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The Pain of Recording Patient Risk Factors as Illuminated by Apixio (Part 2 of 2)

Posted on October 28, 2016 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The previous section of this article introduced Apixio’s analytics for payers in the Medicare Advantage program. Now we’ll step through how Apixio extracts relevant diagnostic data.

The technology of PDF scraping
Providers usually submit SOAP notes to the Apixio web site in the form of PDFs. This comes to me as a surprise, after hearing about the extravagant efforts that have gone into new CCDs and other formats such as the Blue Button project launched by the VA. Normally provided in an XML format, these documents claim to adhere to standards and offer a relatively gentle face to a computer program. In contrast, a PDF is one of the most challenging formats to parse: words and other characters are reduced to graphical symbols, while layout bears little relation to the human meaning of the data.

Structured documents such as CCDs contain only about 20% of what CMS requires, and often are formatted in idiosyncratic ways so that even the best CCDs would be no more informative than a Word document or PDF. But the main barrier to getting information, according to Schneider, is that Medicare Advantage works through the payers, and providers can be reluctant to give payers direct access to their EHR data. This reluctance springs from a variety of reasons, including worries about security, the feeling of being deluged by requests from payers, and a belief that the providers’ IT infrastructure cannot handle the burden of data extraction. Their stance has nothing to do with protecting patient privacy, because HIPAA explicitly allows providers to share patient data for treatment, payment, and operations, and that is what they are doing giving sensitive data to Apixio in PDF form. Thus, Apixio had to master OCR and text processing to serve that market.

Processing a PDF requires several steps, integrated within Apixio’s platform:

  1. Optical character recognition to re-create the text from a photo of the PDF.

  2. Further structuring to recognize, for instance, when the PDF contains a table that needs to be broken up horizontally into columns, or constructs such the field name “Diagnosis” followed by the desired data.

  3. Natural language processing to find the grammatical patterns in the text. This processing naturally must understand medical terminology, common abbreviations such as CHF, and codings.

  4. Analytics that pull out the data relevant to risk and presents it in a usable format to a human coder.

Apixio can accept dozens of notes covering the patient’s history. It often turns up diagnoses that “fell through the cracks,” as Schneider puts it. The diagnostic information Apixio returns can be used by medical professionals to generate reports for Medicare, but it has other uses as well. Apixio tells providers when they are treating a patient for an illness that does not appear in their master database. Providers can use that information to deduce when patients are left out of key care programs that can help them. In this way, the information can improve patient care. One coder they followed could triple her rate of reviewing patient charts with Apixio’s service.

Caught between past and future
If the Apixio approach to culling risk factors appears round-about and overwrought, like bringing in a bulldozer to plant a rosebush, think back to the role of historical factors in health care. Given the ways doctors have been taught to record medical conditions, and available tools, Apixio does a small part in promoting the progressive role of accountable care.

Hopefully, changes to the health care field will permit more direct ways to deliver accountable care in the future. Medical schools will convey the requirements of accountable care to their students and teach them how to record data that satisfies these requirements. Technologies will make it easier to record risk factors the first time around. Quality measures and the data needed by policy-makers will be clarified. And most of all, the advantages of collaboration will lead providers and payers to form business agreements or even merge, at which point the EHR data will be opened to the payer. The contortions providers currently need to go through, in trying to achieve 21st-century quality, reminds us of where the field needs to go.

The Pain of Recording Patient Risk Factors as Illuminated by Apixio (Part 1 of 2)

Posted on October 27, 2016 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Many of us strain against the bonds of tradition in our workplace, harboring a secret dream that the industry could start afresh, streamlined and free of hampering traditions. But history weighs on nearly every field, including my own (publishing) and the one I cover in this blog (health care). Applying technology in such a field often involves the legerdemain of extracting new value from the imperfect records and processes with deep roots.

Along these lines, when Apixio aimed machine learning and data analytics at health care, they unveiled a business model based on measuring risk more accurately so that Medicare Advantage payments to health care payers and providers reflect their patient populations more appropriately. Apixio’s tools permit improvements to patient care, as we shall see. But the core of the platform they offer involves uploading SOAP notes, usually in PDF form, and extracting diagnostic codes that coders may have missed or that may not be supportable. Machine learning techniques extract the diagnostic codes for each patient over the entire history provided.

