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- In this video, the team at Litchfield Family Practice describes how it is advancing population health in a rural community.
To compete in today’s value-based-care market, many physician practices give up their independence. Research commissioned by The Physicians Foundation found that only 35% of physicians describe themselves as independent practice owners, down from 49% in 2012 and 62% in 2008.
But we find a different story at Family Practice Associates, one of the largest independent family practice groups in central Kentucky. How this practice remains competitive – while maintaining its independence – is the subject of a new video:
The integrated suite of Allscripts Professional EHRTM, Allscripts Practice ManagementTM and Allscripts FollowMyHealth® patient portal helped the group earn $375,000 in Meaningful Use incentive payments, improve net collections to 98%, and enroll 20% of its patients in the portal in less than a year.
“Family Practice Associates has always been a very independent organization and wants to remain that way,” Administrator Craig Gillispie said. “It’s important for us to be as efficient as possible and to be on the forefront of new emerging payment models. Allscripts is helping us to do that.”
To learn more, download this free case study.
The scramble to keep up with a rapidly evolving industry is taking its toll on physician practices. Regulatory compliance requires a lot of rigor on multiple fronts, including Meaningful Use, Physician Quality Reporting System (PQRS), Patient-Centered Medical Home (PCMH) and electronic prescription of controlled substances (EPCS).
These requirements and others are causing general fatigue. For example, according to the Top 15 challenges facing physicians in 2015, about eight out of 10 physicians feel they are overextended or working at full capacity, and 70% report that they spend more than one day on paperwork each week.
Unfortunately, there are hidden costs to this exhaustion that many practices overlook.
Burnout can lead to leaving money on the table
Physician practices have become almost desensitized to the worry associated with regulatory requirements. For example, ICD-10 is coming down the path, but it’s not creating the same buzz that Meaningful Use did when it first appeared. The Medical Economics article cites a 2014 MGMA survey that found 79% of practices have not started to prepare for it.
Maybe it’s because clients know that our software is ready for ICD-10. But are the workflows ready? Is the staff prepared for new documentation requirements? These are questions every practice should be asking to avoid serious financial consequences.
Other practices decide that some incentives aren’t worth the work. I just talked to a large physician practice that decided not to attest for Meaningful Use for 2014 because it was too challenging to get patients involved. They’re not alone, but that’s a significant financial decision.
Rigor around value-based care and accountable care initiatives can be financially costly and time intensive, but it pays dividends. It’s the future financial model for health care, and not being ready means practices are leaving money on the table.
Training can help protect a practice from unnecessary fatigue
The industry as a whole is underinvested in training. If you look for the root of what ails physician practices today, it’s that people aren’t using EHRs to their fullest potential in a demanding environment.
Training is not a one-time deal, either. Getting enough training to “go live” on Day 1 is very different from using best practices that help organizations run at peak efficiency. Stopping at the adoption stage without fully understanding the solution’s capabilities causes dissatisfaction and exhaustion.
Continuous training can help equip physician practices for a constantly changing environment. Investing even a small amount of time in training can save time, frustration and fatigue down the road. Learn more about how the Allscripts Education & Optimization team can provide training for clients here.
Has your electronic health record (EHR) met your expectations? If you answered “no,” you are not alone. A recent IDC Health Insights survey found 58% of ambulatory users are very dissatisfied, dissatisfied or neutral about their experience with EHRs.
The key is selecting a strong EHR solution that’s right for your practice. Here’s a checklist of 12 questions to help determine if it’s the right EHR for you:
1. Is the solution the right one for your practice size? Also consider if the solution will fit your needs in the future. For example, if your practice is expanding, you need a solution that can grow with you.
2. Is the solution certified and ready for regulatory requirements, such as Meaningful Use and ICD-10? Once again, look to the future. Will the solution keep evolving to meet ever-changing regulatory requirements?
3. Does the vendor have experience in core EHR systems? The vendor should have a balanced portfolio of products and lots of experience working with practices like yours.
4. Is the vendor financially stable and investing in development? You want your EHR vendor to be around for a long time and confident enough to invest.
5. Does the solution have flexible architecture? To be a solid foundation for population health management strategies, an EHR architecture should be able to integrate with systems from other vendors.
6. Will the vendor continue to optimize the EHR? As health care continues to rapidly evolve, the solution needs to keep pace.
7. Does the solution enable clinicians to easily monitor and manage care? Physicians should be able to monitor the progress of patients – and patient populations – within their day-to-day workflows.
