Twenty years!  It is breathtaking to review where the founders of SETMA were in the spring of 1995 and to where SETMA has come to in twenty years.  It was a little over twenty years ago that four physicians met with a CPA to discuss the formation of a group medical practice.

 Beginning with this small group, today, SETMA comprises almost three hundred employees and forty-seven healthcare providers.  In the beginning, SETMA providers were all primary care; today, they include primary care, pediatrics, cardiology, neurology, rheumatology, infectious disease, and endocrinology and nurse practitioners.

In the beginning, for nine months we operated in four temporary locations until in March, 1996, we occupied a single location at 2929 Calder.  Today, we have seven, permanent clinical locations and three business office locations.  Today, SETMA operates a Diabetes Center of Excellence, physical therapy, an infusion center, a cardiovascular laboratory, a moderate complex laboratory, and an award-winning information technology department which connects all locations, hospitals, nursing homes and provider homes with electronic capabilities.

In these twenty years, SETMA has transitioned from a medical record system which was based on dictation and transcription to a paperless, electronic patient records system.  In that process, SETMA has qualified as a patient-centered medical home (PC-MH) and achieved accreditation by the four organizations which recognized or certify excellence in ambulatory care and In PC-MH.  As of this writing, SETMA is the only practice in the United States to be awarded all  these recognitions.

SETMA’s website has been repeatedly honored for its excellence.  One accolade stated:

“Thanks for the opportunity to review the Automated Team Tutorial Workbook.  I found the information very informative. I believe your organization is well ahead of the curve in balancing the needs of the patient and the medical staff. I took the opportunity to review both the documents you provided to me and the website information. The information was informative and well organized.

“…you have the most informative web site I have ever utilized. Bravo, for sharing valuable information with the entire medical community.”

At www.jameslhollymd.com, the following can be found which describes and tracks SETMA’s growth, development and achievements:

• At  “In the News,” there are links to over 250 articles about SETMA which have appeared in national publications over the past twenty years. 
• At, “Letters,” there are almost 200 important letters and other correspondences from and to SETMA over these years. 
• At “Your Life Your Health,” there are over 1,000 articles published by SETMA.
• At “Presentations,” most of the “invited presentations” made by SETMA are published and many of the studies done at SETMA’s monthly provider-training are available.
• At “Awards and Accreditations,” all of SETMA’s achievements and awards are displayed.
• At  “EPM” (Electronic Patient Management), all of SETMA’s disease management, clinical decision support tools and other innovations are displayed for all to adopt and use without costs or permission.
• At “Syllabus PC-MH Externship,” the contents of SETMA’s training program for senior medical students and primary care residents can be found.
• At “Medical Home,” can be found an outline of all of SETMA’s materials for the design and deployment of a medical home.

These are only some of what can be found at www.jameslhollymd.com.   SETMA’s web master estimates that if printed out in its entirety, SETMA’s website would produce over 55,000 pages of material.  This is our gift to the medical community and anyone who wishes to adapt this material to their program.

SETMA’s recognitions have included:

1. The Texas Physician Quality Improvement Award (2012-2014)
2. HIMMS 2012 Physician IT Leadership Award (2013)
3. Robert Wood Johnson Foundation named SETMA as one of 30 Exemplar Ambulatory Practices in America 2011
4. eHealth Innovator Award for 2012
5. Office of National Coordinator (ONC) for Health Information Technology (HIT) of Health and Human Services (HHS) recognized SETMA as one of Thirty Exemplary Practices for Clinical decision Support
6. The Agency for Healthcare Research and Quality (AHRQ placed SETMA’s LESS Initiative (Lose Weight, Exercise, Stop Smoking)) on its Innovation Exchange in 2010.
7. SETMA was selected by Patient-Centered Primary Care Collaborative (PCPCC) for featuring in the Medical Home and Diabetes Practices in the Spotlight  (2011
8. SETMA was included in the Diabetes Center of Excellence, Harvard Practice-based Performance Improvement Project (PI-CME), 2011
9. HIMSS award SETMA its highest Award for Stories of Success in 2011
10. HIMSS Awarded SETMA the Davies Award for Electronic Health Records in 2006
11. SETMA was the Physician Practice Runner-up National Clinic of the Year, 2004
12. SETMA was named as one of 50 Exemplary Primary Care Practices by the American Board of Internal Medicine Foundation, 2003