Many questions jostled in my mind as I talked to Apixio CTO John Schneider. Why are these particular notes so important to the Centers for Medicare & Medicaid Services (CMS)? Why don’t doctors keep track of relevant diagnoses as they go along in an easy-to-retrieve manner that could be pipelined straight to Medicare? Can’t modern EHRs, after seven years of Meaningful Use, provide better formats than PDFs? I asked him these things.

A mini-seminar ensued on the evolution of health care and its documentation. A combination of policy changes and persistent cultural habits have tangled up the various sources of information over many years. In the following sections, I’ll look at each aspect of the documentation bouillabaisse.

The financial role of diagnosis and risk
Accountable care, in varying degrees of sophistication, calculates the risk of patient populations in order to gradually replace fee-for-service with payments that reflect how adeptly the health care provider has treated the patient. Accountable care lay behind the Affordable Care Act and got an extra boost at the beginning of 2016 when CMS took on the “goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to alternative payment models, such as ACOs, by the end of 2016 — and 50 percent by the end of 2018.

Although many accountable care contracts–like those of the much-maligned 1970s Managed Care era–ignore differences between patients, more thoughtful programs recognize that accurate and fair payments require measurement of how much risk the health care provider is taking on–that is, how sick their patients are. Thus, providers benefit from scrupulously complete documentation (having learned that upcoding and sloppiness will no longer be tolerated and will lead to significant fines, according to Schneider). And this would seem to provide an incentive for the provider to capture every nuance of a patient’s condition in a clearly code, structured way.

But this is not how doctors operate, according to Schneider. They rebel when presented with dozens of boxes to check off, as crude EHRs tend to present things. They stick to the free-text SOAP note (fields for subjective observations, objective observations, assessment, and plan) that has been taught for decades. It’s often up to post-processing tools to code exactly what’s wrong with the patient. Sometimes the SOAP notes don’t even distinguish the four parts in electronic form, but exist as free-flowing Word documents.

A number of key diagnoses come from doctors who have privileges at the hospital but come in only sporadically to do consultations, and who therefore don’t understand the layout of the EHR or make attempts to use what little structure it provides. Another reason codes get missed or don’t easily surface is that doctors are overwhelmed, so that accurately recording diagnostic information in a structured way is a significant extra burden, an essentially clerical function loaded onto these highly skilled healthcare professionals. Thus, extracting diagnostic information many times involves “reading between the lines,” as Schneider puts it.

For Medicare Advantage payments, CMS wants a precise delineation of properly coded diagnoses in order to discern the risk presented by each patient. This is where Apixio come in: by mining the free-text SOAP notes for information that can enhance such coding. We’ll see what they do in the next section of this article.

Has Electronic Health Record Replacement Failed?

Posted on June 23, 2016 I Written By

The following is a guest blog post by Justin Campbell, Vice President, Galen Healthcare.
Justin Campbell
A recent Black Book survey of hospital executives and IT employees who have replaced their Electronic Health Record system in the past three years paints a grim picture. Respondents report higher than expected costs, layoffs, declining revenues, disenfranchised clinicians and serious misgivings about the benefits of switching systems. Specifically:

  • 14% of all hospitals that replaced their original EHR since 2011 were losing inpatient revenue at a pace that wouldn’t support the total cost of their replacement EHR
  • 87% of hospitals facing financial challenges now regret the decision to change systems
  • 63% of executive level respondents admitted they feared losing their jobs as a result of the EHR replacement process
  • 66% of system users believe that interoperability and patient data exchange functionality have declined

Surely, this was not the outcome expected when hospitals rushed to replace paper records in response to Congressional incentives (and penalties) included in the 2009 American Recovery and Reinvestment Act.

But the disappointment reflected in this survey only sheds light on part of the story. The majority of hospitals depicted here were already in financial difficulty. It is understandable that they felt impelled to make a significant change and to do so as quickly as possible. But installing an electronic record system, or replacing one that is antiquated, requires much more than a decision to do so. We should not be surprised that a complex undertaking like this would be burdened by complicated and confusing challenges, chief among which turned out to be “usability” and acceptance.

