The following is a guest article by Gregory Sanders, MD, FACC, Founder and CEO of HybridChart.
In response to this unprecedented pandemic, every industry has seen change and the need for adaptation. Supply chains have been tested. Age-old habits, like shaking hands, have become taboo. Commonplace activities like going to a movie, or to a restaurant, have public health ramifications. Medicine had to rapidly pivot as well. Traditionally, the medical field has been viewed as a slow adaptor, lagging decades behind in technology, clinging to outdated processes that get handed down to each new graduating class. So, in these challenging times, the practice of medicine took bold steps into the modern world, incorporating technology to ensure that patient care was uninterrupted.
Hurry Up and Change
Telemedicine represents the best example of rapid deployment of new technology in the medical space. This modality has been available for years, yet with minimal penetration into the mainstream practice. The reasons I have heard, even from my own partners, was that telemedicine was going to be cumbersome, diﬃcult to implement, and ultimately without a clear business model to support a return on investment. So, it remained on the side stage, being used as an alternative to urgent care, in the behavioral health space, and to fill voids in rural settings.
There are other areas of the medical workflow that have been screaming for modernization for decades, including the archaic process of paper charge sheets for hospital billing, and on-the-fly texting / phone calls to figure out how rounding should be distributed on a particular day.
There are better options available, but like the telemedicine situation, disruption is diﬃcult to accept voluntarily. Most doctors are busy caring for patients, along with the ever-growing documentation requirements. So, a remodel project involving their “back-oﬃce” processes, not to mention getting consensus from the group, seems insurmountable. It is the tin can that gets kicked forward month after month.
The Physician Mentality
I have always been obsessed with process improvement, and began my journey into software development at the age of 14. So, it was no surprise to anyone who knows me that I would bring these passions to my medical world. Years ago, I developed a rounding software solution called HybridChart, with the intent of bringing meaningful change to how doctors care for hospitalized patients. HybridChart provides the ability to organize rounders across multiple hospital censuses, easily capture charges, and functions as a secure messaging platform. I even incorporated discharge management to bridge the gap between the inpatient and outpatient worlds. When I launched my software, I assumed doctors would see the value I saw. Early adopters would comment, “How is everyone not using this?” My answer was usually in the form of a shoulder shrug.
While adoption of my software, and similar products in this space, continues to grow, there has been an inexplicable resistance towards adopting new tools to improve eﬃciency. Early on, I blamed this hesitation on EMRs, citing the hard truth that doctors were still licking their wounds from clunky electronic records, which had been thrust upon them by government regulation. The last thing they wanted was another software implementation. As the years passed, practices became somewhat more receptive to the idea of software solutions, but there was still much resistance. There are many other examples of streamlined solutions to help medical practices, ranging from scheduling, registration, and population health management. The inconsistent adoption of these newer options indicates that this is the default business practice of medical professionals, not specific to one particular technology. Are doctors just fearful of change? Maybe not.
Never Mind, This Is Going to Be Hard
I believe that doctors gravitate towards easy, and dread things perceived to be the opposite of easy. Let’s look at the telemedicine solution again. On the surface, the reasons for resisting this technology were projected onto everyone but the doctor. “My patients will never figure it out.” “It will be too hard for my staﬀ to incorporate.” “My billers don’t think it will be worth it.” No mention of the doctor and their concerns. The real fear is that this will be cumbersome. It will not be easy. A doctor’s time is their most valuable commodity. Every minute wasted is disastrous from a financial and productivity standpoint. Unless something is a good use of time, the doctor will resist. The status quo has been proven to work, so it is a safer choice every time. It is infinitely easier to project these concerns on to other entities. The same outward projection can be applied to rounding solutions. Lack of adoption by billers, support staﬀ, even doctors who are less savvy with technology, are all reasons to continue with the awkward paper solution. In the face of this are clear-cut positives: it will save you time, it will save you money, you won’t miss charges, you can collect useful data, you can eliminate paper (with its infectious implications). Yet the status quo wins again. “We are fine with how we are doing things,” said the doctor.
Fast-forward to the coronavirus pandemic and medicine is now faced with unprecedented disruptions to patient care. Changes to the standard patient encounter must be made to account for the social distancing requirements. While some patients still come to the oﬃce, donning a mask and gloves, many practices realized that they needed to bring in telemedicine, and fast. So, the hemming and hawing of yesterday turned into immediate implementation.
The easing of the regulations and reimbursement in these troubled times helped. Doctors are now using everything from FaceTime, Zoom, freeware telemedicine, and telemedicine platforms baked into their EHRs to carry out virtual encounters. Billers, schedulers, medical assistants all had to pivot and adopt a new workflow. So, how did it go?
What Were We Worried About?
Bottom line: it was easier than everyone thought. Yes, there were some adjustments and a learning curve to the workflow, but the lasting impression was a positive one. Now, with the ease on restrictions approaching an end, practices are trying to figure out how to keep telemedicine as part of the workflow, Once it was thrust upon them, they were forced to work out the return on investment. There are hidden benefits that I have seen personally with the incorporation of telemedicine. I find myself strangely on time (I am as shocked as you). My medical assistants have more time to focus on core duties, and we are discussing new revenue streams for the future.
The same argument can be made to a scheduling app, registration portal, and the dear-to-my-heart mobile rounding solution. Adoption will likely have the same end result. It will be easier than anticipated, and with some adaptation by oﬃce staﬀ and fearful doctors, be a positive experience. By adopting HybridChart, billers can focus on claims and denials instead of chasing doctors for paper slips and trying to read their handwriting. Doctors can stop spending hours on sign-outs, but rather leverage HybridChart’s powerful cloud-based census facilitating workforce allocation.
With Pandemic Comes Opportunity
While this revolution was forced upon medical professionals it would be a shame to lose this transformative momentum. Process improvement will ultimately make practices more eﬃcient and profitable, and will enhance quality of care delivered. Consumer perception is changing as well. The patients skeptical about televisits have been the first ones to say, “This is great!” The expectation of a modern medical practice with well thought-out processes will be the new normal. Let’s hope that “change is hard” and “it will waste doctors’ precious time” will be a perception of the past.
The dangers of this pandemic are very real, both to our collective healths, but also to our economy and businesses. We have begun to mitigate the health aspect. We are social distancing, wearing masks, washing our hands more than we even did before, and flattening the curve. This pandemic is forcing change, and as a modern practitioner, I want to seize this opportunity to improve areas of medicine long overdue for an upgrade.
As a practicing Cardiologist and founder of HybridChart, I am oﬀering the first 2 months of our Rounding and Workflow Software absolutely free without a contract. I am simply eliminating any barrier for you and your practice to evolve the way you round.