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News 8/12/19

August 12, 2019 News Comments Off on News 8/12/19

Top News

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WebMD acquires QxMD, a Canadian company that offers digital, point-of-care educational resources and medical calculators for clinicians.


HIStalk Practice Musings

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Summer’s not over yet. If you’re still looking for reading suggestions to get you through the last few weeks of vacation season, check out this list of the “10 most influential books for doctors.”

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Murder mysteries and psychological thrillers more your style? Check out the writings of Franciscan Health (IN) cardiologist Louis Janeira, MD. He has published eight books and 11 plays under the pseudonym L. Jan Eira. Fitting writing into his schedule was no easy task; he wound up hiring a driver so that he could write in the backseat during his three-hour commute. “I always knew I wanted to be a doctor,” Janeira told the local paper, “but my writing makes me feel good and ‘lights up’ a part of my brain I don’t get to do in daily life.”


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre for information.


Announcements and Implementations

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Henry Schein Medical announces GA of cloud-based, digital behavioral assessments.

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DrChrono incorporates OutcomeMD’s patient-reported outcomes tracking capabilities with its tablet-based EHR.


Telemedicine

New Hampshire Governor Chris Sununu signs a bill into law enabling primary care physicians and pediatricians to bill Medicaid for virtual visits.


Other

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This article profiles Liine, a Raleigh, NC-based startup that has developed sales lead software that sits on top of a physician practice’s phone system. The technology helps front-office staff turn prospective patients into repeat customers, identifies what service patients are calling about, and helps administrators better understand how their patients find their practices. “Phones are a black box,” says co-founder Bradley Blaser. “Doctors don’t know how many new lead calls are or what marketing channels are driving them. There’s no real process to optimize those conversations to increase their conversion rate.”


Sponsor Updates

Blog Posts


Contacts

Jenn, Mr. H, Lorre

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News 8/7/19

August 7, 2019 News Comments Off on News 8/7/19

Top News

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Menopause-focused telemedicine and wellness company Genneve raises $4 million in a seed round led by BlueRun Ventures. The three year-old startup offers its services in 23 states, and will use the new funding to expand to all 50 by the end of next year.


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Chronic care management software vendor TimeDoc Health raises $2.5 million. The Chicago-based company will use the financing to double its staff, and expand its technology to include behavioral health and remote patient monitoring.


People

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Nathan Walcker (Bank of America Merrill Lynch) joins practice management company American Oncology Network as CFO.

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Practice EHR names Chris Baltas (Fellow Health Partners) chief business development officer.


Announcements and Implementations

In Delaware, Kent Diagnostic Radiology Associates selects RCM software and services from Healthcare Administrative Partners.

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Axia Women’s Health (NJ) will offer expecting and new moms at its 115 health centers access to the Babyscripts app, which offers targeted messaging, reminders, and evidence-based educational content.

The State of Idaho implements a custom-made online youth mental health screening tool developed by FEI Systems across its network of mental health providers and clinics, and administrative services organizations.


Telemedicine

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ClearHealth Quality Institute releases draft accreditation standards for telemedicine outcomes as part of its American Telemedicine Association-approved Telemedicine Accreditation Program. Comments are due September 7. If approved, the standards will enable virtual care providers to have their outcomes measured and validated in the areas of:

  • Access to care.
  • Clinical effectiveness.
  • Clinical experience/satisfaction.
  • Financial impact.
  • Operational benchmarks.    

Other

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The local paper in Grand Junction, CO covers the work Quality Health Network is doing to integrate social determinants of health data and resources with its HIE. QHN will soon pilot its Community Resource Network in Mesa County using a $5,000 grant from the Robert Wood Johnson Foundation Social Determinants of Health Innovation Challenge, in which it is a second-phase contestant.

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The authors of this Health Affairs article make their case for the development of a standard, publicly reported measure of primary care to provide stakeholders with benchmarks; better enable them to make investment and resource decisions, and evaluate value-based care programs.

