The pMD Blog

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pMD Blog...

where we cover interesting and relevant news, insights, events, and more related to the health care industry and pMD. Most importantly, this blog is a fun, engaging way to learn about developments in an ever-changing field that is heavily influenced by technology.

POSTS BY TAG | Charge Capture


 

When the pandemic hit this year, my team struggled to become telemedicine software experts. We still struggle with this.” 

I thought downloading a trial version was great. But after hours of attempting to figure it out on my own, I still don’t have a system that meets my needs.”  

We liked the product, but we had to hire employees just to help support it.

All too often, medical technology companies offer software separately from supportive services, like product customization, best practice implementation, systems integration, and product support. This is because unlinking services from a product into discrete offerings makes it easier for that company to account for internal costs. But what’s easier for the vendor adds complexity for the customer to an already complex decision-making process.  

This is the strategy of a vendor. If you look at an invoice or pricing proposal today and see unbundled products and services, that means you’ve likely hired a vendor. And in practical terms, it means that when you have a new problem to solve, you’re either on your own or you’re likely going to pay more money. In financially stressed times like these, you simply can’t afford to invest another cent with a vendor.   

Partnerships are about value creation


Good partners, as opposed to vendors, understand that a successful relationship requires that a combination of services be delivered from a team of experts in order to maximize the value created. pMD's products are backed by some of the highest quality services in the industry. But you won’t see a separate quote for those.  

“pMD acts as an extension of each practice from day one. I’ve seen firsthand their effort to understand the needs of each practice stakeholder and identify workflow improvements down to the individual user level. Each time the result is the same; a finely-tuned set of pMD solutions optimized to deliver value for that team,” says Ibrahim Ali, Associate Director of Product Management for McKesson, The US Oncology Network. 

Since pMD’s corporate strategy is not driven by short-term investors looking to maximize profitability and make a quick exit, pMD prefers to invest in helping to solve your complex issues without a new contract wherever possible. We know that a sustainable partnership is based on mutual successes. Mr. Ali went on to add, “pMD’s investment in understanding our practices and their goals has built our trust in this partnership over the past several years. Leveraging this relationship will be key as we navigate the future of community oncology care together.”  

pMD releases of HIPAA-compliant secure messaging, telehealth, and automated patient appointment reminders to the existing pMD® Charge Capture™ platform at no additional cost were huge value additions for care teams. Customers received those new features paired with experienced pMD workflow experts to deliver the most value possible. No new contracts discussed. No new money requested. These are just a few examples of value-added feature additions that pMD partners have enjoyed over the past years.  

Good partners invest to understand industry trends from industry experts


“Partnerships, like the one between pMD and MedAxiom, are critical to advancing innovation and best practices in the cardiovascular industry,” said Joe Sasson, Executive Vice President at MedAxiom, an American College of Cardiology company.

Anticipating the future needs of specialists, patients, or the industry as a whole is crucial given the development and testing of a new feature can take months. Thus consistently investing in strategic industry partnerships means when a need strikes that industry, a partner like pMD is there waiting with a tested solution. This was very much the case in 2019 when pMD built secure video for telemedicine and added it to our platform for free, months before the industry urgently needed it in 2020.

Mr. Sasson went on to say, “Advancing health care takes place through these types of partnerships, and they are essential to our philosophy of creating bi-directional education between industry and CV programs as a means of creating value through innovation.”

The cost of not partnering with pMD is simply too high


In today’s environment, where every team is tasked with doing more with less, you can’t afford to waste resources on a poorly performing vendor relationship. Fire your vendors. And then click here to discover more about all of the value that a pMD partnership delivers.

To find out more about pMD's suite of products, which includes our charge capture and MIPS registrysecure messagingclinical communication, and care navigation software and services, please contact pMD.




I actually had to go in for a colonoscopy the other day. The next day when I got home from work, my wife said, "The doctor called with your colonoscopy results. Good news - they found your head.”

