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— Alla Kirsch, MD, Family Practice, Ohio
Dr. Glenn Lopez operates a unique primary care practice. His 34-foot mobile clinic provides much-needed medical services in largely working-class and Latino neighborhoods throughout the San Fernando Valley of Los Angeles..
After spending 10 years in Guatemala setting up medical clinics, Dr. Lopez returned to the U.S. determined to deliver similar low-cost, practical healthcare services in his hometown of Los Angeles.
By focusing on the prevention and early treatment of chronic diseases like asthma and diabetes, and then tracking clinical results using the Amazing Charts EHR, Dr. Lopez convinced an LA-area hospital group and major health insurance foundation to underwrite his efforts with a $340,000 grant.
Glenn Lopez, MD, MPH, wants to help fix the broken healthcare system in America, and the Amazing Charts Electronic Health Record (EHR/EMR) is an essential tool in his effort.
After earning his medical degree from Cornell University Medical College in 1983 and spending four years in private practice, Dr. Lopez was ready to do something completely different. He spent the next 10 years setting up 20 clinics and 74 health “posts” supported by mobile physicians in rural Guatemala.
After returning to the U.S., Dr. Lopez earned his Executive Masters of Public Health in Health Services Administration at the UCLA School of Public Health, writing his thesis on the idea of bringing mobile clinics to underserved populations in Southern California.
“In this country, we spend the majority of our healthcare dollars treating preventable complications of chronic diseases like hypertension and diabetes,” says Dr. Lopez, an assistant professor at UCLA's Department of Family Medicine. “Many of the uninsured never see a doctor regularly and don’t seek care until they are symptomatic or have permanent damage. Then they end up in the emergency room, or even worse, in the ICU, and that’s when we all pay through higher insurance costs and taxes.”
In the San Fernando Valley, for example, 7% of all adults suffer from diabetes, while nearly 30% have high cholesterol. Nearly 40% are considered obese, according to L.A. County data from 2007.
“It was ironic to me that Guatemala, this tiny poor nation, would have a more sensible approach to healthcare than the richest nation on Earth, but it was nonetheless true,” recalls Dr. Lopez. “I decided my goal would be the prevention and early treatment of chronic diseases like hypertension and diabetes by bringing affordable healthcare to the streets where people live right here in L.A.”
Dr. Lopez started walking groups to get people outside and exercising, but also to get to know their neighbors and support each other in adopting healthier habits. More than 3,000 people across the valley signed up and participated.
Based on the success of that program, he approached Providence Health & Services, an L.A.-area hospital group, and requested a grant based on the concept of treating preventable diseases to reduce uncompensated care costs for the hospital. After just two formal meetings, Dr. Lopez received a $340,000 grant from the hospital group and Health Net Foundation to help cover start up expenses and two years of operating costs.
One of the conditions of the grant was that Dr. Lopez thoroughly document and report on his patient population’s demographics, existing conditions, and ongoing wellness in order to show whether his approach was effective in reducing chronic disease.
“I needed an EHR system to track my patients, but I had very specific requirements,” Dr. Lopez explains. “I couldn’t use a web-based system because the mobile clinic doesn’t always have broadband reception. The software had to run on a simple laptop computer, and it had to be inexpensive because I needed to spend most of my budget on equipping the clinic. Lastly, I wanted an intuitive EHR I could start using immediately without any formal training.”
He saw a demo of Amazing Charts at a Pri-Med Conference in Anaheim, CA, and was impressed by the user friendliness of the software. He asked for a local reference and visited the office to see how that doctor used Amazing Charts. “After watching someone use Amazing Charts to document a few patient encounters, I was able to use it to see a patient the next day,” Dr. Lopez recalls.
For a one-time licensing fee of just $1,995, the Amazing Charts EHR provided Dr. Lopez with a CCHIT-certified EMR/EHR solution. An additional $995 per year gives him software updates, technical support, and ePrescribing. He describes the download and installation process as being “a piece of cake.”
The affordability of Amazing Charts left enough money for Dr. Lopez to purchase a 34-foot “fifth-wheel” trailer and outfit it with all of the equipment typically found in a primary care clinic.
Most days, Dr. Lopez is found parked in the parking lot of a local church, school or public park in one of 11 different San Fernando Valley communities where he sees his patients. People can make an appointment or just walk in. There is a flat $15 fee for service, and insurance is not accepted.
The Amazing Charts EHR is used by Dr. Lopez and a part-time staff of three, including a pre-med student and a counselor who provides group support to people in the waiting room area of the trailer. The entire staff began using Amazing Charts immediately, with no formal training.
“We just upgraded to version 5.0, and I’m very excited about the built in USPSTF and CDC/ACIP Health Maintenance recommendations,” Dr. Lopez declares. “This feature will make the tracking and treatment of chronic diseases both easier for me and more effective for my patients.”
Dr. Lopez has also been impressed with the new, more powerful search and reporting functions found in version 5.0. The granular reports allow his funders to see how many people he is treating and with what conditions.
“Everyone benefits from early, preventative healthcare,” concludes Dr. Lopez. “The very affordable price and user-friendliness of Amazing Charts enables me to provide low-cost medical services, with little need for technical support, to people in desperate need of care."