Blue Care Network Best Practices

Lead screening

Thorrez Medical Practice makes lead screening a priority

Dr. Thorrez examines Michelle Herrera-Gomez

It is well known that lead exposure can cause neurologic and developmental problems. BlueCaid encourages its primary care providers to conduct lead screenings for all children age 2 and under. Lead screening is also an important Healthcare Effectiveness Data and Information Set® measure for BlueCaid and impacts our health plan rating.

Terri Walters

Dr. David Thorrez, who owns Thorrez Medical Practice in Ypsilanti, has a significant BlueCaid population and has been successful in achieving high lead screening rates in his practice. Terri Walters is a certified medical assistant and clinical manager for the practice. She explains that their office procedures help the practice maintain a high lead screening rate. "The staff prepares the charts and highlights on the physical form whether the child needs a lead screen," says Walters. "The office staff sends letters to patients' parents approximately every two months if they have not been into the office for a lead screening. We explain that we have a lead analyzer in the office so they do not have to make an additional trip to a laboratory."

Having a lead analyzer in the office is helpful because some of Dr. Thorrez's patients have trouble finding transportation, so it's convenient if they don't have to make an additional trip to a laboratory. Using the lead analyzer is also convenient. Blood is collected with a finger or toe poke. The machine takes approximately three minutes for a result. Dr. Thorrez's office sends the results to the state of Michigan through the Michigan Care Improvement Registry. The lead analyzer has been in the office a little over a year and a half. "We are sending fewer reminder letters to patients as a result," Walters says.

Walters uses an office log for the patient results. To make sure that the lead screen is billed for, the receptionist checks the billing information against the patient log. "This double check ensures billing for the test is done," Walters explains. "If HEDIS letters I mail out state that the patient only needs a lead screening, we can set up a nurse appointment."

Some of the challenges Dr. Thorrez's office experiences include patient compliance, transportation issues and communication. To combat the compliance issue, Walters says, "We try to do the lead screening at a sick visit if we don't expect the patient to come in for a wellness check."

Although having the lead analyzer in the office solves some transportation issues associated with going to a separate laboratory, Walters says the doctors and nurses also make accommodations for patients. "Many times, patients will call up and say 'I have transportation today' so we work them in," she explains. The office also keeps phone numbers of taxi services handy for those whose insurance will pay for transportation if they don't live close to a bus route.

Language barriers can also present challenges. Dr. Thorrez's office has a large Latino client base, so there is a Spanish-speaking nurse on staff. Dr. Thorrez speaks Spanish as well.

In summary, Walters says their process includes a lot of teamwork. "Everyone works together to make sure all our patients are screened."

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