Rehoboth McKinley Christian Health Care Services in Gallup, New Mexico Credit: Google Maps
Hospitals and health systems are constantly looking for ways to boost revenue, and a few sound strategies have emerged including streamlining EHR data and simply increasing the number of patients a physician sees in a given day. To bring it all together, however, often requires a bit more technology.
David Conejo, CEO of Rehobath McKinley Christian Healthcare Services in Gallup, New Mexico, found what he was looking for when he stumbled upon Zoeticx, a developer of medical software that bridges the gap between medical quality and patient care.
The way Conejo sees it, seeking out the efficiencies wrought by this technological approach was slow-going. Years ago, he said, with Medicare and Medicaid, there was an attempt to simultaneously expand services and control costs. His hospital followed suit, expanding its services and at the same time trying to access as many people as possible. There was just one problem: As the delivery of healthcare services goes up, so too does the cost.
A number of different avenues emerged in an effort to reduce those costs. Home health. Urgent care centers. Non-medical transportation. Accountable care organizations. All had a positive impact on costs, but the question then became: How do you put all of those elements into one system so there can be some consistency?
That's where an integrated EHR solution comes in. Zoeticx's ProVision Wellness platform is a cloud application that streamlines data integration for Annual Wellness Visits covered by the Centers for Medicare and Medicaid Services and private payers. The idea is that hospital systems and other healthcare facilities can essentially create new revenue centers through reimbursements by government and private payers.
Conejo swears by it largely because it integrates with any EHR system without data duplication, so keeping systems in sync is as automated process. It allows for the management of support tracking for wellness visits, provides a physical assessments guide through preventative exams, and maps out the risk factors for potential diseases for patient follow-up visits. The workflow efficiencies aren't too shabby, either.
"Let's say I come in for an annual visit and the staff says, 'We need to get Mr. Conejo onto the wellness program because we need to get more people involved in this,'" said Conejo. "They then ask me questions: 'Do you regularly monitor your blood sugars?' 'Well, 90 percent of the time.' 'OK, we're going to put instructions for you to do this twice a day, and give you the tools to report back. And because of your age, we're going to make sure there's no cancer, and we're going to do a heart checkup. And lastly, we're going to review your meds.' And I think, 'This is quite the program.'"
The program enters in the relevant data about the patient but, in addition, it includes "everything else that Medicare would recommend for me to have apart from my checkup. So when I come in, they say, 'We're going to do the A1C, check your meds, etc.,but under the program they also say, 'We need to look at your blockage and whether it's increasing. We're going to take a look at your bone structure. We're going to take a look at your muscle strength -- the more muscle you have, the better you metabolize sugar.'"
Patient monitoring at the hospital has improved. That's good news for a facility that now has to think of patients as consumers and all of the market considerations that entails. But it's also a nice arrow to have in the quiver considering the industry-wide dip in inpatient activity that has taken place.
"We're seeing a lot more outpatients, and that offsets the decline in inpatient business," said Cohejo. "So we've been doing more preventative work than diagnostic and treatment work."
Business is growing, with full or near-full compliance. And with its ACO in startup mode, RMCHS is getting a bonus check for $80,000 from Medicare for containing costs, in additional to the new revenues that have been generated.
"A dollar investment in preventative care saves $6 in acute care, so the more you anticipate, the better the whole cost structure," said Conejo.
The fact that more patients can be seen is an added bonus. When the doctor comes in, they already have the requisite information about meds, compliance and other important factors. That doesn't sound like much, said Conejo, but if a physician saves 10 minutes per patient, at 18 patients a day that;'s an extra 180 minutes. More minutes, more patients.
"Our residents will greatly benefit from this," he said.