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Introducing the Office of Johns Hopkins Physicians

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Introducing the Office of Johns Hopkins Physicians

Introducing the Office of Johns Hopkins Physicians

Date: 02/01/2015

Last August, Johns Hopkins Community Physicians opened its first specialty practice in Virginia, extending a network of nearly 40 primary care and specialty outpatient sites that stretches across the Baltimore–Washington metro area.

The creation of the Johns Hopkins Community Physicians Ballston Medical Center in the Ballston neighborhood of Arlington, Virginia, is a boon for area patients, offering general and orthopaedic surgery, gastroenterology, and more. But a footprint in densely populated Northern Virginia also makes sense strategically for Johns Hopkins Medicine. A wider referring network benefits both its community and academic hospitals and specialists. And the Maryland Medicare waiver makes out-of-state business attractive, because the resulting revenue is not capped as in-state revenue is.

The need to engage physician colleagues throughout Johns Hopkins Medicine in supporting the organization’s strategies at a time when the health care environment is rapidly changing is why the Office of Johns Hopkins Physicians was formed. Led by William Baumgartner, the office represents providers across the enterprise, at its core the full- and part-time faculty in the school of medicine, those employed by Johns Hopkins Community Physicians (JHCP) and those employed in Johns Hopkins Medicine hospitals and outpatient sites. Three years ago JHCP came together with the Clinical Practice Association (CPA) to create the Office of Johns Hopkins Physicians.

The CPA, formed in 1997 primarily to handle billing and other physician practice needs, represents some 2,000 faculty physicians and is led by Baumgartner. JHCP’s origins date to 1982, but it took its current name in 2003 and includes some 360 primary care and specialist providers.

Integrating Expertise

JHCP has benefited from the CPA’s expertise in billing, improving JHCP’s collection rates and helping its revenue cycle, says Steve Kravet, JHCP’s president and vice president of the Office of Johns Hopkins Physicians. The faculty physicians in the CPA have, in turn, learned from JHCP’s expertise in using Epic, the electronic medical record, and analytics to measure quality and efficiency.

At the same time, joining the CPA and JHCP under a common umbrella is a significant step toward health system integration, one of Johns Hopkins Medicine’s six strategic priorities.

Patients are the ultimate beneficiaries, says John Flynn, the Office of Johns Hopkins Physicians’ vice president and executive director of the CPA. Links between community physicians and faculty physicians strengthen and extend the continuum of care. Common practice standards increase quality. A shared electronic medical record allows primary care providers in JHCP to schedule patients for appointments directly in many specialists’ schedules, improving access by saving time and effort for patients, and boosting compliance with follow-up care. Improving access, Flynn notes, is a major focus of the Office of Johns Hopkins Physicians going forward, with telemedicine offering new opportunities to care for patients both efficiently and effectively.

“There are many problems that patients come in for that can be handled remotely,” says Paul Scheel, director of the Division of Nephrology, who is heading up Johns Hopkins Medicine’s telemedicine efforts. “Telemedicine also gives primary care physicians the power to consult with specialists directly—say, by sending an image of a patient’s rash—rather than sending the patient to a specialist. The primary care physician stays in charge of the patient’s care and coordinates it. That’s better for the patient and better for the physician.”

Working Together Amid Uncertainty

Health care reform presents challenges to Johns Hopkins Medicine and its individual providers. Although no one can predict precisely how payment reform in particular will play out, all providers will be affected. Because both the Affordable Care Act and the Maryland Medicare waiver financially reward health systems for keeping patients healthy and out of the hospital, improving efficiency in the ambulatory setting has become an important strategic focus now for the Office of Johns Hopkins Physicians.

Having a shared electronic medical record allows measurement of cancellation rates, number of patients seen in a day, resource use and other measures of efficiency.

“Being on Epic has given us the opportunity to develop common standards of practice across the ambulatory setting,” Kravet says.