The entire Life Connections clinic will be "paperless." Patients will check in using touchscreens, and will be able to access patient records and their physicians from their desktops.
The entire Life Connections clinic will be "paperless." Patients will check in using touchscreens, and will be able to access patient records and their physicians from their desktops. Photo credit: Rose Hoban

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And they’re doing it by spending money for a new facility to provide health care for their employees. It’s part of a growing trend.

By Rose Hoban

How would you like to be able to walk downstairs from your office and see the doctor? Or better yet, get a massage or go to your physical therapy appointment?

Leaders at Cisco Systems are betting that their employees will want that, along with primary care services, X-rays, labs and eyeglasses, all on the same campus where they work.

About 25 employees, placed by UNC Health Care, will be working at the Cisco clinic. Here, nurses and medical assistants greet patients into the new clinic. Photo credit: Rose Hoban

That’s the bet behind the new primary care clinic opened on Wednesday morning, when leaders from Cisco Systems and UNC Health Care cut the ribbon on the Life Connections Health Center at Cisco’s Research Triangle Park campus.

“It was clear to us that Cisco understands that to attract and retain great employees you have to do everything you can to make them as healthy, and their workplace as healthy, as possible,” said Allen Daugird, president of UNC Physicians, the physician practice that will be staffing the new on-site clinic for Cisco.

As he inaugurated the clinic before a crowd of Cisco employees, Daugird explained how he and other health care thinkers are trying to “redesign” the health care delivery system, with an eye towards delivering more value – in part, by using data to drive health care decision-making – instead of simply doing more for patients.

And he said health care leaders are reorganizing systems of health care to emphasize the health of a group of people – be it a workplace, a town or a country – over the health of the individual patient.

Cisco leaders say they’ve found in previous experiments with employee health centers that they save money and improve care.

“One of the mainstays of the redesigned health care system and the population approach is the patient-centered medical home, where you have a team of people who are trying to keep folks healthy,” Daugird said.

Family doc

The idea is to have the on-site health clinic function as a family doctor for Cisco’s 5,000 employees in RTP and their families, a total target market of 12,000 people, said Cisco’s Katelyn Johnson.

The entire Life Connections clinic will be paperless. Patients will check in using touchscreens and will be able to access patient records and their physicians from their desktops. Photo credit: Rose Hoban

“But the patient-care experience is going to be different, because the employees will have longer times with their physician,” Johnson said. “It’s all integrated with chiropractic, physical therapy, acupuncture, massage, counseling, health coaching and a vision center.”

Johnson led employees and reporters on a tour through a bright, brand-new clinic, with soft background music, muted colors and cushy exam tables. The clinic will house nine physicians and another 20 to 30 UNC Health Care nurses, medical assistants and therapists.

The company has a similar set-up at its corporate headquarters in San Jose, where Stanford Health Care physicians provide service for about 15,000 employees. Cisco also has close to 10,000 employees in Bangalore, India. All three locations now have employee health clinics.

And all of the patient records are digital.

“If I’m traveling to San Jose and I’m a patient here and I go to the San Jose site for health care … there can be care coordination among the providers,” Johnson said. “Same with Bangalore, India.”

Cisco employee Colleen Coogan talks with her doctor, Alison Guptill, about her new blood pressure medication via video link. All of the clinic exam rooms will be telehealth-enabled. Photo credit: Rose Hoban

Craig Warner, the medical director, said telehealth features built into the patient rooms would allow a physician to have a visit with a patient, even one in California or India.

Warner said his goal is to not churn patients through the clinic with quick visits. Because all the costs are paid up front, the goal is to create a positive patient experience. He called it a “dream” setting for primary care.

“We’re not going to try to time the visits, so to speak,” he said. “We want longer appointment times, we want a more hands-on approach, we want to make sure we take care of the complete needs of the patients.”

Describing what he calls an “integrative model” of care – with the massage, physical therapy, acupuncture and other services on site – Warner said one goal is to arrest problems before they become bigger ones.

Big ROI

All this sounds expensive, but Johnson said Cisco’s experience has shown the model ends up saving about 20 to 30 percent on costs for employees who take advantage of it.

“The savings come from cost-avoidance and overall reduction in medical spend,” she said.

Johnson said the approach also saves employees money, as they pay fewer co-pays and deductibles.

“Say somebody sprains an ankle. They go to the express care and they get an X-ray, they follow up with an orthopedist, they get another X-ray, they get an MRI,” Warner said. “There’s probably a lot of unnecessary surgeries being performed.”

“So if we can become their primary care, we can offer maybe physical therapy [and] we can perform an X-ray in a preferred facility that hasn’t gone through the hoops and has surcharges upon surcharges, like at a hospital-based facility.”

“They’re not seeing additional specialists, they’re not being ordered unnecessary tests, they’re not landing in the ER, because the physicians are managing their care,” Johnson said.

She said Cisco has found that the intense coordination allows employees to reduce the number of medications they’re on, reduce the number redundant visits and stay healthier.

Optician Robert Key in the eyeglass showroom at the Life Connections clinic. Photo credit: Rose Hoban

“You get more care here, because you have physical therapy, chiropractic, massage,” Johnson said. “We’re not denying care, we’re providing a better care experience. They also don’t have to run around.”

The employee health center on the San Jose campus has also helped keep people at their desks and productive, said Francine Katsoudas, Cisco’s head of human resources, who came in from California for the event. And it’s shown improved health outcomes.

“What’s really cool is that our employees can book their appointments online,” Katsoudas said. “If an employee says, ‘Omigosh, I’ve got to go in,’ they can just go online, find an hour that works and then hop on over. So it’s accessible.”

Cisco currently ranks as one of Fortune magazine’s 100 Best Companies to Work For. Of that list, 41 companies provide on-site health care, including organizations as diverse as Mars, Aflac, Nationwide and SAS, which has had an employee health center at its Cary campus for more than three decades. SAS ranks second on Fortune’s list.

A study published this summer looking at SAS’ costs found that employees using the company health care center avoided more expensive care by doctors, labs and hospitals outside the company.

“The goal is to heal our patients and keep them at their best, and not just manage their signs and symptoms with pills and procedures,” Katsoudas said.

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Rose Hoban

Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...