The Opioid Crisis, PDMP, and Interoperability

Barbara Mullarky

Barbara Mullarky

Director, Product Management at SRS Health
Barbara has had a successful career in the healthcare industry, working for both vendors and healthcare provider organizations. She has held roles in sales, marketing, product management and professional services, working with EMR and department-focused solutions for the laboratory and imaging.

Prior to becoming the Director of Product Management at SRS, Barbara was with GE Healthcare (now GE Digital), where she held the positions of Senior Product Marketing Manager for Centricity imaging products, Product Marketing Manager and Customer Collaboration Leader for what is now Caradigm, and Upstream Marketing Manager for Centricity Laboratory. Barbara also worked at the University of Arizona Medical Center, where she managed a team that was responsible for implementing and maintaining 27 departmental IT solutions, the ambulatory EMR and the patient safety initiatives.

Originally from New Jersey, Barbara now lives with her husband in Tucson, AZ. She is a graduate of the West Virginia University College of Medicine and is a registered Medical Technologist. When not at work, she loves traveling, taking photographs, watching football and spending time with her two Brittanys.
Barbara Mullarky

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opioid-blog-image-1The National Crisis

The opioid epidemic makes the news at least once a day in my neck of the woods.  Patients, providers and the government talk about the problem and how they’re going to solve it. Drug companies advertise Naloxone as something that you should have on hand as a first response to an overdose, just like having an Epi-pen on-hand is recommended to respond to severe allergic reactions. One of the most talked about solutions for physicians and eligible provides is the PDMP or Prescription Drug Monitoring Program.

What is a PDMP?

A PDMP is a state run system that records data on prescriptions for Schedule II to V narcotics. Currently, 49 states plus the District of Columbia have implemented a PDMP. Missouri is the only state without a statewide PDMP. The contents of each can vary based on the laws of the state, but generally the database is populated by pharmacies when a prescription is dispensed and, in some cases, by the dispensing physician or insurance claims. There are some holes in the databases. In some cases, federally operated pharmacies such as those on military bases, are not required to submit data. In other cases, prescriptions paid for in cash are not submitted. And they only contain the data for prescriptions written in your state. For those of you who live in towns that border neighboring states, your patients may have their prescriptions filled in a different state than where you practice.

While not perfect, PDMPs are one of the best tools available today to help practitioners understand their patient’s drug history and the patient’s potential to be an abuser.  There are documented successes with PDMPs. New York mandated the use of PDMPs in 2013, and in that first year, doctor shopping decreased by 75%, the number of opioid doses dispensed decreased by 10%, and the number of prescriptions for buprenorphine, a drug used to treat opioid addiction, increased by 15%.[1] In 2012, Kentucky became the first state in the nation to pass legislation mandating comprehensive PDMP use. That legislation led to a 13% decline in opioids dispensed, a 25% decline in prescription opioid deaths, and an almost 90% increase in prescriptions for buprenorphine, a medication to treat opioid addiction.[2]

Making connectivity difficult

Today, 39 states require a provider to check the state’s PDMP before they write a prescription for an opioid. Since not all states use the same software (some are homegrown), the ability for EHR vendors to connect to these databases is not easy or simple.  Some states, like New York, are simply not ready for EHRs to connect. This makes your workflow and the workflow of your staff difficult.opioid-blog-image-2

Figure 1 Information current as of January 2019

Is Your Prescribing Workflow Optimized?

Working with our partners at DrFirst, SRS Health now provides a seamless workflow to allow providers to check the PDMP for 35 states. Three other states are in process. With just one click, the patient’s medication history is displayed and the date that the PDMP check was performed is recorded in your state’s database and made available within the EHR’s prescribing application.

Interstate checking of PDMPs is also available for 47 participating states so practices in border towns can see not only their state PDMP data but that in neighboring states as well. Practices just need to request access to other states at implementation. If access is available across states, it will be set up as part of the installation.opioid-blog-image-3

Figure 2 Connectivity as of November 2018

What else will help?

