Today’s primary care includes healthy dose of acronyms

Primary care physicians – or PCPs – are, simply put, the keystone that holds the ever-widening arch of modern healthcare together.

Primary care doctors are charged with the delivery of preventive care, as well as lowering “rates of mortality, emergency room visits and hospital admissions,” while also reducing overall healthcare costs, according to Modern Healthcare’s website.

That’s a tall order for anyone, but Dr. Cassi Jones and Dr. Miciara Hernandez, along with family nurse practitioner Tamsin Blanchard, are taking on the challenge at their practice across the street from the Sebastian River Medical Center.

Today, their field is absolutely jam-packed with acronyms most people wouldn’t recognize if their lives depended on it. And, as it happens, in many cases their lives might well depend on it.

That alphabet soup includes AWVs (annual wellness visits); EMRs (electronic medical records); ACOs (accountable care organizations); SGRs (sustainable growth rates); FFSs (fee-for-service models); and, as of January 1, 2017, MACRA (the Medicare Access and CHIP Reauthorization Act).

Regarding one of the most important acronyms in the evolving medical landscape, Dr. Hernandez says, “For us, it’s not a huge a change. Dr. Jones and myself and Tamsin are very pro-preventive medicine [and] we try to get our patients here every year to have their [Medicare-mandated] annual wellness visits, so that’s not going be a huge change for us. We have been doing this since we started.”

Jones concurs, explaining, “In our training we were already seeing this and were already focusing on Medicare annual wellness visits to make sure our patients] get all their preventative measures. We were trained that way.”

Maybe no one looks forward to the list Hernandez then rattles off, including colonoscopies, mammograms, PAP smears, rectal exams and prostate cancer screenings included in those AWVs, but the cold hard facts are that those tests do save lives, as well as billions of dollars, by finding diseases earlier rather than later.

Jones adds, “I would say the only thing that’s different for the patient now is, before, you could have your annual wellness visit kind of mixed in with one of your regular follow-ups on blood pressure [or other chronic conditions], whereas now, an annual wellness visit is a separate visit where we do most of your preventative screenings and get caught up on all your records.”

With the exception of the actual primary care provider, those shot and other medical “records” have become another lynchpin in modern healthcare.

President Barack Obama’s Affordable Care Act mandated the switch from paper to electronic medical records, or EMRs. That single move has probably saved more lives than anyone ever imagined at the time.

You don’t have to look any further than your own backyard to see why.

As early as 2004, Dr. Dennis Saver of Primary Care of the Treasure Coast noted that through electronic medical records, a simple keystroke could “show me all my patients who have diabetes who are taking a certain medication.” Saver then added, “That’s basically impossible with paper charts.”

Today the capabilities of EMRs have grown exponentially.

Physicians like Hernandez and Jones can now, almost instantly, spot potentially dangerous drug interactions. When one specialists prescribes drug A for one of their patients while another already has that same patient taking drug B and taking both A and B together poses a problem, these primary care doctors know it immediately. And so will the specialists.

Today, as Jones puts it, the EMRs “will basically flash and tell you when you’re prescribing a drug how many interactions there are. And you can even click the button and it will tell you the severity and exactly what the interaction is.”

Warfarin, for example, taken with acetaminophen, can be fatal; so can Clarithromycin taken with calcium-channel blockers.

That also applies to any number of over-the-counter supplements patients may be taking. Supplements can often radically dilute the effects of a prescribed medication or worse. St. John’s Wort, for instance, can have mild-to-devastating effects when taken with any one of at least a dozen different prescription drugs.

That’s why Jones, Hernandez and Blanchard insist on updating every patient’s records on every drug or supplement being taken on every visit.

And the rest of that alphabet soup? The Medicare Access and CHIP Reauthorization Act or MACRA went into effect just this year. It transitioned away from the old fee-for-service (FFS) approach with the aim of incentivizing healthcare providers to deliver lower-cost care.

Jones, Hernandez and Blanchard collectively say they are “all in” on helping to provide better care at a lower cost.

Dr. Miciara Hernandez, Dr. Cassi Jones and nurse practitioner Tamsin Blanchard are currently accepting new patients. Their office is at 13840 U.S. 1 in Sebastian. The phone number is 772-581-0334.    

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