All jokes aside, in advance of pMD’s attendance at the upcoming GI Outlook conference hosted by ASGE (American Society for Gastrointestinal Endoscopy) this week, we want to share a little more than just GI-related humor. If your gastroenterology practice is interested in improving efficiencies and ultimately patient care, you have come to the right place!

Our mobile charge capture and advanced rounding tools enable providers to easily capture and submit hospital charges in real-time, reducing charge lag from weeks to less than a day. In fact, gastroenterology groups using pMD have reduced their charge lag from 14 days to just 0.2 days

Our custom suite of powerful, efficient, and intuitive technology allows health care teams to communicate and capture data at the point of care, improving accuracy and ROI. 

For example, an average 50-provider practice can realize close to $400K per year in additional revenue by implementing a proactive process around transitions of care. pMD’s automated discharge alerts and scheduling instructions make managing this process a breeze, helping grow outpatient practices in the process. With the help of our robust analytics dashboard, practices can easily follow up with patients, reduce readmissions, and recognize Transitional Care Management (TCM) revenue.

Ultimately, it all comes down to streamlining physician workflows. When providers and staff are equipped with the right tools to enhance productivity and increase collaboration for rounding and hand-offs, consult notifications, billing and secure communication, they can spend less time worrying about processes and more time caring for patients. 

But don’t just take our word for it:
"The most common question I am asked about pMD has nothing to do with its use; my doctors and staff want to know why we didn't get pMD years ago. Hospital billing lag time and lost charges have all but been eliminated. The secure messaging feature works great on both provider cell phones and staff desktops. We had high hopes that pMD might improve our operations...seamless integration with existing systems and workflows, better secure messaging, and a reduction in lost charges and billing lag time. pMD has surpassed these high hopes and become one of the best investments made in my 25-plus years of managing medical practices."

- Lucien Roberts, Gastrointestinal Specialists, Inc., Virginia

"The doctors love it, we love it! We are much more efficient with pMD. We're able to track charges better, and bridge the gap of missing charges. It's easier to maintain over paper and has made our process so much easier. pMD has helped us reduce charge lag by at least 75 percent. We also love the ability to message within a particular patient record. It helps our messaging organization, and allows for faster messaging overall by not having to retype patient information into the message. Everyone references the correct patient immediately and as a result, responses come much faster.”

Tamra Crespo, Coding Compliance Team Lead, Austin Gastro, Texas

We will be exhibiting at the GI Outlook (GO) Practice Management Conference in the Loews Hollywood Hotel, August 2 - 4. Come stop by booth #4 for a demo! 

All groups are different, which is why we provide all customers with a full workflow analysis and unlimited consultation services. We’ll continue to work with your practice until you see tangible improvements to the key metrics that matter most to you!

For more information click here or contact us directly.

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, and care navigation software and services, please contact pMD.





New research has found that Electronic Health Records don’t reduce the administrative costs of medical billing. In a large academic health care system with a certified EHR, “costs for processing a single bill ranged from $20 for a primary care visit to $215 for an inpatient surgical procedure, or up to 25 percent of revenue.” That’s a staggering drain on the bottom line.

Worse yet, the researchers did not find any obvious process issues within the institution’s central billing office that could be streamlined. They said that “the high costs were not caused by wasteful, inefficient processes, duplicate or redundant tasks, or the inappropriate use of high-wage personnel to perform low-skilled tasks.” So what gives?

One factor to consider is the quality and the timeliness of the information that reaches the central billing office. If the institution is relying on EHR software to capture billing information as part of the patient’s progress note or op report, then it may take days or weeks for the physician to finalize and sign that note. Additionally, it may be missing information that is needed for billing. For example, it may have the patient’s complete problem list, but a coder may be required to determine which specific ICD-10 diagnoses this physician was addressing during their visit on this date of service. Charge entry lag and requiring coders to look at every charge would both contribute to billing overhead that can’t be streamlined away on the back end. In other words: garbage in, garbage out.

