Growth, patient engagement, and AI

Kimberly Peters is the chief executive officer of Tulane University Medical Group, an academic medical organization in Louisiana. She shares how athenahealth supported her team through major disruption, helped drive measurable revenue cycle gains, and shaped a thoughtful approach to AI.

Q: What makes athenahealth a strong fit for your organization?

A: I walked into this role about two and a half years ago. The amount of trauma we’ve dealt with in those two and a half years — everything from having to deal with a fire (at Tulane's facilities) that brought us down to ground zero, a transition taking literally all of our clinical enterprise and moving it to a whole new hospital system. Closing down a hospital, moving everything to four different hospitals within the city.  

Every step of the way, athenahealth and the athenaIDX™ team jumped to help us with those things that we were going through. So for me, as a leader, it was me knowing that I had these folks in the trenches with me, not only when things were going good, but when they were really tough.

We’ve been able to not only come out of it and survive, but thrive. Thrive by having a great partner who sits at the table through all the ups, the downs, the problems, the issues we’re dealing with and helps us make a game plan for how we battle what comes up next.

Q: What kind of business impact have you seen from using athenaIDX capabilities more fully?

A: Every aspect of our clinical enterprise has improved. By maximizing our use of the IDX product — everything from text to pay to automated statements to how we run the engine that's provided — we've seen the financial gains. We've seen the staffing reductions. And overall, we’ve also seen just a resurgence of my physicians and my business side of things actually believing in the product and knowing that it can take us to where we need to go.

We had maybe about a 3% growth in our visit volume. We grew in RVUs (relative value units), which show about a 6 to 8% increase — which means our doctors were doing more complex things. It also meant we were capturing more of the work that they were doing.

The biggest halo effect is you take those numbers ... and I had the ability to bring 14% more revenue back in. So those are tremendous numbers.

When we implemented text-to-pay, as an example, we gave ourselves a goal of collecting at least a half a million dollars within the first year. We’re on target to do a million in another month. So we have significantly surpassed our goal.

Q: How did automation change the way your team works?

A: Not everybody’s excited about it, but it’s also given a little bit more revitalization of my team — that automation isn’t something to be afraid of. It just enhances what we do.

I think of IDX as like a Lamborghini, and I think we were using it as a Volkswagen. Not because of anything of IDX, just this fear of change. Sometimes you get worried about automation in that some change might eliminate a job or it might make them not as important.

For them in the old world, we were printing out claims, we were printing out (reports) or supporting documents. It was paper. So literally, paper pushing through the mail or faxing in. I was like, 'Listen, the reality is I want you to be able to electronically go in, be able to attach to that claim, and we’re going to file it electronically.' So if anything, it’s going to bring more money in quicker. And the reality is we have less denials coming back on the other end.

We actually were able to flip some of our team that used to just be doing that paper pushing — to train them to (instead) work actual denials that were appropriate denials. It created, I also think, a lot more job excitement because sitting there paper pushing all day long doesn’t really make you feel like you’re doing a lot.

Q: Where did you see the clearest gains from claims attachment and payment workflows?

A: I was probably a little leery in the beginning about going in on the whole auto-claims attachment (athenaIDX feature that automatically uploads appropriate supporting documents). One of the advantages the IDX team was telling us about is that we do a lot of work where there may not even be a CPT (Current Procedural Terminology) code yet for it. So when you’re going to send that to a payer, you’re going to automatically get that denial. They were like: 'Kim, if you would adopt this, then you could send that claim with all the supporting documentation.'

Once we launched it, with a lot of support from the IDX team, we realized really quickly our denial rates went down. We then realized that many payers in the market weren’t accepting claims attachment. We then started a campaign to get it further expanded. We’ve gotten two payers that didn’t accept (claims attachments) before to agree to start accepting and piloting with us, which has been great. It’s always nice to be on the front end sometimes of things, that you’re not the last one learning. You’re maybe on the front end trying to put some new progress out there.

Q: How has athenahealth helped you use data to drive accountability and improvement?

A: Prior, there really were no KPIs (key performance indicators) that were being looked at in the organization. We sat down with the IDX team to talk about how can we benchmark certain areas that are key areas to us. Everything from denials to how we’re doing with our individual physician performance.

One of the things we were able to do is also take the analytics IQ. That was a huge undertaking — where we could actually look at individual data for each individual physician and be able to show them not only how they were doing on billing and collections, but what were the key areas we were seeing denials on.

We now have these monthly meetings with our physicians that have a coder, a biller, and a business person that talk about what can you impact by doing those individual deep dives. We were able to move the needle significantly on our KPIs. Not only benchmarking ourselves against other like organizations within IDX, which gives you a great barometer for how are you doing. But how do we look against everyone in IDX?

The analytics barometer (within athenaIDX) goes from red to green and it has kind of the rainbow in between — we’re moving into the yellows and greens. Two-and-a-half years in, that’s a tremendous amount of progress to move that needle that far in such a short amount of time.

Q: What did you learn about patient adoption of digital payment tools?

A: My New Orleans area tends to be much more of an older population. For our group of patients that have been with us for years, we were really worried about going to electronic statements and text to pay. When I think of my own parents, they probably would never accept a text message and do something with it.

So when we rolled it out, we did a lot of education. We gave patients the options to opt in versus not, and we were shocked at the number of patients that opted in and actually loved the ease. When you talk about the text to pay: 'Look, I didn’t even have to register. It was so quick and easy for me to get in and do it.'

We originally thought we would only launch it with a 55 and under population. We also had some focus groups with our patients to see how it impacted them. What did they like, what didn’t they like? We were shocked to hear that overall, most of the patients did not have any trouble with it. Which was great for us, because we were worried that that kind of technology with our patient base — folks are coming to us because they’re not feeling well — so we didn’t want to make someone that’s already not feeling well feel worse when you can’t understand what your bill is or how you can pay it.

Most importantly, when we implemented those things — automatic electronic statements or text-to-pay — we didn’t have a bump in patient dissatisfaction. If anything, our patients took to the new technology and actually praised it because it was so easy to work with.

Q: How are you thinking about Artificial Intelligence in healthcare right now?

A: On the clinical side, I think we were a little leery (about AI) to make sure we wanted that human touch. We wanted everyone to know that when you come to us, you are a person.

But we’ve also realized how AI in the background can help do some tasks that maybe will just make us even better, more efficient, and also be able to tend to our patients more and have more real-time hands-on with them — in the times that mean the most.

Whenever you can add AI, it can free up those people to do more hands-on, to concentrate more on the human being and the human aspect of it.  

With our group attached to a medical school, part of our job is teaching physicians how to become better clinicians. And how do we make it easier, more accurate, more time-saving for our physicians and clinicians.

I am optimistic. I think you have to be careful. Sometimes at our place, we may not be the first adopters. I think sometimes that’s a good thing because you want to make sure you thought through it well. We’re dealing with the human body, a human being.  

Q: What stands out most to you about the athenahealth partnership?

A: In my world, it’s not very often when you can look to a vendor and know that they’re the right vendor, producing the right outcomes for you on a business side. But I think it’s even rarer to have that personal side.

When I look to my IDX team, they’re part of my team. When I’m making a decision about something, when I’m making a decision about where we’re going and what we’re going to do, they’re part of my team sitting at the table with me, helping us get to where we need to go to. I think that’s rare.

It’s personal for me with athenahealth and with this team. I’m very grateful. I am extremely grateful.