PM Software: Making a Physician’s Many Hats Fit

Starting a new practice can seem like an overwhelming undertaking. Instead of simply focusing on their clinical practice, independent physicians must also become experts in marketing, finance, human resources, and coding/billing.

Suffice it to say, it’s not easy, and with limited resources, where to invest first can become a difficult choice. Advertising, nicer furniture, and experienced staff members are all important, but when looking for both short- and long-term return on investment, practice management software is the wisest purchase.

While there is (still) considerable unrest around the adoption of EHRs, PM systems have never met such resentment. Why? Because PM software fulfills a more immediate need for independent practices.

One of the greatest complaints about EHRs is the software’s inability to integrate with clinical workflow. PM software handles this smoothly. It’s customary for these products to manage patient scheduling, which frees up front office staff to actually engage with patients once they walk in the door.

Certain PM platforms even offer room assignment functions, further reducing confusion around exam room availability and actually cutting wait time for patients – a key metric that’s tied to patient satisfaction.

Speaking of staff, PM software helps increase employee efficiency by automating a number of tasks including scheduling, intake, and other administrative responsibilities. If you’re opening your own solo practice, it’s likely you won’t have an army of nurses backing you up (at least not at first). Therefore, it’s important to provide the staff you do have with tools that let them accomplish more in less time.

Once your first staff members are trained, you now have an IT infrastructure that can scale with the growth of your practice.

But PM software isn’t just about administrative tasks. Remember all those different hats that independent physicians have to wear? This software helps make them fit.

Take finance. Instead of using different accounting software to track all of your expenses, PM programs often have billing features that measure the financial performance of your practice. Top products will produce finance reports that visualize the fiscal health of your practice, which saves you from endless spreadsheet analysis.

And to help make sure those financial reports aren’t a series of pending accounts, some PM solutions feature advanced billing functions, including claims scrubbing. The most common reason claims are rejected is human error in the coding process – some pertinent piece of information was left out or a procedure was entered incorrectly, perhaps due to a typo.

Claims scrubbing software reviews each of your submissions and “cleans” them, meaning it checks coding against industry standards and autocorrects any inaccurate or incorrectly entered information. This greatly reduces the chance that your claims will be denied based on an erroneous keyboard click.

PM software also talks to a number of diagnostic devices, such as MRIs or X-rays. This quick transfer of information makes it simple to access relevant patient documents, even if you’re not using an EHR.

In short, PM software simply makes sense for independent physicians – especially solo docs. It streamlines a number of processes through one central platform, and it makes running a small practice, for lack of a better word, manageable.

Zach Watson is a senior research analyst at TechnologyAdvice.

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Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

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DOCtalk with Dr. Gregg 10/30/14

Portals and Virtual Visits and Engagement … Oh My!

This is a special time of year for our little practice. We opened our then-brand-spanking new office on Halloween 2006. And on that day, apropos to the occasion, our office was filled with ghouls and goblins, warlocks and witches, jack-o’-lanterns and Sponge Bobs. We had, as Dorothy would say, an office filled with "lions and tigers and bears…oh my!"

Eight years on, as we prepare for our anniversary celebrations, it occurs to me that our lions and tigers and bears have been replaced.

Owing in large part to the techno-geek who runs the joint, we’ve always been inclined toward gadgets and gizmos of the electronic sort. From digital scales and stadiometers to electronic vision screeners and audiometry tools to touchless everything and antibacterial fabrics (for contagion control) to implementation of Universal Design concepts and workflow planning from pre-Day One – we’ve employed all kinds of jazzy tech.

Obviously, the use of HIT/EHR/EMR/computers was part and parcel of this digital development, again from pre-Day One. For a while, those tools were pretty "wow, cool," but they’ve pretty much moved into the passé phase of their impressiveness. The New HIT Kids On The Block are now fully patient-facing … and the early results, at least anecdotally, are very much a resurgence of the "wow, cool."

To be honest, patient engagement tools seemed a little scary, not because engaging patients was boo-ful, but because of the whole "OMG, another workflow processes change" thing. But, our experience with patient engagement has been nothing but positive, from both sides of the patient-provider coin. Sure, it takes some effort, as does any change to workflow and "thoughtflow." And it takes some willingness to experiment and adapt to successes and not-so-successes.

For instance, we found that all the marketing and signage and balloons and streamers in the world don’t hold a candle to the power of office staff talking to and encouraging each and every patient/parent to interact with the portal, to sign up and to actually use it. And, the more we think to communicate via our "online care center," the more our families think to use it, both in response to us and in initiation of conversations.