This is where mobile charge capture software is like delicious revenue peanut butter that complements the EHR’s clinical chocolate. It can get complete and accurate billing information to the central billing office in less than a day, regardless of how long the EHR progress note takes to complete. And that charge already has just the ICD-10 and charge codes that are specific to the physician’s specialty and to the date of service. The charge even acts as a “ticket” to find missing notes and thus lost revenue.

Desktop EHRs were never meant to be mobile charge capture systems, and they don’t reduce the cost of billing for medical services. And it’s expensive to try to patch up and work around issues with charge lag and coding, especially when those originate on the front end, with getting accurately and timely information to the central billing office. Fortunately, pMD Charge Capture and MIPS Registry solves this problem at its origin and results in a much faster and less expensive billing process.

 If you'd like to find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, care navigation, and clinically integrated network software and services, please contact pMD.




When you think of traditional sales, you might think of someone dressed in a suit talking at you and trying to persuade you of why you need their product right at this moment. When I joined pMD’s sales team, I thought about all the new tea flavors I would need to check out to prep my voice for all the talking I’d be doing while selling our products. Because I was joining pMD’s sales team with little previous sales experience, all I had to base my expectations off of were the Hollywood stereotypes of sales. I thought I would be informing people of why they needed our products. Unexpected to me, in the first few months of learning and leading my own sales, I found myself doing a lot more listening than talking. It was very different from what I had anticipated, but I quickly learned that if I did all the talking, there was a lot I’d be missing out on when learning about a customer.

pMD isn’t a one-size-fits-all product. If you work with us, you will quickly find out how focused we are on details and understanding processes. This begins in the sales process and goes all the way through to the implementation and account management stages. pMD employees are always open to listen and to hear how we can make our product work for you.

While we do wear business suits, our sales process differs from the Hollywood stereotype I thought it might be. When talking to a new group, I’m not able to tell them about what pMD can do for them until I take the time to learn about what inefficiencies and issues they’re experiencing in their current process - essentially the “why” they reached out to pMD in the first place. For example, during our charge capture sales process we spend a lot of time learning about how a group is currently keeping track of their billing charges and what areas pMD can assist to make the process more streamlined and efficient. You would think this information could be answered by asking a question or two and then answered in no more than three sentences. Oh no. We are not looking to hear the brief answer. We want to hear all the nitty gritty details. What is a provider's current workflow? What is really frustrating about their current system of collecting and submitting charges? In which areas would they like more transparency? What analytics are they hoping to track? We listen so closely and push for details to uncover the best way to improve a group’s workflow and make sure their account is set up so pMD is easy to use, efficient, and successful.

I recently implemented a customer on pMD's Charge Capture product who was solely using a paper process. During each of the many conversations I had with the group during the sales and implementation process, I learned something new every time from the providers or administrative team regarding difficulties in their current workflow that they were experiencing. Because I came to know their current process so well, we were able to customize pMD for them in a way that helped improve many of those kinks. Listening for key phrases like “it is difficult to track…” or “I find it hard to…” are triggers in my mind to get me thinking about customizations that would help make their process easier. There is something rewarding in having the ability to talk to a group and continue learning about them through each conversation along with what customizations could make their pMD experience more useful and easy to use. At the completion of the group’s implementation, these customizations allowed for better organization and reporting for everyone involved. It felt great to uncover some areas they didn’t even know could be improved!

I’ve come to learn and see first-hand the benefits of taking the time to really listen and uncover the needs of our customers. Customization is something pMD prides itself on and something we are always happy to discuss with any current or soon-to-be customer. If you'd like to find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, and care coordination software and services, please contact pMD.
As a software engineer at pMD, I get to straddle the cutting edges of two very different industries: health care and technology. I’m familiar with how quickly the technology world moves -- developers jumping on a new front-end technology every other day, “sprinting” through “agile” hoops at the speed of light. But I’ve been surprised to learn how thoroughly the health care environment is also evolving. I’ve learned that over the next few years, physicians will be facing fundamental changes in the way they see and treat patients. It has been one of the most interesting parts of my job to not only learn about these changes, but to help providers transition to the health care environment as it transforms around them.

