Written by: Center for Care Innovations

Neighborhood Healthcare, which has branches in San Diego and Riverside County, cares for 65,000 patients a year. Located in Southern California, the clinic has been a mainstay of the safety net community since 1969. It sees an extremely diverse population of underserved patients, most of whom receive government-funded insurance and often face a slew of barriers to healthcare. The clinic offers medical, prenatal, dental and behavioral health care to ethnic groups ranging from Latinos, blacks and Asians to Arab-Americans, focusing on those most in need.

For decades the office staff gave out a paper with medical questions to patients as soon as they arrived. However, many of the forms were being lost or turned in incomplete. Even when the office staff got a finished questionnaire, it had to be entered manually into the patients’ Electronic Health Record (EHR). Besides wasting time, the process was ripe with the potential for transcription errors.

The solution seemed obvious: It was time to get rid of the paper forms and go digital. The innovation team decided to switch to electronic tablets, testing them out in a pilot study before rolling them out to the whole operation. But as the team would soon find out, nothing is ever as straightforward as it seems.

“Any time an innovation team sits down and creates something in a meeting room, you’ve got to expect that it is not going to work out the way you envision,” says Derek Carrillo, Neighborhood’s operations specialist. “If people roll out a project in a vacuum, it’s bound to be a failure. For things to work in real life, a feedback loop is so essential.”