Personally, I was concerned that using a patient portal would demand more from us and be less efficient than our tried and true communication workflows – i.e., telephones, letters, and faxes, basically. Nothing could have been less true. I love using the portal, when appropriate, and find that I’m actually interacting more with my families and feeling less stressed about keeping up with provider-patient communications than ever before! It probably helps that we found an absolutely beautiful patient portal tool that’s as easy on the eyes as it is to use. It’s so nice that almost every day I get some parent commenting on how much they love it. It’s definitely as, if not more, efficient than other communication methods. Plus, I think it’s made me more responsive and more communicative. I honestly think it’s made me a better healthcare provider.

Building on the success of this newfound satisfaction with better communication, we’ve also decided to start offering virtual visits to our families. We’re just rolling this out, but from the results of preliminary informal surveys of many of our families it appears that many, if not most, would be interested in having the online visit option, when appropriate. "Save time, save gas, save money." I can’t say yet how well the rollout will actually work, but again we found a really great, and affordable, HIPAA-compliant tool and our test runs have been superb. (And it helps that the development folks behind the virtual visit tool, just like the teams behind our patient portal and our wonderfully usable EMR, are just fantastic!)

And, remember, this is all in a small practice in rural, little Nowhere, Ohio, with a Medicaid population of over 40 percent. We’re not talking big-city, techno-savvy, Starbucks-drinking, cutting edge-concerned, modern-day Yuppies. We’re talking salt of the earth, small town types, many of them farm folks. It appears that folks all over are open to better healthcare communication options. (Duh.)

It’s funny: Our patient engagement efforts appear to have the power to engage us providers right along with our patients/families. Thus, this Halloween, it’s far less spooky in our office with portals and virtual visits and engagement … oh my!

From the trenches…

“Once I had brains, and a heart also; so, having tried them both, I should much rather have a heart.” – The Tin Man (L. Frank Baum, The Wonderful Wizard of Oz)

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

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Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

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News 10/30/14

Top News

Talk about multitasking: An ONC blog post says that National Coordinator Karen DeSalvo, MD will continue to lead ONC while under reassignment as Acting Assistant Secretary of Health, explaining that she will continue to chair the Health IT Policy Committee and work on ONC’s Interoperability Roadmap. I hope DeSalvo doesn’t find herself caught in the classic multitasking trap of doing too many things at once, and none of them very well. At a time when the public is ridiculing the White House’s choice of an “Ebola Czar” and wondering when a permanent Surgeon General will be named, the ONC’s move is none-too reassuring.

HIStalk Practice Announcements and Requests

I felt like crawling into the Serenity Pod bed once I finally made it back home from MGMA last night. I didn’t quite win enough in Las Vegas to cover the $10,000 Skymall price tag, so my usual bed had to suffice. After a good night’s sleep, I had time to further ruminate on my MGMA experience. Not once did I hear any discussion of ONC’s personnel shuffle, leading me to believe that physicians in the trenches have better things to worry about than who’s winning at musical chairs in Washington.

I did see one exhibitor prepared to give away an Apple Watch once it’s released early next year, but FitBits, iPads, and various gift cards were the trendy giveaways. If you’re a FitBit fan, check out Lt. Dan’s write up on the company’s next generation of activity trackers. Unless you’re an Apple junkie, the FitBit Surge might be the better deal if you’re looking for Apple Watch-like features at a lower price point.

Webinars

November 5 (Wednesday) 1:00 ET. Keeping it Clean: How Data Profiling Leads to Trusted Data. Sponsored by Encore, A Quintiles Company. Presenters: Lori Yackanicz, administrator of clinical informatics, Lehigh Valley Health Network; Randy L. Thomas, associate partner of performance analytics, Encore, A Quintiles Company; Joy Ales, MHA, BSN, RN, senior consultant, Encore, A Quintiles Company. Data dictionaries, organizational standards, and pick lists for data entry fields may describe the intent of a particular data field, but don’t guarantee that the data captured in the source system actually reflects that intent. Data profiling is the statistical analysis and assessment of the data values in source systems for consistency, uniqueness, and logic to ensure that the data landing in a data warehouse or analytic application is as expected. Attendees will learn which projects benefit from data profiling and the resources needed to accomplish it.

November 12 (Wednesday) 1:00 ET. Three Ways to Improve Care Transitions Using an HIE Encounter Notification System. Sponsored by Audacious Inquiry. Presenters: Steven Kravet, MD, MBA, FACP, president, Johns Hopkins Community Physicians; Jennifer Bailey, senior director of quality and transformation, Johns Hopkins Community Physicians; Robert Horst, principal, Audacious Inquiry. Johns Hopkins Community Physicians reduced readmissions and improved quality by implementing a real-time, ADT-based encounter notification system (ENS) to keep the member’s healthcare team informed during transitions in care. Johns Hopkins presenters will describe the clinical, operational, and financial value of the ENS for care coordination along with its technology underpinnings.

