Creating an Integrated Care Team
Minnesota Oncology is a 70+ provider group serving 12 clinical locations across Minnesota’s Twin Cities. Minnesota Oncology is a well-connected network of community providers whose goal is to create an integrated care team to help guide and support the patient each step of the way through their treatment. Minnesota Oncology was first started 40 years ago by two of the state’s first formally trained oncologists, Dr. John Brown and Dr. Irving Lerner, and has deep roots in community care. The two providers both ran practices in different locations across the Twin Cities but saw the synergy and benefits to be experienced by working together across the community. The Minnesota Oncology team is growing a network of care providers who are dedicated to serving their community by providing compassionate, patient care while leveraging the power of both a local and national network of dedicated care providers.
Minnesota Oncology was searching for a product to help their providers successfully share clinical and financial patient information across multiple points of care, hospitals, and geographic locations. The providers were moving from hospital to hospital using various electronic medical systems to access patient information while doing their best to organize their billing and care team communication across these disparate systems. The providers and their care teams needed a solution to help them improve care coordination. Additionally, the administrative team needed a solution to improve their own administrative workflows, financial health, and revenue growth of the organization.
The first key product feature they required was one that improved the turnaround time and accuracy of entering hospital and surgical procedure charges. They had a good system for office charges but were unable to efficiently incorporate the inpatient charges. All of their hospital rounding was previously done as a paper process. The hospital census was printed off daily and was then carried around by the providers as they made their rounds and added their diagnosis and charge codes to the paper census. “Providers would do their best to enter charges as they went through their day, but charges were often missed,” said Dr. Dean Gesme, a physician leader at Minnesota Oncology. “Additionally, providers would sometimes lose their paper census or forget to submit the paper charges to the right people. Before pMD, the average turnaround time for hospital and surgical charges was around 25 days. Today, with pMD, we are able to turn these charges around in 5 days. There has been a significant improvement in the number of unsubmitted claims as well as an increase in revenue due to a drastically improved charge entry lag.”
The second key product feature that was essential in a new system was a secure messaging platform. The group had previously been using multiple messaging platforms and wanted to revisit their e-communication strategy as an organization. Different providers liked different applications and there was no uniformity among the group when it came to communication. “Today, all of our providers are using pMD secure messaging and I can say with confidence that pMD does a better job when it comes to communication than any of our previous communication applications,” said Dr. Gesme. “With pMD, we are able to instantly receive our messages on our smartphones as well as receive backup reminders when we have unread messages. We even have our answering service using pMD, which allows after-hours phone operators to easily and securely contact providers on call for urgent patient issues and consults.”
The group was most notably struggling to process their hospital billing data in a way that was timely and efficient. The providers were doing their best. However, charges were often missed or there was significant lag in charge submission. Additionally, the quality of the charge entry was problematic. “Before pMD, if there were 200 hospital visits submitted, roughly half of these visits would need to be sent back to the provider due to billing errors,” said Joan Theis, Business Office Manager. When these hospital charges were returned to the provider requiring corrections, they needed to cross multiple hands, leaving room for error as well as causing additional time delays. According to Joan, “pMD took out the middle-man here. pMD allows the Central Billing Office to communicate billing discrepancies to the provider directly and therefore the turnaround time on visit submission has drastically improved.”
While providers are limited by the physical space of a piece of paper, pMD provides more granular coding, which therefore leads to less “rejected” visits. According to Joan, “We went from having over half of our visits needing to be rejected back to the provider, to having a mere 1-2 a month that need to go back to the provider for review”. Cathie Baker, Coding and Charge Entry Supervisor, also believes that her team is able to work more efficiently now that some of the administrative burden has been alleviated. Cathie states, “My coders are doing a lot less work, they don’t need to fill out tedious spreadsheets, and can focus their energy in more efficient ways. Any coder will give you a glowing recommendation of pMD.” Cathie goes on to state, “I remember the first day we were trained on pMD. We found an error with a visit and were able to correct this issue in real time. After that moment, the Central Billing Office was on board immediately.”
pMD has benefited the Central Billing Office teams and how they now spend their time. Joan Theis mentioned that, “We wanted them to know that leadership is looking out for them. We want them to be freed up of tedious tasks so that they are able to focus their energy on more fulfilling and engaging areas. For example, we realized the tedious nature of duplicate charge data entry and we therefore made sure to establish an interface between pMD and our practice management system. This interface automates their work, minimizes the risk of human error, and also improves the overall morale of the team.” The implementation of pMD has also allowed the team to focus on new tasks which are directly contributing to the group’s financial health. According to Michelle Quast, Director of Practice Operations, “We are now leveraging a new process which is significantly more efficient. We are therefore freed up to focus our energy on the ‘right front’ versus being distracted by overhead. For example, we are able to dedicate specific resources to cleaning the claims on the front end and moving this work upstream versus needing to correct errors reactively on the backend. The staff is freed up to focus on resolving higher denials, avoiding unnecessary workflow.”
Minnesota Oncology was founded as a community-oriented health care organization which seeks to provide oncology care to patients in the comfort of their own neighborhood. To provide this type of service, the group has over 12 clinics across different cities and towns within the Twin Cities. To be successful when providing care across a local network, a health care organization must truly make care coordination and communication a top priority. Providers, clinical support teams, and administrative staff must be able to communicate efficiently and seamlessly with one another. pMD secure messaging allows each provider across the network to communicate safely and efficiently with one another in real time. pMD provides a single, uniform platform for all members of the care community to communicate.
