Unaiza Hayat, MD is CEO and chief medical officer of Avecinia Wellness Center, which provides primary care, aesthetics, and alternative therapies at its facility in Clovis, CA. The center’s name is derived from Ibn Sina (known as Avicenna in the west), the 10th century Persian physician known for bringing together medical sciences from various regions. The center employs three clinicians – each of which sees 20 patients a day, a massage therapist and esthetician, six administrative staff, and six instructors for its various classes.
The center transitioned in 2010 from an eHealthCare practice management system and Prognosis EHR to athenahealth solutions, citing complexity and poor customer service as reasons for the switch. Avecinia is currently using athenahealth’s EHR, practice management, and patient communication services. Over the next six to 12 months, it will consider implementing a tablet-based patient check-in service that integrates with athenaNet software, and look at working with a mobile health app to help with medication adherence. It has met Stage 2 Meaningful Use requirements and is now working to exceed its core and selected criteria as part of patient workflow.
Why do you think only 458 eligible doctors have met Stage 2 MU requirements thus far? What challenges did Avecinia face in preparing to attest?
The numbers speak for themselves. If nearly 60 percent of those meeting Stage 2 MU work with one EHR, then it probably has a lot to do with the EHR being used. We noticed that a particular type of provider ends up using athenahealth versus other EHRs. These providers tend to be forward thinking, understand what they know and what they don’t, and appreciate the role of technology as a tool in providing superior patient care. One of the reasons we selected athenahealth was the forward-thinking vision they are driven by, which aligns with our vision. By creating a partnership where we can focus on providing patient care and athenahealth can focus on the tasks best suited to its expertise, we have been able to easily complete something that many other providers find difficult, confusing, and time consuming. We didn’t face any challenges since the requirements are organic to our workflow.
As you alluded to, nearly 60 percent of those that have attested are athenahealth customers. How important was your relationship with them during the attestation process?
See above. If and when there is ever a hiccup, athenahealth has the resources to assist the practice in overcoming those challenges. There is also a robust user group where users exchange best practices and ideas on how to use the technology to its maximum capabilities.
Based on your experience, what advice would you give other physicians looking to attest for MU? What should they be looking for (or be wary of) in an EHR vendor or consultant?
We have a saying: “Meaningful Use is only as good as the meaning we give to it.” By working with an EHR that works the MU requirements seamlessly into our workflow, we were able to give Meaningful Use meaning. For example, by helping us identify at the point of care if someone needs a flu shot or TDAP, or if it has been more than a year since their last preventive visit, we can make sure our patients get the care they need, and that we capture the revenue opportunity.
Our advice would be to see how the vendor incorporates MU into the patient workflow. Does it assist in providing better care? Who is responsible for collecting the data, making sure you are staying on track and submitting the data on your behalf? If the vendor is going to do it, and has a track record of being successful, then that’s probably the vendor you should choose. You aren’t going to save money by trying to hire the necessary staff and spending clinic time to do the work necessary to attest on your own.
How receptive have your patients been to your patient engagement efforts, such as the patient portal?
They have been very receptive. We believe our relationship with our patients goes beyond the four walls of the clinic and so have made a committed effort to engage with them and the community through social media (our Facebook page has 2,300 fans and we are also on Pinterest, Instagram, YouTube, Twitter, and LinkedIn), community activism, and philanthropy. We use those opportunities to help shape the conversation around healthcare and well-being. Our patient portal has also been a successful part of our patient engagement. We have an over-50-percent adoption rate, and the patients find it a convenient and useful tool in managing their healthcare. Athenahealth’s communication suite goes beyond being a portal, though. The appointment and order reminder system is integral in keeping our no-show rate at 2 percent, and helping our patients stay actively involved in their healthcare.
You have received numerous accolades for being a top leader and businesswoman in your community. How important is leadership before, during, and after a healthcare IT implementation?
Thank you for noticing that. Leadership is crucial throughout healthcare IT implementations because, like any project, it requires buy-in, teamwork, guidance, accountability, and humility. We have found that when leadership takes on the role of being a coach/mentor, the group is more successful in reaching its goals. Most importantly, it engages the group and encourages them to also develop leadership skills.
Bonus Question: What coordinated care initiatives are currently underway?
We meet the criteria to be a Level 3 Patient-Centered Medical Home but have not applied for it because the application process is costly and there is no revenue benefit in Fresno/Central Valley for doing so. Neither private insurance nor Medicare recognize those programs here. We are also interested in establishing an ACO because we have already laid the foundation, but the hospital systems and other providers in Fresno have a long way to go to catch up to us. We have approached Medicare and private insurance companies with no luck. It is really unfortunate because the population in Fresno and the Central Valley has some of the highest rates of obesity, diabetes, and other chronic conditions that could benefit from the ACO model.
In the meantime, we have been asked by the newly established Central Valley Health Information Exchange to help lead the efforts in getting other private physician groups to, at the very least, register with the exchange. We are open to working with any organization that is willing to lead the way with us in adopting and promoting new, engaging models of healthcare delivery.
Thank you for the opportunity to share our success with HISTalk!