How transparency and benchmarking support practice growth

Chris Pittman, M.D., is medical director and chief executive officer of Vein911 Vein Treatment Centers, a vein care organization in Florida. We talked with Pittman about how data drives decision-making, how athenahealth supports consistency across locations, and where he sees artificial intelligence creating opportunities for healthcare practices.

Q: What makes your practice distinct, and what does patient care look like at Vein911?

A: We are a world-renowned, award-winning center for care, education, and research. We’re one of five locations in the United States that trains new venous and lymphatic medicine physicians. I’m privileged to lecture all over the world. I’m not an academic, but we do some meaningful research in my office.

My mission every day is to help the millions of unaware Americans who suffer from vein disease that they and their doctors don’t know about. The episode of care is long. It could take a dozen visits to get through our episode of care. Honestly, we’re going to see patients more than they might see their primary care physician in 10 years. So, we develop deep relationships with our patients. We treat everybody with authenticity. There’s no frosty glass in my office, and there are no mean people behind it. Every patient is our friend.

Q: Why has athenahealth been such a strong fit for your organization over time?

A: Data is everything. Given enough knowledge, you’ll always make the right decision.

I vetted the top 12 EMR (electronic medical record) vendors for the Florida Medical Association. In 2011, I picked athenahealth. It was right then. It’s still right now. The data, the metrics, and the dashboards are second to none. Without data, you’re doomed, at least from a business standpoint.

It’s not innate for physicians to run a business, and athenahealth gives you the dashboards you need to at least know what’s going on. A lot of physicians think they know what’s going on. But you need to trust but verify. Or inspect what you expect. In business, that’s very important. athenahealth gives us the opportunity to inspect what we expect very quickly, easily, and in an objective way.

Q: How does athenahealth help your clinicians work efficiently while maintaining high standards of care?

A: Just about everything in our company is protocol-driven. Standard operating procedures, checklists, those kinds of things. While there’s a variety of patients, we follow specific protocols.

The ability to use templates, macros, and all the other bells and whistles that athenahealth offers has allowed us to fine-tune our templates to the point where we’re very efficient with what we do.

We collect information that we’re able to publish and move the needle in venous and lymphatic medicine. But something I tell my leadership team and the physicians in our network is that it’s not just about being efficient when putting information into the EMR. You need to be able to consume it quickly as well. We focus a lot on consumption, ease of consumption, and speed of consumption. athenahealth has allowed us to do that. 

The [templates and] dashboards are great. It’s nice to know: "Hey, am I as efficient as I can be with my ultrasound technologists? Where do I fit on profitability or the number of patients I’m seeing?" We do a lot of benchmarking, and that can be eye-opening. I’ve materially changed my practice because of benchmarking. I’m like: "Hey, I’m an outlier over here."

Q: How has athenahealth supported your growth and consistency across locations?

A: It’s supported our growth because we can onboard practices pretty well. Practices that sign up with athenahealth obviously have an onboarding structure, but our team and our director of operations can do it pretty well, too.

I have many doctors whom I’ve convinced to get onto athenahealth thank me. It’s helped us because we can share table space with new practices. They don’t have to start from scratch. We can share what we’ve already developed. So, it has helped us scale pretty well. It’s been very consistent.

Q: What role does athenahealth play in the operational and financial side of the business?

A: Wouldn’t it be great if you could confirm that your front desk person was collecting the right copay and deductible? Well, I can just press a button and see whether Tom, Sally, and Jane [at the front desk] are performing properly.

The easiest thing we do every day is practice medicine. We don’t really have to think about it. Everything else is a pain. athenahealth gives you the dashboards it takes to at least know what’s going on.

A lot of people think vein care is cash and cosmetic, but it’s mostly insurance and medical. Cash is maybe 5% of revenue. So, we’re in the trenches doing authorizations and all of that, just like most practices.

What I tell people is this: cost is what you pay, but value is what you get. I tend to focus a lot on value. [athenahealth is] providing an important service. More importantly, they’re providing the metrics that are going to help you run your company better.

athenahealth gives you so many bells and whistles to control how you’re spending your time as a physician and how your staff is spending time. The most expensive thing isn’t the EMR. It’s the doctor and the staff. And if you’re not running them efficiently, you’re out of business.

What athenahealth does is gives us the ability to manage the multimillion-dollar portfolio that is schedules and all the other things that many doctors unfortunately don’t think about.

Q: How has athenahealth helped you stay independent?

A: I’m not sure we’d be independent today without picking the right EMR partner. That’s what I preach to doctors. If you make a mistake on technology, you could be buried.

No margin, no mission. When I was vetting EMRs more than 15 years ago, many [vendors] either started as billing companies and added clinical capabilities later, or started with clinical capabilities and tacked on billing later. athenahealth was right then, and it's right now, because they started on the billing side. The clinical aspects of an EMR are actually easier than the other stuff. That's one of the main reasons we went with athenahealth. One of the main reasons I promote athenahealth is they have billing right.

What athenahealth allows us to do is stay involved enough to know what's going on. It's important to know what's going on in your billing. You should be looking at it. It offers complete transparency. Whether athenahealth provides your billing solution, a third party provides it, or you're doing it in-house, I have complete visibility into what's going on.

As someone with deep experience in revenue cycle, [you need] that transparency. You don't have the transparency in your revenue cycle management company that you get with athenahealth. Regardless of who's doing it. So that's a major thing. Super important.

Q: What matters most when it comes to clean claims and revenue performance?

A: If you don’t have a clean claim that gets paid immediately, you just lost a lot of money. Any time you have to retouch a claim , you’ve already lost. Now you have to resubmit all this stuff. It’s super costly not to have a clean claim paid right. I consider it a loss.

We pre-populate codes and pull them out rather than putting them in at the end. That’s an efficiency thing. We collect all the requisite information we need to get paid by Medicare and all the commercial payers. We ensure we collect all the information needed to meet the criteria for any payer.

It’s critical. I tell my staff to collect copays and deductibles. A lot of physicians don’t realize that’s probably one-third of your revenue, especially at the beginning of the year when [deductibles] reset. If your staff isn’t good at that, you’re out of business.

athenahealth allows us to pay attention to those critically important things. Card on file has been revolutionary.

Q: Where do you see AI making the biggest difference for healthcare and for your practice?

A: We’re right in the middle of evaluating some solutions. Clearly, we’re going to use it. If you don’t use AI, you’re going to get beaten in the marketplace. It has accelerated the speed of business by an order of magnitude.

It’s not going to be the answer to everything. A lot of hype behind AI. You’re going to want to understand it. You’re going to want to engage with it. It’s going to move the needle on a lot of things, but not everything.

I think you can do a lot in the back office. I think you can do some things clinically for us. I’ll tell you where I think AI is going to help us the most. I think it's going to be with connection with the patient. We already know it can figure out a lot of stuff — transcribe and all of that. I think where AI is really going to help is to open up the blind spots to the physicians. Like: "Hey, your patient said X, and you never answered it." That’s where I really think it’s going to make the most difference — by allowing us to connect with our patients a lot better.

It’s not going to replace the patient-provider relationship. It’s going to be a tool. It’s going to help. It’s going to help us diagnose better, code better, and do other things better. But it’s not going to replace us.

It's just going to accelerate processes that are already completely human-driven. It’s going to help us prevent mistakes. I think AI is going to prevent wrong claims from going through. It’s going to make everything more efficient. It’s going to help our authorization people work faster. But, just as importantly, do it more accurately.