PDMPs are one of the tools available for clinicians to help fight the opioid crisis. Utilizing electronic prescribing for controlled substances is another tool. EPCS prevents prescriptions from being altered or copied and refilled multiple times.  Pharmacists tell stories about how a 30-day supply has become a 130-day supply.

MYTH: Not many pharmacies accept electronic prescriptions for controlled substances. FALSE

According to Surescripts, > 95% of pharmacies in the US are EPCS enabled[3],[4] while physician and provider adoption remains low, with only 31% of providers using EPCS. New York leads the nation with 93.8% of controlled substances prescribe electronically. North Dakota, Maine, South Dakota and Minnesota round out the top five with 57%, 41.2%, 37.3% and 34.2%.[5]

While only 5 states require EPCS (Arizona joined the ranks as of January 1), ePrescribing of opioids is coming. Six more states have passed laws that go into effect from January 1, 2020 through January 1, 2022. In October, 2018, the federal government passed the Opioid Response Act[6]. A portion of the act called the “Every Prescription Conveyed Securely (EPCS) Act will require electronic prescribing for patients covered by Medicare and Medicare Advantage plans of all Schedule II-V narcotics beginning January 1, 2021. Earlier in the year, retail giants Walmart and Sam’s Club announced that they will require EPCS for all controlled substances by 1/1/2020 – less than 12 months from now!

How can you prepare?

For SRS Health EHR users, the answer is simple. We’re ready so you can be ready too. With our new Rx application, powered by DrFirst, we deliver an integrated eRx, EPCS, PMDP access and mobile application that allows you to meet all the state and federal mandates and help improve patient care. Just contact your account manager to learn more.

For non-SRS Health EHR users, check with your EHR vendor to see what capabilities they offer. Contact us if you’d like to learn more, our team is ready to help.

Citations:

[1]  Shatterproof, et al. “Prescription Drug Monitoring Programs: Critical Elements of Effective State Legislation.” March 2016.

[2]  Shatterproof, et al. “Prescription Drug Monitoring Programs: Critical Elements of Effective State Legislation.” March 2016.

[3] Electronic Prescribing for Controlled Substances, Surescripts

[4] E-Prescribing Pharmacies

[5] E-prescribing up more than 500% since 2015. Health Information Technology, May 8, 2018

[6] Senate easily passes sweeping opioids legislation, Washington Post, October 3, 2018

Patient Portal: The Gift That Keeps on Giving

patient-portal-blog-v3Gifting season may be over, but there is one gift that you can give to your patients that will keep giving benefits to you and them for years to come. To improve patient engagement, you need a portal that is easy to use, responsive, and allows your patients to communicate with your practice on their terms.

What results when you empower them with the right tool? A gift that keeps on giving—increased patient satisfaction, time and money savings for your practice, and increased quality of care.

Here are the top 3 ways a patient portal could benefit your practice:

  1. Streamlined Patient Registration and Intake Process
    • Registration forms can be downloaded and filled out at home—providing the convenience of being able to complete forms at their leisure and decreasing their wait time
    • Data provided can auto-populate to your EHR—allowing your staff to spend more time interacting with your patients
  1. Improved Patient Engagement and Communication
    • Patients can efficiently and conveniently connect with the portal to schedule  and manage appointments, pay bills, view documents, and communicate  with staff members and physicians via messaging—reducing time spend on back and forth phone calls which oftentimes causes delayed responses and miscommunication
    • Better engagement leads to better patient-physician relationships, ultimately increasing retention and improving clinical outcomes
    • With a mobile solution, the patient has access to all their health data as they communicate and manage appointments on the go—empowering the patient to make their own health decisions
  1. Optimized Operational Workflow
    • With online access, patients can schedule appointments, access their records/tests, refill prescription, pay their bill etc. on their own, which frees up your staff and physicians’ time to focus on other important tasks, as well as allow practices to decrease bad debt and get paid quicker
    • Improved communication efficiencies and automated patient reminders reduce no show rates as well as overall wait time allowing you  to see more patients in a day
    • Patients filling out forms prior to their visit allows the practice to better prepare for the visit, decreases in office wait times and the work involved with scanning paperwork and updating chart data

So not only does providing the best patient portal solution help your patients succeed at their own care, but also helps your practice win! What are your 2019 strategies to improve patient engagement?