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“We’re just innocent bystanders:” Eye care professionals who have leased space within a medical building in Salt Lake City deny they are linked to the building’s owners after that group is found guilty of laundering $511 million through its businesses and real estate. News outlets have been quick to pick up on the fact that the guilty group is also part of a polygamous sect known as the Kingston Group.


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Jenn, Mr. H, Lorre

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From the Consultant’s Corner 8/7/19

August 7, 2019 From the Consultant's Corner Comments Off on From the Consultant’s Corner 8/7/19

Patient Access Centralization – Far More Complicated Than Anticipated
By Nancy Gagliano, MD

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Nancy Gagliano, MD is CMO at Culbert Healthcare Solutions in Woburn, MA.

Over the last decade, healthcare organizations have implemented centralized access centers with the promise of a panacea to improve patient satisfaction, access, volume, revenue, and all that ails ambulatory operations. Numerous articles have espoused the value of this approach. Unfortunately, organizations are struggling with numerous challenges, having underestimated the complexity involved in running a successful patient access center.

The wide variety of challenges are not easily covered in one article. This article will summarize and highlight common opportunities. Over the next few months, I’ll dive deeper into these challenges, highlighting considerations and recommended solutions. Topics will include:

  • Scheduling templates and governance.
  • Technology and telephony.
  • Staffing and service level agreements.
  • Establishing a patient access center approach.
  • Self-service – where the future lies.

“Centralized Patient Access” does not have one clear definition. In some organizations, it defines the approach to registration and insurance verification. In other organizations, it includes scheduling and referral management. In some, it also includes pre-authorizations and nurse triage. Without a clear short- and long-term vision, organizations struggle with whether this is a finance or an operations unit. When the initial foundation and governance is not clear or aligned, it leads to broader challenges as a centralized approach is expanded. In some organizations, we have seen two central access groups – one for financial-related activities and the other for patient clinical activities, creating unclear accountability. Other organizations have one center but are challenged because of matrixed responsibilities and structure.

Scheduling: A common scenario includes scheduling staff centralized into pods of expertise responsible for registering and scheduling patients. Patients, in theory, will be evenly distributed to all available providers, filling any open slots, and providing access quickly to patients, resulting in increased patient satisfaction and overall volume. While organizations are aware this works best when schedule templates are simplified with clearly documented protocols, the hard work of obtaining provider buy-in and changing their schedule templates is often not completed due to provider resistance. Without simplified schedules, the patient access center often makes errors as well as ends up with unused slots in schedules. Without easy access to talk to providers, schedulers cannot fill unused slots for “different” patient types. It is often best for central access centers to start with more general specialties, such as primary care, and then add complexity associated with specialties as the foundation for success is established.

Governance: An opportunity often underappreciated is the need for a governance model that has accountability for both the performance of the central access unit and dependent clinical operations components. For a centralized unit to be successful, a collaborative dyad between the practices and the central unit is required. An organizational approach to scheduling templates, visit times, provider availability, and bump rules needs to be defined and managed. Practices, in turn, need to be assured of appropriate staffing, training, and performance of the centralized unit. Working together through joint governance creates the collaborative approach necessary for the foundation of success.

Technology and Telephony: There are numerous third-party vendors available to support effective call center operations. Many organizations leverage telephony and provider matching systems already in place. However, for efficiency and quality, additional systems can be extremely helpful. I have seen organizations have too many systems, too few systems, poorly leveraged systems, as well as a  lack of internal expertise to maximize the use of technology.

Staffing: Appropriate staffing for call centers is quite complex. Turnover is often as high as 30% – higher than ambulatory practices. Replacement staff tend to lack training, experience, or exposure to the clinical setting, and are therefore less efficient and prone to errors. Given high turnover, most centralized call centers are short staffed, particularly on Mondays and Tuesdays, in addition to most mornings, which see peak call volumes. Appropriate staffing is also dependent on which specialties are included in the access center. The more specialized the departments are, the more complex access support is, requiring a higher level of staff skill.

