By Samant Virk, MD, CEO and co-founder, MediSprout.
Ask a doctor why he or she decided to go into the field of medicine and their answers vary. Many want to help people and they have personal stories like a sick parent that motivated them to become a physician. Others may come from a long line of doctors in their family and it’s a real point of pride. But, one thing is very clear, you likely won’t find a doctor who answers that question with, “So I could deal with insurance companies or get great at filling out the electronic health record (EHR).”
The cold truth is that in 2019 doctors spend more time filling out paperwork, playing phone tag, navigating federal and state mandates, and dealing with medication authorizations than they do helping their patients. Doctors spend only a fraction of their time actually building a better doctor/patient relationship and treating people. It’s hard to pinpoint when the doctor/patient relationship inextricably changed. But it’s estimated that doctors today spend just 27 percent of their time with patients.
Perhaps the biggest disappointment in healthcare is technology. We’ve all heard the “Oh how wonderful this new system is, it will change your world and healthcare for the better.” Rather than help us be better doctors who are able to assist a greater number of patients more effectively, it has created barriers and reduced our impact, interfering with one of the most essential parts of healthcare in which we were trained — communicating with our patients.
That’s because the technology is actually designed to reduce costs by leveraging data collected from government-mandated EHR rather than toward actually making patients feel better by addressing their medical needs.
Just like Uber disrupted the taxi industry and fintech is disrupting financial services, our practices need disrupting, too. And I believe it should be an inside job. Start-ups with 20-something computer geniuses are clearly brilliant, but the start-up model of launch, fail, re-launch won’t work for doctors. In healthcare, there is little room, or tolerance, for error.
The implementation of electronic health record (EHR) is not a new thing in the industry. The digital wave has completely transformed the way medical records were maintaining before and now. With increased demand for efficiency and faster solutions, more and more medical practices are embracing EHR to simplify and organize their data storage process. Initially, many providers were reluctant and hesitant to use EHR. However, with Medicare and Medicaid incentive programs, providers are encouraged to adopt EHR. As a result, since the time EHR implementation began in 2009, around 73 percent of providers have registered for the EHR incentive program.
However, still, some challenges hinder EHR adoption and slow down the process for many. The initial implementation may be easy, but the user experience was not a good one for many.
Here are some of the obstacles that medical practices, healthcare professionals and others from the healthcare industry face while leveraging EHR:
DocuTAP crafts on-demand healthcare software and services that make over a thousand urgent care clinics run efficiently. We design a tablet-based EHR and PM, offer RCM services, and refine patient workflow.
A better urgent care experience.
In May of 2000, DocuTAP’s founders realized that wireless devices would play an increasingly important role in the delivery of healthcare. From that day, DocuTAP software was designed for use on handheld wireless devices. Founding CEO, Eric McDonald dreamed up the idea behind DocuTAP in his basement back in 1999. Eric spent his time consulting with physicians. In 2000, Eric officially started DocuTAP as a company with the help of angel investors. Today, he leads client relations and provides company direction and vision for technology and product design while being viewed as a thought leader in the urgent care industry.
DocuTAP works with urgent care clinics to provide a range of solutions and services including electronic health records, practice management, patient engagement solutions, analytics, billing services and consulting. As the healthcare industry continues to adopt on-demand models to serve the evolving healthcare consumer, DocuTAP provides the necessities for facilities to deliver efficient, affordable and good quality care.
The healthcare industry is changing. Patients are becoming consumers, and the healthcare consumer wants access to quick and convenient care- without booking out months in advance to still wait in multiple waiting rooms. DocuTAP serves urgent care clinics, however increasingly other healthcare verticals such as pediatrics are adopting on-demand business models increasing the different markets that are in search for the tools and solutions DocuTAP provides. As with every other industry, healthcare must now market themselves to the healthcare consumer, to not only attract visitors but keep them coming back. By keeping patients out of the waiting room with online scheduling and monitoring, allowing physicians to finish a chart completely in under two minutes, and optimizing the work flow of the front desk, DocuTAP gives urgent care clinics the resources to market all of these capabilities to consumers and deliver on these promises each and every time.
Who are your competitors?
