Podiatry group finds the right technology partner to widen its footprint

Case Study | Upperline Health
  • ""

    150 providers in 7 states, with plans to expand

  • ""

    The nation’s largest medical organization dedicated to lower-extremity care

  • Laptop Checkin Teal

    Focused on value-based care


  • Quality program reporting
  • Adopting a comprehensive care approach
  • Onboarding new practices amidst rapid growth
  • Disparate vendors, including for billing and clinical solutions


  • athenaOne®


  • Success in value-based care programs
  • Reduction in number of amputations
  • Increased documentation compliance
  • Increased revenue per visit
  • Reduction in patient phone calls about billing

David Thorpe’s and Stephen Nash’s backgrounds in palliative care used to keep them awake at night. They witnessed the impact of the country’s high number of diabetes-related lower-extremity complications and amputations – and the ensuing hospitalizations and mortality rate – and knew it was an issue they wanted to combat. Now as the co-founders and Chief Executive Officer and Chief Strategy Officer, respectively, of Upperline Health, they along with Chief Medical Officer Michael King describe their organization’s mission as “serving patients by integrating and transforming specialty healthcare.” Their team is “a critical force to solve the lower-extremity amputation problem in America,” they said.

As the country’s largest practice dedicated to lower-extremity care, Upperline has reduced the incidence of diabetic foot ulcers for its at-risk population by 60 to 70 percent and improved wound healing time by 50 to 60 percent. But it’s not just Upperline’s focus on quality measures or hands-on, preventative care that has yielded results. It’s their focus on using technology to scale a business and support better clinician-patient experiences.

A customizable, adaptable EHR optimizes specialty’s performance

As Upperline continues to expand to several more U.S. states, they’ve benefitted greatly from adopting a cloud-based solution that requires little or no internal IT maintenance; and one that’s easy to scale and train clinicians on, say King and Nash. But as more podiatrists join their organization, they’ve noticed challenges others can encounter when sticking to a specialty-focused EHR or using multiple solutions for clinical and financial record-keeping.

Having athenaOne’s clinical, revenue cycle management, and patient engagement tools as one streamlined suite has been essential, said leadership.

“We’re big believers that it’s most important to have an EHR that can provide the full suite of technological, operational, clinical, and financial opportunities and features to allow you to develop the highest-functioning organization. With those capabilities, you can build in specialty-specific modules that you need,” said Nash. “A lot of specialties have been handicapped by these smaller, specialty-specific EMRs, and have ultimately been left behind and not gotten the benefits that exist with more advanced technological solutions. A higher-functioning EHR is a benefit to their patients. It’s a benefit to their practices. Bottom line, it’s a benefit to them as providers.”

Having all clinicians use one solution gives Upperline’s leadership team access to benchmarking data to motivate top performers or identify others who may need coaching, they said. And by using streamlined templates and encounter plans across the enterprise – including many customized by King – Upperline reports success increasing documentation compliance and revenue per visit, with decreased phone calls from patients about care issues and billing questions.

Improving and maximizing patient outcomes through proactive care

Partnering with athenahealth also gives Upperline “the right seat at the table” when it comes to integrated care models. Using a podiatry-specific EHR “further separates you from the larger healthcare ecosystem, not being able to build out these care management modules, or have accurate, real-time clinical data,” says Nash.

Robust data from athenahealth provides Upperline with the ability to identify and then address high-risk patients, while also opening the eyes of others across the healthcare continuum about the importance of proactive versus reactive podiatry services, said King. “All podiatrists are acutely aware of the at-risk patient — and that 70 percent of people who have a below-knee amputation perish within five years. That’s substantial,” he said. “athenahealth is giving us the metrics to show that yes, a single visit to a podiatrist can save limbs and the system billions of dollars. This leads us to a better outcome in the value-based world.”

Since 2017, Upperline has reduced the incidence of diabetic foot ulcers for its at-risk population by 60 to 70 percent and improved wound healing time by 50 to 60 percent.

Both King and Nash pointed to the front- and back-end advantages of athenahealth solutions that allow the organization to seamlessly satisfy quality measures, so that providers can “focus on what they should be focusing on – the patient,” said Nash. “athena does a really good job at the point of care of identifying when there are care gaps, or other at-risk clinical factors for you to consider, in a way in which most EMRs force you to constantly be looking at everything, for every patient. athena is more clinically flexible so that care gaps relevant to the patient are flagged.”

That’s important for a specialty that’s so hands-on, says King, who owned his own practice for three decades and is a past president of the American Podiatric Medical Association. His background has led him to champion technology that enhances both the patient and provider experience. A good EHR is one of the most essential aids a doctor can have, he said. “Besides your scalpel and your bandage scissors and X-ray machine, the EHR is really another tool in your toolbox for providing care.”

A partnership that supports a strategic plan and a mission

Upperline plans to widen its breadth of offerings by integrating vascular services, including arterial and vein services, surgery centers, wound care, and outpatient care. Those ambitious plans would not be attainable without athenahealth’s robust capabilities, says Nash. He cited reporting capabilities and accessibility among disparate locations and settings among the EHR’s superior capabilities.

King sees athenahealth’s growth track as parallel to Upperline’s. Integration is “critical” to the comprehensive care model, he says, and managing at-risk patients cooperatively with other providers used to be a challenge. Not anymore. “athenahealth makes that easier. And, as athena continues to grow, and now has a podiatric platform to it, I see that as one of the windows into the next phase of comprehensive care.”

Michael King, chief medical officer, Upperline Health

These results reflect the experience of one particular organization and are not necessarily what every athenahealth customer should expect.
Upperline Health participates in athenahealth’s Client Advocacy Program. To learn more about the program, please visit athenahealth.com/client-advocate-hub. Upperline Health was not compensated for participating in this content.