Guest post by Greg Link, co-author with Stephen M. R. Covey of the national bestseller Smart Trust: The Defining Skill that Transforms Managers into Leaders.
As the name implies, patient satisfaction scores are nothing more than a measure of a patient’s healthcare experience. Like customers in any other industry, healthcare patients expect good, old-fashioned, caring customer service and to have their expectations met. Unfortunately, due largely to the extreme complexity of the healthcare experience, patients have historically lowered their expectations and defined extraordinary service as merely having their health issue ultimately resolved. That’s like ignoring all of the service aspects of a hotel stay as long as you slept through the night.
Now, in response to the Affordable Care Act, which links hospitals’ government reimbursement payments to how well they score in the Hospital Consumer Assessment (HCAHPS) on patient care, hospitals across the country are scrambling to improve their scores.
Stephen M.R. Covey
“The reality is, hospitals can’t talk themselves out of a problem they behaved themselves into,” Stephen M. R. Covey said, author of The Speed of Trust and Smart Trust.
Covey suggests that the patient experience is not a campaign or a department; it is a function of a high-trust culture generated by good, old-fashioned, common-sense behaviors demonstrated by all stakeholders. These behaviors are common to trusted people and organizations throughout history – behaviors like listening first, clarifying expectations, talking straight, creating transparency, extending trust, and demonstrating respect. One compelling example of a remarkable extension of trust is the Cleveland Clinic, where they are so transparent they give patients online access to their own charts and medical records, including doctors’ notes.
Vitera and Greenway merge. Goodbye, “Vitera.” The company is now officially known as Greenway Medical Technologies, Inc. According to a press release on the subject, the two “leading providers of clinical, financial and administrative solutions to healthcare providers, today announced the completion of a previously announced merger resulting in the combination of the two companies into an innovative leader in health information technology.”
The two are one, the marriage underway.
Vista Equity Partners, owner of Vitera, acquired all outstanding Greenway common stock for $20.35 per share in a transaction valued at approximately $644 million.
The combined company will be privately held and operate under the Greenway brand. Tee Green, Greenway’s CEO, will maintain that position. Vitera’s CEO, Matthew J. Hawkins, will serve as President. Both will serve on Greenway’s board of directors.
The combined company will maintain headquarters and principal operations in Carrollton, GA, Tampa, FL, and Birmingham, AL, serving 100,000 providers across nearly 13,000 medical organizations nationwide — including healthcare enterprises, ambulatory practices, public health, retail and other clinics.
Vitera, through Vista, bought Success EHS earlier this year, which is located in Alabama.
Despite the enormous amount of knowledge that was imparted upon you during your education, perhaps one of the most important elements of maintaining a successful practice was, most likely, barely touched upon. The concept of quality health care is not complete without a rigorous discussion of patient satisfaction. A good physician/patient relationship is a crucial element of a successful practice. The fact that patients do not complain does not necessarily mean they are satisfied with the care they are receiving.
The Necessity for a Patient Satisfaction Survey
Let’s face it: In the big picture, seemingly no matter which profession, a majority of complaints to licensing boards does not revolve around specific ‘practice-based’ issues. Instead, those complaints tend to be based on “client-expectation” issues. From this, we can make the claim that happy clients do not tend to complain. If your practice can meet your patients’ expectations then your patients will more than likely react favorably by continuing their relationship with your practice, and perhaps even recommend your practice to a friend. The best method to gauge your patients’ opinion of their experience is to ask them, and by far the most cost effective method of achieving that is by a properly constructed and thoroughly analyzed patient satisfaction survey.
The Objections to a Patient Satisfaction Survey
Certainly, there are what some see as “legitimate” objections to the patient satisfaction survey. Certainly high on that list would be the issue of cost. If your practice is a member of a medical malpractice insurance organization, it’s possible that the administration and analysis of a patient satisfaction survey is a member service, available to the practice for no additional cost. If not, there are independent consulting firms that can work with your practice to design and analyze a survey. Additional costs that would be incurred would include staff time necessary to distribute and collect the survey.
The Brookdale University Hospital and Medical Center is one of New York’s most innovative hospitals on the forefront of health IT. As one of Brooklyn’s largest voluntary nonprofit teaching hospitals with 530 inpatient beds and a regional tertiary care center, Brookdale provides general and specialized inpatient care to hundreds of thousands of people every year. In addition, the medical center provides 24-hour emergency services, numerous outpatient programs, and long-term specialty care. Brookdale is one of Brooklyn’s largest, and most experienced full-service emergency departments and a regionally recognized Level I Trauma Center that receives more than 100,000 visits a year.
Brookdale University Hospital and Medical Center has come to rely on two main resources to seamlessly and securely access patient data and medical history.
