From smooth billing to AI-driven care

Jeff Drasnin, M.D., is the managing partner of ESD Pediatric Group, a full-service pediatric practice in Ohio. We spoke with him about how athenaOne® supports practice growth and cash flow, how data and reporting improve both care and financial performance, and why artificial intelligence represents the next major opportunity to reduce administrative burden.

Q: Why has athenahealth been such a strong, long-term fit for your practice?

A: athenahealth was an interesting choice for us. When I took over the practice, we were challenged with billing. If anybody knows the history of athenahealth, it was intitially founded as a billing company.

The quote I tell everyone who will listen about joining athenahealth is that the only negative I could get from somebody was: “I wish I did it sooner.” Here we are, dozens of years later, and I would say the same thing. [athenahealth has] really has been key to our success. It has kept us competitive.

We went from being a busy practice that struggled to make payroll every other week to one that can do some new things. We were so happy with what athenaOne did for us on the billing side. But the concept of having your RCM (revenue cycle management) and your clinical side being one [solution] as opposed to two different products [was also exciting].

[At the time], we were a five- or six-provider practice; we're 14 now. [We've] opened a new office, and the ability to scale with athenaOne has been great for us.

Q: How did athenaOne help improve the financial health of the practice?

A: The biggest thing is cash flow and the ability to get our claims paid in a timely fashion. Before athenahealth, our days in accounts receivable was like 50, 55 days. That’s the time it takes from when you do the work to when you get paid. With athenaOne, it's under 20 days.

I have transparency with athenaOne. I know what I’m putting on the books. There are reports that I look at every day. My administrator looks at different reports, just to keep a handle on the financial success of our practice. Within two to three weeks at most, I know what’s going to show up in my bank account. And it's smooth cash flow.

That allows us to budget and invest in ourselves. Where do we want to put that money? In improving care and improving the salaries of our employees.

Some people think those are two things that are very much in contrast — quality of care and being financially successful. But I think they’re both the same. One allows you to do the other, and athenaOne hits both sides. That’s the cool part.

Q: In what ways has athenaOne helped your practice operate more effectively day-to-day?

A: It’s about where you spend your time. When we got on athenaOne, we didn’t let staff go. We repurposed people to do better tasks. It’s not just putting information into a system; it’s [getting] visibility back from the system. I think that’s one place athenaOne just crushes everybody: You have information at your fingertips.

As the managing partner, I look over the finances and the general direction of the practice. I also can look at my providers — who’s being more productive, who's being less productive. I see that data in real time.

Our goal is, when someone’s seen in the office, that claim is out the door — sent to athenaOne — before the patient [gets to the parking lot and] starts their car. When you do that, that improves your cash flow. You improve cash flow and you have a more financially solvent practice. When you have that, you can then focus on better care.

Q: How are you using athenaOne data and reporting to improve care?

A: You can make decisions based on how you feel, and sometimes there’s a place for that. But you also need to make decisions based on what’s really happening. If we say: "Hey, we do a great job getting people their flu vaccines." Then we run a report and it says only 48% of people got their flu vaccine this year. How can we do that better? [The real data] allows us to focus.

You don’t know where you are unless you have the data. We can use athenaOne to look at getting everybody flu shots. Who do we want to concentrate on? People who have asthma or underlying respiratory conditions. I can query athenaOne with the press of a button, pull out those patients, and check to see if they’ve had a flu shot yet. If they haven’t, we’re going to text them, email them, call them. And that improves care. That’s what we’re here for.

We also started using population health campaigns with athenaOne. [For instance,] we can see if there's anybody over the age of 5 who hasn't had a checkup in over a year. Then we'll call them [to come in]. We want people to come in for their well visits, and athenaOne helps us do that.

Q: How has athenaOne affected the patient and provider experience?

A: athenaOne allows us to be better doctors. We’ve got 80% to 85% of our patients using our portal regularly. Some docs say: "I don’t want to answer the portal questions." I say: "OK, well, just be better docs."

Many of the things that differentiate us are [because of] athenaOne: We don’t spend a ton of time writing notes; we interact with our patients pretty seamlessly; we send messages and appointment reminders, and we don’t have a lot of people challenged by insurance.

The absence of the mundane work leaves you with the ability to do better work, higher-level tasks. If you minimize that, you get a happier doc, you get a happier nurse practitioner. If they’re happier, they’re going to do a better job in the exam room. If they do a better job in the exam room, someone’s going to tell somebody: "Hey, I had a great experience at ESD." That’s how you grow your practice.

Q: How do you think about the value athenahealth delivers beyond simple return on investment?

A: I think athenahealth is hard to evaluate [strictly] from an ROI perspective because how do you put a number on better care? A lot of people will look at athenahealth and say: "It seems so expensive." Because they look initially at the percentage. They take that number, multiply it by their net revenue the year before, and think: "Oh my God, that's expensive."

But at the end of the day, do you pay a little more to get something better, to make your practice better? I think because we've spent that money ... it comes back to us in quality of care and practice growth. My practice is three times as big as it was when I started.

How did we get there? We got there by doing a good job. We got there by our collections being what they needed to be.

Q: Where do you see the greatest potential for AI in healthcare and in your practice?

A: In the future, we're going to improve care. We're going to do it more efficiently. And we're going to decrease physician burnout.

I’m pretty efficient on my computer. I'm not really burned out by my computer, but a lot of the younger doctors are. It’s my younger docs that are taking charts home. Ambient listening [through products like Ambient Notes] is the way to go. You get more details in your notes, better notes. Will it help you with clinical decision-making? Yes, it can.

Whether it’s AI within the clinical space, clinical decision-making, in note writing, or in the front-office space, the newer AI bots are amazing. We want to have the ability to schedule 24 hours a day — you call my office at 10 at night, you make your appointment. It’s an upgrade that is long overdue, and we’re excited about it.

I'm just fascinated by AI. Even someone like me, who’s done it a long time, I want to get better every day until the day I retire. I, as a doc, want to operate at the highest level: treating patients, working with patients. The other stuff I want to do as little as possible. We’re looking to take all that mundane work, move it to the side, and operate at the highest level.