With value-based health care on the horizon, providers will need to bring the patient into the center of their care. For the more than 100 million Americans with chronic illnesses, for example, the occasional face-to-face encounter with a provider might not be enough. Obviously, for those types of patients, providers must think beyond the 30 minute annual checkup; with constant management of medication, treatment, and services. In today’s day and age, providers often have difficulty bridging communication gaps, leading to inconsistent data, increased expenses, and poorer outcomes for their chronically ill patients.

We are trying to solve that problem at pMD, and to help providers proactively coordinate their patients’ care. Every new feature we are working on supports providers as they take on this new paradigm shift. One of the simplest ways we help providers is by showing them how they can get reimbursed for adapting to this new, patient-centric health care model. For example, since 2015, Medicare has reimbursed providers who offer at least 20 minutes a month of non-face-to-face medical care to patients with two or more chronic diagnoses, through CPT code 99490. For our providers -- who have been using pMD's charge capture tool to record services outside of face-to-face encounters like medication reconciliation review and care coordination, and may soon start to use pMD for patient education -- this could prove to be a fruitful change that helps them transition to tomorrow’s health care system.


As I mentioned in a previous post, almost every EHR vendor out there has some sort of mobile component to their offering. This tool is typically a useful extension of the EHR for every physician using the system, from primary care providers to specialists. Try to envision a car that will satisfy the needs of every person in America. It needs enough seats to fit a large family, and don't forget about good gas mileage and passenger comfort. If you're building a car for everybody, it would probably look like a minivan. Similarly, the mobile component to most large EHR systems is the minivan of mobile software. You sacrifice performance for the ability to do something for everybody.

Now imagine that you're a consultant for a large health system that just spent millions dollars and thousands of man hours implementing a cutting-edge EHR across all of their facilities and clinics. Sure it was expensive and took a few years, but since it's such a comprehensive offering the health system only has to work with a handful of vendors instead of a hundred. Your job as the consultant is to help them determine which vendors will comprise that handful. Some of the physicians have mentioned an app they currently use called "pMD," so you've started investigating the EHR's mobile offering. Doctors can use the EHR’s mobile software to look up patients’ clinical information and order medication refills without logging into a desktop environment. You start wondering what it can't do and schedule meetings with doctors to discuss your findings.

In your meeting, primary care physicians and specialists rejoice! The EHR's mobile app, as you would expect from a minivan, offers utility for nearly everybody. 70% of the doctors are satisfied and head home. But the specialists hang around and keep asking you questions. The cardiologist is wondering if it can work offline. The critical care doctor asks how quickly she can capture hospital charges for 30 patients on her iPhone. A hospitalist asks how fast he can take over his partner's patients and view handoff information in the app. What is this "pMD" thing they keep mentioning? Although these specialists only comprise about 20-30% of the physician headcount, you know they command a huge percentage of the health system's revenue.

So what's going on here? You just tried to replace somebody's race car with a minivan. The minivan can go farther and fit 8 people with all of their luggage. A race car can't do that, and frankly it's not all that comfortable to drive. But how fast is the minivan? What if somebody is extremely busy, and their primary need is to get from Point A to Point B, on a paved road, disgustingly fast? The number of passengers, luggage capacity, comfort, and all-around capabilities take a back seat to speed.

These specialists need the race car of charge capture because they are insanely busy. They usually spend half of the day seeing patients in their clinic and the other half driving around to around to various hospitals rounding on another 20-30 patients. They are up before the sun and still working on documentation at midnight. The math on an extra few seconds or clicks on a per patient basis adds up quickly. This is why they can't use a minivan for charge capture. If you give them the minivan, they will wait until they have time to use it: at the end of the week or at the end of the month. And where does this revenue reside between weekly or monthly submissions from the specialists? On paper.