Another Black Book report, this one from 2013, revealed:

  • 66% of doctors using EHR systems did not do so willingly
  • 87% of those unwilling to use the system claimed usability as their primary complaint
  • 84% of physician groups chose their EHR to reach meaningful use incentives
  • 92% of practices described their EHR as “clunky” and/or difficult to use

None of this should surprise us but we need to ask: was usability really the key driver for EHR replacement? Is usability alone accountable for lost revenue, employment anxiety and buyers’ remorse? Surely organizations would not have dumped millions into failed EHR implementations only to rip-and-replace them due to usability problems and provider dissatisfaction. Indeed, despite the persistence of functional obstacles such as outdated technology, hospitals continue to make new EMR purchases. Maybe the “reason for the rip-and-replace approach by some hospitals is to reach interoperability between inpatient and outpatient data,” wrote Dr. Donald Voltz, MD in EMR and EHR.

Interoperability is linked to another one of the main drivers of EHR replacement: the mission to support value-based care, that is, to improve the delivery of care by streamlining operations and facilitating the exchange of health information between a hospital’s own providers and the caregivers at other hospitals or health facilities. This can be almost impossible to achieve if hospitals have legacy systems that include multiple and non-communicative EHRs.

As explained by Chief Nurse Executive Gail Carlson, in an article for Modern Healthcare, “Interoperability between EHRs has become crucial for their successful integration of operations – and sometimes requires dumping legacy systems that can’t talk to each other.

Many hospitals have numerous ancillary services, each with their own programs. The EHRs are often “best of breed.” That means they employ highly specialized software that provides excellent service in specific areas such as emergency departments, obstetrics or lab work. But communication between these departments is compromised because they display data differently.

In order to judge EHR replacement outcomes objectively, one needs to not just examine the near-term financials and sentiment (admittedly, replacement causes disruption and is not easy), but to also take a holistic view of the impact to the system’s portfolio by way of simplification and future positioning for value-based care. The majority of the negative sentiment and disappointing outcomes may actually stem from the migration and new system implementation process in and of itself. Many groups likely underestimated the scope of the undertaking and compromised new system adoption through a lackluster migration.

Not everyone plunged into the replacement frenzy. Some pursued a solution such as dBMotion to foster care for patients via intercommunications across all care venues. In fact, Allscripts acquired dBMotion to solve for interoperability between its inpatient solution (Eclipsys SCM) and its outpatient EMR offering (Touchworks). dBMotion provides a solution for those organizations with different inpatient and outpatient vendors, offering semantic interoperability, vocabulary management, EMPI and ultimately facilitating a true community-based record.

Yet others chose to optimize what they had, driven by financial constraints. There is a thin line separating EHR replacement from EHR optimization. This is especially true for those HCOs that are neither large enough nor sufficiently funded to be able to afford a replacement; they are instead forced to squeeze out the most value they can from their current investment.

The optimization path is much more pronounced with MEDITECH clients, where a large percentage of their base remains on the legacy MAGIC and C/S platforms.

Denni McColm, a hospital CIO, told healthsystemCIO why many MEDITECH clients are watching and waiting before they commit to a more advanced platform:

“We’re on MEDITECH’s Client/Server version, which is not their older version and not their newest version, and we have it implemented really everywhere that MEDITECH serves. So we have the hospital systems, home care, long-term care, emergency services, surgical center — all the way across the continuum. We plan to go to their latest version sometime in the next few years to get the ambulatory interface for the providers. It should be very efficient — reduced clicks, it’s mobile friendly, and our docs are anxious to move to it,” but we’ll decide when the time is right, she says.

What can we discern from these different approaches and studies?  It’s too early to be sure of the final score. One thing is certain though: the migrations and archival underpinnings of system replacement are essential. They allow the replacement to deliver on the promise of improved usability, enhanced interoperability and take us closer to the goal of value-based care.

