Taylor Smith sits on a couch wedged in the corner of a bustling coffee shop on the campus of Western Washington University.
Unlike most students around her, Smith, a 22-year-old senior, isn’t studying or buzzing on a caffeine fix. She’s getting a checkup.
Licensed nurse practitioner Jody Hoppis sits beside her chatting and measuring Smith’s pulse. Hoppis biked to campus; her medical gear is locked in a small orange cart attached to her bike outside the building.
“I know Jody personally, so I feel comfortable with her,” Smith said. “I think it’s a cool way to do medicine.”
Hoppis runs Mobile Medicine, a traveling medical practice she started in 2008. She meets her patients – more than 200 total – at work, home, school, retirement centers and nursing homes – wherever is most convenient for them.
Hoppis sees 15-20 patients each week, with each call lasting from 30 minutes to two hours depending on the patient. Most of her patients are older than 65.
After working as a nurse in an office for most of the past two decades, she said Mobile Medicine was a product of brainstorming an outside-the-box approach to nursing care.
In office settings, health care professionals face a lot of pressure to turn profits, she said. The easiest way to do that is to see as many patients as possible.
Unfortunately, Hoppis said, with money as the driver, patients simply become names on charts, and wind up seeing their doctors and nurses less and for shorter amounts of time.
Going the mobile route gave her more direct ability to handle her patients’ needs.
“I just wanted more decision-making capability,” Hoppis said. “I wanted more control over the amount of education I was providing and the amount of prevention I was able to do.”
Using paperless records
One thing completely absent from Mobile Medicine is paper medical records.
In order to see her patients’ medical histories on the go, Hoppis uses electronic records, which she accesses through an online service called PracticeFusion.
Hoppis said one of her major goals when she started Mobile Medicine was to reduce waste generated by a typical medical practice. With all the records, memos and faxes attached to medicine, the health care world goes through tons of paper, she said.
About 50 percent of medical professionals reported using some form of electronic records in 2010, up from 18 percent who reported use in 2001, according to the National Center for Health Statistics.
The increase has been buoyed by a federal push to take more health care facilities electronic. As part of the $789 billion of stimulus money in the American Recovery and Reinvestment Act of 2009, Congress offered financial incentives to health care providers with Medicare and Medicaid patients if they switch to electronic records by 2015.
PracticeFusion, a San Francisco-based company, provides health care providers free access to web-based electronic medical records. Since its founding in 2005, PracticeFusion has grown to become the electronic platform for more than 130,000 physicians nationwide.
Michael Kellner, a spokesperson for the company, said electronic records not only reduce errors and potential loss from accidents or natural disasters, they also give patients more control over their personal medical information.
“The ultimate goal is to have a birth-to-death medical history located on one platform that is easily accessible to both doctors and patients,” Kellner said. “I think it allows the patient to better understand their health history.”
Hoppis said she wouldn’t be able to operate Mobile Medicine without the site.
Though the transition from paper records to electronic ones is a daunting task for doctors at large health care companies, Hoppis said she thought the shift would make medical records more the property of patients, rather than information physicians have privileged access to.
The medical world will benefit from the use of digital records, she said.
“I think in urgent-type situations when people need to get that information out, it makes a huge difference,” Hoppis said.
For physicians seeking to pocket stimulus money by making the electronic changeover, Kellner agreed the switch can be frustrating. He said he thinks PracticeFusion, with an ad-based revenue model that allows doctors to use the service for free, helps make the transition easier.
As the health care world moves forward over the next couple of decades, electronic medical records are likely to become commonplace in doctor’s offices and hospitals across the country, Kellner said.
“I think that’s really the direction the industry is going, I can’t see it any other way,” he said. “Health care is a last frontier as an industry that has not gone into the digital age.”
For Hoppis, using electronic web-based records in her practice gives her peace-of-mind so she can focus on the more important aspects of patient care without having to worry about keeping track of hundreds of files and charts.
She said away from all the records and paperwork is where Mobile Medicine truly shines as a face-to-face approach to health care.
“I try to have this be a very human interaction,” she said. “Healing happens when we’re all heard.”
PHOTOS BY BRIAN COREY