Mending the Fabric of Primary Care

by Andrew Hines
Mending the Fabric of Primary Care

Today, after three years of steadfast development, I’m thrilled to announce general availability of Canvas for independent primary care practices across the country.

We started this journey with a simple mission: help clinicians help their patients. As a technology partner in primary care, we’ve always thought of our role as standing behind the clinician, making the right information available at the right time, and otherwise doing our best to get out of the way. It’s surprisingly difficult to make software intuitive enough to feel invisible, but that’s exactly how Canvas brightens your day-to-day experience as a clinician — you’ll stop seeing the software and just see patients.

As we unspooled what it really means to help clinicians help their patients, we realized what primary care teams have always known — every role in the practice and every touchpoint with the patient is a chance to improve their experience and their quality of care. So we expanded the scope of our redesign from medical records to scheduling and billing, document management and care coordination, patient engagement and population health management, team messaging and task management. Whoa! By focusing exclusively on primary care, we reimagined every aspect of how technology empowers the primary care practice.

The need for better technology is not exclusive to the primary care specialties or to the independent practice model. But cost pressures and regulatory forces have come together to make independent primary care the linchpin for successful transformation to a sustainable system. As Canvas co-founder and president Julian Malinak likes to say: independent primary care practices are the best stewards of our healthcare dollars. They are the only organizations with incentives that are fully aligned with waste reduction, and early results from the Medicare Shared Savings Program show they save almost $400 more per beneficiary per year as compared to integrated organizations.

Even as independent primary care practices outperform their corporate counterparts, many are struggling to survive. The rate of consolidation has been faster in primary care than other specialties, with the strongest pattern emerging as the assimilation of solo and two-doctor practices into the mega systems while the mid-sized groups remain strong. To understand the small office phenomenon, all we have to do is look back at the history of Canvas.

Our very first development partner was Family Doctors of Santa Cruz, a primary care practice on the California coast with two physicians and three PAs. After forty years of serving the community, Family Doctors shut down in 2017. They were about three years into operating with a well-known EMR and were unable to lift productivity back up to pre-EMR levels. They also had a large Medicare panel and were daunted by the upcoming MIPS reporting requirements and payment adjustments. With Canvas still in development and no other solution in sight, they decided it was time to pull the plug.

The only semblance of a silver lining was to sharpen our focus on overcoming the productivity and reporting challenges that contributed to the closure of Family Doctors. Robert Wachter’s 2015 book, The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age, elucidates exactly why fixing the EMR is central to achieving the transformation our healthcare system needs. Prior to Canvas, EMRs presented clinicians with a zero-sum game, pitting data quality against productivity. Clinicians care deeply about ease of use and productivity, but they also know and appreciate that high quality data is the only path to reliable decision support and effective population health management — two core Canvas capabilities that are key to success from here on out.

Clinicians should never have to choose between easy, good, and safe. In Canvas, they’re all the same thing. We’re absolutely thrilled to make Canvas generally available starting today.

Canvas Medical News and Insights

Subscribe for updates, data, and essays on American primary care