An emergency room isn’t an ideal place to use for primary care, Dr. John Benages of the Elmhurst Clinic said.

But a new “medical home” program piloted by the clinic with the help of Blue Cross Blue Shield of Illinois will look to help keep costs down and fill the holes in care for patients with chronic illness.

“What we try and do is identify these gaps in care ... but people are busy and it’s tough for the physician to contact these patients on a proactive basis,” Benages said. “Unfortunately our system is fragmented, and we don’t do a good job of preventing care.”

That might change with the medical home model, which Blue Cross Blue Shield of Illinois is piloting at the clinic because of its large patient base and electronic medical records. The clinic is one of two locations in the state piloting the program.

In 2008, the clinic treated 63,000 patients out of the BCBS preferred provider organization (PPO) alone.

The clinic will implement the pilot program for two years.

The program begins with a newly hired case manager, who contacts patients with the highest risk every week to make sure they’re in good health, while coordinating prescription changes and visits, should they arise.

“For instance a diabetic, they should have an annual eye exam because outside of macular degeneration, diabetes is the leading cause of blindness in the United States,” Benages said. “When the physician opens up his file, he’ll see that the patient hasn’t gotten an eye exam in over a year, gets him to see an opthamologist and it becomes a super visit even though the patient was there for a sore throat.”

Benages said a similar North Carolina program has shown reduced emergency room visits and costs, and Medicare will employ the medical home project with 400,000 patients across eight states in a five-year study.

The project requires electronic medical records for the physician’s office, but for large outfits such as the Elmhurst Clinic, a large one-time cost could be worth it.

“Over two years, we’re going to be able to report significant reductions,” Benages said. “It’s a little bit of proactive care we believe down the road will result in significant cost savings, but again, those cost savings you don’t realize right away.”

But, electronic medical records are paramount to the success of the medical home model, according to Benages.

“I think it’s very hard for a solo physician to implement an autonomic medical record and medical home ... IT funds need to be in place for the medical home, you have to be able to identify high risk patients and electronic medical records can do that,” he said.

Ottillie Taylor, 81, of Bensenville said she goes to the Elmhurst Clinic with her husband every six to eight months, and the medical home model works for her.

“It really is good, I have no problems with it,” she said.

With three months down and 21 months to go to determine whether the model is successful, Benages is optimistic that if funds for electronic medical records for physicians are included in the final federal health care bill, the medical home model will become the norm.

“It’s certainly gathering a tremendous amount of steam,” he said.