 

*Source: Patient Portals: Build Them Well and They Will Come

 

The Essential Elements of Value-based-care Success

Khal Rai

Khal Rai

CEO at SRS Health
Khal Rai brings over 20 years of leadership experience to his role as President and CEO at SRS. He possesses a breadth of knowledge and expertise in the healthcare and technology sectors earned through a career that has spanned the globe. His passion for collaboration, strategic development, and delivering healthcare IT solutions that make it easier for medical professionals to deliver care while navigating the ever-changing healthcare industry, inspires and motivates his team, while positioning SRS Health clients for current and future success. Khal has a B.S. degree in Computer Engineering from the University of Cincinnati, and an M.S. degree in Electrical Engineering from Purdue University.
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For a medical practice to operate successfully, all its constituent parts need to fit together as seamlessly as the atoms in a molecule—because that’s what it takes to succeed in today’s changing healthcare environment.success-blog-image

In a water molecule, for example, the oxygen atom is balanced and supported by the push and pull of two hydrogen atoms. This simple structure nourishes all life on the planet. But remove one of the atoms and the molecule ceases to exist, breaking down into its component elements of hydrogen and oxygen.

In much the same way, a medical practice is held together by the push and pull of different elemental forces. The doctor is supported by—but also has to balance the demands of—the clinical and financial sides of the practice. When this is done successfully, the result is a caregiving structure that nourishes the health of the patient. If the balance is lost, however, the practice begins to break apart, disrupting the equilibrium between the business of medicine and patient care.

Keeping this already precarious balance has become even more challenging with the shift to value-based medicine, which has altered the healthcare paradigm from doctor says/patient does to doctor/patient collaboration—adding another element to the healthcare molecule—the patient. Now, in addition to keeping up with the latest clinical developments and keeping the practice fiscally afloat, doctors have to find ways to bring the patient into the loop.

This year’s User Summit gave healthcare providers a forum for discussing what it takes to succeed in the evolving, value-based healthcare environment, and it gave us a chance to showcase the innovations we have developed to help you keep the right balance between the elements.

So how do we involve patients more deeply in the healthcare process? How do we make sure that they are informed and engaged with their care team, that they understand and comply with their care plan, and that they are financially supported in maintaining care?

For us at SRS Health, the challenge is to develop solutions that reduce the barriers between the patient and the practice. This means providing practices with tools that:

  • offer both speed and flexibility,
  • improve both the clinical and patient experience,
  • remove physician and clinical team distractions while still providing true mobility,
  • streamline the efficient collection of relevant data and corresponding intelligence at the point of care, and
  • address the healthcare consumer’s role in driving patient satisfaction and practice financial health.

In other words, finding practical innovations that support all of the elements of healthcare in achieving success.

How Your Practice Should Compete in the Digital World

As technology has changed the way people receive information, it has also changed the way patients determine a care path for an injury or condition. Most significantly though, it has changed the way patients choose a specialist to treat their condition.  Practices must adapt their patient acquisition strategies to reflect this more informed and more digitally savvy audience if they want to remain profitable in the coming years.

This is especially true for practices that wish to remain independent as hospitals and health systems continue to acquire referring practices, such as Primary Care and Family Medicine.  However, too often practices do not understand the need to implement a cohesive digital strategy until they begin to see a decline in patient volume or an increase in competition.  It is important to understand the impact the digital shift has had on patients and how to use it to remain profitable.  Below are some of the basic strategies practices should be using:

A Mobile Responsive and Unique Website 

Statistically, almost 70% of medical journeys begin online with patients searching for conditions and a provider to treat that condition.  What’s more, 60% of all internet traffic now comes from a mobile device (phone, tablet, etc.).  What this means is that the majority of potential patients are researching a condition or searching for a provider on a smartphone or tablet. This is where your practice’s website becomes one of the most important tools in patient acquisition.

