Columbia Primary Care, of Spokane, is a lot like the primary-care physicians that are its membersit takes care of the basics.


The organization has 50 physician members who pay a monthly fee to Columbia Primary Care to negotiate reimbursement contracts with insurers, oversee major information-technology initiatives, and implement improvements in administrative processes.


Being part of Columbia allows us to operate as a larger organization, says Dr. Michael Stephens, a member of the organization and a primary-care physician with Family Health Center of Spokane PS. It really has proven to be a nice organization with which to learn more from each other and make things more streamlined and focused for the practice itself.


Columbia Primary Care was founded in 1989 to help individual primary-care doctors and small-group practices here compete against big clinics in the realm of managed care, says Valeri Steigerwald, executive director of the organization, which is located at 501 N. Riverpoint Blvd.


Health plans wanted to contract with larger entities, Steigerwald says.


While Columbia continues to negotiate contracts on behalf of its members, it has expanded its role to include helping members improve their patient care as well as their business processesoften, through better technology, Steigerwald says.


For example, doctors affiliated with Columbia were among the first in the region to take part in a statewide program to enhance health care for diabetics, she says. (See related story, this page).


Likewise, all of the doctors affiliated with Columbia take part in a statewide immunization registry operated by the Washington state Department of Health. That database tracks the immunizations individual children receive.


The doctors participation in those initiatives was spearheaded by Columbia, Stephens says.


Especially regarding the diabetes-management program, Had it not been for Columbia, we wouldnt be doing it, he says.


He explains that Columbias quality-assurance committee seeks out opportunities to enhance care, which helped its members get involved in both the diabetes and immunization programs early on. Plus, the doctors participation in the programs required a fair amount of transferring of paper records to an electronic format, and many of the physicians involved in Columbia likely wouldnt have had the time or resources to do that by themselves, he says.


Next up, all of Columbias physician members plan to adopt the same practice-management software, which will be used for patient and physician scheduling, billing, and accounting, Steigerwald says. Columbia will handle the task of switching all of the offices over to the new software, which will save a great deal of time for the office managers of the 20 practices that are part of the organization, she says.


Each clinic could not have an IT (information technology) expert like they are able to access at Columbia, she says.


In addition, all of Columbia Primary Cares physician members have been issued iPaq pocket computers so that they can check drug interactions and insurance formularies while sitting with a patient in an examining room, Steigerwald says. Some doctors also are using the hand-helds to transmit prescriptions to pharmacies electronically, she says.


Electronic prescriptions are a huge push for us because of the number of prescription errors in the United States, Steigerwald says.


While Columbia Primary Care has been concentrating lately on elevating the technology used by its physician members, the doctors also have asked the organization to start providing them with more human-resources services, Steigerwald says.


Accordingly, a Columbia employee now provides members with human-resources consulting and helps with recruiting on a limited basis, she says.


Currently, Columbia has five full- or part-time employees, including Steigerwald, and while its a nonprofit organization, its not tax-exempt, she says.


Columbias members pay dues of about $400 per doctor per month for the organizations services, a level thats set at the beginning of each year by the organizations board. If more money is needed in a particular year due to higher expenditures on computer equipment, for example, its billed to each doctor or practice based on their size.


The group has limited its growth over the years and doesnt plan to get any bigger, Steigerwald says.


What theyre focused on is improving care, she says. If you get too big its difficult to change practice patterns.