DocuTAP has competitors that offer some of the services and solutions they offer, but not in the end-to-end capacity that DocuTAP does. Given DocuTAP’s all-encompassing service and solution offering, DocuTAP considers a few companies who offer similar services competitors.
How does your company differentiate itself from the competition and what differentiates DocuTAP?
DocuTAP’s key differentiator is they are not just a software provider, they are an end-to-end business partner. Each customer who works with DocuTAP relies on them for software, consulting, strategic advice, technical support, and expert insights. Whatever a customer needs, they are able to go to DocuTAP for, something competitors are not offering.
DocuTAP has a deep and extensive log of valuable data, available to visualize and pull out useful trends and findings that give them an edge in the market.
By Mark Weber, SVP of healthcare development, Infor.
With payer models changing, it is time to start thinking of patients as both clients and customers. Are they as satisfied with the cost of service as they are their experience and outcomes? Will they keep coming back?
With high deductible and health savings plans shifting more of the patient cost burden to their own pocketbooks, healthcare consumers are motivated to make more informed care choices. The good news, for them, is that they have a lot more options, as nontraditional players such as retail clinics, online diagnosis sites and others have entered the market. There is more information about those choices available to them, whenever and wherever they need it.
However, all of that creates more competitive pressure among providers. Patients can be an organization’s biggest cheerleaders—or biggest detractors. That means like any brand, healthcare providers must work hard to maintain loyalty to remaining successful—or even sustainable—in the industry. And technology is helping lead the transformation.
The Era of Consumerism Is Here
According to Shafiq Rab, CIO of Rush University Medical Center, “It is all coming together as the ‘day of the patient.’ We call it care where you are. Where you want it. How you want it.”
He then went on to say that while technology continues to support the era of big data, digital innovations and advances also provide healthcare’s biggest opportunity to streamline the care experience across the continuum.
EHR Is Just a Start
One of the biggest evolutions is the implementation and proliferation of the electronic health record (EHR). It has been a catalyst for more efficient, personalized care and is integral to a better patient experience.
However, if the EHR is unable to connect to disparate systems, or across facilities (especially in this era of increasing mergers and acquisitions), or between non-affiliated organizations, its value decreases as the potential for real interoperability is lost.
What healthcare organizations really need is an engine that pulls together the EHR and other systems. To have a single patient data source, organizations need to streamline the exchange and aggregation of clinical data within an organization, and between its facilities and partners. Do not forget that such an engine needs to be built with standards such as FHIR as a top consideration and can create apps that allow patients to schedule appointments via laptop, tablet and phone.
Even efficiencies a patient cannot see are key to patient satisfaction and a positive consumer experience. Such efficiencies include the processes that power everything from claims processing to supply chain to equipment maintenance. If supplies are missing or need to be tracked down, patient care and experience are compromised. Or imagine arriving at your appointment and finding the MRI machine is down. A truly integrated system will provide real-time, role-based insight to minimize risks, issues and service disruption.
As savvy consumers demand more cost transparency, revenue generation must be balanced with the constant need for cost efficiencies. As a healthcare organization, a wise endeavor is to bring accounting and cost analysis to a new level by allocating patient and department expenses, such as procedural and lab test costs. From there, you need to break down expenses by patient cohort, surgeon, procedure or provider. Imagine getting a bill from the hospital that clearly outlines charges in a manner that you, as a consumer, can easily understand. Not only does that help achieve a higher level of consumer satisfaction, but it helps the healthcare organization understand the true cost of patient care.
Though many Medicare and private payer reimbursement programs that require practices to begin moving to value-based compensation already have set sail, most small practices are still treading water near the shore when it comes to this new wave of payment models.
While admirable in their care goals, these quality care-based reimbursement programs can pose some insurmountable challenges for small providers. In fact, they require a whole new way of providing care for some practices, as well as creating new documentation of integrated data analysis, development of care coordination with other providers, payer reporting applications, and often times new technologies that can support these new provisions.
What’s more, all this change also can be quite expensive for small practices and wreak havoc on current business practices.
Set the course
No doubt about it, though, the move to value-based care is on. According to the 2015 Physician Compensation Survey, conducted by Physicians Practice magazine, 63 percent of physician compensation is currently tied to productivity; 37 percent to value metrics and 29 percent to patient satisfaction scores.