About Justin Campbell
Justin is Vice President, Strategy, at Galen Healthcare Solutions. He is responsible for market intelligence, segmentation, business and market development and competitive strategy. Justin has been consulting in Health IT for over 10 years, guiding clients in the implementation, integration and optimization of clinical systems. He has been on the front lines of system replacement and data migration and is passionate about advancing interoperability in healthcare and harnessing analytical insights to realize improvements in patient care. Justin can be found on Twitter at @TJustinCampbell

Can Online Self-Scheduling Really Change the ER and Urgent Care Experience? – Communication Solutions Series

Posted on June 9, 2016 I Written By

The following is a guest blog post by Laura Alabed-Olsson, Marketing Manager of Stericycle Communication Solutions, as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter:@StericycleComms
Laura Alabed-Olsson
As a part of the team behind online self-scheduling solution InQuicker, I am asked this question a lot. When you’re dealing with the sickest of the sick of patients, can online self-scheduling really make a difference? Yes, it can. Let’s begin by looking at things from a patient’s perspective.

Imagine you’re sick. Really sick. You haven’t showered in a day or so. You’re in your pajamas and buried under the covers in your bed. Even if your favorite ER or urgent care is the best of the best – think big-screen TV, a beverage bar and a tall stack of your favorite magazines – wouldn’t you rather wait from home than this palace of a waiting room? Online self-scheduling makes this possible. You simply go to your preferred provider’s website. Select an estimated treatment time. Provide some basic information. And then you wait from home until it’s time to be seen. It’s that easy. (You still feel crummy, but at least a little bit happy that you won’t have to wait long when you get there, right?)

Now, let’s look at it from a provider’s perspective. With online self-scheduling, you have the benefit of knowing who’s coming in, why they’re seeking care, and when they’ll arrive – giving you plenty of time to prepare space and allocate resources. Online self-scheduling supports operational efficiency, big time.

Running behind and fearful that you can’t see a self-scheduled patient at their estimated treatment time? No problem. Just let them know when you’ll be ready, so that they can adjust their timing. Then, bask in the glow of knowing that when they do arrive, they’re certain to be happier than they would have been had they been sitting in the waiting room the entire time. Talk about getting the patient-provider relationship off on the right foot!

Today’s patients want – and increasingly expect – a patient-centric approach to healthcare. Online self-scheduling supports this (along with patient acquisition and retention, operational efficiency and care coordination). In fact, across the clients that use InQuicker for their online scheduling needs, we see patient satisfaction rates that average 90 percent.

Yes, online self-scheduling really can change (and improve) the ER/urgent care experience. Do you want happy patients and happy providers? Online self-scheduling could be the answer.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality telephone answering, appointment scheduling, and automated communication services. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services. Connect with Stericycle Communication Solutions on social media: @StericycleComms

Healthcare in an E-Commerce World – Communication Solutions Series

Posted on April 14, 2016 I Written By

The following is a guest blog post by Laura Alabed-Olsson, Marketing Manager of Stericycle Communication Solutions, as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter:@StericycleComms
Laura Alabed-Olsson
These days, it seems as though I can’t pickup an industry publication, or even a major daily newspaper, without finding at least one article on healthcare consumerism. Consumers want to shop for healthcare the way they shop for TVs and cars, they say. Consumers expect cost information, quality ratings and anytime access, too, they tell us.

All of this makes me wonder: For healthcare providers that have long operated in a traditional, not so consumer-centric world, where does one begin? Results from a handful of recent surveys offer some insights:

  1. More than 40% of consumers say that information found via social media affects the way they deal with their health.
  1. 77% of consumers use online reviews, often found on sites like Yelp and Healthgrades, as their first step in finding a new doctor.
  1. 56% of consumers have actively looked for healthcare cost information before getting care; 21% of these have compared prices across multiple providers.
  1. Consumers expect the same online service in healthcare that they see in other industries, and they will switch providers to get it.

So, let’s dig in.

Insight #1: 40% of consumers turn to social media for healthcare information. This statistic may not come as a surprise, especially when you consider the number of patients sitting in waiting rooms – or restaurants or coffee shops or wherever  – with phone in hand, endlessly scrolling Facebook, Twitter or Instagram.  What is surprising is how relatively few healthcare providers are pursuing this captive audience with educational content that accurately informs consumers about health-related issues (while simultaneously addressing demands for a “connected” experience). Is your organization leveraging social media to educate and engage with patients? Perhaps it should be.

Insight #2: 77% of consumers look to online reviews when choosing a provider. To further validate this point: Did you know that Healthgrades.com, the for-profit site that shares a variety of information about physicians, hospitals and other provider organizations, gets a million hits a day? Clearly, consumers have an appetite for information on patient satisfaction and clinical outcomes. Is this information readily available on your organization’s website? If you don’t provide it, others will and, in doing so, they are poised to steer prospective patients elsewhere.

