"Welcome to our company blog. Within these blog posts, we hope to share our insights on clinical quality management, the patient-centered medical home, chronic disease management in primary care, evidence-based medicine, and the use of technology in ambulatory care settings."

- David Morin, CEO and Donald Nease Jr., MD, Chief Medical Officer

I haven't seen this covered in any of the daily health care newsletters I receive, but I certainly think it warrants great attention. "Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home" is a paper published in the May/June 2009 edition of the Annals of Family Medicine. In it, the authors summarize the findings of the American Academy of Family Physicians' National Demonstration Project where a model of the patient-centered medical home was tested in 36 family practices across the US. For anyone working toward or contemplating a Medical Home model, you really need to pay attention to the outlined Initial Lessons Learned and Practice Recommendations. In summary, it shows that moving to a medical home is not easy, in fact, it's really hard to do. And it takes a huge commitment. Regarding technology, there's a great quote in the paper "For example, it is possible and sometimes preferable to implement e-prescribing, local hospital system connections, evidence at the point-of-care, disease registries and interactive patient Web portals without an EMR." 1 In other words, Cielo Clinic with e-prescribing may be what you need for a medical home. Cielo is a big proponent of the medical home model and our software supports what it requires. But, I also believe that the items in this paper regarding the transformation process are what's most important to consider if you are taking this journey. I urge you to read this paper, it's in the Annals of Family Medicine, Vol 7, No 3, May/June 2009. 1 Annals of Family Medicine 7:254-260 (2009) Dave Morin CEO and Co-Founder Cielo MedSolutions LLC

A question we get asked a lot is "what diseases do you support?". The answer is : virtually all. This is the beauty of a table-driven rules engine (our rules engine is the technology that manages all the clinical guidelines you follow. Based on a patient's information, it generates reminders for their due services). All you do is fill out a web form; put in the diagnoses, co-morbid diagnoses or clinical indicators you want to build the guideline rule around and, voila, the guideline is in your system, ready to use. You can set a whole host of other attributes around the guideline, but again, you are just filling out a form. No programmer necessary! Any disease management system that requires a programmer to "create the rule" is one that won't scale and will require dollars for support of that programmer each time a change is needed. "Next-generation" disease management systems are built with table-driven rules engines. Dave Morin CEO and Co-Founder Cielo MedSolutions

Today we announced something that we think is quite unique. Many providers tell us that their electronic medical record system (EMR) or physician portal doesn't provide the chronic disease management functionality of Cielo Clinic and ask if we could "embed" Cielo Clinic into their existing technology solution to make it even more powerful. Well, now we can! Cielo Clinic now provides an embeddable web service. For you non-techies, here's what this means: Cielo Clinic's clinical decision support functionality can be integrated directly into another health IT application. (In other words, Cielo Clinic can run inside another application). This allows you to get evidence-based guideline clinical care reminders right inside your electronic medical record or physicial portal system. No need to utilize two separate applications to get care reminders! We've already begun work with our first EMR vendor that wants to integrate our technology and have many more we are talking with. This is pretty unique stuff and we think it is important. As we've said in the past, our goal is to make technology fit into your workflow and this certainly helps in that regard. If you'd like to talk about how this can integrate into your EMR or physician portal, just give us a call or e-mail! Dave Morin CEO Cielo MedSolutions LLC