What are the top challenges facing small- to medium-sized, independent physicians as they fight to maintain their independence and compete with the large, corporate providers? This month, we are looking at the top 10 challenges, so please join us for this informative series and tune back in every Tuesday! If you're reading this post first, please go back and read Part 2 from last week and Part 1 from the week before, where we looked at why doctors should even be fighting the battle for independence, as well as challenges one through seven (high insurance claim rejections, slow reimbursements, and clunky, user-unfriendly, overpriced EMR systems, high merchant services costs, scheduling nightmares, struggling with HIPAA and coding compliance, and dealing with old paper files ). Let's move on to causes eight through ten today!
8) Bad debt. Doctors often hate talking about money. What they hate even more? Chasing it. Nobody likes asking people for money, and doing so aggressively often alienates patients. But it’s hard enough operating a profitable practice without having tens, sometimes hundreds, of thousands of dollars in bad debt. That’s why we offer QuickCollect, a soft approach to collecting from patients, and one that allows you to maintain full visibility and control. Eighty percent of all patients who ever will pay, do pay through this process. It relieves your staff from this troublesome burden but without doing traditional collections, which has a low success rate.
9) Marketing. Large, corporate providers have marketing budgets in the six- to seven-figure range. How can a smaller provider compete with that? Again, we bring technology to the table to solve a problem. We offer AutoCard, an automated mailer marketing service to help doctors stay in touch with their patient base and even market to prospective patients. In an age when it seems that most emails are ignored and/or go to the spam folder, physical mailers are the new email. It’s both affordable and effective.
10) Verifying benefits. You often find even smaller practices dedicating up to half a headcount solely to this task. That number should be exactly ZERO. With the right technology, you should have this process fully automated. Our iClaim solution solves benefits verifications with the push of a single button. No more phone calls, no more chasing. And that also means fewer denials.
So how successfully is YOUR practice facing these challenges? If you could use help, contact us today to set up a free, no-obligation, 30-minute practice analysis. We will either show you how we will add more value than we cost, or we simply won't ask for your business.
What are the top challenges facing small- to medium-sized, independent physicians as they fight to maintain their independence and compete with the large, corporate providers? This month, we are looking at the top 10 challenges, so please join us for this informative series and tune back in every Tuesday! If you're reading this post first, please go back and read Part 1 from last week, where we looked at why doctors should even be fighting the battle for independence, as well as challenges one through three (high insurance claim rejections, slow reimbursements, and clunky, user-unfriendly, overpriced EMR systems). Let's move on to causes four through seven today!
4) High merchant services costs. Not a lot of physicians think about this one, but it’s yet another way smaller providers pay more than larger providers. Many smaller practices pay well over 3% on credit card transactions and can’t even take online payments. We have changed all that. By leveraging the buying power of thousands of doctors, we get rates as low as 1.79% on merchant services for Visa, Mastercard, American Express, and Discover. And we can help doctors accept payments online and even offer a free, full-service patient portal. All in a fully HIPAA-compliant payment solution designed especially for doctors.
5) Scheduling nightmares. Unlike the larger providers, many smaller practices do not offer online scheduling. And they often find that their waiting room times are unpredictable and unmanageable, leading to decreased patient satisfaction. Again, we bring technology to bear to solve this: we offer a system that not only allows for online scheduling, but even helps doctors optimize their patients’ waiting room experience and reduces patient dissatisfaction by minimizing waiting room times.
6) Struggling with HIPAA and coding compliance. This is a constant challenge for all providers, but it hits smaller providers harder because the costs of compliance are higher in relation to their revenue, especially if they manage compliance entirely in house. We can help doctors get and stay HIPAA compliant and we also do coding audits to ensure they aren’t overcoding (dangerous!) or undercoding (costly!). By outsourcing this, smaller providers can leverage the expertise they need but at a cost they can afford.
7) Drowning in paper. While most practices are trending towards paperless environments thanks to EMR systems, many still have large volumes of old paper files they have to manage. It’s not just costly to store these, it’s also a giant HIPAA-violation waiting to happen. We have a solution that is a very cost-effective hybrid: by partnering with local, secured-site records companies and using our own iDocsNow technology, we can help smaller providers get rid of all paper in their offices. For files they don’t need to access very often (potentially ever), we can have the documents stored for as little as $0.30 per box per month, then have them safely destroyed once they no longer need to be maintained. For paper files the office may need to access more frequently, we can have them scanned and entered into iDocsNow, our paperless file management system that converts paper files into OCR-based, fully searchable PDFs in our Cloud system. Then, going forward, any new paper files would be scanned into the system and destroyed immediately. We can even provide discounted pricing on HIPAA-compliant shredders.