Insight #3: 56% of consumers are paying attention to healthcare costs. While the idea of comparison shopping for healthcare is a relatively new one, it’s one that consumers and providers alike must embrace (consumers, because they’re increasingly accountable for a greater share of out-of-pocket costs, and providers, because cost transparency is the new norm – and if you want to effectively compete with traditional providers, retail clinics, telemedicine, docs-on-demand and whatever comes next, you’ve just got to get onboard). Is your organization empowering patients to make thoughtful decisions? A cost estimator on your website – or even a promise to have cost information available when patients request it – could make for a great start.

Insight #4: Healthcare consumers want an online experience that mirrors what’s being offered by retailers like Amazon, Southwest Airlines and OpenTable. When consumers want to book an airline ticket or reserve a table at their favorite restaurant, they don’t have to pick up the phone and call between 9 a.m. and 5 p.m. They hop online when it’s convenient for them and, in just a few clicks, they’ve gotten what they want. Why should healthcare be any different? By offering online self-scheduling on your website, you’re giving patients 24/7 access to care – and you’re doing it in a way that is familiar and convenient for them. Does your organization offer a way for consumers to access care when and how they want to? Research suggests it should.

Healthcare consumerism requires a significant shift in how providers serve patients, for sure. But in just a few, small steps – like those mentioned here – you can be on your way.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality telephone answeringappointment scheduling, and automated communication services. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media: @StericycleComms

Small Practice Marketing Strategies Twitter Chat (#KareoChat)

Posted on April 12, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Health IT Marketing and PR Awards 2016

Last week we held the Healthcare IT Marketing and PR conference which is organized by Healthcare Scene. By all accounts, the conference ran well and the feedback I’ve gotten is that people really enjoyed the event and the healthcare marketing and PR community we’ve built. During the event, we held the HITMC Awards and Kareo won the award for Best Social Media Program. This is a well deserved honor since they put a lot of work into hosting the weekly #KareoChat.

Coming out of the conference, Kareo asked me if there were some topics from the conference that would work well for the #KareoChat audience of small practice physicians. After reviewing the sessions at the conference, I realized that there was a lot of lessons from the conference that could be applied to small practice marketing. In fact, so many of the topics could be a #KareoChat of their own. With that said, they asked if I’d host this week’s #KareoChat based on topics from the conference. So, I decided to pull together a potpourri of topics that applied well to small practices.

Kareo Chat - HITMC

Here’s a look at the topics for this week’s #KareoChat:

  1. When and why should a physician practice go through a rebranding? #KareoChat @HealthITMKTG
  2. How can you use your and your competitors’ online reviews (good and bad) to your benefit? #KareoChat @mdeiner
  3. Could small practices benefit from their own podcast? Is it worth it?  #KareoChat @GetSocialHealth @Resultant @jaredpiano
  4. How and when should small practices use visual content in their office? #KareoChat @csvishal2222
  5. How can the 4 communication preferences (Facts, Futures, Form, Feelings) help small physician practice marketing? #KareoChat @ChartCapture
  6. Where and how can we use the power of storytelling in small physician practice marketing? #KareoChat @ctrappe @stacygoebel

If you’d like to join us to discuss these topics, just follow the #KareoChat hashtag on Thursday, April 14th at Noon ET (9 AM PT). I expect it will be a really diverse and interesting chat across a wide variety of topics related to small practice marketing.

Full Disclosure: Kareo is an advertiser on one of the Healthcare Scene websites.

Consistency, Consistency, Consistency – It’s a Must in This Age of Healthcare Consumerism

Posted on March 10, 2016 I Written By

The following is a guest blog post by Laura Alabed-Olsson, Marketing Manager of Stericycle Communication Solutions, as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter:@StericycleComms
Laura Alabed-Olsson
Whether I’m visiting my favorite restaurant, online shopping from the couch, or navigating airport security (grrrr), for me, consistency counts.  In fact, it’s amazing how even the most daunting of tasks can seem more manageable when I know exactly what to expect.

