Bio: Faisal Mushtaq is President of Allscripts Payer Life Sciences business. This business focuses on generating immediate value for providers and patients by leveraging Allscripts data and clinical, adherence and education messaging infrastructure to enable improved clinical outcomes at a lower cost. Faisal leads a team of cross-functional professionals skilled in field sales, product management, and client support and implementation services. He also oversees the PayerPath business. Faisal has been in the healthcare IT industry since 2000 and has extensive entrepreneurial business experience. He has led teams of all sizes, spanning many organizational areas including Portfolio Strategy, Sales, Business Development, Technology, Operations and Software Development. Before Allscripts, Faisal served in several leadership roles at Misys, which was acquired by Allscripts in 2008. Following the acquisition, Faisal served in various executive leadership roles in the Solutions Development organization of Allscripts, including the leader of Solutions Management for the ambulatory market and the leader of Portfolio Management. Faisal is a member of the Board of Directors at the Council for Entrepreneurial Development, an organization that helps entrepreneurs grow their business by connecting them to the network, knowledge and capital needed to start their company. Faisal earned a Bachelor of Science degree in Computer Science and Computer Engineering from the University of Wisconsin-Madison. He has also completed Advanced Management Program at Harvard Business School.
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- Use big data to speed outcomes-based research. As EHRs mature, more organizations realize the value of the data that a connected community can capture. Our solutions aggregate and “anonymize” data to give insights to both providers and payers. Using the data for analytics, research, clinical trail management and other purposes helps lower costs overall.
- Help with day-to-day transactions to improve clinical outcomes. From prior authorization to clinical decision support, these tools help clinicians. For example, patient education and adherence programs can help with compliance and improve results.
- Automate manual processes. Technology can reduce burden and expense by creating a secure connection between providers and payers for chart audits. Accelerating the transfer of chart information can reduce administrative burden and speed payment.
- Improve claims management systems to make billing more efficient. With Payerpath, payers and providers appreciate more accurate, timely claims.
- Enabling patients to be more engaged in their health care. Allscripts integrated set of patient engagement solutions enable improved patient education, patient adherence, office visit payments.
- Clinical Documentation: With the existing templates already configured in Allscripts Professional EHR™, users can now complete a review of systems and physical exam documentation
- Assessment & Plan: Users can now identify the problems being assessed, enter orders associated to those assessed problems and utilize all short lists and favorites as already configured in Pro EHR.
- Sign—off and Billing: Users can now preview the complete H&P report and submit charges as well as confirm billing details such as encounter type and billing provider, select the Encounter Pack to determine what documents will be printed, and sign off.
Today’s prior authorization (PA) process for certain high-cost medications is often a lengthy, manual back-and-forth process among the doctor, payer, pharmacy and patient. But times are changing, and about 20 states have legislation proposed or in place to improve the process with electronic prior authorizations (ePA).
The industry is at a tipping point and ready for change. Health IT partnerships with payers and life sciences companies can enable physicians to obtain PA electronically, leading to faster patient access to medications and reduced rates of prescription abandonment.
Manual prior authorizations aren’t working
According to Frost and Sullivan, about 70% of patients who encounter a manual, paper-based PA do not receive the original prescription, and patients abandon about 40% of manual PAs. With 180 million PAs each year, we can estimate that about 72 million prescriptions are abandoned each year.
Manual PA processes are also a time drain for healthcare staff. The average time to complete the approval process is about 15 minutes, though it can take several days or an entire week to fully resolve an authorization.
Physician practice saves up to 3 hours per day with Allscripts eAuthTM
For North Country Family Practice (Southlake, Texas, U.S.A.), eAuth* solved many of the challenges of the manual PA process. “The manual prior authorization process was pure chaos,” Nurse Manager Shelley Wallis said. “The formularies weren’t always accurate, we had to handwrite forms and fax them in, there were multiple patient calls and pharmacy calls…it took so long and hardly ever went smoothly.”
When Wallis learned about the capabilities of eAuth, including the fact that physicians can complete the ePA with their Allscripts electronic health record (EHR) workflow, she was “ecstatic.” Because physicians are doing the ePAs, instead of other staff members, they can provide the rationale for that particular medication and avoid extensive rounds of phone tag among patients, providers and pharmacies.