Tune in next week as we look at causes eight through ten!
What are the top challenges facing small- to medium-sized, independent physicians as they fight to maintain their independence and compete with the large, corporate providers? Over coming weeks, we are going to look at the top 10 challenges, so please join us for this informative series and tune back in every Tuesday!
First of all, why should independent physicians even try to maintain their freedom? Isn’t the corporate takeover of our healthcare system inevitable? In 2018, employed physicians outnumbered independent physicians for the first time ever, according to Medical Economics. Many independent physicians are despairing that selling out is just a question of when, not if. That’s especially true in the era of Obamacare and MACRA, when the increased rules and regulations are making it more and more challenging for physicians to operate confidently and profitably while complying with all the Byzantine rules.
But it’s a fight worth fighting! Studies show patients of small- to medium-sized independent physicians fare better. Medscape recently highlighted several studies that bear this out. Smaller practices have “ambulatory care-sensitive admission rates fully 33% lower” and lower overall costs for care for diabetes, for example.
So we need to win this battle for our patients. But how? Let’s look at the biggest issues the independent doctors face.
1) High insurance claim rejection rates. On average, 34% of all insurance claims submitted to the insurance companies are initially rejected. Many are eventually paid out, but only after resubmitting, often multiple times. When you consider that each reworked claim adds an average of $25 in cost to the practice, you can see how this is one of the biggest burdens for small providers. But isn’t that just how the game is played? You submit, they reject, you resubmit? Many practices, even smaller ones, have entire headcounts dedicated to nothing but fighting this battle. But they don’t have to! In fact, it makes no sense to. Doing your own claims, especially if you are doing them manually, makes zero financial sense for providers with under 25 staff. The math simply doesn’t add up. Using a resource like Fast Layne Solutions solves this in two ways: it brings advanced Revenue Cycle Management technology to bear on the problem (thus slashing that rejection rate to under 2%) and brings economies of scale to bear to cut your claims management costs by on average 60%.
2) Slow reimbursements. Even when you do get paid, it is often taking far too long. The solution: use a provider that has an independent clearinghouse connected to all insurance companies and that gets your claims paid the first time. That’s why our doctors get paid in days, not months.
3) Clunky, user-unfriendly, slow, overpriced EMR/EHR systems. It is the shame of our industry. Talk to any doctor pretty much anywhere in the United States and they will tell you the same story: I HATE MY EMR! There is even a popular parody account on Twitter dedicated entirely to how awful the leading EHR system in the US is perceived to be by the doctors and other healthcare professionals forced to use it. And to add insult to injury, these systems are incredibly expensive. And on top of all that, most are PC- or laptop-based, which interferes with the doctor-patient interaction. And many are so complicated that even a smaller practice often has to have a full-time IT headcount to maintain their systems. The solution: EMRx, a Cloud-based (read “zero maintenance and no IT staff needed”), software-as-a-service EMR designed by doctors, for doctors, and currently used by thousands of doctors nationwide. EMRx is tablet-optimized, meaning you can maintain eye contact with the patient. It is so user-friendly that our average documentation time per patient encounter is just two minutes for general practitioners, somewhat greater for certain specialists. (And yes, everyone always thinks that’s a lie….right until they see the demo.) And because it is software-as-a-service, the start-up costs are far more reasonable, there is zero maintenance for you, you have access to award-winning support, and the ongoing costs are reasonable. Also, you aren’t stuck in multi-year contracts.
Tune in next week for challenges 4 to 7!
Today’s guest blogger is a Registered Nurse and hospice administrator who shares with us her personal experiences and observations of a life in healthcare from her front-line perspective. We welcome guest bloggers who can share insights regarding the many facets and aspects of healthcare: tech, administration, policy, and patient outcomes, among others. Interested in contributing? Please send your credentials and a brief content pitch to us at email@example.com, using GUEST BLOGGER in the subject line.
What Do Nurses Eat?