Research shows that I’m not alone in my preference for predictability and familiarity, especially as it relates to consumerism.  A 2014 study of 27,000 American consumers by McKinsey & Company found that a consistent customer experience across the entire customer journey increases satisfaction, builds trust and boosts loyalty.  Similarly, a 2015 study by King Brown Partners found that 80% of people agree that consistent consumer experiences strongly impact brand perception.

You may be wondering what all of this has to do with healthcare.  Do your patients (and prospective patients) really think about shopping for a TV and shopping for healthcare in the same way? In this world of high-deductible health plans, narrow networks and walk-in clinics on every corner, yes.

Consider this:

  • 92% of consumers want more control over their personal health. [1]
  • 52% report searching online for health or care-related information. [2]
  • 91% say they are loyal to their doctor, yet 44% may change for a more convenient location and 33% may change for a lower cost. [3]
  • 67% say the overall patient experience plays an extremely important role in their decision-making process. [4]

The consumer mindset has clearly taken root in healthcare. While slashing prices or relocating to a more convenient location likely isn’t possible, thankfully, there are simple things providers can do now to deliver a consistent, consumer-centric experience that gets and keep patients.

  1. Ensure customer satisfaction during each and every encounter – and across all channels. This means having staff, protocols and supporting mechanisms (from online self-scheduling to after hours call support) in place during regular office hours and beyond. Today’s healthcare consumers expect 24/7 access and the most successful providers deliver.
  1. Communicate with patients frequently and in a way that’s convenient for them. A majority of patients believe that technology supports better care, so use it to reach out with appointment reminders, preparation and discharge instructions, preventive health reminders, and messaging that helps with disease management. Doing so supports a stress-free (and wonderfully predictable) care experience – while also minimizing scheduling gaps and boosting population health.
  1. Welcome questions (above and beyond the regular ones). This new age of healthcare consumerism can be challenging for providers and patients alike. By welcoming patient questions specific to once taboo subjects like cost, quality and alternative therapies, you’re helping build trust, loyalty and a better healthcare consumer – and that’s good for your patient, your business and the healthcare industry at large.

Yes, consistency is where it’s at…the numbers don’t lie. Are you delivering?

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality telephone answeringappointment scheduling, and automated communication services. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media: @StericycleComms

References:
[1] Ipsos, Pfizer and the National Council on Patient Information and Education, April 2015
[2] Deloitte’s 2015 Survey of US Health Care Consumers
[3] RBC Capital Markets Consumer Health & Information Technology Survey, April 2015
[4] Beryl Institute, September 2015

Managing People Is the Hardest Part of an Organization

Posted on February 18, 2016 I Written By

The following is a post by Vishal Gandhi, CEO of ClinicSpectrum as part of the Cost Effective Healthcare Workflow Series of blog posts. Follow and engage with him on Twitter @ClinicSpectrum and @csvishal2222.
Vishal Gandhi
When managing a healthcare organization, the hardest part for most leaders is managing the people involved in the practice. This shouldn’t be a surprise since “getting the right people on the bus” has always been the challenge of any successful business. Making sure you hire the right people and then ensuring those people are working at maximum efficiency often determines the success of your organization.

While we can’t quite ask Siri to take care of managing our staff for us, technology solutions can help us better manage the process of hiring the right people and managing staff productivity.

Let’s first talk about the process most healthcare organizations use to hire and on-board new staff. The reality is that the majority don’t have a well defined process. Some well organized managers do have a consistent hiring and on-boarding process, but most are just trying to keep their head above water as they bring on new people. This inconsistency can lead to hiring the wrong person and possibly even major legal consequences.

By implementing an HR management solution like we created with HRMSpectrum, it forces your organization to put some structure into your hiring process. All applicants participate in the same application process. The system allows the applicant to schedule the interview themselves. It even supports telephone, video, or in-person interviews. Could you do this with a mix of spreadsheets and other technology? Absolutely, but it can get messy very quickly. However, regardless of what technology you use, spending the time to create a well defined process is enormously valuable.

Plus, a proper HR management solution supports not only the application and interview process, but also tracks the employee as they get on-boarded with the organization. This can include such features as document signing, employee training and evaluation, employee clocking and attendance management, and performance appraisals and incentives to name a few. All of this ensures consistency and uniformity in the hiring and on-boarding process.