Acquisitions, Funding, Business, and Stock

Mednax acquires NEXus Medical Group (GA) and its Meridian Anesthesia Consultants subsidiary. Terms of the deal were not disclosed. The transaction marks the ninth for Mednax this year.

Booz Allen Hamilton acquires population health informatics company Epidemico to further develop analytics offerings in population health. I won’t go so far as to surmise that BAH is jumping on the Ebola-outbreak bandwagon, but it is worth noting that Epidemico’s HealthMap software tool is designed to track more than 200 infectious diseases globally. Do they know something we don’t?

Announcements and Implementations

Diagnotes joins the Allscripts Developer Program to integrate its mobile communication system for medical groups with existing Allscripts products.

AMA introduces the Health Workforce Mapper, an interactive tool that illustrates the locations of the healthcare workforce in each state, including professional shortage areas, hospital locations, and other related workforce trends. This seems like it will be a useful tool at the med school level in combatting the physician shortage that was much discussed at MGMA. I’d like to see AMA (or some other industry organization) take this one step further and overlay healthcare IT workforce data on top of physician information. This could potentially give vendors a good idea of where to find job candidates with clinical experience.

MedicalMine Inc. partners with Bluefin Payment Systems to offer an integrated payment and security solution through its ChARM EHR, PM, and billing solution.

Spring Creek Family Medicine (VA), part of the Martha Jefferson Hospital network, goes live on the My Martha Jefferson Clinic Record patient portal from eClinicalWorks. SCFM’s Andrew Hawkins, MD doesn’t seem too thrilled: “It’s just another layer and unfortunately, for better or for worse, nowadays, we’re on the computers a lot and so that allows people that use the computers in that way to be able to better access their system.”

ADP AdvancedMD launches a patient portal, financial dashboard, and mobile e-prescribing capabilities.

Truven Health Analytics announces an agreement with Cerner that enables it to resell the Micromedex CareNotes product. The patient education resources in CareNotes will be accessible from Cerner’s EHR by clinicians in acute care and ambulatory facilities.

Research and Innovation

Google is developing a pill containing miniscule nanoparticles capable of searching the body for disease with a goal of providing patients with early warnings leading to proactive treatment strategies. The company is also working to develop an accompanying small, wearable device capable of attracting and counting the particles, and alerting the user if something is found. The lead molecular biologist on the project has high hopes for its outcome: “Every test you ever go to the doctor for will be done through this system. That’s our dream.”

MolecularMatch Inc. launches a beta software system for oncologists to help them connect cancer patients with appropriate FDA-approved treatments and clinical trials based on the molecular make-up of the patient’s disease. The software uses technology licensed from MD Anderson Cancer Center (TX).

An MGMA survey of 1,000 medical practices finds that around 85 percent of them think Medicare’s quality reporting programs detract from patient care and reduce physician productivity. More than three-quarters of respondents say the programs are too complicated, irrelevant to specialty care, expensive to implement, and include unachievable thresholds.

Government and Politics

The House Science, Space, and Technology Committee subpoenas former US CTO Todd Park to testify on November 19 about security lapses on Healthcare.gov. Park has refused to testify before the committee on five previous occasions. The subpoena was issued on the same day the committee released a 59-page report contrasting HHS emails to what Park has said he knew about security flaws before the website’s launch.

Other

IBM donates communications technology in Nigeria and Sierra Leone to create a public platform for sharing certain Ebola data. The company has helped create phone lines that people can call or text to ask for supplies, request an ambulance or burial services, and even to report power outages. Researchers at IBM’s Africa Lab in Kenya are using the data to create a map showing where relief efforts are most needed.

Sponsor Updates

• Allscripts partners with ScriptSave to deploy innovative capabilities that can promote patient adherence
• EClinicalWorks selects Exostar’s ProviderPass to expand its EHR product line to include electronic prescribing of controlled substances.
• Allscripts launches Sunrise Mobile Care for its Sunrise EHR to deliver medication, order, and result data to the mobile devices of clinicians.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

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From MGMA 10/28/14

My third and final day at MGMA started off with a session on “Practice Sustainability in an Age of Uncertainty,” featuring moderator Anders Gilbeg, senior vice president, MGMA government affairs; Susan Turney, MD, former CEO of MGMA and current CEO of Marshfield Clinic Health System (WI); and James Madara, MD vice president and CEO, AMA. The giant hall in which it took place was maybe half full, leading me to wonder how the rest of MGMA’s members were spending their morning. (No doubt they slept in after a fun night out courtesy of the many vendor parties that took place the night before.) Whatever the case, I settled in to hear the three touch on healthcare’s affordability problem, the plight of small physician practices, how to build better relationships between hospitals and practices (a question that got a laugh from the audience), and how to stem the physician shortage.