By now most practices have a website – but that may not be enough.  In 2014, Google began to penalize websites that did not meet the standards of a “mobile responsive” website.  What this means is that the website had to be updated to use a theme or platform that automatically detected whether the potential patient was using a phone, tablet or desktop computer and automatically reformatted the layout and navigation of the website to ensure a better user experience.  If your website does not meet these criteria, Google began to push your website further down in the results if a search came from a phone or tablet.  If patients have to spend time pinching and scrolling to be able to read the content on your site, they are far more likely to leave your website and go to a competitors’ website to find the information they are looking for.

In addition to the mobile responsiveness of your site, Google bases your placement in search results based on the content within your site.  Too often practices make the mistake of simply listing the conditions they treat or procedures that they perform.  Not only does this lack of content hurt your placement is Google search results, but it also hurts your new patient acquisition.

In a world where a wealth of information on any medical condition is accessible instantaneously, the modern patient needs more than just a bullet point on your website to ensure that you are the right doctor for them.  To increase patient acquisition, your website should have individual pages for each treatment you provide, condition you treat and procedures you perform.

A Google Pay Per Click (Adwords) Strategy

A Google Adwords Strategy gives your practice the ability to target your message to patients in your area looking for your services at that very moment.  Google Adwords allows your practice to “bid” on relevant search terms in your area and shows your results at the top of the page. Google Adwords is statistically the highest ROI digital marketing effort a practice can utilize.

The most important aspect of Google Adwords to remember is that these ads allow you to outrank your competitors for only the most relevant searches and keywords related to the services of your practice for those searching in your area.  Also, these ads are shown above the organic search results, so even if a competitor’s website outranks yours, your ad can be shown above their website.  

But, running a Google Adwords strategy on your own may be more complex than it seems and can result in wasting a large amount of dollars if not implemented and monitored correctly.  Knowing what kinds of phrases indicate a patient is simply doing research versus those terms that a patient is specifically looking for a physician can be the difference of hundreds or thousands of dollars in a month.

Social Media Marketing

According to a 2017 Pew Research Study, 67% of all Americans get at least half their news from Social Media sites.  This represents a significant shift from print and TV being the primary news sources, but does not seem all too surprising considering that the average American spends almost two hours per day on social media sites.

The likely reason for these shifts is that social media sites like Facebook serve as aggregate news sites where users can get information from all their trusted news sources, from local newspapers to national TV networks, in one single place.  Platforms like Facebook recognized very early on how to monetize the time users spent on the site or app by allowing for highly targeted advertisement being shown to their over 1 billion users.

In most cases, medical practices conceptualize social media as a place where people post pictures of their children, pets and food.  While that may be what you see externally, internally Facebook and Instagram have an incredible amount of data about their users that can be used to target specific ads to potential patients in your area.  These platforms track data points that include your age, gender, location, purchases you make, websites you have visited, interests you have and thousands of other data points.  All of this data can be used to create a behavior profile of a patient that may be in need of your services and target them with ads both on social media and on other websites they visit.

Facebook and Instagram ads are imperative for brand awareness and have become the modern newspaper or magazine ads and are far more cost effective.

What digital healthcare marketing strategies are your practice implementing to help build brand awareness with your patients?

 

daniel-goldberg

About the Author 

Daniel Goldberg is the CEO of Gold Medical Marketing and has been a thought leader for almost a decade in the field of Healthcare Marketing. Daniel has also lectured at some of the most esteemed medical conferences in the country and has contributed to many healthcare industry publications on the topics of Medical Marketing and Direct to Patient Marketing.  Daniel and his team at Gold Medical Marketing have helped practices around the country implement unique marketing strategies based on their specialty and unique patient demographics.