Once you’ve hired the right people and on-boarded them into the organization, how do you ensure that your employees are working productively? In healthcare, we know how productive a doctor is being since we can see how many patients he has on his schedule. With a productivity solution like our ProductivitySpectrum you can easily track and manage the rest of your employees’ productivity. That includes things like benchmarking and performance analysis, but also includes important time clock functionality as well. Any productivity solution you use should also prevent time spent on non-productive web browsing and social interaction online.

There’s nothing more powerful in an organization than to reward your staff for the work they do. By tracking their productivity you can identify and reward high performing individuals in your organization. Yes, that also means you’re going to find lower performing individuals. However, by tracking productivity you have the hard data to illustrate and inspire a low performing individual to improve their performance. Performance evaluations based on data are better for everyone involved.

No doubt there’s a lot more to managing people in an organization than just using the right technology. However, technology can assist managers in both the hiring and productivity tracking process. It can provide uniformity and raw data to help a manager better manage their staff. What HR and productivity management solutions are you seeing and using in your organization? I’d love to hear about them in the comments.

The Cost Effective Healthcare Workflow Series of blog posts is sponsored by ClinicSpectrum, a leading provider of workflow automation solutions for healthcare. ClinicSpectrum offers a full HR hiring and on-boarding solution called HRMSpectrum. For managing staff productivity check out ClinicSpectrum’s ProductivitySpectrum solution. Connect with Clinic Spectrum on social media: @ClinicSpectrum or at Booth 1270 at HIMSS 2016..

Finding The Perfect Match…The Hunt For A Provider Patient Relationship That Works – Communication Solutions Series

Posted on February 11, 2016 I Written By

The following is a guest blog post by Brittany Quemby,  Marketing Manager of Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Brittany Quemby - Stericycle
With Valentine’s Day right around the corner, some of my single friends are sharing the difficulties they are having while trying to find “the one.” This got me thinking about the relationships in my life where I’ve struggled to find “the one.”

Most of us put in a lot of time and consideration when choosing a healthcare provider.  If you think about it, it’s almost like online dating.  We research our physicians online, take a look at their reviews, get feedback and recommendations from friends, and meet with them to make sure it’s the right fit.  After what could be months of trying to find the right doctor we finally make a decision and bring them onboard as a trusted healthcare advisor.  You entrust them with your health, your life, and your future.  This got me thinking…are our healthcare providers taking the same amount of time and consideration when evaluating the services they provide to us?

Healthcare providers offer a number of services and contract many different service organizations when it comes to running their organizations. Everything from EHRs, to Patient Engagement tools, to Lab Facilities, to Digital Health apps, to their telephone answering service is outsourced in one way or another. I wonder, how can you ensure you’re selecting a physician who takes as much care choosing service providers and their amenities as you did choosing them?  After all, your care and health outcomes are impacted by both people in the relationship being the “right match.”

After working in the healthcare industry for several years, I treat my visit to my doctor’s office like I would a first date. I take notes, try to spot the red flags and ask lots of tough questions. Anything from which EHR they are using, to how they document my visit, how they dispose or store patient files, how they remind me for my appointment, how they route my calls, what patient educational tools they offer me, my wait-time, and even who they buy their supplies from.

Now…I am able to spot these things because I have an idea of what I am looking for and the right questions to ask.  But what about patient’s who don’t know what to look for? Do they know what they are looking for in a long term provider relationship? What are the most important characteristics to them and what are they willing to compromise?

Here are some of my deal breakers:

  • Old Equipment and Technology. It’s important to me that my provider uses the best healthcare products and services on the market that can help manage my health effectively.
  • Lackadaisical Security. It’s imperative that my health data is secure. My provider must understand the importance of maintaining secure patient information and employing vendors who are HIPAA compliant.
  • Unavailability. I get that my healthcare provider may not work 24 hours a day, but there are times that I think their service providers should. What if I need an appointment on a Saturday? What if I need to get a hold of my physician after hours? Who will take that call? A provider who I can only communicate with Monday to Friday between 9am and 4pm is a deal-breaker for me.
  • Poor Communication. I always have questions about my health and how to better maintain it. For me, my provider has to be available, approachable, caring, and communicative to serve as a consultant in my healthcare journey.
  • Makes me pay. When I am searching for the right providers, insurance is the first place I start. Does the healthcare organization accept my insurance, or will I have to pay for my services? Don’t take my insurance? Deal breaker!

