Guest Column | September 27, 2016

Outpatient Providers: Unsung Health IT Heroes

Outpatient Care Movement In Oregon

By David McMullan, PT, Chief Therapy Officer, SourceMed

It’s National Health IT Week, a time to raise awareness of how information technology (IT) is being used to advance healthcare. As we honor the strides made in health IT, one area that stands out, but often does not get the attention it deserves, is outpatient facilities — both ambulatory surgery centers (ASCs) and rehabilitation therapy clinics.

Because it was more organic than forced, outpatient adoption of health IT is unique. For example, legislative and regulatory developments such as Medicare and Medicaid’s Meaningful Use Incentive payments have been a key driver for health IT adoption in the physician practice and acute care worlds. However, the outpatient space has proactively adopted IT even though its use is not required and most providers are not yet eligible for Meaningful Use incentives.

Over time the outpatient industry has become an “unforced” adopter and innovator in its use of health IT, driven by an increasingly competitive landscape and the move toward value-based care. Outpatient facilities must continuously look for new ways to improve operational efficiencies and optimize revenue while improving outcomes. For many, the secret to their success and adaptability is health IT. It is time we recognize the outpatient industry for its foresight and proactive achievements.

Surviving And Thriving
Outpatient facilities have a strong track record of providing affordable, quality care, and positive patient outcomes which are the reasons for this expansive growth. For example, from 2005 to 2015 nearly 45 percent of all spine cases were done on an outpatient basis. This compares to approximately 5 percent in 2005, according to the Society for Ambulatory Spine Surgery. Lower cost per case in an outpatient setting and significant improvements in postsurgical pain management are just two of the drivers cited for this shift. However, with increasing regulation and declining reimbursements, all has not been easy for outpatient providers.

In their quest for creative cost management strategies, outpatient providers are employing new technologies. One example is the significant cost savings that have resulted from a change in how ASCs manage inventory. Historically, ASCs have relied on ad-hoc processes and manual methods like spreadsheets to track products and expenses. With reimbursements on the decline, ASCs administrators quickly realized more sophisticated inventory management was essential to survival. Using technology to automate the inventory management process, ASCs can easily track supplies. In addition to avoiding overstock items and shortages, ASCs can quickly see how much is spent on supplies and the financial impact to the center.

In order to optimize revenue cycle performance, analytics tools are becoming more common in the outpatient space. New value-based payment models and the sheer volume of clinical, operational, and financial data available have made it increasingly challenging for outpatient providers to effectively manage their revenue cycle processes. Analytics tools are helping outpatient providers leverage the myriad of data while providing valuable business insight by regularly tracking Key Performance Indicators (KPIs) such as days in A/R, cost per patient or case, profitability per patient or case. The ability to integrate these tools with a center’s existing management software eliminates the possibility of errors while saving significant staff time.

Outpatient providers have also begun taking advantage of patient engagement IT solutions to replace time-consuming, repetitive tasks and gain more face time with patients. For example, instead of relying on clinical staff to phone patients in advance of their procedure to gather medical histories, patients can enter their health history, including allergies and medications, through a secure online portal. Once submitted, information is delivered directly to clinical staff in real time. This allows clinical staff to focus on managing the information and properly planning for the patient's care instead of spending 20 minutes with each patient simply collecting information. The use of patient engagement systems is a win for both clinical staff and patients. Clinicians have more time to spend with patients that have questions, which is proven to result in better medical outcomes and higher patient satisfaction.

Taking It To The Consumer
Some of the most creative users of health IT are outpatient rehabilitation providers. New legislation drives their innovative use of IT, but not in the way one might typically think. In the past 18 months, some important legislative changes have taken place in the rehab world with the passing of the Direct Access legislation which puts treatment choices back in patients’ hands. Under this new bill, patients in all 50 states can see any physical therapist (PT) they wish without a referral. While there are no new technology mandates associated with this bill, savvy PT owners are quickly turning to technology to reap the benefits of this openness.

In this new world of patient choice, many in the outpatient rehab space have realized the importance of marketing to patients more like consumers rather than waiting to have customers driven to them by doctor referrals. This means communicating services in terms of the value a PT can bring to a person’s overall health and well-being. As a result, the adoption of patient acquisition and engagement tools has become increasingly common as a way to market services to the community. Outpatient rehab providers have also become active on social media. Many are proactively using Twitter, LinkedIn, and Facebook to offer tips to draw people in and create an engaging presence.

Because patient data is more is valuable than ever, many PT owners are proactively leveraging technology to monitor trends in clinical outcomes. With the information in hand, they can differentiate themselves by quantifying the quality of care they can deliver against other providers and ancillary services such as chiropractors.

A Look Ahead
As the healthcare industry heightens its focus on value-based care, outpatient providers are poised for continued success. The reason, value-based care is not new to ASCs and Rehab Clinics which were founded on the fundamentals of providing cost-effective, convenient and high quality care.

While surgery centers and therapy centers are engaged in bundled payments today, it is only at the retrospective level. The initial push for value-based care is directed at hospitals and doctors. However, expect things to change quickly because providers will not get the full balance of money until the results are seen. This will require full engagement of all organizations across the entire healthcare ecosystem, surgery centers and therapy clinics included, and more creative uses of health IT.

About The Author
David McMullan, PT, is the Chief Therapy Officer for SourceMed, a provider of integrated, end-to-end technology solutions and revenue cycle services for outpatient facilities. David has over 20 years of outpatient rehabilitation healthcare experience in both private practice and hospital settings.