SETMA’s efforts in the past twenty years have been directed at true transformation of healthcare delivery.  In 2015, one national observer said of SETMA:  “It is as I suspected, Dr. Holly: SETMA  is ahead of the value-based payment model curve.  Is there any area of healthcare reform SETMA has left unexplored?!  SETMA is an impressive reformist figure, with unique depth of experience.” 

Teams from all over the United States, Mainland China, Australia and others have visited SETMA.  Students from several medical schools and residency programs have completed SETMA’s Externship in PC-MH and in July, 2015, SETMA was asked if students from anywhere in the United States could apply for participation in the Externship.

After their visit, the team from Australia said,  “We need time to reflect on the huge panorama that has opened up as a result of viewing the world from that mountain peak, Mt SETMA…For today I will reflect on SETMA’s statement:  ‘Quality metrics have made us better healthcare providers. The public reporting of our performance of those metrics has made us better clinician/scientist.  But what makes us better healthcare providers is our caring for people.’  We recognize that the only way we can truly thank you is ..."" that continued dialogue will stimulate both/ [all] of us to excellence and to the transforming of health care delivery.’ Yours in astonishment and delight.” 

After a visit to SETMA, a national pharmaceutical leader said the following:

“ I lead a pharmaceutical team of about 100 people. In the past, we have followed a ‘traditional’ approach to working with providers. Now, in this new world we are seeking to partner and to earn a seat at the table to provide solutions that are ‘patient centric’ while meeting the needs of providers…In order to do so, we have sought to learn all we can about ‘meaningful use,’ and how it impacts the provider from HIT, protocols, etc. We have learned about quality metric incentive programs as it relates to commercial and Part D reimbursements and frankly how offices are now required to interact and “prove” their impact. This presents all kinds of opportunities with other organizations. SETMA is so far advanced with this approach & leading by example that it is challenging on my end to find alignment points.

“As I prepared to meet with Dr. Holly, I sought to learn about your practice and understand what your needs might be. My first insight is that-SETMA is light years ahead with technology. Many offices have just recently converted and those that had earlier, are now faced with challenges of HIT companies closing doors, not following up on “issues” or not enhancing the systems to provide needed capabilities. Your system is AMAZING. Its capabilities allow for quick learning and thus, quick adjustments on your end.

“Second, I don’t know of another practice that has the accreditations that you hold.  This represents more than just marketability; it represents a team of healthcare providers working closely together to ensure many details are met to reach these goals. It speaks volumes to your team, how you lead them, & the culture you have built over time -- A true team!

“Lastly, how your organization involves so many for the benefit of the patient is somewhat overwhelming. Your Patient Centered Medical Homes, your Community Council and the SETMA Foundation are remarkable just to name a few.

“Please know that you are setting an excellent example of how it should be done. Your organization is truly changing the approach to healthcare and showing others what ‘good’ looks like.

“My commitment to SETMA is that we will continue to work to find that alignment point that serves patients and truly helps your organization. I look forward to working with you and redefining what it means to work together between providers and the pharmaceutical industry.”

Perhaps the most important summation of our twenty years comes from the team which has joined us and stayed with us over the long haul.  Two years ago, we received the following note from an employee; it stated:

“It has been such an honor to work with SETMA for the last ten years. I don’t believe I ever told you this but in my last semester of school, November, 2003, I spoke with my mother about my possible future with SETMA. She was my best friend and I shared with her my fears of being part of such a large group. She was a nurse who worked nights at St Elizabeth… (She said), ‘You need to work for (SETMA) and God will do the rest.’  She was right (as always)…she died about 3 weeks later, just after I took my last exam. I just want you to know.”

Twenty years from now, some of us will probably not be here, but SETMA will and we will continue to work hard to fulfill our commitment to our motto:

Healthcare Where Your Health is the Only Care.