Brooklyn Health Information Exchange (BHIX) is a Regional Health Information Organization (RHIO) devoted to developing, deploying, operating and promoting innovative uses of health information technology to facilitate patient-centric care in Brooklyn and surrounding areas. BHIX was established in 2007 as a community-driven collaboration between providers and payers interested in improving patient care across healthcare settings.
RHIOs, such as BHIX, maintain medical records that are continually updated by participating healthcare providers, who can then access the accumulated data with a patient’s consent.
As one of the largest and busiest full-service emergency departments in Brooklyn and a regionally recognized Level I Trauma Center with more than 100,000 visits a year, Brookdale University Hospital and Medical Center has a demonstrable need to instantly and securely access accurate patient data from a multitude of sources. In an emergency situation, access to critical patient data such as medical history, medication usage, and allergies can often make the difference between life and death.
One of the greatest sources of information that depicts the changes in health IT trends across the industry landscape is from Michael Lake, healthcare technology strategist. Through his monthly reports on the state of health technology, published by his company Circle Square, he provides succinct highlights from throughout the last month. Possibly, what’s best about these reports is that they cover such a diverse segment of the ecosphere.
For example, in one of his most recent reports, the focus was the EHR vendor sphere, cloud EHRs and their importance to independent practices, the use of faxes in hospitals, vendor news and transactions and practice portal insight, among other news.
According to his most recent report, cloud-based EHRs with integrated billing are quickly becoming a key to a practice’s future success as an independent practice. In his report, he cites Black Book as ranking solutions that seamlessly integrate electronic health records (EHR), revenue cycle management (RCM) and practice management (PM). Kareo tops on the list, per KLAS.
However, most practices feel that billing and collections systems and processes need upgrading (87%) and more than 40 percent (42%) are considering an upgrade to RCM software in in the next year . Most practices (71%) are considering a combo of new software and outsourcing services for improvement.
Guest post by Laura Kreofsky, Principal Advisor at Impact Advisors.
It is no surprise many hospitals and eligible professionals are “heads down” on meaningful use Stage 2 preparations. EHR upgrades, evaluating performance against increased thresholds for carry-over objectives from Stage 1, and delving into the technical, procedural and workflow complexities of many new objectives has caught many providers off guard, particularly those for whom meeting Stage 1 was a relatively easy goal.
Two very challenging areas for Stage 2 for most eligible hospitals (EHs) and eligible professionals (EPs) are the objective “Summary of Care Record at Transitions of Care (ToC)” and those that relate to Public Health reporting.
For these objectives, it is not necessarily the performance thresholds that present the challenge, rather the EHR functional requirements, the requirements-behind-the-requirements, or the workflows that are the cause of consternation. These objectives and their unique challenges are described below:
Summary of Care Record at Transitions of Care (ToC).
This objective is challenging on two fronts. First, the population and generation of the Summary of Care Record (the “Record”), and second, the actual transmission of that document at transitions of care to intended recipients.
All change faces resistance, and the adoption of technology in healthcare is no different. Advocates speak of the advantages to quicker information access, paperless offices and speed of care. On the other side of the spectrum, technology laggards point to the physical and theoretical technology barriers during a patient exam, a perceived loss of nuance in capturing data and data security issues.
Today’s medical students are debunking the debating by adopting a modern medical approach that merges technology and a focus on patients. Coined as “patient-centric care,” future physicians are encouraging patients to be engaged in their care and live a healthy lifestyle with the aid of technology.
This fresh and engaging method of healthcare delivery, known as patient-centered care, revolves around three key approaches: shared decision-making, a care-team approach and adherence support.
Shared decision-making involves creating a more active discussion between clinicians and patients. This not only develops a mutual sense of trust and information sharing, but also leads to better outcomes. If a patient feels that the physician is speaking with him versus at him then they will be more willing to share information and widen the gateway of communication. Furthermore, the impression of physicians being the sole and final authority has been challenged by the pervasive availability of health information (accurate or not) on the Internet.
CIOs in healthcare face the constant challenge of doing more with less. Most are being asked to dramatically cut costs while continually tackling an ambitious list of responsibilities, including maintaining their organizations’ ability to demonstrate meaningful use, making the transition to ICD-10, sharing information through healthcare information exchanges (HIEs) and maintaining stringent patient privacy and HIPAA compliance programs.
Three key and often overlooked elements can help to address these tasks: document scanning, clinical language understanding and integration standards. Mastery of this electronic health record (EHR) trifecta can significantly simplify the healthcare CIO’s challenge.
Document scanning
Electronic health record adoption levels are steadily increasing, but ongoing interoperability issues result in high volumes of paper-based communications between providers. In fact, a survey conducted by the Bipartisan Policy Center in Washington, D.C., found that 71 percent of physicians identified lack of EHR interoperability and exchange infrastructure as major barriers to HIE.
Vitera and 
The two are one, the marriage underway.
