Commonwealth Pain and Spine, a provider organization that serves Indiana and Kentucky, was undergoing rapid growth, but its electronic health record system was not keeping up with needs.

THE PROBLEM

The system staff were using at the time felt archaic to them. Physicians and clinical staff did not have any input into the initial set-up, and therefore no equity in or understanding of the system beyond its very basic capabilities, said Jeff Ellison, CEO of Commonwealth Pain and Spine and CEO of managed services organization ConfirmaMD.

"Since it wasn’t configured correctly from the start, it created chronic inefficiencies," he explained. "Our providers felt compelled to create workarounds to move through the system, which ultimately made the administrative portions of their job more time-consuming.

"As we were growing, we knew this wasn’t sustainable," he continued. "It was crucial to both improve EHR workflows to reduce administrative burden for our clinicians and implement an EHR technology stack that would enable us to standardize processes across multiple clinical sites amid our expansion."

It also was important to staff that a modern EHR was equipped to empower higher-quality outcomes for patients via stronger and easier-to-mine data analytics.

"We serve many patients who require complex and multimodal care for their chronic pain, and felt it was essential that we improved data collection to improve comprehensive care for this population," Ellison said. "We are not IT experts, so the preferred EHR system had to present data in an intuitive manner so we could build effective and comprehensive treatment plans for our patients.

"Finally, we wanted to bring our revenue cycle management processes in-house in a very cost-efficient way," he noted. "At the time, we were relying on third-party RCM platforms for back-end workflows, which created more steps. Our processes lacked transparency."

When making this decision, staff knew the ideal EHR platform would be able to marry clinical and back-office workflows to increase the efficiency in collections and RCM.

"Beyond those major priorities, we needed an EHR system that would serve as an extension of our teams, which were struggling with limited bandwidth," Ellison added.

PROPOSAL

Commonwealth Pain and Spine spoke with several EHR vendors in 2017, and ultimately chose athenahealth in 2018 because of the vendor's ability to help build a customized EHR.

"We had unique priorities at the time, with our rapid growth and need for an entire overhaul of our EHR system," Ellison recalled. "The athenaOne platform and athenahealth’s large network of marketplace partners presented new opportunities for us to improve operational efficiencies and revenue cycle management.

"The technology also was extremely user-friendly in how it married together front- and back-office processes," he continued. "We had confidence that both clinical and nonclinical staff could easily learn to optimize use of the technology."

Through a partnership with the EHR vendor, Commonwealth Pain and Spine saw the potential to have greater visibility and more control across the practice.

"Additionally, the overhaul we needed would have been significantly more time-consuming and costly had we not worked with athenahealth," Ellison said. "Their team’s support allowed us to create operational efficiencies that increased the productivity of our existing staff instead of needing to hire and train more people."

MARKETPLACE

There is a wide variety of electronic health record vendors on the market today, including Allscripts, athenahealth, Cerner, eClinicalWorks, Epic, Greenway Health, Medicomp Systems, Meditech, Medsphere Systems and NextGen Healthcare.

MEETING THE CHALLENGE

Commonwealth Pain and Spine ultimately created a customized EHR system that leveraged athenahealth’s cloud-based EHR, revenue cycle management and patient engagement systems.

"Early in the implementation stage, we also looked to the athenahealth marketplace to find turnkey partners that could add value and optimize performance of our investment," Ellison recalled. "Initially, we elected to partner with Phreesia to streamline patient intake, collect patient-reported data, increase time-of-service collections and close care gaps.

"This partnership continues to provide a proven ROI," he added. "Since launch, we have used the marketplace to locate other preferred partners, including, but not limited to, partners that assist us with delivery of chronic care management and integrated behavioral health solutions."

The new technology stack improved operational performance so much that the provider organization wanted to help other pain management practices do the same.

"We believe they can share in many of the workflow improvements, first-time-right claims submission, back-end denial metrics, time-of-service collections and clinical efficiencies that we have recognized," Ellison said. "By enhancing existing workflows and creating new ones, we saw an opportunity to launch our own managed services organization."

ConfirmaMD was born after only two years of launching athenahealth’s technology within the practice.

"Our goal with ConfirmaMD was to work peer-to-peer with managed clients who need support increasing revenue and improving operations," Ellison explained. "We offer the workflows we’ve built with athenahealth to our customer base, which has been extremely impactful."

The EHR vendor's technology is easy to use and helps enhance operational success, he added.

"A key component to the success of this technology within ConfirmaMD is that it brings clinical and back-office workflows into one platform to eliminate information siloes in the practice," he noted. "Most notably, it improves productivity by removing the burden of time-consuming tasks like denied clams or flagging revenue gaps.

"From our perspective, having all our clients on one platform grants us strong visibility into operational performance across practices and empowers us to quickly identify and act on any concerns or opportunities to improve," he said.

RESULTS

"ConfirmaMD’s growth has been exceptional, and athenahealth’s technology is a major pillar to our success, as it’s a key selling point to our clients," Ellison said. "In the last two years alone, we went from one standalone practice to managing 12 practices in five states, representing 35 physicians and about 100 clinicians. We expect continued growth, too, and recently hired 80 people at our headquarters in Louisville, Kentucky.

"The success is notable on an individual practice level, too," he continued. "One of our managed practices saw a 45% increase in revenue within the first 90 days of adopting athenaOne. This wasn’t because of an increase in patients – the practice was simply given stronger collections processes through the technology."

The practice increased monthly revenue by 45% in the first three months with improved speed and accuracy of claim submissions, he added.

ADVICE FOR OTHERS

"Making the decision to move to a new EHR and adopt new, emerging technologies can be a scary proposition," Ellison remarked. "Healthcare provider organizations must weigh the workflow disruptions, the time investment and the capital investment against future benefit.

"Often, these organizations elect not to make these changes in fear of the short-term negative effects of running their practice," he continued. "It is important to not make these decisions in a short-sighted manner. We are on the precipice of a material shift in the way healthcare is delivered and those practices that do not make the necessary investments and technological advancements will find it difficult to impossible to survive."

Investing in sophisticated technology platforms that have a commitment to continued improvement and a proven track record for regular and proactive product enhancements is key to the survival of healthcare organizations – both small and large, he advised.

"Simply stated, healthcare organizations will need to make these difficult decisions to provide the best possible patient outcomes in a technologically advanced healthcare environment," he concluded.

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