What do nurses eat? Well, the old adage is that “nurses eat their young.” Not literally of course; I’m not talking about a nurse cannibalizing their biological children. I’m talking about the abuse a new nurse sometimes faces when he or she enters the workplace. It’s a surprising hurdle that a lot of nurses must deal with: bullying, hazing, and conflict in the workplace. The types of bullying can manifest in different types of forms, such as unwillingness to help a coworker, verbal abuse, mocking, gossip, exclusion, and, in extreme cases, even physical abuse.
I find it so unusual that even though nursing is a profession that is committed to helping, caring, healing, and loving others, it's also very consistent with such bullying tactics like hazing. Nursing is regarded as one of the most trusted professions; however, in this career we are subjected to high pressure, stress, and extreme emotions, which could lead to a boiling point that may precipitate aggression towards each other.
Does that still stand as true today as when I started out? Unfortunately, I believe it does, and I see it happen often in my own career. It often happens when new nurses are insecure and unable to defend themselves. Suddenly, they find themselves in this new, big, scary world and in a new role straight out of nursing school.
Believe me, we all know that nursing school is no joke, and some nursing school instructors can be vicious. I wonder if such experiences make new nurses accustomed to this treatment as a result of nursing school and clinicals. Is it possible that being bullied, humiliated, and harassed is familiar and it just carries on into the workplace with them? Is this a rite of passage, akin to hazing in sororities and fraternities?
The bigger questions are why it is necessary and when does this end? Does it end when a person has been a nurse a certain number of years? Does it start over and over when a person goes into a new job, regardless of how many years s/he has actually been a nurse?
I witnessed one of the first instances of bullying of nurses while attending nursing school. There was in our class one student who was particularly bright, beautiful, and organized (let’s just say she was perfect). Honestly, she rather intimidated the rest of us and would consistently stand to speak anytime she had a question or to answer a question. She was the kind of girl that we all detest: her always perfect notes were pristine, she always made A’s. When it was her turn to speak, she would stand, poised as Princess Diana, and in the most articulate voice you can imagine, would answer or ask a question.
One day after a very grueling test, we were all literally in tears because we were sure that we had failed it. Suddenly, this young lady stood up to ask a question. That’s when it happened: another student blurted out to her, “would you please just sit your ass down?!”
The entire room burst into laughter. Even the instructor laughed out loud and openly. Very slowly she sat down. I saw tears run down her face. That was the very first instance that I can recall that I witnessed nurse bullying and this poor girl wasn’t even officially a nurse yet. It was so blatant that I was actually shocked. The instructor did nothing, giving absolutely no reprimand to the student who blurted out. Through the instructor’s silence, the bullying student’s behavior was condoned and somewhat rewarded. For the remainder of the term, the bullying student was regarded as the leader of the class.
I often wonder about that young lady today. I wonder what her nursing career has been like since we graduated. I wonder: does she still display her intelligence boldly? Does she still stand while being extremely poised in all her interactions with people, or did she shrink and become quiet and reserved? I think and wonder about her frequently, and I feel very sad that on that day when everybody burst into laughter, I joined in the chorus. I succumbed to the peer pressure to laugh and ridicule a fellow future nurse who was just trying to make her way, just as I was.
For years, this culture of bullying has been widely tolerated among nurses; however, there has been increased public attention brought to this problem. As a nurse leader, I am very watchful of bullying behavior by senior nurses towards new staff, making it clear to them that it is not accepted as part of the culture of our workplace. I think about the new employees and especially the nurses that come under my leadership and strive to cultivate a new adage: “nurses protect and treasure their young.”
My name is Freda Beaty. I’m originally from Winston-Salem, NC, but currently live in Greenville, SC. I am a Registered Nurse and I am the Administrator for a hospice company. During my free time, I am a jewelry designer and self-proclaimed photographer. You can reach me at firstname.lastname@example.org.
Corporate Social Responsibility
CSR, or Corporate Social Responsibility, is undeniably important, and is also largely industry-agnostic. What we mean by that is this: doing good is good for business, any business. We believe this deeply, and as a company that combines a subscription-giving platform, volunteer concierge, and personalized impact reports to serve as a "CSR-in-a-Box" for 50-500 person companies, we are incentivized to believe it. Additionally, though, we have identified that some companies can move beyond the baseline notion above that doing good is simply good for business. What we mean by that is this: Some companies are set up to be better at the "doing good" part, as well as receive higher returns from the "good for business" part. HealthTech companies are one such example.