Customers or Clients… What’s the Difference?

Catherine Armstrong

Catherine Armstrong

Director, Communications at SRS Health
Catherine brings over 20 years of marketing, communications, and brand stewardship experience to her role as Director of Communications at SRS. She has worked for nationally recognized brands in the healthcare information technology, real estate, hospitality, and luxury automotive industries, including SRS Health, BMW North America, WCI Communities, Cendant, and Orient Express Hotels. She has a passion for understanding the challenges facing her audience, and connecting them with their ideal solutions. Catherine has a B.S. degree in Communications, and is currently working on her M.F.A. in Creative Writing.
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I have read a lot of books on customer service, including, J. W. Marriott’s The Spirit to Serve and Without Reservations, as well as Hug Your Customers by Jack Mitchell, upscale clothier to the rich and famous. Both describe the service culture, personal attributes, and dedication required to build a trusted brand and to create an exemplary customer experience that keeps customers coming back.

A lot can be learned from these entrepreneurs and the organizations they’ve built. In fact, we at SRS Health have a lot in common with them in striving to create an experience that exceeds expectations. But there is one important difference. While these trusted brands sell a product or service, we are charged with offering our clients ongoing professional guidance and support.

In short, customer service involves a one-time transaction (which may be repeated if there is a good experience) while client service involves an ongoing relationship (which may not go on very long if there is not a good experience).

With the healthcare landscape changing at a rapid pace, a good client experience requires an atmosphere of mutual trust so that medical professionals can rely on their healthcare IT partners to advise them. Just as financial counselors are charged with ensuring their clients are informed and prepared to make sound investments decisions, HCIT partners are charged with ensuring that their clients have the insight to make sound decision regarding their healthcare IT investments.

But that is not all—we are also charged with providing expertise in regard to compliance, operational efficiency, patient engagement, and more. As trusted advisors, we need to know where the industry is headed, and to provide the solutions that prepare our clients to succeed in that future.

At SRS, we like to say that our expertise is helping specialists practice their expertise—we provide solutions that take care of the business side of medicine so that medical professionals can take care of their patients. In practice, this means integrating intelligence within physicians’ workflows—where it can be seen and used to help them make informed patient care decisions efficiently and effectively.

And it doesn’t end there—we also provide the business intelligence within the administrative workflow, so that business leaders can utilize the data to improve operational efficiencies, lower cost, build their practice reputation, and improve their bottom line.

A continued passion for, and commitment to, ensuring that our clients are prepared to achieve their patient care and practice profitability goals—that is how we grow our relationship and earn their trust each and every day.

Does your healthcare IT partner make you feel like a customer or a client?

Hackathon IV: Notes 2.0 and Beyond… A New Evolution Has Begun

Vishu Viswanathan

Vishu Viswanathan

Director of Software Engineering at SRS Health
Vishu started his career with SRS Health as the Director of Program Management, and is now the Director of Software Engineering. In this role, he is responsible for the architecture, design, and development operations for the SRS product lines.

Prior to joining SRS in 2017, Vishu was with GE Healthcare, where he was the SW Engineering Director for the Centricity Imaging PACS product. Vishu has had a successful career in the healthcare industry, with deep domain expertise in Healthcare imaging, devices and information technology, and medical software development. He began his career as a Software Engineer with GE Healthcare and has held progressively responsible roles in both product development and program management.

Vishu is an Agile practitioner and is passionate about people and product development. He holds a Bachelor’s Degree in Computer Science and Engineering, and Masters in Business Administration.
Vishu Viswanathan

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Hackathon 1Last month, SRS Health participated in an energizing, collaborative and fun-filled Hackathon IV, a company-wide event designed to stimulate the innovative mind-set and competitive spirit of the organization to explore creative solutions for client needs.

