Blue Care Network Best Practices

Well-child care

Edgewood Pediatrics' commitment to well-child care and immunizations is a team effort 

Dr. Gendelman and Tina Wandrei

Edgewood Pediatrics in Commerce Township is dedicated to getting all its patients into the office for well-child visits and immunizations. "It's easy to do this because there's a reward in this," says Dr. Brian Gendelman. The reward, he says, is healthy children.

The office has six doctors and one physician's assistant. The process starts with the doctors. "Communication is key and it happens all the time," says Dr. Gendelman. "A patient never leaves our office without a directive on when to come back. For every encounter, sick or well, the medical assistants check the chart to see when the last physical was done."

Dr. Gendelman with Theresa Zonneveld, Christian Zonneveld and Michelle Philip

Tina Wandrei, medical assistant, spends much of her time tracking visits for wellness checks and immunizations. "For Blue Care Network, I call noncompliant patients and generate letters from Health e-Blue," she says. "I check to see when patients are due for their physicals and immunizations, and I do a lot of phone calls and letters. I'm constantly tracking to see what they're missing."

Every visit is considered an opportunity to educate the parents about the importance of immunizations, says Dr. Gendelman. "We advise them of the importance of having their children vaccinated. Based on the amount of time we put into those discussions we run an 80 to 85 percent success rate. If they are concerned about getting their children vaccinated, we also explain, in a non-threatening way, that their emotions are playing havoc with their logic and we discuss the greater risks of not getting vaccinated."

Keeping up with the charts and bill sheets is a full-time job. Wandrei says that she documents specific information in patient charts, including well visits. The staff also checks the billing sheet when the doctors see a patient. All immunizations and well-child visits are logged into the Michigan Care Improvement Registry and the office generates files for MCIR every few weeks to keep the system up to date.

Wandrei also works on Health e-Blue weekly to review lists of noncompliant patients. "I make notes next to patients' names and go back to see when they are due and when they have an appointment. I also schedule phone calls and letters."

One of the most important things in achieving compliance is to not make parents wait for appointments. "We take same day appointments for physicals," says Dr. Gendelman. "We never say no."

Keeping up with the number of immunizations required can be daunting. The office follows American Academy of Pediatrics guidelines for physicals and Wandrei makes sure that requirements are constantly updated.

One of the challenges to providing the recommended number of well-child visits and immunizations is documentation. "We had a documentation issue in the past when we had new patients but we didn't have their records," says Dr. Gendelman. Using the MCIR records has helped the office better track immunizations. The office checks MCIR on an as-needed basis. "If parents haven't brought a child in for well visits and immunizations, we check to see if they had their visits elsewhere," says Wandrei.

Keeping a chart on each patient also helps the office staff see at a glance what a patient needs. "We have a phenomenal team," says Dr. Gendelman. "We have weekly meetings and bring information back to the medical assistants. Any time there's a change, we're on it." Dr. Gendelman and Wandrei agree that the most important factor is making a time commitment. "You have to agree that this is important," says Dr. Gendelman. "It's a daily discussion between patients, doctors and our medical assistants. At the end of the day it's doing the right thing for the children."

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