“There’s always a big problem in doctors’ offices with communication,” says Craig Tidwell, MD, FACOG, a physician at Associates in Obstetrics and Gynecology, based in Dalton, GA. Tidwell is no stranger to that issue. Not long ago, he and his colleagues had no efficient method of contacting patients to remind them of appointments, alert them to outstanding balances, or inform them of office closures. They still had a very high patient volume due to a lack of medical providers in the surrounding counties, but the front desk staff had to take on all the work of calling patients themselves.
During this time the practice was using siloed practice management and EHR solutions that couldn’t share information. But the practice wanted an integrated EHR and practice management solution. It needed a system that could meet Meaningful Use and future quality program requirements, but also help with the billing process and patient communication. “We felt like athena was perfect for those things that we really needed,” says Tidwell.
The practice implemented athenaOne, athenahealth’s integrated EHR, revenue management solution, and patient engagement service, in 2012. Through its partnership with athenahealth, today the practice sees even more patients, has increased its revenue, and has improved the quality of patient care and engagement, while remaining independent.
A fully supported OB workflow
Tidwell and his colleagues strive to remain present and attentive during the moment of care. They don’t want to focus on the patient’s chart; they want to document as quickly and accurately as possible. During a visit, Tidwell uses athenahealth’s templates because he likes how they individualize his documentation. He often uses customized text macros and freetext boxes directly in the chart that help provide a consistent provider experience, “whether you’re scheduling a hysterectomy, discussing depression, or treating a UTI,” says Tidwell. Documentation isn’t an issue for the practice because of athenahealth’s clinical workflows that remember a provider’s preferences. “I always tell providers: This thing is a Ferrari…It has so much to offer that you don’t [even] have to get it out of first gear to be great at it.”
athenahealth helps the practice manage the specific needs of its obstetricians. When documenting a pregnancy over time, they use “the athena OB Flow Sheet, which is very easy,” says Tidwell. The flow sheet allows for customization so that obstetricians can see the important information at the top of the chart. Tidwell can keep track of routine procedures, labs, non-invasive prenatal tests, and even the name of the patient’s unborn child. Tidwell and his colleagues are satisfied with athenahealth’s OB charting capabilities. “As you work with it, it just makes you more and more efficient as you go through it,” he says.
Then, when the patient is ready to deliver, Tidwell easily coordinates care at the practice’s affiliated hospital, Hamilton Medical Center, which uses a different EHR. “The nurses [and midwives] just pull up the chart,” says Tidwell. That’s because athenahealth’s patient record sharing capabilities connect the practice to every other provider on the athenahealth network and to those on numerous other EHRs via CommonWell and Carequality. And, because athenahealth’s network is cloud-based, Tidwell can keep tabs on his patients when he’s not in the office, looking at their charts on his smart phone. “I’ve done it in line at the grocery store and the bank, or even waiting for a movie to start,” says Tidwell. “I’ve done it everywhere.”
The practice continues to see rising physician satisfaction with athenahealth because they’re able to focus on their patients. “The depth of patient care is so much better than it ever was,” says Tidwell. In fact, he never has to complete documentation and administrative work after hours: “I close every patient. I’ve never gone to bed with an open case and that’s since [we went live with athena in] August 2012.”
Improved patient communication and satisfaction
As the practice’s already high patient volume increased since partnering with athenahealth, no-show rates have also decreased by 16% since going live with athenaOne. Tidwell attributes that to a vast improvement in patient communication, which is managed through athenahealth’s patient portal, appointment reminder calls, and patient outreach campaigns.
Now, the front desk staff manage routine patient communications and much of their scheduling through the patient portal. When they need to let patients know a change in office hours during a winter storm, they use athenahealth’s automated outreach campaigns. “We used to call them all ourselves. Now athena does it,” says Tidwell. According to Tidwell, these automated communications have helped decrease not only no-shows but administrative burden as well.
In Tidwell’s experience, the patient’s biggest concern is often communication. “They can’t get in to see a doctor. They can’t talk to a doctor,” says Tidwell. That’s why the ability to give patients greater access to their doctors and the practice has had such a great impact. Patient visits have even increased by 2.93% since going live with athenaOne. “That is due to the assistance of athena with its communication. [The patient engagement service] that athena has provided us has really helped facilitate more patients through our office…The communication is so good.”
Cleaner claims, faster adjudication
The practice used to struggle to get paid on time and keep up with the requirements of quality programs. “Prior to athena, I would pick up a medical journal [and] I was so worried about getting paid, I would spend 90% of my time reading about Meaningful Use,” says Tidwell. “Instead of spending my time learning about new tips and difficult procedures, I was spending most of my time reading about the financial portion.” When the practice partnered with athenahealth, “they said, ‘We’ll take care of it.’ And after that moment, I’ve never worried about it,” says Tidwell. Now, Tidwell can spend less time researching requirements because they’re integrated directly into clinical workflows.
Tidwell also considers athenahealth crucial to getting paid. “athena’s really good about reminding patients that they have bills. athena’s really good about reminding us that we need to get paid.” Since athenahealth helps track industry trends, its billing rules engine ensures that the practice abides by changes to payer policies and requirements when it sends in claims. “Before, we may not have gotten notified [about a denial] for three months. And then we didn’t get paid for three months’ worth of patients,” says Tidwell.
Now, having seen a nearly 11% decrease in DAR, the practice not only gets paid, but it gets paid faster. Before partnering with athenahealth, the practice had stacks of papers with patients’ outstanding bills each quarter. But due to athenahealth’s reminder calls to patients about their unpaid balances, the number of patients with balances has dropped 90%. “athena just gets the bills out much faster than we did. I think our paper process just took much longer,” says Tidwell.
Through athenahealth, “we’ve been able to increase our revenue, [which] allows us to stay independent,” says Tidwell. The practice finds athenaOne intuitive and easy for all levels of users. They rely on features like real-time eligibility checks and running reports online directly in the Report Library. “There’s just so many things that [athenahealth] rolls out that benefit us…And when I’m talking to potential athena clients, I just tell them that they’ll learn something that I don’t even know that I wish I knew. There are so many good features.”
As much as I love the income increase, it doesn’t even get close to comparing to the improved patient care and communication. The depth of patient care is so much better than it ever was. The communication is so much better.
— Craig Tidwell, MD, FACOG, Associates in Obstetrics and Gynecology