me by my father inform the decisions I make today as I lead the largest and most complex health care system in the state and the region.
The role of the primary care physician in Lifespan’s mission, Delivering Health with Care, has experienced a renaissance of sorts lately—and one
that is long overdue and completely justified. Most primary care providers (doctors who specialize in internal medicine, pediatrics, family practice, and
geriatrics) will tell you that the reason they chose their specialty, and the most rewarding part of their work, is the relationship they have with their
patients. Practically speaking, your health and mine depend on that relationship. If you’ve had the same primary care physician for years, he or she knows
not only your medical history, but also the things that make you unique—what diseases run in your family, whether taking care of your health is high or low
on your list of priorities, whether your general outlook on life is “glass half empty” or “half full” and the social determinants of health like smoking
and nutrition. Your primary care physician provides a physical exam but also monitors your mental health and psychological well-being—all are critical
components of overall health. At Lifespan, we are making a commitment to provide total health care—not just total hospital care. As we
move more of our services out of our hospitals, open ambulatory care centers at locations around the state and the region, this point becomes more obvious.
And as patients receive care in an ever-increasing variety of settings, the role of the primary care physician becomes more important than ever.
Lifespan is committed to assisting and supporting our primary care physicians in a variety of ways. And they need our support. On average, primary care
physicians work 54 hours per week and report that nearly a quarter of that time is spent on paperwork, administrative tasks, hunting down lab reports and
test results, and trying to get in touch with other physicians. Again and again, we hear that what primary care physicians want, more than anything, is
more time to spend with their patients. Next on the list is better communication with other physicians—particularly specialists. I believe Lifespan can
In the past few years, we have partnered with community-based primary care physicians and our academic foundations to address many care coordination issues
that have been raised. We have entered into contracts with these physicians and United Healthcare and Blue Cross & Blue Shield of Rhode Island to
collaborate, share risk, coordinate care, enhance communication and measure outcomes. Better care inevitably lowers costs and work is underway to share
those savings, when realized, among all members of the provider community.
Information sharing is fundamental to practicing good medicine, and it is imperative that physicians have the right information in the right place and at
the right time to practice effectively and efficiently. This is particularly true for primary care physicians. In this era of electronic record-keeping, it
is deplorable that physicians still spend hours every week trying to track down lab results, medical imaging reports and consultations. Epic will be part
of the clinical landscape next year throughout the Lifespan system. Our go-live date for our single, enterprise-wide electronic medical record is slated
for March 29, 2015. Once up and running, all physicians will be able to request access to the system, enabling them to view physician notes, test results
and surgery performed at any of our facilities on their patients. Providers will be able to access all of this information and more through “Lifespan Link” after a simple enrollment process and at no cost to them. We will be reaching out to practices in the near future
to facilitate their transition if they are currently accessing LifeLinks or if we receive a request for access. Work is also underway to develop a strategy
to assist practices with implementing Epic as their EMR if that is desired by the practice. More to come on that in the near future.
Lifespan has also established a committee to create better channels of communication among caregivers in the community and those in our hospitals so that
community-based physicians and hospital-based physicians can manage the care of patients at every step of the patient’s health care journey. We’ve also
created an ambulatory care transitions team and have a primary care liaison to work with offices and care managers, primary care providers and hospital
care teams to share information and management during a patient’s hospital stay and to facilitate care beyond the hospital stay. That work is well underway
and the early results are incredibly promising.
When my father began practicing medicine, there were fewer tests, fewer treatments, fewer medications and fewer options. The world has changed since then
but the role of physicians like my father has remained as it ever was. Primary care physicians are at the heart of health care. By working together with
them, we help our patients, our families—and ourselves.
In the steadfast pursuit of excellence, I remain,
Timothy J. Babineau, MD
President, CEO of Lifespan
President, Rhode Island Hospital