Us/Them Mentality: When practices have their staffing cut to support a central unit, it commonly sets up tension between the two. Practices may want all calls to be handled centrally and are often slow to respond to calls from the call center in need of support and clarification. Practices may undermine the central unit by providing patients with a “back number” to the practices. Or practices will avoid scheduling any patients, such as follow-up when leaving their visit, and refer all scheduling events to the call center. In turn, call centers voice frustration on calls they receive that may not technically be their responsibility, such as medication refill requests or complaints that the practice hasn’t returned the patient’s calls. The antagonism is typically not anticipated or realized until the center is underperforming and improving relationships is difficult.

Patient Satisfaction: While patient satisfaction and consumerism are often a core rationale for centralized patient access centers, underperforming central access may worsen patient satisfaction. Poor response times, handle times, errors, and lack of expertise may lead to dissatisfied patients who find back channels to the practices to get their problems solved. Subsequently, providers and practice leadership, vent their frustrations to organizational leadership.

Referring Providers: An effective patient access center is designed to efficiently handle referrals to minimize leakage and reduce the work by outside practices to schedule their patients. Unfortunately, many call systems are still working through faxed referrals, resulting in only about half of the requests ending in actual patient visits. To complicate matters, most organizations do not have an efficient tracking process to inform referring providers of complete or incomplete referrals.

Cascade of Challenges: The result of an ineffective patient access approach is a cascade of challenges. The central patient access center is challenged in meeting call demand and is fraught with scheduling errors. The practice staff spend time cleaning up schedules, rebooking patients, and dealing with frustrated patients. Because practice administrative staff numbers have been transferred to the central unit, the time spent in “clean-up” precludes practice staff from supporting in-office patient flow and other patient needs. Subsequently, providers are less efficient, frustrated with the central unit, and often request being removed from the central until. The overall result is frustrated patients, providers, practice staff, and access staff without significantly increasing access, productivity, or reducing costs.

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If operating a superb patient access center isn’t challenging enough, most organizations initially set up their centers for phone-based interactions with patients. Now access centers are transitioning to multi-channel communications, because patients want the ability to communicate by phone, text, email, and chat. The next goal for organizations is to support patient and referring provider self-service. However, without setting the above foundations, self-service will only be a vision for the future rather than a near-term reality.

In summary, operationalizing a patient access center is extremely challenging and many organizations are looking for ways to improve performance, patient satisfaction, and provider engagement. While there are no quick fixes, organizations should assess their vision, governance, provider scheduling approach, technology, and staffing. Stay tuned for deeper dives into these topics.


Contacts

Jenn, Mr. H, Lorre

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News 8/5/19

August 5, 2019 News Comments Off on News 8/5/19

Top News

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Ambulatory health IT reseller and consulting company DAS Health acquires the WRT collection of companies, which includes WRT Specialties, Easy PC Solutions, EasyMed Billing, and Systech Solutions. It’s the company’s fifth acquisition in the last year.


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre for information.

Check out the recording of last week’s webinar from Mercy Technology Services titled “Modern Imaging Technology for the Enterprise: Improve Imaging Cost, Speed, Capacity and Care Quality.” Mr. H called it “among the best ever.”


Acquisitions, Funding, Business, and Stock

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Imaging center and software company RadNet uses assets from newly acquired Nulogix to launch a division focused on developing, acquiring, and investing in AI technologies that better enable image interpretation and radiology business processes.


Announcements and Implementations

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DirectTrust announces that more than 1 billion messages have been sent and received using its secure messaging system since it began tracking transmissions in 2014. The milestone follows last week’s news that the nonprofit is developing a standard for secure instant healthcare messaging.

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Workit Health, an addiction care company that offers its programs and services through telemedicine, will open a brick-and-mortar clinic in Kern County, CA. It received grant funding last month from the Center at Sierra Health Foundation to expand its services in California, and start pilot projects with emergency departments in certain counties.