A significant amount of the revenue these doctors generate, and therefore a significant percentage of the health system's revenue, is generated outside of their office clinic, so this can be hugely detrimental to the health system's business. At best, it slows down a large amount of revenue. Worst case, the paper (and revenue) goes missing entirely.

EHR mobile solutions and pMD Charge Capture are not mutually exclusive for the same reason that you might keep a minivan alongside your race car in the garage. The minivan is the clear choice for taking the family to a tee-ball game, but it would be absurd to show up in a minivan for some track time at the local raceway. The EHR's mobile solution is built with every physician in mind, and pMD is purpose built for specialists. Although a user may never be able to articulate why, they can definitely tell you that using pMD for charge capture is insanely fast. I can't fault them; I can't clearly explain the excitement of driving a race car with words, but I sure can tell you I love the feeling of such raw power and performance. What is it about pMD that doctors love so much? I've worked with doctors that use pMD all across the country and I'll do my best to articulate why on the next post. Cheers!
Apple will report their Q2 FY15 Earnings on Tuesday, April 27th, so it’s time for us to ever-so-loosely hypothesize how Apple market share has fared based on the technology trends among our niche of physician Apple users.

Q1 was a record breaking quarter for Apple, who posted the biggest profit in corporate history largely due to the success of iPhone sales. Last quarter we saw a mild increase from Android physician users despite Apple’s phenomenal iPhone growth. This quarter, Android users again showed slightly more net growth than Apple, climbing up 0.12 percent.


Apple’s earnings from Q2 should indicate just how successful the iPhone 6/6 Plus phones have been performing, as well as the adoption of the new MacBook that was released this quarter. Let’s take a look at what’s been happening with the iPhone growth by model among our users this past quarter.


Users are finally turning in their iPhone 4 and 5 devices and investing in newer models, which is great for Apple. Given the substantial increase in iPhone 6/6 Plus devices over the past quarter, both from upgrades as well as new users, we’re anticipating that Apple will post sound Q2 earnings with a resulting uptick in stock value. We’ll call it more of a hunch. Apple just released pre-orders for their Apple Watch with orders nearly topping 1 million, so we’re likely to see the impact of this innovative new gadget in Q3 earnings. Until next quarter!
At pMD, we wear many hats. When I describe my job to friends, they often ask "Aren't you a programmer? Why are you doing so many other things?" They, at most, have two major responsibilities at their companies and they assume my other tasks are bothersome. But having those extra responsibilities isn't a burden at all! Instead, I see them as a badge of honor. What I find often overlooked is the fact that hats translate to trust. Being given multiple hats to wear means the company is entrusting you with those responsibilities. They view you as having the ability to own these tasks and to execute them at a high level. Essentially, the company believes in you! And having different responsibilities means no two days are the same, which makes work fun and allows me to avoid the repetitive. Here's a snapshot of one of my developer days at pMD:
pMDers love Porsches, but I wouldn’t say that we have a company full of car enthusiasts. I learned a lot about Porsches when I first started working at pMD because we do have some car enthusiasts. pMDers love Porsches because the “Porsche Principle” resonates so deeply with the way we operate:

“The underlying principle is to always get the most out of everything. From day one, we have strived to translate performance into speed – and success – in the most intelligent way possible. It's no longer all about horsepower, but more ideas per horsepower. This principle originates on the race track and is embodied in every single one of our cars. We call it ‘Intelligent Performance’.”

We share a similar philosophy for the mobile charge capture and secure messaging products that we design, implement, and support at pMD. So why have I never come across a single person using the Porsche BlackBerry in our office?


