Lessons Learned from Implementing a Practice Automation Platform in the Safety Net

Evaluating the effectiveness of Charlie, healthfinch's refill automation tool, in safety-net settings

Seth Emont


The average physician receives 10 to 25 prescription refill requests per day, contributing to the growing administrative burden placed on doctors. This reduces time with patients and can cause burnout — especially in a safety net comprised of understaffed, resource-constrained institutions. In the post-Medicaid expansion era, safety-net providers could alleviate this burden, expand capacity, and make care more timely and efficient by using automated tools.

Healthfinch, a Madison, Wisconsin-based technology company and CHCF Health Innovation Fund investee, designed a practice automation platform — “Charlie” — to make each refill faster and easier and to delegate elements of the process to other clinical staff. CHCF engaged Seth Emont, an independent evaluation consultant, to evaluate the effectiveness of Charlie in safety-net settings. The evaluation took place at two Federally Qualified Health Centers, Alliance Medical Center in Sonoma County and QueensCare Health Centers in Los Angeles County. About two-thirds of their patient populations are Medi-Cal beneficiaries, and each center uses a cloud-based version of the Epic electronic health record (EHR) system supported and hosted by OCHIN, a non-profit health IT provider.

Both health centers saw positive changes, including more refills completed the same day, a larger share of refills filled by non-physicians, and more provider hours saved by delegation of tasks. Both also experienced high provider and staff satisfaction with Charlie, successful implementation of both medication protocols and standardized workflows, and better refill authorization decisions.