Case Study: Adult Medicine of Lake County achieves improved care coordination and 16% fewer hospital readmissions with eClinicalWorks

Better Coordination Yields Better Care

Adult Medicine of Lake County, a long-established primary care practice serving a mostly rural community north of Orlando with many Medicare patients, needed better visibility into patient cases, improved program coordination, and a path to value-based care. Leadership set out to modernize workflows and patient engagement while preserving local, comprehensive care.

Building on its eClinicalWorks EHR, the practice implemented population health tools—Chronic Care Management (CCM), Transition Care Management (TCM), HEDIS-based risk stratification—and patient engagement features like kiosk check-in, the healow app, and online booking. In one year they enrolled more than 800 patients in CCM, combined CCM and TCM operations for a single post-discharge coordinator, cut hospital readmissions by 16%, nearly doubled HEDIS/quality ratings, and began attracting younger patients (4% of visits now booked online), while reducing documentation burden for providers.

Adult Medicine of Lake County

Matt Cady

Practice Administrator