8. Are advanced patient and financial analytics tools available? Analytics is another key component of successful population health management strategies. Identifying, monitoring and managing care for groups of patients begins with these important data capabilities.
9. Are user-friendly patient engagement tools available? You have to make it easy for your patients, especially your high-risk patients, to engage with you and their own health.
10. Can the solution manage non-traditional payor environments? Thinking beyond traditional payor environments can help move your organization from fee-for-service to value-based financial models. To capture this rising revenue stream, you need financial analytics that can help you understand the cost of care for each facility, staff member, patient and device.
11. Can you access training and continued support? Maybe you need online training, or prefer modules that are built directly within the EHR, or maybe the option to add on in-person, customized trainings. Make sure you have the options you need to succeed.
12. Does the vendor have a solid track record for on-time, on-budget implementations? You can’t afford costly mistakes during implementation in terms of time or money. Talk to other clients to learn if their experiences met expectations.
If you answered “yes” to most of these questions, you’re in good shape. If not, you may want to evaluate other EHR solutions for your practice.
For more information, download this free resource: Redefining Ambulatory EHR: An eBook on Selecting an EHR replacement or join us for an upcoming webinar Strategic Planning for the Ambulatory Practice: Developing an EHR Replacement Plan on Tuesday, October 21 from 1 to 2 p.m. Eastern time.
The Centers for Medicare & Medicaid Services (CMS) conducts audits to follow up on Meaningful Use (MU) incentive payments. These audits can intimidate providers, even ones that have meticulous reporting habits.
Soundview Medical Associates, a 22-physician, multi-specialty practice in Connecticut, faced two consecutive MU audits for 2011 and 2012. The responsibility for completing them fell to the organization’s only IT person and executive director, Eileen Smith.
Keep calm and respond to CMS
Upon receiving the first audit notice in the spring of 2013, Eileen reacted the way many providers might, “What did I do wrong?” The answer: probably nothing.
Some audits are targeted, but many are random. It’s an opportunity for the government to exercise due diligence over its investments in incentive programs (see a CMS fact sheet on audits for more information).
Auditors ask for a variety of reports, for example drug-to-drug allergy checks and reports for patients with certain conditions. They require dozens of documents within a 10-day time period.
Good reporting habits can ease audit stress
Eileen carefully followed instructions and gathered reports. An Allscripts Professional EHRTM client since 2009, she turned to Allscripts for help. We provided documentation, including verification that Soundview is using certified software.
As required, Eileen uploaded all of the materials onto a CMS auditor website. She estimates it took about 8 hours of her time to complete each audit. Because Soundview has solid reporting habits, it was not as difficult as Eileen first thought it would be.
The auditors had a few follow-up questions about each response. For example they asked about Soundview’s efforts to review security risks. Soundview submitted a gap analysis that Allscripts conducted in 2011 to comply.
The one thing that surprised Eileen
Because there is so much information, Eileen wondered if the government actually read all of the CMS reports she submitted through the attestation period and beyond. Throughout the audits, it became clear to Eileen that the CMS had carefully reviewed Soundview’s materials all along.
Soundview and Allscripts worked closely together and learned a lot through the process. We are thrilled to have the government’s validation that we are doing the right things for patients at Soundview.
To learn more about how Soundview Medical successfully completed two Meaningful Use audits, watch this video.
How are you preparing for potential audits? Leave your answer below.
Speeding past the farm fields of central Illinois, you’ll find the exit for Litchfield. The 7,000-person town is home to Litchfield Family Practice, an innovative rural health system that just achieved a Level 3 Patient-Centered Medical Home (PCMH) Certification from the NCQA. It scored an impressive 97.5 out of a possible 100 points.
“Small step” approach leads to success
It all started in 2009, when Litchfield Family Practice and the local hospital, Hospital Sister’s Health System (HSHS), explored the medical home concept. “We felt the PCMH model was similar to the way that we were already practicing medicine,” said Daniel Wujek, MD.
Litchfield is home to seven busy practices under one roof. While they had worked as a team for decades, there were still many different approaches to documentation. For example, clinicians didn’t always measure the patient’s height to calculate a Body Mass Index (BMI), a key health indicator. Litchfield team members wanted to become even more patient-centered, more consistent and improve the way they shared information with each other.
During the 18-month process to apply for PCMH certification, Litchfield used “small steps” to stay organized and move forward. For example, two physicians met every Tuesday afternoon to review progress and plan next steps. And four times each month during a two-hour window, the practice’s IT manager led repeating 15-minute, drop-in training sessions for staff on specific topics.
