Anticipating Clients’ Needs

client-needs-blogI was recently fortunate enough to visit two Ritz-Carlton Hotels in the span of a few weeks followed by another premium hotel which I will refer to as Hotel B.  If you have ever stayed at a Ritz, the following will come as no surprise, but they seem to read your mind at times.  Sure, you are always greeted with a smile at any hotel and offered help with luggage or directions.  What I’m referring to is how they anticipate your needs either through past experience or more importantly through listening to what you are not saying.

As an example, while departing Hotel B, my car was brought up, bags were put into the car and I was on my merry way.  Whereas  when leaving the Ritz, my car was brought up, bags were put into the car, but I was then asked where I was headed.  I explained I was headed to San Diego while absently loading an address in my cell phone’s GPS app.  Before I looked up, the valet had returned with water bottles stating that traffic could be rough this time of day and I might need them.  Additionally he saw the route in my GPS, along with my vacation appropriate attire, and made a recommendation for an alternate route if I didn’t mind a more scenic drive with less traffic.  It was this anticipation of needs that inspires guest loyalty, and commands a premium.

As I look around in the healthcare technology space, we must do a better job of anticipating our clients’ needs, rather than just reacting to what they are saying to us.  The industry is suffering from a lack of satisfaction and companies are having a hard time standing out from the herd.  Most are banking on their next big feature to be a differentiator that certainly has a powerful impact if it solves a particular problem. But without a firm understanding of their needs, it’s not going to resonate. Features will also come and go, requirements will morph, and regulations will change— and that’s due to the very nature of software and healthcare as a whole.  I would argue, let’s make service the one thing clients can’t live without.  Let’s stop simply listening to clients, and instead try to anticipate their needs and offer them solutions to problems they may not have verbalized yet.

After all, the features we offer are only as good as our fundamental understanding of their needs, spoken AND unspoken.

Data Done Differently

data-funnelAs I mentioned in my previous post, The Truth Is Stranger Than Friction, some physicians are so dissatisfied with their EHRs that they wish they could return to the days of paper charts. The main culprit is the data collection process, which causes friction between doctors and patients. I argued that workflows should, first of all, adapt to each doctor’s style so that doctors can concentrate on patients rather than technology, and, second, enable seamless data collection during patient interactions so that doctors don’t waste time recording data later. Traditionally, EHRs have been vendor-led in how they were built rather than being designed around how clients wanted to use them.

The role of an HCIT vendor is to understand its clients’ and prospects’ requirements. This step is often overlooked. We are seeing huge dissatisfaction in practices’ experiences with their current EHR solution. This can be seen with the impact these solutions have on the doctor-patient relationship; many practices have seen a reduction in the amount of face-to-face time with patients, as well as a decrease in the number of patients they can see.

According to a recent Medscape study, 45% of patients made complaints either occasionally or frequently about lack of eye contact, excessive questions, or providers focusing more on the equipment than the exam. On top of that, a recent article on Healthcare Scene reinforces that doctors are frustrated by using EHRs because they don’t match their workflows, feel clunky, and require too much time for documentation. The article goes on to say that these frustrations lead to both physician burnout and a decrease in EHR use.

However, is technology the culprit? No. I believe these problems are not a reflection on the technology. We see in other industries how technology has been optimized to improve business operations and improve customer satisfaction. I would argue that the fundamental problem with EHRs is a lack of understanding of what challenges practices face, and how to accommodate and plan for both today and tomorrow’s needs. This lack of understanding usually results in a poor implementation plan that is set up to fail from day one. Unfortunately, with the move toward a valued-based model, this misunderstanding is likely to cause even more problems.

What is needed is not only a way to capture and share relevant data, but a way to do this without disrupting the physician’s workflow. This is especially important for specialty practices with a high-volume of patients. Workflows should be personalized so they fit around the physician’s way of working rather than interfering with it, and a crucial part of this is cutting out the clutter and showing only relevant information as defined by the physician and practice.

Our team’s philosophy has always been to put the clients’ requirements first in everything we do. We work closely with clients to understand their workflow, and then we provide a solution that improves their operations in a way that makes sense to them. Our years of experience in providing best-of-breed specialty solutions to ambulatory practices has given us a strong appreciation of the importance of designing an agile solution that effectively handles a high-volume patient intake and put through while improving practices’ bottom line.

When it comes to data, we feel just as strongly, if not more so! We want to enable seamless data collection during patient interactions, so that doctors are not spending hours recording data later. We want to empower practices to determine who should capture the data they want, when and how they want, in the context of patient encounter. This means providing a flexible solution that is future-proof, leveraging mobile platforms and predictive technologies, while incorporating Outcomes and Analytics that not only keep up with busy specialists, but actually help move them forward.

That is what we mean by data done differently.

Securing Your Business: Disaster recovery – do you need backup or a business continuity plan?

bouncer-blogAs an MSP specializing in healthcare and security, StratX IT Solutions is often asked,

“Is there a difference between backup and business continuity plans for disaster recovery?”

