Geraldine Valme-Daleus is the office manager, biller, and registered nurse at a primary care practice in Ditmas Park, Brooklyn. Her father is the doctor, her brother is the front desk manager, and her aunt works at the front desk as well. The family business, Gerald Valme MD P.C., sees about 40 patients a day. In 2017, Geraldine led the practice to successfully achieve the Modified Stage 2 Meaningful Use objectives on Christmas Day, just before the last day of the final reporting period of the year. We spoke to Geraldine about her experience.

Can you tell us about your practice?

We have seven staff members and one doctor. We treat everyone from babies to geriatric patients. The most common conditions are hypertension, diabetes, and high cholesterol – I call it the triple threat. We provide all services, even GYN. Most of our patients are Haitian immigrants and insured through HMOs, some have private insurance. We take everyone from everywhere.

What prompted you to work towards Meaningful Use? How did you start?

We had missed it a few years because we are so busy, and decided we couldn’t miss another one. We wanted to get the incentive rewards, and the motivation from NYC REACH helped a million times more. We already had an EHR but had no idea how to go about achieving Meaningful Use, so I called NYC REACH in August.

I spearheaded the process, and the front desk staff took on a lot of new responsibilities. The doctor mostly did patient education, sharing materials from our EHR with all of the patients. Everyone helped to get patients to sign into the patient portal. I was a bossy lady, especially to the doctor! We had to catch up with about 1,700 to 1,800 patients in a three-month period. It was missionary work.

What challenges did you have? How did you overcome them?

Getting patients to sign in to the patient portal was challenging, particularly with geriatric patients. They were willing to do it, it was just a matter of making sure they logged in right away.

The front desk came up with a strategy. We logged in every single patient that visited before they left the office. We also hired a temp to help out. The doctor would even tell patients before they left, “make sure they have your email at the front!” I created a general welcome email from the portal and sent it to every patient. Without this process we would not have made it.

Another issue was working with specialists to be able to exchange electronic referrals. I called providers from every single specialty, even told them how to set up a direct address through their EHRs. Many specialists just didn’t have the capability set up. But we eventually found one of our ophthalmologists did accept electronic referrals. We have so many diabetic patients, and all of them need to see an ophthalmologist, so we started to refer every diabetic patient to him. This focused strategy helped us to meet the referrals threshold.

How did the process improve your practice?

I like being able to contact patients by email. We can answer questions more quickly, tell them when they missed an appointment, tell them to get flu vaccines, etc. And specialists can send us results more easily.

What advice would you give to providers who would like to achieve Meaningful Use?

Definitely do it. Start the process now and don’t wait until the last minute. It’s 100% worth it in the end. You are going to have to be on board with MIPS, and you don’t want to be starting from scratch. Know that there’s help out there, and that it gets easier. Sign the patients into the patient portal at the office and get them interested in using the portal, encourage specialists to get on board, and find a good EHR.

How did NYC REACH help?

Our Client Services Coordinator was extra, extra, extra amazing – on the phone with the EHR vendor to get upgrades, motivating us to get it done, keeping on top of deadlines. She was 50% of the reason if not more why this was done. If you’re trying to do this, definitely call NYC REACH. If not for them I wouldn’t have done it.

Now that you’ve achieved Meaningful Use, are you going to participate in other Quality Improvement Programs?

Yes! There are so many things I want to do, but one thing at a time. I’d like to work towards Patient-Centered Medical Home next.

Meaningful Use, also known as the New York Medicaid Electronic Health Records Incentive Program, is still active. The last year to attest and receive payment is 2021. Providers can contact pcip@health.nyc.gov with any questions or for support with achieving Meaningful Use.