How Detroit Health Department Modernized Billing, and Patient Access

Background

When Brandon Atkins joined the Detroit Health Department of Michigan in 2020, his role didn't yet exist. He was hired as Director of Clinical Administration specifically to lead the department into an electronic health record (EHR), a role created in response to one of the department's most urgent needs.

Brandon brought over 20 years of public health experience to the job, including a background in infectious disease immunology and prior leadership over immunization and reproductive health clinical operations. That experience gave him a clear view of what the department's fragmented record-keeping was costing staff and patients alike.

"My role really is to oversee our clinical operations division, administration of any aspect that really does impact our clinic, and one of those major tools for our clinical staff is an electronic health record," Brandon said. "That's really what segued into the search and procurement of what is now our Patagonia Health contract."

The Challenge: Disconnected Records, Manual Billing

Before Patagonia Health, the Detroit Health Department was piecing together patient information from paper files, smart sheets, disjointed data, and scattered data files. There was no single source of truth, and different clinical programs serving the same patients had no way of seeing each other's records.

"You had reproductive health and immunizations, which see a lot of the same clients, but certainly were not keeping records in the same way," Brandon explained. "If a client came in and was seen in our reproductive health clinic, they wouldn't have access to those same files, because they were kept in a different place. That just does not make any sense."

That disconnect meant staff across programs were often working with an incomplete picture of the same patient, and patients themselves bore the cost of that fragmentation, repeating information to different clinical teams within the same department simply because the systems couldn't talk to each other.

Billing was just as strained. Without a clearinghouse embedded in a health record, the department's medical billers were left to process claims manually, a slow and error-prone approach compared to an automated system.

"There's certainly a lot to be said for a clearinghouse that's embedded within a health record that can go through and help with those claims and get those claims processed in a timely fashion," Brandon said. "If you're trying to calculate some vast mathematical equation with an abacus, it's certainly going to work a lot differently than if you use a modern tool like a calculator or a computer to figure that out for you."

For a department managing high patient volumes across multiple clinical programs, this meant claims work competed directly with time that could otherwise be devoted to patient-facing tasks.

Patient communication, meanwhile, relied almost entirely on phone calls. Scheduling an appointment or requesting information meant calling a clinical line and waiting, with no way for patients to see their own records or lab results in between. For patients trying to stay on top of their own care, that left real gaps between visits, with no visibility into results or next steps until someone was available to answer the phone.

The Solution: Patagonia Health

For Detroit Health Department, the deciding factor was that Patagonia Health is designed for public health, not adapted from private practice or hospital software. That distinction mattered immediately when it came to reporting.

"Epic, which is an amazing system and does all kinds of really amazing things, doesn't have any kind of verbiage or reporting that's catered specifically to grant funders," Brandon said when describing prior EHR experiences. "Patagonia [Health] being more public health-centric at the onset has catered some of those tools more specifically for a public health practice," he added, pointing to reporting for Title 10 grants and the Federal Program Annual Report (FPAR) as examples of built-in support other systems don't offer.

Being part of a larger group of Michigan health departments that all use Patagonia Health also gave Detroit Health Department more leverage to solve shared problems. Today, Patagonia Health supports public health departments across 68 counties in Michigan, serving more than 1,940 users statewide and giving Detroit a sizable peer network to draw on.

"We're one of many health departments in Michigan that are utilizing Patagonia Health," Brandon said. "So we have a larger work group and consortium, and a lot of our programs are pretty similar to one another. If there are issues, we can work through them as a bigger group, not just one person trying to identify one specific practice pinch point."

Each year, Patagonia Health brings customers together through its Michigan User Group, creating space for peer learning, shared problem-solving, and direct feedback that helps shape the user experience. We also asked Public Health program manager, Angel Reed, at Detroit Health Department, what she had to say about her experience with Patagonia Health. 

Giving Patients Ownership of Their Care

Patagonia Health's myHealth Patient Portal changed the way patient communication was handled the Detroit Health Department, shifting it from phone-dependent to self-service.

"The patient portal embedded within Patagonia Health is helpful because it helps clients take on their own ownership of their medical records and their health. They're able to schedule appointments, communicate with providers, and see lab results. They're able to just get in and take a larger section of their own health into their own hands." - Brandon Atkins, Detroit Health Department 

That shift required a change in mindset for some patients accustomed to walk-in, phone-based public health services. Brandon and his team made a deliberate choice to help patients see themselves as active partners in their own care, rather than passive recipients of a free service.

"We really had to change that narrative, because you are the only person who can really advocate for your own health," he said. "You shouldn't be responsible or relying on anyone else to do that informational sorting for you."

That shift matters practically, too: Medicaid requires patients to have portal access before providers can see them under their assigned plan, so the portal isn't just a convenience — it's what keeps the department's Medicaid patients connected to care in the first place.

Support That Goes Beyond the Software

Two features stood out to Brandon as differentiators from other systems he's worked with: the ticketing system and the Learning Library.

"I love the ticketing system. As an administrator who's dealing with a lot of the bumps along the way, being able to follow up on tickets, have people responding to those tickets, having data that you can input with them, being able to share information within the system has been really helpful." - Brandon Atkins, Detroit Health Department

For an administrator managing the day-to-day realities of a live EHR across multiple clinical programs, that visibility matters. Rather than issues disappearing into an inbox or getting lost between departments, Brandon can track a ticket from the moment it's raised to the moment it's resolved, with a record of what was said and done along the way.

Because Detroit is one of several Michigan health departments on the Patagonia Health platform, that support extends beyond one-on-one tickets. Common issues get solved once and shared across Michigan's network of health departments, rather than each department working in isolation. That means a fix or workaround discovered by one health department doesn't stay siloed. It becomes part of a shared body of knowledge that benefits the wider consortium, saving other departments from solving the same problem from scratch.

Patagonia Health Academy has filled a training gap, Brandon says he hasn't seen matched elsewhere.

"There are so many resources available in that library, and the way it's been designated now, to be able to deploy specific curriculum," he said. "I think that it's something that any EHR should have with it, but with the ones that I've utilized, I haven't seen quite that level of buy-in for the educational component."

For a department that has onboarded new staff in waves since go-live, that library has become a dependable way to bring new users up to speed and refresh existing ones, without pulling administrators away from their own work to do it one-on-one. Instead of Brandon or another administrator sitting down to walk every new hire through the system individually, staff can work through a structured curriculum on their own schedule, freeing up administrative time while still ensuring new team members start off with a solid grasp of the tools they'll rely on daily.

Where Things Stand Today

Years into the partnership, Detroit Health Department runs on a single system built around public health workflows, rather than the patchwork of paper and disconnected files it started with. Clinical staff across programs can see the same patient in one place. Billing runs through an embedded clearinghouse instead of manual processes. Patients can schedule appointments, message their providers, and check lab results without picking up the phone. And when something doesn't work quite right, there's a ticketing system and a consortium of peer health departments to help sort it out.

Asked to sum up Patagonia Health in three words, Brandon said: "Intuitive, streamlined, and adaptable…"

"They're working to get better all the time. And that's what I like about it."

Benefits of Moving to Patagonia Health

• A single, unified record accessible across clinical programs, replacing paper files and disconnected data
• An embedded clearinghouse that moved billing and claims off manual processes
• Reporting built around public health grant requirements, including Title 10 and FPAR
• A patient portal that gives patients direct access to scheduling, provider communication, and lab results
• A ticketing system that helps administrators track and resolve practice-specific issues, with visibility across a statewide consortium of health departments
• A Learning Library that supports structured onboarding and ongoing training for new and existing staff