Pennsylvania Dermatology Partners is a dermatology group practice with 12 locations. In its previous group practice formation, it had used a homegrown practice management system with an integrated electronic health record.
THE PROBLEM
The various PM and EHR components worked sufficiently independently, and also had good integration – but the vendor was not well-positioned to continue modifying the software as rules and regulations changed, said Andrew C. Frankel, COO and co-founder of Pennsylvania Dermatology Partners.
“Simple tasks like keeping up with new modifier rules or certifying for PQRS were out of the question,” he remembered, referring to the federal Physician Quality Reporting System. “Co-founder Dr. Daniel Shurman and I were driven to open a private practice with the primary goals of achieving clinical excellence, practice efficiency and patient engagement.”
In their previous experience, available PM and EHR systems were not comprehensive enough to meet their mission-driven approach: As Frankel puts it, they were stuck with limiting tools while envisioning the optimal “Swiss army knife” solution that would execute the wide variety of tasks required by different team members.
“Our previous experience also had involved use of a third-party online scheduling system,” Frankel added. “We weren’t keen on using this strategy for the long term, and also weren’t thrilled to be sharing our patients’ demographic data outside our organization unnecessarily.”
The user experience also left a lot to be desired, he said. They did want their patients to have easy and secure access to perform key functions and view their own medical data – all the while being highly satisfied with the services the physicians were providing. This meant making sure patients had seamless and simple connections with the practice by their preferred means, whether online or by phone.
“Finally, both Dr. Shurman and I had seen the financial difficulties that claims denials and regulatory hurdles could bring,” Frankel said. “It was important to remain compliant and have clear visibility of our collections and financial trends to optimize our practice’s growth. True insight into daily operations would enable a ‘big picture’ perspective for us to achieve our ultimate goal: Being the best practice we could be.”
PROPOSAL
When the two executives opened Pennsylvania Dermatology Partners in 2012, Dr. Shurman was the dermatologist and Mohs surgeon, Frankel was the COO, and they had one nurse practitioner and a small office staff.
With high aspirations for growth, they selected vendor AdvancedMD’s Rhythm platform for its scalability and integrative capabilities. They integrated AdvancedMD with a different EHR, but use AdvancedMD practice management system and various AdvancedMD solutions for billing and patient engagement.
“Currently our patient volume and financials are up 20 percent for 2019. We’ve added new sites, new employees and many new patients. We attribute much of this growth to the technology that’s helped us every step of the way.”
Andrew C. Frankel, Pennsylvania Dermatology Partners
“We chose the AdvancedMD system because of its ability to unify our workflows and integrate areas that were previously considered silos,” Frankel said. “We also needed the EHR side of the platform to be dermatology-specific, adaptable to our unique patient and practice needs. Our patients would be able to access their medical information and perform basic functions – including scheduling and bill pay – through the secure, cloud-based portal 24/7.”
The executives also wanted the ability to reach out directly to patients in both individual and automated capacities to share important messages and personally engage. Patient expectations for online access and communication were only forecasted to grow in the coming years and decades, so they knew they wanted to put themselves in a position to meet these demands.
“Since integration was AdvancedMD’s most prominent feature, we anticipated lowering our administrative overhead for management of both basic and more sophisticated practice tasks,” Frankel said. “Considering the patients first, we knew the technology could streamline communications for better service delivery, and that our staff would have more time to attend to their specific needs.”
On the billing and claims side, the solution would help the practice stay on top of reporting requirements especially for the Medicare population, which comprises 40 percent of the practice’s patient base. In this, the practice would gain better insights about how the practice was succeeding, and what opportunities existed for improvement where it wasn’t.
Most of all, Rhythm would be flexible enough to meet all of the practice’s various needs and roles as the practice grew internally and expanded its reach in the community, Frankel added.
MARKETPLACE
There are many medical practice management software vendors on the market today. Some of these include athenahealth, CareCloud, DrChrono, eClinicalWorks, GE Healthcare, Kareo, NextGen Healthcare, PatientNow, PrognoCIS Practice Management, Remedly, SimplePractice and Virence Health.
MEETING THE CHALLENGE
The Rhythm platform touches every aspect of the Pennsylvania Dermatology Partners practice and every employee that works for the practice.
Since 2012, the practice has grown to 12 physicians, seven nurse practitioners and physician assistants, a front desk staffer in each of the 14 locations, eight patient advocates in a customer service center, and a full billing team. They all use the practice management functionalities in various capacities – and usually with enthusiasm because both the deployment and ongoing utilization has been smooth, said Dr. Daniel Shurman, a dermatologist, surgeon and co-founder at Pennsylvania Dermatology Partners.