The Centers for Medicare and Medicaid Services (CMS), however, has expressed its goals of having more providers participating in value-based plans each year, with a goal of 50 percent by 2018. And it has further incentivized physician participation by specifying increasing reductions in payments for non-participation that began in 2013.
So unless they want to start leaving money on the table, practices have no choice but to take the plunge into such new compensation programs.
Lift the Anchor
Before diving in and potentially draining money and resources to participate in such programs, physicians need to look around and assess their current situation to determine how the new reimbursement model might work in their practice. For example, they need to evaluate current technology, vendors, resources and physician support to determine what changes they need to make, as well as what internal infrastructure they can use.
The long awaited road to true healthcare IT system interoperability is being implemented at Good Samaritan in Indiana, enabling the 232-bed community healthcare facility to better deliver on its commitment to delivering exceptional patient care. The system will also enable the hospital to substantially increase their practice’s revenue while containing healthcare system integration costs.
“We strive to be the first choice for healthcare in the communities that we serve and to be the regional center of excellence for health and wellness,” said Rob McLin, president and CEO of Good Samaritan. “We are proud to be the first hospital in the country to implement this great integrated health record system that will allow us to provide a much higher level of continuity of care for our patients, as they are our top priority.”
The integration is being made possible with Zoeticx’s Patient-Clarity interoperability platform that will integrate WellTrackONE’s Annual Wellness Visit (AWV) patient reports with Indiana’s Health Information Exchange (IHIE) and the hospital’s Allscripts EHR. IHIE is the largest HIE in the US, serving 30,000 physicians in 90 hospitals serving six million patients in 17 states.
Revenue Generator for the Hospital
WellTrackONE and Zoeticx will enable patient’s AWV data to flow from the application to Allscripts EHR and the IHIE system. With Zoeticx’s Patient-Clarity platform and WellTrackONE’s software, the healthcare IT integration passes on increased revenue from the Centers of Medicare & Medicaid Services (CMS) and decreased IT costs for medical facilities.
Medicare pays medical facilities $164.84 for each initial patient visit under the AWV program and $116.16 for each additional yearly visit. With the AWV integration in place, the hospital is now able to meet CMS’s stringent requirements for patient reimbursements.
It is estimated that the Good Samaritan will be able to generate $500 to $1,200 per AWV patient from follow up appointments for additional testing and referrals for approximately 80 percent of the Medicare patients that are flagged by the AWV for testing, imaging and specialty referrals within the hospital.
This subscriber number is expected to trend upwards into 2050 and will create billions in new healthcare revenue through the US as the population ages. The hospital is not charged any costs for the system until it is reimbursed by CMS.
Overcoming Healthcare System Limitations
The hospital began offering Medicare’s AWV’s a few years ago, but had to develop its own tracking protocols, which impacted its budget and staff resources. The system it had created also operated poorly, allowing hospital staff to only view about 10 percent to 15 percent of patient data.
Good Samaritan medical teams were also constrained by interoperability, having to enter new illness findings and other medical info manually and fax PDFs to other facilities where they would have to again be entered into a different system. The hospital also had all of the data contained in WellTrackONE and Allscripts’ system, but no way to integrate the two, let alone achieve that integration with IHIE. Providers were also spending valuable patient face time trying to find specific patient data buried in the EHR system.
“Our systems were working fine, independently of each other,” said Traci French, director of business development and revenue integrity. “But we could not achieve true interoperability between the two systems. The best we could do was basically reshuffling PDF documents. The next challenge was to integrate that data with the exchange. We needed to get data to providers where they needed it, when they needed it.”
In this series, we are featuring some of the thousands of vendors who will be participating in the HIMSS15 conference and trade show. Through it, we hope to offer readers a closer look at some of the solution providers who will either be in attendance – with a booth showcasing and displaying key products and offerings – or that will have a presence of some kind at the show – key executives in attendance or presenting, for example.
Hopefully this series will give you a bit more useful information about the companies that help make this event, and the industry as a whole, so exciting.
Facilitating more than five million patient visits every month, Practice Fusion’s platform is the new gold standard for ambulatory EHR technology. We can support your organization’s goals for risk adjustment, accurate coding and coordinated care management—in real time and at scale. We also partner to support clinical programs in collaboration with our physicians to improve outcomes for patients at the population level. Finally, our connectivity services provide a single point of connection to our ecosystem of over 112,000 health care professionals nationwide.