Many believe that data backup and business continuity plans are one in the same but they are not! One allows you to recover your files, and the other enables you to continue operating your practice regardless of the severity of the outage or your physical location. They are complimentary solutions and you need both in order to secure the business of your practice.

With estimates that 70% of data outages are caused by human error (eg, opening emails with viruses*) and the Gartner Group study which predicts that 25% of PCs will fail each year, asking “IF” you need a disaster recovery plan for your systems has become moot. What is critical is “HOW”.

But let’s backup for a minute (bad pun intended). Let us explain what data backup and business continuity plans are, and what StratX recommends to our clients as the most failsafe combination.

It all starts with data backup. It is the foundation for disaster recovery and business continuity – no backup means no business continuity.

But, not all backup solutions are created equal.  Remember when tape backup was the only option? Data protection is a fast-evolving market, and solutions that were put in place a decade or so ago are no longer suited to meet today’s regulatory and requirements.

What is required is a robust, viable foundation for ensuring secure, HIPAA compliant data backup and retention. Backup products fall into three (3) basic categories:

  1. Onsite backup (data stored on hardware kept physically in your office)
  2. Cloud backup (data stored on hosted hardware via the internet)
  3. Hybrid onsite-cloud backup (combines the first two categories)

Onsite backup works well when a quick restore of lost or damaged files is required. The data is onsite and, it’s fast and easy to restore to its original location. But what happens if:

  • The power goes out?
  • If the device fails?
  • Or if the equipment is stolen or fails?

You might think the cloud looks more attractive due to onsite backup’s “what ifs,” but cloud-only backup is risky too.

  • What if you lose connectivity to the internet?
  • Restores tend to be difficult and time-consuming.
  • And, after all, the cloud can fail, too.

What is a hybrid onsite-cloud solution?

  • Your data is first copied and stored on a local device and your data is also replicated in the cloud.

StratX recommends that our clients purchase and use a hybrid onsite-cloud backup solution. By using onsite backup to mitigate the risks of the cloud, and using the cloud to mitigate the risks of onsite backup your data will be available to you in case of an emergency and allow you to put your business continuity plan into action.

Furthermore, we recommend our clients use a hybrid onsite-cloud solution which gives them the ability to work virtually. The backup contains full server images (vs. only files or data) which can be restored or activated as servers in a disaster and allow you to work as if the original servers were still functioning – this is where a business continuity plan comes into play.

Business continuity, the ability to keep daily operations running, isn’t a product that you purchase per se, it’s the action plan that is designed and managed by your IT staff or vendor.

The plan lays out how you will access your server, software, applications and data when disaster strikes and also sets a timeline to achieve that access. It should also have provisions to have your IT support continually test the process before you are faced with an issue. It’s better to troubleshoot failed “test” restorations than to lose days, weeks or even months reinstalling and configuring your systems.

The only safe way to head-off downtime of your systems, regardless of the cause, is to be informed and prepared. Do you have a clearly outlined plan in place for your practice?

It’s critical that you are prepared, ask your IT staff:

  • How quickly can my business be up and running in the event of disaster?
  • Do we have documented backup, security and a business continuity plan in place which meet our regulatory requirements?
  • Is all of our critical data backed up daily, or more frequently?
  • How fast can we get our systems up and running to a pre-disaster operating state?
  • Have we done a real world test our backup and business continuity plan?


Jack Mortell

SRSsoft guest blogger: Jack Mortell of StratX IT Solutions

* Print our “email safety guide” for your staff. It describes the key signs they should look for to identify and avoid opening malicious emails.

MACRA News: CMS Yields to Pressure with “Pick Your Pace”

yieldAs everyone is in the midst of anxiously trying to prepare for MACRA while awaiting the Final Rule, (due November 1), CMS announced yesterday that it is stepping back the requirements and the timetable to make it easier for providers to avoid the 2019 negative payment adjustments set out in the Proposed Rule. This decision comes in the wake of 4,000 comments and subsequent pressure from professional groups and from Congressmen/women pleading for relief from the rushed implementation of a complex and overly aggressive set of requirements that would negatively impact many practices, particularly small groups.

Andy Slavitt, Acting Administrator of CMS, published a blog that gave an overview of the new options that allow providers to “pick their pace” of complying. It appears that the only way a provider would receive a negative adjustment in 2019 would be if they do almost nothing in 2017. He outlined 4 options for participation:

  1. Do something! Avoid a negative payment adjustment in 2019 by submitting some data in 2017. This begs the question: what constitutes “some data?” Does this mean some data in each MIPS category, some data in one category, quality data only? (To me, the wording in Slavitt’s blog is reminiscent of CMS’ past MU shift to “capability enabled” or “met for 1 patient”.)
  2. Report for a short reporting period (“a reduced number of days”) could qualify you for a “small” positive payment adjustment.
  3. Comply with MIPS as defined in the Proposed Rule—or I assume, as it will be defined in the Final Rule— for the full calendar year and you could qualify for a “modest” positive payment adjustment.
  4. Participate in MACRA’s Advanced Alternate Payment Model option. CMS is hinting that it may broaden the definition of an APM.

