Turning theory into practice: When cutting-edge doesn't always cut it

A Boston-area group adapted just about every service and technological innovation available. But it's finding out that revolutionizing the patient-doctor experience isn't easy.

By Tyler Chin, AMNews staff. Nov. 8, 2004.

Arlington, Mass. -- "Oh, my goodness! How lovely!" patient Lila Tulin said upon seeing a sunlight-filled space featuring two inviting couches, an overstuffed chair and large potted plants.

From the interior décor to the glass-encased conference room, from the relaxing jazz music coming from tiny speakers wired to a digital media player, from tweaks in care processes to offering patients coffee, water or tea, Renaissance Health tips off visitors that it wants to be considered different from the typical doctor's office.

Tiring of studying but not personally applying quality improvement concepts in the real world, Rushika Fernandopulle, MD, and Pranav Kothari, MD, opened an internal medicine practice to show that they could deliver better care by redesigning primary care processes, supporting those processes with appropriate technologies and getting patients actively involved in their care. To accomplish that, the doctors adopted recent innovative services that practices around the country have implemented one or two at a time and integrated them all at once.

Dr. Fernandopulle said he is frustrated with the "incremental" change he sees in primary care delivery. He said that he believes it may be better to change everything in a practice, rather than changing "one little part of a system" at a time.

Thus, Renaissance Health uses electronic medical records, offers patients 24-hour access to physicians via e-mail and telephone, and offers same- or next-day appointments. Patients soon will have online access to their health record and the ability to schedule appointments electronically, and will be offered group visits and classes.