Technology came up a few times, mainly in the form of telemedicine and mobile health tools. When addressing the potential demise of the small physician practice, Turney explained that practices have to be inwardly focused and progressive, with technology being a key component.  She seems to feel that practices can’t wait for government or payers to catch up when it comes to reimbursement for using mobile technology. She added that, “If we do the right thing, the payment system will follow.” I find that a little hard to believe. Yes, payment reform might come about, but how long will it take? Can physicians barely keeping their doors open afford to wait for payers to catch up to what’s “right?” Time will tell whether her optimism is naïve or right on point.

I then buzzed around the exhibit hall for about an hour, taking in one last round of vendor offerings. I was pleased to see many of our sponsors proudly displaying their HIStalk signs. Contrary to my experiences at HIMSS and HFMA ANI, the last day of the exhibit hall at MGMA seemed to be bustling. I had expected to find sales reps nose deep into their phones, but most were busy engaging with attendees, one of whom was in a kilt, oddly enough.

Note to vendors: A smile and direct eye contact will get you everywhere. I still do not understand the absolute rudeness some vendors feel it is ok to exhibit to those whose conference badges don’t scream prospect or customer. One look at my press badge and a few sales reps brushed me off without a backward glance.

Others, like Sheri Blaho at CS3 Technology, were happy to chat with me for a few minutes. (CS3, by the way, is a consulting firm specializing in ERP software implementations.)  I also had the opportunity to chat with Todd Occommy, MD at the Doctor on Demand booth. The company has been in the news of late thanks to nabbing an additional $21 million in investment money. Todd told me that attendee interest in the company’s white-label and co-branded telemedicine services was good, adding that a team from a large multispecialty practice in Texas had shown great interest just before I showed up.

I had the good fortune to run into HIStalk Practice contributor Micky Tripathi, president and CEO of Massachusetts eHealth Collaborative. I snagged the picture below just before he co-presented on “Getting Quality Reporting Under Control: Meaningful Use and Beyond” with MAeHC client Paul Bergeron, MD, CMO, Central Massachusetts IPA. The presentation didn’t touch too much on Meaningful Use, instead focusing on CMIPA’s journey to building a data analytics warehouse for the use of its member physician practices. (Many physicians in the state have been on EHRs since 2005, which has given them a comfort level with healthcare IT reflected in new statistics that show positive EHR-related gains in safety, quality, and decision making.) 

Based on the number of audience questions at the end, I’d say their presentation was a success. Most questions revolved around how to manage the sticky situation of who pays for what in an IPA-led IT implementation, and how to fairly distribute quality-based incentive payments fairly. As Paul reiterated a few times, the safe answer to both is “there’s no one size fits all.”

My last, and perhaps most enlightening conversation of the show came when I decided to rest my feet next to those of the CEO of an orthopedics practice in Texas. She was at the show specifically looking for a new SEO marketing firm to better raise the practice’s online visibility. My, what a story she had to tell about her practice’s recent conversion to Allscripts from Phoenix Ortho, which provided terrible customer support and user interface. While she didn’t use the word “nightmare,” the ensuing litigation between Phoenix Ortho and the practice likely keeps her up at night. Her staff seems happy enough with Allscripts, though she calls her physicians “click busy” due to the numerous amount of clicks it takes them to get anywhere. She stressed that it’s much better than the Phoenix Ortho EHR, which displayed a patient’s left knee when users clicked on a right shoulder.

The clock struck 12 pm, at which point I hustled to the airport to catch my flight home. All in all it was an enjoyable experience. I appreciated getting up close and personal with physicians, sponsors, and readers. Did you attend the show? What were the highlights for you? Email me and we’ll compare notes.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

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News 10/28/14

Top News

Leading health groups decry the mandatory quarantine imposed by New York and New Jersey on health workers returning from the Ebola epidemic in West Africa. Representatives from the AMA; Medecins sans Frontiers; Infectious Diseases Society of America; Association for Professionals in Infection Control and Epidemiology; and AIDS activists, researchers, and doctors have all issued statements taking politicians in both states to task for not basing their quarantine decision on solid, scientific evidence. Johns Hopkins School of Public Health Dean Michael J. Klag, MD, MPH has added his voice to the outcry via a letter to NJ Governor Chris Christie criticizing the quarantine.