We initially identified this super-CSR mutation from a few of our early, successful clients in Visibly & Candid Co. We then looked across the HealthTech industry to confirm if it was widespread, and confirm we did. Here's why all companies prioritize CSR, and why HealthTech companies carry super-CSR mutations:
Why all companies prioritize CSR programs:
Why HealthTech companies carry super-CSR mutations:
So, to the thousands (ok, hundreds) of HealthTech companies who've read this far, how are you going to do better by doing good?
In an average day in clinic, I might see 15 patients, get 75 emails, 10 secure messages, 3 pages and 5 EMR messages in my inbox. Not too long ago, some emails were from frustrated colleagues, asking me to do something for a second or third time. Sadly, some were from parents of my patients, kindly reminding me that they were sitting in the lab waiting for the orders I forgot to place or trying to book their colonoscopy, for which I had forgotten to submit the form.
I pride myself on making sure my patients and their families feel cared for and supported, yet here I was dropping balls, overwhelmed by emails, camp forms, 504 plans, orders to place and callbacks. I needed help and jotting chicken scratch on the back of clinic notes, Post-Its and even a little black book wasn’t enough.
I had an incredible team of nurses and administrative assistants, yet there was no effective way to collaborate; the time, effort and inability to close loops made it almost easier to do things myself. I was burning out, increasingly frustrated and weighed down by the “toil” of practicing medicine. The dozens of clinicians and healthcare teams we later interviewed were feeling it too.
Healthcare, Meet Design
Last year, I received an email out of the blue. Keather Roemhildt, a veteran user experience designer from the Silicon Valley, was interested in applying her talents to problems in healthcare. Well, I though, we certainly have plenty of those.
Just a few weeks later she spent an “afternoon in the life” of our busy gastroenterology inpatient team and was captivated by the potential. After just a few hours together she saw the awesome re-design challenge that is healthcare and was willing to work together to build something that could bring the joy back to healthcare for providers and improve the quality of care for patients.
Boiling the Ocean
We spent several days in clinic together and countless late nights on Zoom from Boston to San Francisco designing solutions for how we could make things better. We thought we’d start off small and redesign the electronic medical record (EMR) [sarcasm]. Over our first several months, we built a beautiful user interface, a visual story chock full of icons, graphs and all the things that us clinicians find frustratingly inadequate about existing options. We explored navigating this EMR by voice, freeing up the hands of clinicians and getting their eyes back where they belonged, on the patient. Our explorations led to three things that have been part of the software revolution in every other industry — except healthcare: communication, collaboration and task management.
The Digital Divide
I began reflecting on my life outside of medicine, my Apple fanaticism, my dependency on elegantly designed productivity tools like Evernote and Dropbox. The ease of asking my wife to pick something up at the supermarket by simply adding it to our shared to-do list on Wünderlist. How platforms like Slack, Asana, Trello and many others have become engines for collaboration and communication, eliminating hundreds of dead-end emails.
Yet, in healthcare, we’re forced to use antiquated software and click our way through poorly designed interfaces, because HIPAA and the nuances of healthcare have scared off the disruptors. Increasingly, the lack of HIPAA-compliant corollaries to the apps that have changed our lives outside of medicine is helping lead to insecure and risky use of many consumer apps.
Keather and I started to realize that beyond the crappy design of the EMR, there was no system to collaboratively manage the workload. Despite the fact that healthcare is a team sport, we all are forced to do it alone.
Not surprisingly, when we asked 14 colleagues about stress resulting from fear of forgetting to do something for their patients, the stress level averaged a 3.9 out of 5. This is despite having dozens of communication platforms: email, EMR message centers, secure and insecure text messaging. Sadly, most of these platforms end up creating more work as a byproduct. Unread and flagged emails quickly get buried, paper notes get thrown out or lost, tasks continue to pile up. Unfortunately, loops are rarely closed as the cognitive load is simply too much and the inertia to generate a formal email or place a message in the EMR is too cumbersome. In the end, we work in our silos, slowly chipping away at the tasks that adds up over the course of the day and week. We spend nights and weekends catching up on notes, billing and the seemingly mundane to-dos that we’re able to remember. And we’re all stressed about dropping balls, forgetting to do something for our patients who we took an oath to care for and protect.