The solution instantly gives prescribers access to preferred formularies for insurance plans, and gives alternatives that may not require PA. Wallis reports that this step has reduced the number of PAs by almost half for the practice. For the PAs that are required, Wallis estimates the turnaround takes an hour or two most times, compared with a process that could take days or weeks.
Wallis noted that providers were initially concerned about the additional demands on their time to complete the PA process themselves. But when they saw how easy the process is, and how it ultimately saves time for the practice, it became a non-issue.
“eAuth lifts a heavy burden from staff, because they’re not focused on this paperwork anymore,” Wallis said. “It’s freeing up staff to reach out to patients who have chronic diseases or are at risk for these conditions…staff can better use their knowledge to help improve outcomes and potentially realize more revenue through our Medicare ACO [Accountable Care Organization].”
Wallis continued, “eAuth helps us do the right thing for the patient…they’re not waiting for these prescriptions and our staff now has more time to provide the quality care they need.”
This solution illustrates the importance of bringing together all stakeholders—providers, payers, health IT, patients – to effect change in health care. Together we can answer the call for more efficient and effective care delivery throughout the continuum. Learn more about eAuth here.
Payer requests for medical records can be time consuming. Even though the physician practice is likely using an electronic health record (EHR), many times these transactions require vast amounts of paper and labor. It can be a cumbersome task for both the practice and the payer.
Hutchinson Clinic (Hutchinson, Kansas, U.S.A.) Chief Information Officer Bob Davidson explains it this way, “Everyone here already has a full-time job. When we get requests from a payer for charts that require pulling massive quantities of patient information, we have to pull somebody off of their tasks to do it, or the payer sends someone to work on site. It’s very time consuming.”
Davidson continued, “We had one request last year that was for 160 hard-copy charts, which took one person a full week – 40 hours – to pull the charts, copy them and ship them to the payer….every time we got a massive request like that, it delayed other projects for our staff.”
Davidson acknowledges these requests aren’t as noticeable when the payer only needs one or two records, but it’s a different story when Hutchinson Clinic must fulfill reporting requirements for programs such as MCQA HEDIS®, the CMS Five-Star Quality Rating program and CMS risk scores.
No more manual responses to payer record requests
Because Hutchinson Clinic is an Allscripts TouchWorks® EHR user, it was able to deploy eChart Courier, a solution that automates the electronic delivery of medical information, at no additional cost. The solution went live in October 2014 and enables Hutchinson Clinic to securely share records directly with payers, usually within 24 hours.
“Allscripts eChart Courier implementation was absolutely easy and the solution requires very little effort from us,” Davidson says. “Because we don’t do anything for eChart Courier, it’s virtually invisible, whereas before we had lots of disruption of activity to provide records to payers.”
Davidson believes that the solution not only helps Hutchinson Clinic staff, but also relieves burden from the payers, too. Ultimately, that’s what Allscripts is all about: helping healthcare stakeholders collaborate to provide value and improve outcomes.
If you’re a TouchWorks EHR client, Professional EHR client or a payer who would like to learn more about eChart Courier, contact us.
We’re partnering with life sciences companies to address gaps in care, one of the key steps in better managing population health and improving patient outcomes. It’s important to collaborate with all stakeholders – patients, providers, payers, life sciences and health IT companies – because that’s how we’ll succeed with value-based care.
How is Allscripts working with life sciences companies? Here are a few examples:
#1 – Are clinicians identifying enough patients who need clinical intervention? Allscripts has independently analyzed best-in-class guidelines that address gaps in care for certain therapeutic areas. Allscripts builds those guidelines into point-of-care alerts. Sponsored by life sciences companies, we are educating providers and practices about how to use the Allscripts alerts to close gaps in care for patients. We have partnerships in place to address rheumatoid arthritis, diabetes, asthma, vaccines, and other therapeutic areas. These programs will increase awareness of potential gaps in care so that the clinician can work efficiently to improve patient outcomes.
#2 – Do patients take their scripts to the pharmacy? About 30% of new prescriptions go unfilled. Clinicians can provide patients with patient-appropriate medication education at the point of prescribing. This education has the added benefit of serving as a reminder for patients to pick up their medications and helps physicians achieve credit for the Meaningful Use patient education measure, in addition to driving medication first-fill compliance.