The theme for the 4th Annual Hackathon Event was, Notes 2.0 and Beyond. Technological advancements in the healthcare space has enabled the use of various mobile devices and technologies at the point-of-care. The team was challenged to come up with ideas that revolutionize the process of capturing and documenting patient encounters, while maintaining/improving accuracy, high productivity, and efficiency for the end user.

Scores of ideas were submitted from across the organization and narrowed down to six ideas that our hackathon teams focused on. At the end of the event, the organization held a traditional “science fair” to showcase the incredibly innovative solutions developed over the one-week event.

We are excited that a number of these concepts have the potential to make it into future versions of our products. We look forward to sharing them with our clients in the 2018 User Summit’s Innovation Expo in October in Las Vegas.

At SRS Health, we strive to bring innovative healthcare IT solutions to the marketplace and our hackathon events allow the team to innovate without restraints.

Hackathon 2

Spring at SRS Brings New Growth

Khal Rai

Khal Rai

CEO at SRS Health
Khal Rai brings over 20 years of leadership experience to his role as President and CEO at SRS. He possesses a breadth of knowledge and expertise in the healthcare and technology sectors earned through a career that has spanned the globe. His passion for collaboration, strategic development, and delivering healthcare IT solutions that make it easier for medical professionals to deliver care while navigating the ever-changing healthcare industry, inspires and motivates his team, while positioning SRS Health clients for current and future success. Khal has a B.S. degree in Computer Engineering from the University of Cincinnati, and an M.S. degree in Electrical Engineering from Purdue University.
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ceo-spring-blogThree months have passed since I took over the reins at SRS Health, and what I have enjoyed most over that time is sharing in our clients’ successes, as well as learning about the challenges they face, their experiences, and their visions for the future. So far this year, I have had the pleasure of speaking with many of them on the phone and off traveling around the country to meet others in their practices or at conferences like ADAM, AAOS, AAOE, The OrthoForum, and HIMSS.

One recurring theme that has been a part of every conversation is the need to embrace change—to look forward, to anticipate, and to strive for improvement. Our mission is to help our clients do just that. We are excited to share the innovations SRS has been working on to help our clients excel at the practice and the business of medicine. Here are a few examples:

SRS Health launches the first end-to-end integrated clinical and financial solution suite for high-performance enterprise practices

I am pleased to announce that SRS recently debuted a unique and powerful new addition to our end-to-end software suite that leverages both clinical and financial expertise. What makes this solution unique is the integration that addresses true episodic care. SRS’ roots in the orthopaedic market combined with the new financial management capabilities offers a seamless set of tools for enhancing workflows, adapting to regulatory changes, adopting risk-based models, managing the increase in patient economic responsibility, and expanding programs in the employer market.

The Opioid Crisis and Drug Monitoring

As you know, the opioid crisis has become a top-of-mind political, social, and policy challenge. SRS has committed to joining the fight by being the first specialty EHR to offer PDMP (Prescription Drug Monitoring Program) checking and documentation integrated within the prescribing workflow—delivering a 67% time savings over current methods. More than 40 states already have PDMP mandates and it won’t be long before they all do. This is a great step in keeping our clients ahead of the curve.

Improving Our Clients’ Experience

While working on innovation, we haven’t forgotten about our clients’ day-to-day experience. To ensure their success, we have been formalizing the structure of the SRS Client Success Program. This year we’ve launched the Client Success Training Program and the Features Improvement Team. In addition, we have increased our clients’ ability to integrate with registries, HIEs, and more. These programs ensure that they have the knowledge and skills to fully leverage their HCIT solutions, the facility to share knowledge across their organization, and the connections to exchange information with optimal efficiency.

Medicine continues to put more and more demands on physicians, clinicians, and other healthcare professionals, and we’re excited that our integrated solutions suite optimizes performance and care before, during, and after the patient encounter. Our goal is to help our clients by taking care of the business of medicine, so they can focus on what matters most—their patients.