With today's growing population and the demand for more health services, hospitals are increasing their geographical coverage by building new facilities, acquiring clinics and entering into partnerships with independent physicians. Of the three, the last model poses a benefit for both the organization and practice: Health systems can provide winning strategies and Infrastructure as a Service to smaller groups, and those practices are able to maintain their independence while accessing technology otherwise out of their budget's reach.
These are some areas in which hospitals are providing these value-added services to clinics and independent physicians:
Hosted medical records with billing and scheduling components
For some physicians the Software as a Service (SaaS) model can be financially attractive. The availability of an EHR package with no significant up-front software licensing costs is one of the benefits of any subscription model. This also means that the software would not require any significant hardware investment in the back end, storage, backups or disaster recovery, since the hospital would be responsible for all that.
This model has been offered in places like Novant Health System in Charlotte, N.C., and Cone Health in Greensboro, N.C., using Epic Systems Corp. products. There are no statistics naming the current number of subscribed independent physicians in those programs, but both health systems have been able to offer comprehensive offerings that leverage their current Epic system and its components.
Health systems are developing new trends in outsourcing options.
Many physicians are leveraging the federal incentive dollars they receive. Obtaining those funds comes with the challenge of managing and dealing with the meaningful use requirements and their complexities. In some cases, it is better for practices to leverage third-party healthcare consulting firms; hospitals also are providing independent physicians in their communities with meaningful use services to meet that challenge. Hospitals will have an on-site project manager, technical experts and health information exchange connectivity, in addition to their certified EHR.
Supporting care collaboration
There is no question healthcare is moving toward an outcome-based payment model, and with that comes the need for software and systems that support collaborative care delivery. Independent physicians cannot put together the up-front capital for building and connecting such systems. Hospitals are providing access to data that is collected from different subspecialties and the information exchange platforms that can offer case management and other aspects of care collaboration.
Group purchasing power
Hospitals tend to have more leverage when it comes to negotiating special pricing for software, hardware and telecommunications. These savings then can be passed down to the clinics. Hospitals can also offer clinics group purchasing discounts on scanning services, IT services, medical equipment and supplies.
Best practices and IT standardization
Hospital IT departments typically support a large number of customers (hospital staff). Part of their role is to also support a wider range of applications and systems. This also means they are acclimated to the notion of strong system safeguards to protect data and enterprise systems. For some practices, outsourcing their IT or parts of it completely would potentially mean that they have access to privacy best practices, IT standardization and procedures for creating stable infrastructures. In some cases, the alternative could be that they get support from third-party vendors that may not be acclimated with the industry and cannot adequately address healthcare compliance requirements and needs.
Patient satisfaction and excellence
With some of the offerings that hospitals provide independent physicians, care teams who don't belong to the same organization are able to work together on patients with serious or chronic disease. Patient satisfaction scores can increase due to the improved level of care coordination and streamlined scheduling and sharing of data in this model. It also means that billing is consolidated, so patients see one bill for all services across the system, including in some cases their primary care or specialists not directly employed by the hospital.
Larger groups traditionally have offered volume-purchasing discounts on technology and communications services. But with the ever-changing landscape in healthcare, many hospitals are providing more than just those basic services. From EHRs, billing, and scheduling, to imaging, marketing and IT-in-a-box, health systems are developing new trends in outsourcing options. By mixing SaaS and Infrastructure as a Service, they can provide the complete outsourcing model for small and medium-sized practices as a turnkey solution.
Independent physicians in today's health IT world
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Independent docs don't trust meaningful use tech
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This also opens the door for independent physicians to utilize private HIEs within a health system, which allow practitioners access to personal health information across the hospital and its affiliated practices. IT departments are acclimating themselves to offering this service to outside entities as part of the overarching role played by the hospitals.
Hospitals offering services to independent physicians can provide access to systems which independent groups otherwise may not be able to purchase individually. But it's been noted there still are serious concerns around data ownership and lack of flexibility when it comes to customization and integration capabilities which may hinder physicians who adopt technology hosted by a hospital.
Physicians considering purchasing technology and other services from hospitals must evaluate the offerings and ensure they are in line with long-term goals, as well as compare them with similar offerings from competing health systems. As we continue to see the consolidation of health systems, we will likely see competing services offered to independent physicians that can drive new revenue for the hospitals through purchases and net new patients.
Reda Chouffani is vice president of development with Biz Technology Solutions Inc., which provides software design, development and deployment services for the healthcare industry. Let us know what you think about the story; email firstname.lastname@example.org or contact @SearchHealthIT on Twitter.
This was first published in December 2013