After the third email from my admin reminding me to do something, I realized I needed a system and a process. As the great Atul Gawande suggested in the all-too-relevant The Checklist Manifesto, checklists provide a “cognitive net…that catch the mental flaws in all of us.” I was using Wünderlist, a beautifully designed checklist so effectively in my home life, why not try it at work I thought?
I was easily able to convince my core team, my administrative assistant, and nurse to try out a shared to-do list; they probably thought getting in touch with me couldn’t get worse. Since Wünderlist isn’t HIPAA compliant, we decided to only use patient’s first names and not put any PHI on the app.
So I invited my team to our “GI clinic” list on Wünderlist and within minutes, we were assigning tasks to each other. We sifted through our unread emails for all the outstanding stuff that was pending and suddenly had clarity on what the tasks were and who was assigned to them. Perhaps more impressive was how fast things came off the list. We all felt motivated to clear the list as quickly as we could, since nobody wanted a task assigned to them languishing for the group to see. Checking that box announcing that you completed your assignment was deeply satisfying.
Wünderlist for Healthcare
Suddenly we had a minimum viable product. Without a dollar spent or an engineer writing a single line of code, Wünderlist had provided us with a proving ground. Over the next several months, my colleagues and I completed nearly 1,000 tasks and learned invaluable lessons about what was needed to make something like this truly impactful in healthcare.
My team had never been more efficient. We were collaborating on tasks that might have never risen to the level of an email or EMR message. The truth was, few of these items were even EMR-worthy, mostly administrative chores. Suddenly we had clarity, we had accountability and we were all on the same page.
Using a shared task list brought a life-changing reduction in my stress level. I had a place where I could easily deposit all the inbound requests, reminders and minutiae that had previously weighed me down. Tasks were declared and assigned by design, so an email or EMR message was no longer necessary. The barrier to entry was incredibly low, and the ability to work together, collaborate and communicate was transformative.
We learned from pioneers like our friends at TigerText: create an indispensable tool for healthcare, fundamentally built on a technology that is ubiquitous in the consumer world. Our solution couldn’t be just HIPAA compliant, it had to integrate into the workflow of providers. Fortunately, for us there is no incumbent system or workflow, our largest competitor is the Post-It note. The scary truth is that most providers don’t have a process for remembering their to-dos, let alone a shared one.
Getting Accelerated @Boston Children’s Hospital
So we had a good idea, a great MVP and a bunch of market research validating the pain point and our proposed solution. Thanks to Keather, we even had killer designs for our mobile app. You know where that gets you as a healthcare startup? Nowhere, fast. We still had to develop the technology, figure out the sales and marketing, and prove our value proposition, for starters.
Fortunately, we had the opportunity to apply to the Innovation & Digital Health Accelerator at Boston Children’s Hospital where their impressive advisory board selected our idea (then called HeyDoc) to be accelerated in 2016. This enabled us to work with talented software engineers, startup analysts, marketing experts and graphic designers who helped to create the working app we now call Dock Health. In collaboration with HT Developers, we began a closed beta program in early September, using our native iOS app and responsive web platform at Boston Children’s Hospital. We’ve already learned a ton from our users and continue to improve upon it daily. We’re excited about the future, with our public launch at Health2.0 and our first external pilot at UC-Irvine School of Medicine to kick off in the next few weeks.
Into The Wild
Nothing has been more exciting than to see the impact of our product in the hands of real clinical teams. We have a long journey ahead of us, but we know that we are going after something of critical importance.
Clinician burnout is an emerging epidemic, in large part due to the administrative burden of patient care. The triple aim — improving patient experience and patient care, and lowering costs — can only be accomplished if the providers are able and willing to work towards that important goal. We believe in the quadruple aim, and that easing the administrative burden will make for happier, more productive providers. While something as simple as a to-do list for healthcare might seem trivial on its face, we believe that a secure hub to store, prioritize and collaboratively delegate a mounting number of tasks may very well change the game of healthcare. And that’s just the beginning.
To learn more about Dock Health and sign up for secure team collaboration and better patient care, click here. We’ve got a better way to-do healthcare.