This news will no doubt be greeted with relief and cheers by most providers, but I wouldn’t be surprised if they are left feeling more uncertain now of what will be required in 2017 than they did before the announcement! What constitutes sufficient reporting in options 1 and 2 above? How many days are in a short reporting period—90 perhaps? How do the revised “small” and “modest” payment adjustments compare to the potential 4% proposed for 2017 and to each other? Will performance still be evaluated relative to other providers? And what happened to budget neutrality, i.e., where is this money coming from if hardly anyone will receive a negative adjustment?

Please let us know what you think of this latest MACRA news, and stay tuned as we learn more!

MIPS: 5 Things You Can Do Now to Prepare

5-things-mips-blogEven though the final MACRA rule is not expected until November 1, 2016, you would be well advised to start putting an action plan in place now. As proposed, the first performance year begins on January 1, 2017, a mere 2 months after the expected release of the Final Rule—you won’t have sufficient time to prepare if you wait until then. Yes, CMS has hinted about a possible delay or a shortened reporting period (in response to numerous concerns expressed in the 4,000 comments to the proposed rule), but you cannot bank on that until it is finalized. There are things you can do to start planning your strategy and improve your chances of success when this first regulatory foray into value-based payment begins:

  1. Focus on 2016 PQRS reporting: Quality reporting carries a 50% weighting next year, which makes it the most important of the 4 MIPs performance targets, (the others being Advancing Care Information, aka MU; Clinical Practice Improvement Activities; and Resource use, aka cost). Take advantage of the next 4 months to improve your quality measure workflow and reporting.
  1. Think about whether to report MIPS as individual physicians or as a group: It’s important to look at your practice’s current MU and PQRS performance as a predictor of which option might be more beneficial. You may already be reporting PQRS as a GPRO—success here makes a strong argument for reporting all categories as a group. (Remember, as proposed, you must report consistently across all 4 MIPS categories.)
  1. Develop workflows to support success: Identify the ACI patient engagement and health information exchange (HIE) measures that are of most interest or relevance to your practice. Analyze and try to enhance the workflows that support these measures. Ask your EHR vendor for a professional services evaluation—they may be able to offer assistance in this regard.
  1. Review the list of Clinical Practice Improvement Activities: Review the list provided in Table H of the Proposed Rule. Are there activities that fit your practice or possibly some that you were considering, even before MACRA?
  1. Evaluate your current technology resources: Is your EHR up to the job—or is it killing your productivity, particularly when you use it to meet the government requirements? If you are not satisfied, now is a good time implement new technology.

The most important step to take now and in the coming months is to keep yourself educated and up to date as the regulations evolve and the start date approaches, (But you clearly know that, since you’re reading this post!) On, you will find Quality Payment Program Resources pages. You can also consult your professional societies/academies for specialty-specific guidance or reach out to your EHR vendor for training. I invite you to watch (or watch again) my webinar titled, “MACRA/MIPS: 962 Pages in 30 Minutes”, which is available on demand.

Frictionless Product Delivery

upgradeWhat if I told you that software deployment could be simple? You’d likely accuse me of smuggling Kahlua into my morning coffee. It seems like only yesterday that installations required CDs and that every workstation needed hands-on attention. Once you got to a particular unit, you would be greeted with an array of screens and prompts that could conceivably require hours of monitoring. Allow me to assure you that those days are over!

The term “innovation” is usually applied only to product development, but at SRS, we have pushed this approach to all facets of what we do, including procedures and processes. One of our many innovations this year has been the incorporation of a software deployment tool, which silently installs applications without user interaction.

While I would love to take all of the credit for this major advancement, I can’t. We first heard about it during our IT Round Table collaboration session at our User Summit last year when we were discussing the tools IT professionals use for software, patches, and file deployments across their infrastructure.  All were pleasantly surprised by the ease of use, consistency, reliability, and advanced options offered by this software deployment tool, and they all agreed that it was much more reliable than Group Policy deployments and other well-known software deployment tools on the market. We took this feedback and did our homework.

How does this Software Deployment Tool benefit you?

  • Quick and easy deployments – only one resource needed to create and deploy a package across multiple sites without any user interaction
  • Deployments scheduled at your convenience
  • Detailed report provided in real time during and after the deployment is completed
  • No prior technical knowledge required

In some cases, the workstation deployment time of an SRS upgrade has been reduced from 3.5 hours to 20 minutes. That is an outstanding 90% improvement! A simple adjustment to your process can have a dramatic impact on both the time and cost spent in the deployment process.

You must be wondering, “There has to be a catch!” I assure you, there isn’t! Perhaps the best part is that there’s no need to review a complex manual. At SRS, we provide training and testing, and have confirmed that non-technical users can configure the deployment and re-use it without our assistance—it’s that easy!

Whether your focus is software development or deployment, or sales or marketing, innovation designed to remove friction will always lead to increased efficiencies and better results!