These and other practical steps helped Litchfield tackle the lengthy PCMH certification process. “It can be overwhelming reading the principles,” said Pat Bickoff, practice manager at Litchfield Family Practice. “But once we got into it, we were surprised at how well we were already doing.”
Litchfield’s progress with population health management
With help from HSHS, Litchfield now offers patients access to a care coordinator, called a Nurse Navigator. “Patients love the extended time they have with her – for free – to learn about their conditions and work towards manageable goals,” said Bickoff.
Allscripts Professional EHRTM helped the practice add specific medical home terminology to documentation to enable targeted, comprehensive reporting. “The reporting is one of the most beneficial things for us,” said Dr. Wujek.
For population health management, the practice performs a review of diabetic care twice a year and set up reminders for breast cancer and hypertension screenings. “This reporting capability gives us an ability to be much more proactive in our patient management,” said Dr. Wujek.
Litchfield hopes that payers will soon begin to offer incentives for medical homes in rural Illinois. Until then, it continues to focus on providing great family medicine through an independent group of physicians to about 350 patients every day. According to Bickoff, the team also enjoys the bragging rights that come with the practice’s outstanding PCMH certification score.
To learn more about Litchfield Family Practice’s success, you can read a case study or watch a video. You can also learn more about the process in another recent blog post, 10 tips for achieving Patient-Centered Medical Home (PCMH) certification.
For the past 29 years, Calvin L. Dixon, M.D. and his wife, Daisy Dixon, have managed a busy pulmonology practice in Duncanville, Texas. They help patients ages 4 to 94 with lung diseases, such as asthma, pneumonia and emphysema.
Earlier this year, the practice made the transition from Allscripts MyWayTM to Allscripts Professional EHRTM. This practice is one of 1,400 organizations making the switch as part of an initiative Allscripts announced last fall, to meet the needs of an evolving healthcare industry.
We received a thank-you letter from practice manager, Daisy Dixon. She recently spoke with us about her experience, which included 10 reasons she’s glad the practice migrated:
- Able to keep 95% of the workflow the same. Dixon took many opportunities to learn about the system to adopt Pro to her practice’s workflows. She attended weekend trainings and started the simulation training in February. By the time data migrated on March 24 and the practice went live on June 24, Dixon was able to adopt nearly every workflow to her practice’s needs.
- Data migrated accurately. Dixon admits she was concerned about how well the data would migrate from one system to the other. However she was pleased to note that, “The data was accurate and we found very few errors.”
- More detail appears on reports. Staff finds it helpful that the reports contain more details, including the patient’s insurance information. Also according to Dixon, patients appreciate new details, such as the next appointment date, that appear on clinical summaries.
- Easier to reprint statements. Dixon found this process to be simple in Pro.
- New reports to track claims. Now, Dixon can obtain detailed services and procedure reports and see if claims have been paid partially or completely.
- Patients can do more online. Patients have reacted positively to the new online options, such as paying bills or viewing lab results.
- More thorough claim validation process. “To process a claim, I have to click a few more buttons in Pro,” Dixon said. “But by the end I know that claim is clean, and it is going to get paid.”
- Potential to see more new patients. As the team learns to use the system more efficiently, Dixon expects they will be able to see more patients.
- Practice drew strength from solid support. “The support team was fantastic and helped with a seamless transition,” said Dixon. “To know that we could call in to a live support option the first week was so comforting.”
- Continuous learning options. Dixon intends to continue to attend trainings to help with ongoing goals, including preparing for Meaningful Use Stage 2. “Allscripts support team always goes the second mile,” she said. “They answer my questions and then explain other helpful tips related to my questions. I learn so much about the system that way.”
Adjusting to the wider variety of options available in Pro has taken some time, but Dixon said the benefits make it all worthwhile. When giving advice to practices considering the transition, Dixon laid out three key steps:
- Step One – Preparation. “Use ClientConnect. It has such wonderful articles, webinars and live demonstrations. If you know what you’re getting into, it makes the whole process easier.”
- Step Two – Activation. “Definitely use the simulation training and weekend trainings. They will cover things specific to your practice.”
- Step Three – Customization. “We customized everything according to our own workflow. That is what made our transition easier.”
Thanks to the Dixons for sharing their experience with the Connected Community of Health. For other examples of successful migrations, visit ClientConnect, or read a recent blog post: Compass Pediatrics masters migration from Allscripts MyWay to Allscripts Pro EHR. If you would like more information about the upgrade, please contact ProUpgradeQuestions@allscripts.com.