Our weekly device breakdowns don’t even acknowledge Porsche (or BlackBerry) as having a horse in the race! This is probably because Porsche should stick to what they excel at: building legit sports cars. I will continue giving Apple my money because they consistently deliver the high-end sports car of smartphones to my pocket, and I need cutting edge mobile technology to stay productive while traveling across the country.

Similarly, pMDers are fans of Epic. Judy Faulkner’s motto of “Do good, have fun, make money” certainly resonates with me. It is truly amazing what they have accomplished in the medical industry. With that said, I can’t tell you how many times I have been asked how pMD is going to survive competing with a juggernaut such as Epic.

“Epic does everything! They have a mobile app!”

At first these statements were a bit disconcerting, especially for my cat since she’s somewhat dependent on pMD’s ability to stay in business for her kibble. Epic has a mobile app. pMD has a mobile app. The cat has nothing to worry about. Porsche isn’t competing with Apple. pMD isn’t competing with Epic.

This isn’t unique to Epic. Almost every EHR vendor out there has some sort of mobile component to their offering. Epic comes to mind because we happen to have quite a few mutual clients that have been asking me about this. pMD’s relationship with some of those mutual clients started when an Epic client acquired a medical group that was already using pMD. During the transition phase, Epic replaces many of the products that the newly acquired medical group was using. The physicians draw a line in the sand when they come across pMD.


This is usually the beginning of a two year evaluation process that begins and concludes with happy doctors using pMD. After spending thousands of dollars on a team of consultants, internal projects, meetings and demonstrations, our client comes to the conclusion that pMD is a complementary service that enhances the physician experience for specialists.

During one of these evaluation cycles we were introduced to an Epic expert at one of these consulting firms. Our mutual client asked us to work together to understand how pMD compares to Epic’s mobile offering. At our first meeting, the consultant very candidly admitted that he was tasked with replacing pMD with Epic’s mobile product. Oddly enough, this was good news! Instead of wondering where the overlap might be, we were able to collaborate with him and develop some concrete answers about how pMD would (or wouldn’t) fit in at an Epic site.

Every one of our mutual clients goes through this evaluation sooner or later. This process is expensive and takes a long time. It’s not a good use of health care dollars and certainly doesn’t help patients or our client’s profitability. But since we know the cycle begins and ends with happy pMD users, I’m hoping to help educate the market and our customers going through this transition by writing some blog posts about what we’ve learned working with the Epic expert.

Porsche has not released a smartphone that competes with the iPhone. That’s seemingly obvious. Working with the Epic expert helped us understand why pMD is the sports car of mobile charge capture, even at an Epic site.

Stay tuned to chargecapture.com to find out why.


My dog, Irwin, and I share many common interests, including playing frisbee, going on trail runs, eating good food, and participating in hardcore coding sessions. OK, maybe that last one is just me, but when I do dive headfirst into a serious software development task, I try to take some inspiration from my canine friend.

When Irwin puts his mind to something, he is focused and persistent. For example, when we play fetch at the park, he makes it his mission to retrieve his favorite ball and return it to me as quickly as possible, and he ignores all of the other dogs around us. Normally, he’d be interested in socializing with his doggy buddies, but fetch time is fetch time, and nothing gets in the way of that.

I try to take a similar approach to my coding sessions. I do everything I can to eliminate outside distractions during these focused times. Working as a developer at a fast-paced charge capture and secure messaging company means that there is always a lot to be done on a number of different fronts. However, to be able to tackle tough software problems, I need my entire brain to be concentrated on the task at hand. Much like Irwin, I ignore for a while all the things around me that I’d normally engage with, and throw all of my energy at my code.

There is a lot of research out there, including a study reported by the BBC, which argues that multitasking of any kind makes us less productive. I personally believe that there are certain times when multitasking is OK and even necessary to get the job done. However, like Irwin, I know that certain tasks are just more productive, more efficient, and more fun when I devote my full attention to them. My coding sessions rank highest on this list, which is why I like to refer to my approach to software as Dog Driven Development.