Unfortunately, there is not a Match.com to help pair the right patient with the right provider….yet. (With the demands patients are putting on healthcare organizations I wouldn’t be surprised if we are swiping left or right when picking our providers in the next 5 years). However, as patients become more and more involved in their care decisions and continue to expect more from their providers I’d encourage everyone to create their list of deal breakers and ask the hard questions, and when in doubt, introduce them to your mom!

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality telephone answering, appointment scheduling, and automated communication services. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media:  @StericycleComms

Using Technology Outside the EHR to Make Your Organization More Efficient

Posted on February 9, 2016 I Written By

The following is a post by Vishal Gandhi, CEO of ClinicSpectrum as part of the Cost Effective Healthcare Workflow Series of blog posts. Follow and engage with him on Twitter @ClinicSpectrum and @csvishal2222.
Vishal Gandhi
The complaints about EHR systems not making doctors more efficient and more broadly that technology should improve a practice and not make it worse are starting to really swell. All of these poorly designed and poorly implemented EHR are giving all healthcare technology a bad name and it shouldn’t.

Technology has improved so many businesses outside of healthcare and it can have the same impact inside healthcare. We just need more practices to stop focusing on government incentive money and government regulations so they can focus on meaningful (pun intended) technology which will actually improve the performance of their healthcare organization.

This requires a major shift in thinking for most healthcare organizations. Instead of evaluating technology based on its ability to receive government incentives, you now have to look at technology that will make your practice run more efficiently, increase your practice revenue, or improve the quality of care you provide. In many cases this means looking at technology that’s been benefiting other industries for years.

A great example of this is implementing a complete workflow management system. Document workflow management systems have been around for a long time, but so many areas of healthcare are missing out on the benefits. We’d like to think that an EHR would make us paperless, but that’s far from reality. That’s especially true on the medical billing and practice management side of healthcare. A well done workflow management software like we created with WorkflowSpectrum takes your current paper based processes and makes them more efficient and trackable.

With an electronic workflow solution a healthcare organization can quickly see how well their back end office processes are running. They can track how long it takes for a process to occur. This ensures your staff are held accountable for the work they’ve been asked to do. You can easily assign and re-assign tasks to people in your office without having the files get lost or misplaced in the process. Document management options like this have been available forever, but far too many have been distracted by EHR to implement these solutions. Plus, many practices have yet to realize that even small practices can afford workflow management solutions that will dramatically improve the efficiency of their practice. The cost of these systems has dropped dramatically over the years and they’re much easier to implement as well.

Another example of non-EHR technology that could benefit many healthcare organizations is a client support and electronic device management software package. We’ve created one that we call SupportSpectrum, but there are a number of other device management and support software programs out there. These software packages provide the most value when you’re required to manage multiple devices across a wide range of locations. If you’re involved in this, you know about the challenge of managing your electronic device inventory including warranty and contract management.

Thanks to ubiquitous internet, it’s now easy for even remote support staff to manage and support clients and electronic devices (including mobile devices) at a distance. That includes things like application, service, and hardware management. It also includes backup tracking, support ticket and issue management, application updating and much more. No doubt many organizations implement some sort of hodgepodge of software to tackle this problem. That works fine when you’re small, but gets quite cumbersome as you grow. A unified platform for support can provide many needed efficiencies and a much higher level of support.

The problem is that talking about many of these non-EHR technologies isn’t considered “sexy.” We can’t talk about the billions in government incentive money from implementing these technologies. We can’t use government penalties to drive fear in providers. However, what these non-EHR solutions do provide is efficiency and increased revenue for your healthcare organization.

Maybe I’m old school in this regard, but give me a well run, efficient, patient focused organization over some government program driven healthcare organization every day of the week.

The Cost Effective Healthcare Workflow Series of blog posts is sponsored by ClinicSpectrum, a leading provider of workflow automation solutions for healthcare. ClinicSpectrum offers a client support module to help you better manage the support you provide your clients’ computer systems. ClinicSpectrum also offers a document workflow system to optimize your practice’s workflow processes. Connect with Clinic Spectrum on social media: @ClinicSpectrum or at Booth 1270 at HIMSS 2016.