Patient-centric messaging is a feature of pMD that Minnesota Oncology has implemented as part of their Care Coordination efforts. Patient-centric messaging allows the user to send a message that is linked to a patient in pMD. These messages are organized in their own conversation thread and are linked to the patient profile so there is no ambiguity around which patient is being discussed. This feature provides the ability to link more clinical information to the patient in pMD and therefore, facilities were able to improve patient care across multiple providers and locations. Minnesota Oncology was an early adopter of this functionality.
In 1996, the physicians of Minnesota Oncology entered into a long-term management services arrangement with the practice management company, US Oncology. The practice leaders wanted to join forces with other dedicated oncologists and hematologists across the nation in an effort to gain new knowledge and insight from external sources as well as to participate in setting national quality standards. An example of Minnesota Oncology’s dedication to striving for clinical excellence and adopting new and emerging national standards can be seen with their recent initiative to become an Oncology Medical Home. An Oncology Medical Home is a care model dedicated to ensuring the delivery of quality care through care coordination, which is both monitored and measured. pMD is helping Minnesota Oncology achieve this status by facilitating after-hours clinical advice as well as by providing patient discharge reporting.
The Minnesota Oncology answering service, as well as their switchboard, have all implemented pMD secure messaging. These internal and external teams leverage pMD daily to communicate with providers in real time, both efficiently and securely. As part of the Oncology Medical Home, providers must be available to communicate off-hours clinical advice to patients in need. When patients call into the Minnesota Oncology office, they are able to be connected with the on-call provider in a matter of minutes, using pMD secure messaging. This streamlines the process in which providers share vital clinical advice and allows the Minnesota Oncology team to track these conversations. Conversations can be made “patient-centric”, which allows visibility into which patients were discussed, when the discussions took place, and provides additional vital clinical information about the patient to the clinical team.
A key aspect of the Oncology Medical Home Model is ensuring that when patients are transitioned between care settings, important clinical information follows the patient through the continuum of care. For example, as a patient is discharged from the hospital, it is critical that any next steps or relevant clinical information regarding that visit stays with that patient and is available to their primary oncologist. As part of these efforts, Minnesota Oncology wanted to ensure that any patient discharged from the hospital had their discharge summary uploaded and stored in the EHR for the primary oncology team to review. pMD was able to partner with Minnesota Oncology to create a workflow ensuring that this information was captured and shared as needed. The medical records team is now able to run a report on all of the patients who were discharged from the hospital the previous day. From this report, the team can then retrieve the necessary discharge summaries from the hospital EMR and ensure that these clinical documents are uploaded and stored in the practice management system.
Minnesota Oncology is a multi-specialty group that spans 12 locations across the Twin Cities. The group has over 70 providers, ranging from Thoracic Surgeons to Medical Oncologists to their newest provider, who is the first Plastic Surgeon of the group. The pMD implementation took place in 4 phases over 4 months. The first group, the Medical Oncologists and Thoracic Surgeons, went live in September of 2016. Following this group, each month a new clinic (or subset of clinics) was brought live on pMD. The implementation plan required precision and extremely detailed planning. In the end, each group was implemented successfully, on time, and according to the implementation plan which was originally confirmed in August, 2016.
Additionally, as part of the implementation plan, the group requested an interface between pMD and their practice management system. This interface was required as a means to automate the flow of patient data from their practice management system to pMD along with the automatic transfer of charges from pMD into the practice management system. The interface was vital to the success of the implementation and was completed as planned. Although Minnesota Oncology is a very complex group with multiple specialties and locations, the implementation was able to be completed on time and without fanfare due to the organization and dedication of both the Minnesota Oncology team as well as the pMD implementation team.
Large and complex groups similar to Minnesota Oncology require a nimble product which can evolve with the group itself as well as adapt to the ever-changing health care landscape as a whole. pMD’s product is constantly improving, in part thanks to the thoughtful feedback and ideas shared by all of our pMD clients, with Minnesota Oncology being no exception. Minnesota Oncology is a great example of an innovative group who is always eager to leverage new features as well as provide honest feedback on features they would like to see. Per Dr. Gesme, “The pMD team is extremely responsive to product feedback. There is a strong sense of partnership between the Minnesota Oncology and pMD teams as we work together to ensure that the product is meeting both the current and future needs of our group.”
Product feedback helps pMD to continue to grow and expand the product while also aligning closely with the goals of customers. pMD is always innovating in a way which best serves clients and their patient population. Michelle Quast, Director of Practice Operations stated, “pMD has been very well-received within our group! It’s so nice to work with a vendor who really listens to our concerns and takes our feedback on the product into consideration. The providers know they are being heard and this makes them feel good!” Product feedback from customers is vital in helping pMD to move the product forward and build the best product possible. Product feedback is essential in driving what features are developed, when they are developed, and how they are developed.
Minnesota Oncology is a forward-thinking and innovative group of providers, clinicians, and administrative team members who put patient care above all else. They are a community-focused group who must therefore serve many needs, across many disparate systems. Together, with Minnesota Oncology, pMD is able to make significant improvements with regard to both the financial health and care coordination of the organization. These joint efforts have allowed providers to better serve their patients and administrative teams in order to better serve the organization as a whole.
pMD develops powerful software for doctors and health care professionals. The proprietary software allows health care teams to provide more efficient and coordinated patient care, while also capturing valuable data for reimbursement on their services. Health care providers can record and securely share information on patient encounters from their smartphones right at the point of care. Through charge capture, secure messaging, care coordination, and quality registry, pMD provides health care teams with the tools to collaborate and communicate securely so that patients are given the most appropriate and timely care necessary. pMD is compatible with iOS (iPhone + iPad), Android, and web apps. For more information, contact pMD.