#3 – Can patients afford their prescriptions? Clinicians receive an alert at the point of care if there are any coupon programs available for the medication they just prescribed. Clinicians can pass those savings along to the patient, which also increases the likelihood of first-fill compliance and adherence.
#4 – Will prior authorization (PA) delay access to medications for patients? Certain high-cost medications must be pre-authorized by a payer before a patient can receive them and PA requirements are growing every year. Today’s authorization process is often a lengthy, manual back-and-forth process among the doctor, payer, pharmacy and patient. According to Frost and Sullivan, about 70% of patients who encounter a manual paper-based PA do not receive the original prescription, and patients abandon about 40% of manual PAs. Our partnership with payers and life sciences companies enables physicians to obtain PA electronically, leading to faster patient access to medications and reduced rates of prescription abandonment.
#5 – Does the provider have relevant patient care information from other providers? Inclusion of the Payers Health Profile in the EHR will enable and expand the longitudinal view of a patient’s health record based on claims and other data aggregated by the payer from multiple providers.
These are just a few examples of how we’re helping clinicians close gaps in care. We have the largest network of providers using EHR technology and a large patient base through the FollowMyHealth® patient portal. Working with all stakeholders, we’ll enable clinicians to access the knowledge they need to transform health care as we know it.
Payers and providers have a complex relationship. Stereotypes suggest payers want to cut expenses, while providers want quality care (regardless of cost). Conventional wisdom says these parties have treated each other with suspicion in the past.
But the U.S. healthcare industry is in the midst of evolving to new outcomes-based payment models, and as a result the payer-provider relationship is evolving. As providers become more responsible for cost, payers are willing to offer information and expertise. Provider insights about practicing medicine can enrich payer data.
Both sides share the goals to improve quality and reduce expense. There is a more collaborative approach among payers and providers in the U.S. healthcare industry today than ever before. I believe that trend will continue.
How Allscripts helps strengthen these collaborations
Allscripts can make these collaborations even stronger. Our solutions connect more patients with more caregivers than any other healthcare IT company. The Allscripts community includes 13,000 post-acute facilities and 1 in 4 U.S. hospitals. We have 180,000 physician users and 50,000 physicians using our patient portal.
In order for the new healthcare paradigm to be successful, this collaboration must extend beyond the payer and provider to the patient as well, primarily since the patient is starting to play a very active role in managing health outcomes and costs
With such a robust community, we can help foster this innovation and connection, and not just among providers and payers. We are bringing together parties that are traditionally on the fringes of the payer-provider relationship, such as pharmaceutical companies, research organizations and pharmacy benefit managers.
Ultimately, strengthening these connections improves quality of care and cuts costs for everyone along the continuum. We sell software and services that:
By connecting all the players in the value chain, we can bring more innovation to the market. We continue to think BIG in this space. Because the stronger these relationships are, the more opportunities we have to improve health care.
Do you see more collaborative payer-provider relationships in our future? Please share your thoughts in the comments below.
Since we launched the Allscripts Wand™ application for the iPad® in April, response has been tremendous. Nearly 7,000 clients have used Wand to enable support staff to enter patient data into the Allscripts EHR from the iPad. Then, physicians told us loud and clear they need a few more features.
Working closely with hundreds of physicians, we developed a new version of the app – Allscripts Wand v1.1. We build Wand from the ground up to address client preferences on how they want to interact with technology.
With Wand, providers can easily move between their desktops and iPads in the way that works best for them for safe and efficient patient consultations and management. Physicians told us a flexible user interface is key. With the iPads, doctors can enter data by touch, by speaking or a combination of both methods.
Our clients had other needs, too. To meet these needs, this latest version now includes:
Taking advantage of mobile devices is a smart way for clinical practices to get easier and faster access to the EHR features that care providers use most. I’m especially excited about the reaction from the physicians whose input shaped how the app works. It’s an ongoing conversation that will help shape future versions of Wand.
What’s on your wish list for mobile apps that interact with your practice’s EHR?
For more information, visit www.allscripts.com/wand.