“Administratively, the portal has enabled convenient and easy patient appointment scheduling, complemented by a reminder system that’s set according to specific patient preferences,” Shurman explained. “Many patients want to go online and manage their visits, bills and medical records retrieval personally: They no longer want to use their lunch hour to make phone calls, and it’s exciting that we can make this happen for them.”
Still, others want to speak directly with an employee. The practice has an efficient phone system that’s manned by excellent, attentive, friendly people, Shurman stated. So regardless of what access point patients choose, the practice is able to improve flow and make the entire process convenient and results-oriented for high satisfaction, he added.
“Many patients want to go online and manage their visits, bills and medical records retrieval personally: They no longer want to use their lunch hour to make phone calls, and it’s exciting that we can make this happen for them.”
Dr. Daniel Shurman, Pennsylvania Dermatology Partners
“The AdvancedReputation solution has really helped our practice physicians manage and address feedback about patient visits,” Shurman said. “Our practice management software interfaces with Google Reviews and asks patients to rate their experiences right after their appointments. Our physicians can now quickly reach out to a patient if he’s had a perceived negative experience.”
It goes a long way with satisfaction when the doctors want to listen and try to find a way to address the issue and do better, he added. They can also then push positive reviews out to the practice’s Facebook page; the plan is to do the same with other sites like Healthgrades, Vitals and Yelp to help maintain the practice’s reputation and further expand the practice, he said.
RESULTS
Pennsylvania Dermatology Partners has experienced a consistent growth trajectory of about 15 percent a year since using the practice management package, Frankel said.
“Currently our patient volume and financials are up 20 percent for 2019,” he said. “We’ve added new sites, new employees and many new patients. We attribute much of this growth to the technology that’s helped us every step of the way. AdvancedMD’s solutions have been the foundation of our success for both serving an engaged patient population and maturing with seamless expansion.”
The practice now treats 10,000 patients per month who are engaged, cared for and supported, he added. No one has fallen through the cracks or gets neglected: the technology makes sure of that, he said.
“In January of this year, we had more than 400 patient visits scheduled online – up from 330 in June 2018,” he reported. “At least 6 percent of our appointments are being made directly online without assistance at all hours of the day and night. Our front desk staff uses this ‘gained time’ to help patients one-on-one with personal needs, prescription or procedure questions, and other high-touch demands. Since we implemented the online scheduling capability, we’ve seen a 3 percent increase in new patients, a figure that continues to grow.”
The reputation management efforts managed through the software also are yielding positive results. In a recent week of receiving 1,267 online reviews, 1,076 patients (or 85 percent) of patients rated service as five stars out of five, while 157 (or 12 percent) of patients gave four stars.
Furthermore, in a survey sent to 30,000 patients, early results of 1,200 responses have shown they are generally happy with the practice and that they like the technology offerings like online scheduling; patient portal access; text, email and voice reminders; and automated birthday messages.
“We take great joy and pride that our patients are satisfied in their relationships with our physicians, and that our practice is meeting their needs on various levels,” Frankel said.
As portal use has increased, so has utilization of paying bills online. Online payments are now up to 18 percent of all patient payments for the practice, which is a huge benefit for the practice, Frankel said. On the other side, billing management advancements through the platform have also been advantageous: The practice is able to bill very quickly in the integrated EHR and see many payers settle claims in less than seven days, he added.
ADVICE FOR OTHERS
“To remain competitive and thrive in private practice, you have to build your practice on an integrated technology platform,” Frankel advised. “In this era of value-based care, it’s imperative to be as lean as possible while providing successful outcomes for patients. You will want to choose a technology partner who is constantly reinvesting and improving their technology to keep up with the pace of change in healthcare.”
This simply is not going to happen with outdated technology or solutions that are not tightly and seamlessly integrated, he said. While it may initially feel like a leap of faith, the investment in a practice software suite will give a practice the edge to meet the industry’s ever-increasing demands with poise and profitably, he added.
“Keeping pace technologically is critical, but I’d also emphasize that providing that human touch is still at the core of what we do,” Frankel said. “Listen, communicate, help, serve; and train your employees to make every interaction with patients as positive as possible.”
Unfortunately, more and more of the expense of care is trickling down to patients: Give them the confidence that they are receiving the best treatment possible for their expense and effort, Frankel advised.
“Especially during patients’ stressful or medically unstable times, a practice’s commitment to excellence really shines through,” he concluded.
Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com