FORT HOOD, Texas— Carl R. Darnall Army Medical Center (CRDAMC) is taking a new approach to primary care. It is transforming all five of its community-based primary care clinics to “QUiC” clinics. QUiC stands for “Quality, Urgent, internet and phone, Care.” Patients will quickly notice that their clinics have become urgent care clinics – open during duty hours for acute needs without requiring appointments. QUiC clinics will ALWAYS see sick patients. This approach will be novel for patients used to having to make appointments before all medical encounters.
Even so, QUiC clinics are substantially different than civilian urgent care centers. The difference lies in that QUiC clinics are designed to have an ongoing relationship with patients. QUiC clinics are, in fact, primary care clinics responsible for vaccinations, preventive health needs, and routine health needs in addition to urgent care. Patients can expect continuity for all their primary care needs with a single provider and medical team. Unlike urgent care clinics, QUiC clinics are also charged with maintaining the health of their populations. Indeed, they obsess about quality – the ‘Q’ in QUiC. Patients enrolled in QUiC clinics can expect frequent contacts from their healthcare team to ensure that they are up-to-date on vaccinations and cancer screening procedures. QUiC clinic staff even provide case management services for patients with complex conditions.
Patients might question where their current clinics found the time to attack both urgent and routine efforts simultaneously. The answer lies in the “i” or internet and phone portion of the QUiC title. QUiC clinics have embraced low-cost, high volume communication techniques to manage the routine needs of patients, without generating a face-to-face appointment time. For example, a provider can create four or five refill prescriptions for the same cost in time as a face-to-face appointment. CRDAMC has proven this methodology by leading in virtual care utilization across the Defense Health Agency (DHA).
According to CRDAMC Commander, Col. Richard Malish, QUiC clinics are designed with the Quad Aim in mind, which includes Better Health, Better Care, Lower Cost, and Increased Readiness.
Patients are not the only ones benefitting from the QUiC model–providers love it because it puts them in charge of their time and patient panel. As long as they maintain the health of their population, see sick patients when they are ill, and retain high-satisfaction scores, they are in control.
“It might be a simple comparison, but in the QUiC model, providers act as air traffic controllers…keeping their charges in good health and in-flight through frequent communication and bringing them in ‘for maintenance’ whenever they need to ‘land.’” stated Malish. Providers are responsible for the metrics – but they are offered autonomy as to how they manage their panels.
Dr. Kathleen Bybel, a Family Medicine physician at West Killeen Medical Home, and a physician in the DOD/DHA for six years at multiple military treatment facilities said, “The QUiC method has significantly improved primary care. I will often hear from patients how grateful they are that we were able to see them the day they called, especially when they are ill. We’ve even contacted patients who had already been in an urgent care waiting room, and redirected them to us instead which is great for Primary Care Manager continuity and overall patient care.”
Through various patient satisfaction surveys, many are expressing positive feedback about the QUiC method such as: “This was a video visit. Thank you for encouraging this convenient and personal method of providing care;” and “I really enjoyed the video appointment. I hope you will consider keeping that system. I felt it was more personalized to my need, the setting is more comfortable and I feel that I got more time with my provider.”
The results to date have been outstanding. All five clinics demonstrate remarkable improvements in access-to-care, patient satisfaction, and quality metrics. Both the Army Medical Command and DHA are taking notice and CRDAMC has developed its model into an exportable package for other healthcare systems to consider and emulate. The future of healthcare just may be hatching in Central Texas.