Revenue cycle, medical record platforms start driving patient experience for smaller practices

While larger healthcare providers often have the scale to make large investments in technology, the rise of consumerism and the accessibility of affordable technology is giving small outfits the opportunity to stay on top of the trends.

Physical therapists, for instance, are subject to much of the same customer scrutiny and online user reviews as the larger health systems and hospitals. But it's only been within the past couple of years that they've had the technological means to adopt a modern approach to things like documentation or patient outreach.

It was a number of years ago that physical therapist Heidi Jannenga, decided to address a need she was having in her practice. The office was still using a pen-and-paper approach to documentation and she knew of a number of similar practices who were stuck in the same boat.

Seeking improvement, Jannenga's husband, a technologist and software engineer, was surprised to learn that a more modern documentation approach wasn't widely available to physical therapists.

"We did a bit of research first to try to find me some software because most of the physicians we knew had made the transition to some kind of electronic documentation," said Jannenga. "But when we did our research we found they were all server-based and way too expensive. It was out of our range in terms of a capital expense. They were clunky, and not very user-friendly."

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With physicians now required to maintain electronic documentation, something had to be done. So she and her husband launched WebPT, an electronic medical record specifically designed for the medical rehabilitation industry. Alongside its documentation platform is a revenue cycle management component.

Shortly after its implementation, Jannenga's practice experienced a 99 percent retention rate, and the monthly cost of maintaining the program in lieu of a large capital expense has been a financial boon.

It has also, she said, improved the patients' experience and resulted in more efficient, cost-effective care.

"It allows therapists to do what they love to do, and spend more time with the patients instead of spending so much time on documentation," said Jannenga. "That's increasingly important for patient satisfaction and just their outcome.

"The big emphasis now is making sure you're trying to reduce the cost of care," she said, "which in terms of PT means reducing the number of times you're seeing the patient. Now we say, 'Yes, we've cut the patients' visits but also delivered great outcomes.' So now you're delivering high-quality, efficient care for the patient."

It's that focus on patients which has inspired many organizations to pursue technology as a means of affecting change. No longer the sole province of top-shelf regional health systems and brand-name medical centers, the technological approach is being utilized even by outfits that don't provide direct care. Patient advocacy organizations are harnessing the power software to transform the health picture for marginalized groups, hoping to reduce health disparities and make the health system as a whole more efficient and cost-effective.

Equality Health has made that its mission. Based in Arizona, its technology solutions focus on addressing health disparities with the Hispanic American population. CEO Hugh Lytle said that while it's one thing to have that demographic covered by insurance, it's another to make sure they're utilizing services in a way that's beneficial to both them and to the health industry.

"The Affordable Care Act did a lot to increase the number of insured in that population," said Lytle, "but when we talk about community, we're talking about a traditional health plan network that doesn't include the things that are relevant to a big subculture like the Hispanic community. Would I want to work with a midwife instead of an OB? Would I want to work with a faith healer, because that's my background and that's what I trust? That's what we're focusing on."

Not all of Equality Health's initiatives are technological in nature. The firm is building brick-and-mortar cultural care centers that will house job training and transportation services, part of a multi-pronged approach to addressing the social determinants of health that affect the Hispanic population there.

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But one of the major prongs is is a mobile app that's targeted directly to Spanish-speaking consumers, allowing them to connect to a Spanish-speaking clinician or navigator who can help them locate services -- or answer questions about the American healthcare system, such as what a deductible is, or a copay.

"It's a pretty big mix of economics and cultural factors that go into how people seek care," said Lytle. "We're trying to help the clients we serve to understand what's going on.

"So we focus on the up-front assessment," he said. "Not only a health risk assessment for these underserved folks, but cultural and social determinants. Once we have that, that allows us to identify high, medium and low risks."

The mobile app is effective in achieving these ends, said Lytle, because the Hispanic community tends to skew younger, with a population that has honed in on social media, mobile technology and texting as a means of communicating and viewing the world.

By blending its programs into their daily lives, Equality Health is hoping to make healthcare more of a focus for the Hispanic market. It's also hoping to boost patients' adherence and compliance when it comes to medications and treatments that have been prescribed by their doctors.

Lytle sees other minority communities in other pockets of the country that are being underserved for similar reasons and sees technology as a means of bridging that gap and improving the outlook for both patients and the providers who serve them.

"To do it right, you have to to do it right in your own backyard," said Lytle. "We're in this for the long haul. We're a very mission-oriented group of people."

Twitter: @JELagasse