Practice Fusion is the #1 cloud-based electronic health record (EHR) platform for doctors and patients, with a mission of connecting doctors, patients and data to drive better health and save lives. A driving force in modernizing American health care, Practice Fusion is used by a community of more than 112,000 active medical professionals with over 100 million patient records under management. In 2014, Practice Fusion’s EHR facilitated more than 56 million patient visits (approximately 6% of all ambulatory visits in the US) and is the fastest growing EHR in the US.
Founded in San Francisco in 2005 and bootstrapped in a Starbucks, Practice Fusion has grown dramatically, building the largest physician-patient community in the U.S.
Services and Products Offered
Clinical data exchange, HCC code assist, digital care management
In the first real-world trial of the impact of patient-controlled access to electronic health records, almost half of the patients who participated withheld clinically sensitive information in their medical record from some or all of their health care providers.
Should patients control who can see specific information in their electronic medical records? How much control should they have? Can doctors and other clinicians provide safe, high-quality care when a patient’s preference may deny members of the medical team from seeing portions of the electronic medical record? What is the appropriate balance between individual privacy concerns and health care providers’ need for relevant data?
The Regenstrief Institute, Indiana University School of Medicine and Eskenazi Health (formerly Wishard Health Services) partnered to design and conduct the first real-world trial intended to help answer these and related questions. During the six-month trial, 105 patients in an Eskenazi Health primary care clinic were able to indicate preferences for which clinicians could access sensitive information, in their electronic medical records, such as information on sexually transmitted diseases, substance abuse or mental health, and designating what the clinicians could see.
Regenstrief informatics developers then created a system where those preferences guided what information doctors, nurses and other clinic staff could see. Patients were able to hide some or all of their data from some or all providers. Importantly, the healthcare providers were able to override patients’ preferences and view any hidden data, if they felt the patient’s healthcare required it, by hitting a “break the glass” button on their computer screens. When providers hit this button, the program recorded the time, the patient whose electronic chart was being viewed and the data displayed.
Guest post by Brian White, founder of Competitive Solutions.
Should every physician practice adopt electronic health records? Maybe not. When evaluating the transition to an EHR system, it is critical to consider the long-term efficiency of the practice. Simply put, EHR adoption will not yield operational improvements for every practice.
While many practices using EHRs increase the overall throughput of the business and enhance profitability, others struggle with adoption of the new technology – slowing operations and creating significant financial losses. Many practices repeatedly change vendors or abandon the EHR entirely after significant investment. Making the right decision for your individual practice and navigating the pitfalls of EHR implementation can be difficult and time-consuming. Maximize your potential for success by undertaking a strategic evaluation that includes the following considerations.
If your practice has not adopted EHR, is now the time to do so?
1. What are the operational benefits/detriments of adoption?
a. Will EHR allow the practice to see more patients? Or, will it cause the practice to see fewer patients?
b. Will EHR require additional labor in the day-to-day function of treating patients? (In most cases, the answer to this question will be yes.)
c. Will EHR provide the ability to track trends in patient status, statistical data or ease of access that will be more efficient and/or clinically beneficial?
Guest post by Mike Hoaglin, a fourth-year medical student at the University of Pennsylvania School of Medicine.
“Patient engagement” is a phrase that reinvigorates the doctor-patient relationship and prioritizes the patient experience. With many designers scrambling to “engage” patients in their healthcare journeys, it is easy to get lost in the chaos. But what lies at its core is simple: healthcare leaders need to find easy methods that better connect people with the environment and the technology.
One way this is already proving effective is with the smartphone physical. Led by medical students from John Hopkins and University of Pennsylvania, quick diagnostic tests using devices connected to a smartphone are changing the face of the traditional physical and begging the question as to why modern medicine struggles to become more patient-centric.
The smartphone physical uses a series of peripheral devices attached to a smartphone to measure and analyze patient data ranging from weight to blood pressure to even heart activity. Patients are then able to receive an overall health picture and potentially electronic health record (EHR)-ready results from the smartphone physical immediately after the experience. Essentially these robust handheld digital devices are re-engaging patients because they promote more personalized, data-driven decision-making at the point of care.