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Choices Counseling Center (OR) selects EnSoftek’s behavioral health-focused DrCloudEHR.


Government and Politics

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Ohio Governor Mike DeWine announces that the state’s PDMP has reached record utilization levels, recently surpassing 1 million daily queries on two separate occasions. In 2016, Ohio became the first state to offer direct integration of its PDMP into EHRs and pharmacy dispensing systems free of charge.


Telemedicine

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Baton Rouge, LA-based startup Relief Telemed raises $150,000 in a family-and-friends seed-funding round. Co-founder and CEO Vishal Vasanji is also the co-founder of Patient Plus Urgent Care. CMO Ronald Andrews, MD is the owner of Pediatric & Internal Medicine Associates in Baton Route. Vasanji says the company just signed its first payer, and that eight clinics in and around the city are using the company’s software. He added that practices will eventually be able to buy a white-label version of the technology.


Sponsor Updates

  • Nordic will exhibit at the CORE Conference August 5-7 in Salt Lake City.

Blog Posts


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk.

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News 7/31/19

July 31, 2019 News Comments Off on News 7/31/19

Top News

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This JAMA editorial highlights the fine line pediatricians must walk when engaging in portal messaging with parents. The physician authors point out that in one large group practice, the average pediatrician responds to 10 portal messages a day – none of which are eligible for reimbursement and all of which likely add to administrative burden and burnout. Additional challenges include managing patient expectations when it comes to response times, and taking the right tone so responses aren’t misconstrued. The authors recommend that physicians:

  • Develop standards and establish expectations for what constitutes a reasonable period between a parent’s message and a physician’s reply.
  • Create guidelines for parents about what types of concerns are appropriate for a message as opposed to a telephone, video, or office appointment, and how quickly parents should expect a response.
  • In a group practice setting, develop templates to enhance the consistency of written instructions.
  • Create electronic in-basket coverage structures and cohesive expectations for how thoroughly covering clinicians should address issues.
  • Train other clinicians to be part of a team that addresses portal messages from parents.

HIStalk Practice Musings

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Pure literary torture: The Booker Prize includes Lucy Ellman’s “Ducks, Newburyport” in its list of finalists. The book is actually a single sentence that runs over 1,000 pages. Just typing that reminds me of the pain I felt trying to get through “Moll Flanders” in high school. Chapters, not to mention full stops, were created for a reason!


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre for information.


Announcements and Implementations

BetterPT incorporates patient engagement and telemedicine tools from BlueJay Mobile Health into its patient app, which features provider search and appointment scheduling capabilities.


People

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Patient check-in company Clearwave names Mike Lamb (SimplyWell) CEO.

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Shailendra Sharma (Nuance) joins Precision Point Specialty Analytics as president.


Other

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They’re coming for you, Claire’s: Rowan launches at-home ear-piercing services in New York and Connecticut, cutting out the mall middleman and ensuring the blood-drawing rite-of-passage is done by a licensed nurse. The company’s real bread and butter will come from its subscription service, which offers monthly boxes of earrings and tween-friendly trinkets. Founder Louisa Schneider says RNs will be key to the company’s success: “We found that nurses were very interested in an opportunity to earn another stream of income that did not involve things like end-of-life care or home care. This is typically a fun experience for them. It’s a celebration.”

This article about medical students serving on the Little League World Series medical team reminds me how much I’ve enjoyed reading about Dr. Jayne’s adventures at the World Scouting Jamboree. I’d love to hear from any readers that may have served in similar capacities at large gatherings like these. Any Olympic or Paralympic clinicians out there? Email me with your anecdotes.


Sponsor Updates

  • AdvancedMD will exhibit at APA2019 August 8-11 in Chicago.
  • Culbert Healthcare Solutions will exhibit at West Coast CORE August 7-9 in Salt Lake City.
  • LightSpeed Technology Group achieves SOC 1 and SOC 2 Type 2 attestation.

Blog Posts


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk.

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