HIStalk Practice Announcements and Requests

Today’s post is a bit briefer than usual, given that I’m in Las Vegas covering MGMA 2014. Catch up with what’s happening at the show via my 10/26 and 10/27 updates. You’ll find lots of show-floor pictures, attendee insight, and exhibit hall trends. I’ll post the third and final installment on 10/28.

Webinars

November 5 (Wednesday) 1:00 pm ET. Keeping it Clean: How Data Profiling Leads to Trusted Data. Sponsored by Encore, A Quintiles Company. Presenters: Lori Yackanicz, administrator of clinical informatics, Lehigh Valley Health Network; Randy L. Thomas, associate partner of performance analytics, Encore, A Quintiles Company; Joy Ales, MHA, BSN, RN, senior consultant, Encore, A Quintiles Company. Data dictionaries, organizational standards, and pick lists for data entry fields may describe the intent of a particular data field, but don’t guarantee that the data captured in the source system actually reflects that intent. Data profiling is the statistical analysis and assessment of the data values in source systems for consistency, uniqueness, and logic to ensure that the data landing in a data warehouse or analytic application is as expected. Attendees will learn which projects benefit from data profiling and the resources needed to accomplish it.

If you weren’t able to participate in last week’s webinar, this  YouTube video contains the complete 49-minute, Imprivata-sponsored webinar, including the Q&A. The presenters cover the DEA rule, which requires EMRs to be certified and providers to use two-factor authentication (along with other technical requirements). New Yorkers should be especially interested since the I-STOP act requires EPCS starting in March 2015. HIStalk webinar questions can be directed to Lorre.

Announcements and Implementations

Emdeon announces the completion of the transition from CaparioOne to the Emdeon One brand, and the addition of a new Advanced Denials Management service to be integrated within the Emdeon One portal. Emdeon acquired Capario earlier this year, and according to show-floor conversations with Emdeon reps at MGMA, the two teams are integrating quite nicely.

CareCloud launches Advanced CareCloud Analytics to provide visibility into a medical group’s financial, operational, and clinical performance. The company has also partnered with Precyse and HealthStream to offer their ICD-10 education program for physicians to its clients.

Palmetto Primary Care Physicians selects the eClinicalWorks EHR, and Care Coordination Medical Record for population health management.

Acquisitions, Funding, Business, and Stock

RCM and analytics services vendor MediGain LLC closes a $38 million investment transaction with Prudential Capital Group. MediGain Chairman Dinesh Bhutani notes the investment will likely spill over into helping grow the company’s business in India.

Limeade, a Washington-based startup specializing in employee health and wellness engagement platforms, secures a $25 million investment led by led by Oak HC/FT Partners of New York. The Washington state Health Care Authority signed a five-year, $15 million contract with Limeade to use its engagement platform to help HCA employees get healthier.

Government and Politics

HHS announces the four-year, $840 million “Transforming Clinical Practice Initiative” incentive grant program to move providers to value-based, patient-centered, coordinated health services, saying that healthcare IT will be a key component.

AMA President Robert Wah, MD, expresses AMA’s displeasure at the departure of Karen DeSalvo and Jacob Reider from ONC, citing the personnel shuffle as one more nail in Meaningful Use’s coffin, leaving “a significant leadership gap which could jeopardize the growing momentum around interoperability.”  

Research and Innovation

The Center for Connected Health and pharmaceutical company Daiichi Sankyo Inc. will create a mobile app that will help improve treatment adherence and medication compliance for patients living with atrial fibrillation. It will also foster feedback loops that connect physicians to the patient.

People

David Kobrinetz (Teladoc) joins U.S. Healthworks as director of telemedicine.

Other

Meneko Spigner Mcbeth, RN, wins $1 million for coming up with the winning flavor – wasabi ginger – in the Frito-Lay “Do Us a Flavor” potato chips contest. Finalist flavors included cappuccino, mango salsa, and cheddar bacon mac and cheese.

And speaking of spicy foods, Tabasco hot sauce proves to be a successful training aid for healthcare workers learning how to avoid contamination when taking care of Ebola-infected patients. As part of their training, University of Texas Southwestern Medical Center trainees rub their eyes and touch their lips after they finish removing their protective gear. If they receive no tingling or stinging sensation, they know they have safely removed their gear and avoided contamination. I don’t think I’ll ever look at Tabasco the same way again.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

More news: HIStalk, HIStalk Connect.

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