Welcome to the new Fast Layne Solutions blog! Tune in here for regular updates on a variety of topics, from updates about the company and valuable promotions to topics of interest to professionals in the field of healthcare. We'll also be welcoming some wonderful guest bloggers, so stay tuned! To make sure you don’t miss any updates, please sign up for our newsletter and also follow us on Twitter. (We use safe unsubscribe, so you can unsubscribe from our newsletter at any time.)
To kick off our blog, we’d like to tell you about Fast Layne’s missions and history. Fast Layne Solutions started as an idea in our CEO’s head back in 2016: bring together all the best industry solutions under one roof to create an affordable, one-stop shopping experience for small- to medium-sized, independent physicians’ practices who need cutting-edge tools and services to maintain their independence, stay profitable, and compete with the large corporate providers and hospital systems. And we accomplished that mission! From the industry’s best revenue cycle management solution (iClaim) to a user-friendly, MD-designed EMR (EMRx) to affordable merchant services that enable online payments (ChoicePay) to a patient debt management system (QuickCollect) to HIPAA and coding compliance services to practice marketing to credentialing assistance, we have all your needs covered! And best of all, it’s all 100% à la carte: we customize our solutions specifically to your needs.
But we have more than just a business mission here at Fast Layne. We also have a mission to give back to the communities we serve. That started with a commitment to earmark 5% of our net, post-tax profits to St. Jude Children’s Hospital for pediatric oncology research. We also work with local non-profits to help create new revenue streams by tying successful referrals to ongoing revenue-sharing with them. We’re even kicking off a project to create great jobs in economically distressed areas. (If you run or do fundraising for a non-profit, email us at email@example.com for more information and to see if we can work with you to help your organization.)
We also work with individuals in the healthcare sector to identify doctors’ practices that need our services, and in exchange we pay referral fees up to $3000. So if you know a doctor with any of these issues (see below), send an email to firstname.lastname@example.org, and if we sign that doctor’s office, we will pay you a referral fee! Ask for the details and “fine print” when you provide the referral and we will give you all the terms and conditions in our response. (Don’t worry! We keep the fine print to a minimum!)
Problems we solve:
-High insurance claim rejection rates. If over 2% of a practice’s claims are being initially rejected by commercial insurers (e.g. Blue Cross/Blue Shield, UnitedHealthcare, Aetna, Anthem, Cigna, etc.), Medicaid, and/or Medicare, we can help transform their bottom line! Even if those claims are eventually getting paid after resubmissions, it’s hurting the practice: consider that each reworked claim adds an average of $25 in cost to the practice.
-Slow reimbursements. Do you know a practice that is taking weeks or even months on average to get paid by the insurance companies? We can help! We get our doctors paid in days, not months.
-Clunky, user-unfriendly, slow, overpriced EMR/EHR systems. Do you know a doctor who spends too many nights and weekends catching up on charting? Or who is just paying way too much for such a system? (Many systems average tens of thousands of dollars PER DOCTOR PER YEAR!) Then talk to us! Our MD-designed, cloud-based, tablet-optimized subscription EMR is so efficient that doctors spend an average of only two minutes per patient encounter to finish charting. And it’s actually affordable!
-High merchant services costs. Many doctors pay well over 3% on credit card transactions and can’t even take online payments. We change all that! By leveraging the buying power of thousands of doctors, we get rates as low as 1.79% on merchant services for Visa, Mastercard, American Express, and Discover. And we can help doctors accept payments online and even offer a free, full-service patient portal!
-Scheduling nightmares? We offer a system that not only allows for online scheduling, but even helps doctors optimize their patients’ waiting room experience and reduces patient dissatisfaction by minimizing waiting room times.
-Struggling with HIPAA and coding compliance? We can help doctors get and stay HIPAA compliant and we also do coding audits to ensure they aren’t overcoding (dangerous!) or undercoding (costly!).
-Trouble with patient outreach? We offer AutoCard, a mailer marketing service to help doctors stay in touch with their patient base and even market to prospective patients. In an age when it seems that most emails are ignored and/or go to the spam folder, physical mailers are the new email!
So if you know a doctor who is struggling with any of these issues, drop us a line!
Thanks for tuning in to our first blog. Come back and visit us often and follow us on our mission to help independent doctors stay independent and to help them be doctors again, paper-pushers.