My ears perked up. What could possibly be worth a gazillion dollars in health care?
"And at the same time, you'll help the doctors do the right thing. Which they want to do anyway - it's just too difficult today," he continued.
This customer was talking about Transitional Care Management (TCM), or the set of services that have to happen when a patient gets discharged from the hospital. pMD has included transitional care features in its charge capture software since 2009, but due to a series of government initiatives, interest in improving transitional care is at an all-time high right now. The customer was already up and running with the TCM functionality that we had at the time, but he wanted to tighten the timeframe even further in which patients were contacted by his schedulers after they were discharged. He also wanted to improve communication to the patient's regular outpatient doctor, who sometimes didn't even realize that the patient had been hospitalized unless they really did some digging.
"Immediate, unambiguous, and impossible to miss" was the request - not just a report that someone could run, or a fax sent to a machine that gets cleaned out once a week. And giving the discharging physician the option to include some clinical details, for example about any medication changes in the hospital, was icing on the cake.
But was it really worth a gazillion dollars? Well, there is real money on the table from Medicare and other insurance carriers who are trying to decrease patient readmissions and the cost of health care. It turns out that if you contact a patient right away after they are discharged, and you make sure they get seen quickly in the outpatient setting, you can dramatically lower the chances that they'll have another crisis and bounce right back into the hospital. This is "doing the right thing" for the patient, and thanks to these incentives, it's also the right thing for a practice's finances. One customer told me that they could make an additional $2,000,000 per year just from the Medicare transitional care bonus. Large oncology practices could see similar sums from the Oncology Care Model. And hospitals could save at least that much money by reducing readmissions, since they don't get paid for the second stay if the patient comes back within 30 days after discharge.
So when you add it all up, there are many billions of dollars that could be squeezed out if everybody got this right. pMD won't see much of that directly since we don't charge our charge capture customers extra for this functionality. But doing the right thing for patients is priceless, and making doctors happy is our mission.
The same customer came back to me after we rolled out the new TCM version and said it was the smoothest software rollout he had ever been part of in his long career. He said they had "unanimous support from the physicians" - something he had almost never seen before, given the huge size of his group. That was enough to put a smile on my face.