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A Digital Roadmap to Improved Patient Access – An Interview with Richard McNeight

Posted on December 4, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We recently interviewed Richard McNeight, Executive Vice President & Chief Digital Officer at Health First, to learn about there efforts to implement new patient access and provider data management solutiuons from Kyruus.
In this interview, Richard McNeight offers some great insights into patients’ expectations and ways his organization is trying to meet these expectations.

What led you to the decision to invest in more patient access technologies?

“Dramatically improved consumerism” is one of our key Integrated Delivery Network (IDN) digital strategic goals. The first and most important consumer priority is to “Find a Provider.” Not just any provider, but the right provider that can best treat the exact condition, has significant experience treating it with high-quality outcomes and has performance ratings for success.

What kind of buy-in did you need to go in this direction?

As Chief Digital Officer, my first responsibility was to develop an IDN digital strategic plan, which identified provider search as the most demanded customer request. The digital strategy was first approved by our Strategic Planning Council. Once adopted by our Executive Team, the initial collaboration was with our Marketing Department, which confirmed the most important consumer initiative was to “Find a Doctor.” A requirements specification was then developed for a provider portal, with input from all major IDN stakeholders, and a request for approval (RFP) process solicited bids for the provider portal solution, ultimately resulting in the selection of Kyruus.

What benefits do you expect to achieve from the implementation of ProviderMatch?

The key benefit we will achieve using the Kyruus ProviderMatch tool is meeting our customer’s goal to find the “right provider.” This is achieved by allowing the patient to complete a robust search by entering their “clinical condition” in simple, easy-to-understand textual language. ProviderMatch leverages a taxonomy of more than 18,000 clinical terms, which helps match the patient’s condition to a provider who specializes in treating that condition. This is in addition to the normal search criteria and qualifiers such as geolocation, insurance network, provider gender and more.

Which challenges do you still face when it comes to patient access?

The biggest challenge we see in implementing Kyruus is appropriately defining the “Scope of Practice” for each provider, narrowing it to only the top conditions that provider specializes in treating. Related to that is the discussion we will be having with our providers as to acceptable and accurate provider quality rating, frequency of procedures performed and outcome results that will be displayed in the search results profile for the provider.

How have your providers reacted to the idea of allowing online appointment booking to patients?  What did you do to get them on board?

Over the last year, we have methodically been preparing for online scheduling by standardizing and minimizing the number of appointment templates for our employed providers, initially for primary care providers, and by the end of this year, for most specialists.

Where are you looking next when it comes to improving the patient’s experience?

As defined in our IDN digital strategy for consumerism, after “Find a Doctor,” the next three online features our customers want most are:

  • Make an Appointment – Online scheduling, providers (Kyruus DirectBook), diagnostic procedures, urgent care and more than 20 additional online scheduling activities
  • Price Transparency – Cost estimation, ease of payment and bill simplification
  • View my Medical Record – Easy, single mobile-enabled access to their unified health record

Once our customer finds the “right provider,” they will have the option to either immediately schedule an appointment online using ProviderMatch DirectBook or be shown a phone number to call to schedule the appointment. Our digital roadmap addresses technology solutions and implementation timelines for all of the other consumer experience features listed above.

Differences Between ROI, Ease of Meaningful Use Vary Between Vendors

Posted on March 21, 2012 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

New research by KLAS seems to have uncovered important differences between the way EMR vendors perform when organizations are mounting them for Meaningful Use compliance.

According to the research firm, which interviewed 104 MU-compliant providers, both large and small hospitals successfully passed through Meaningful Use attestation.  However, the choice of vendor did seem to make a difference — one which, if KLAS is right, hospitals would be ill-advised to ignore.

KLAS concluded that hospitals using Allscripts, Healthland, HMS, McKesson had a harder time moving ahead on MU than organizations that went with MEDITECH, Cerner, CPSI and Epic. (It should be noted that while MEDITECH had the highest number of successful attesters, most of those came from a single large IDN, which makes it a bit hard to tell whether the IDN’s execution strategy or the product deserves the credit.)

One surprising bit of data, for me at least, that community hospitals were having an easier time covering their costs than larger IDNs.  KLAS notes that this varied from vendor to vendor, but didn’t name which were the higher performers.

Why the difference? My guess is that the bigger IDNs bought “Extormity” software (such as Epic and Cerner) and are having a hard time paying for it; that they have higher integration costs; and that they’re dealing with larger piles of smoking heaps of machinery (oh, excuse me, I meant very outdated mainframes and what have you).

As for problems, providers obviously had plenty to share.  Reporting and problem list functions were the most commonly reported challenges, KLAS said. In these areas, it seems, all vendors performed poorly, including the ever-popular Epic Systems.

Community and Mid-Size Hospitals are in the Sweet Spot of the EHR Market

Posted on November 29, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Community and mid-size hospitals arguably have the greatest number of choices for enterprise HIT solutions. Critical access hospitals have a small, but growing, selection of vendors which can deliver clinical applications at an affordable price point. Large IDNs are limited to a select group of vendors which have the resources and IT architecture which can scale to high volume environments and advanced requirements.

The middle of the market benefits from technologies originally designed for the larger and smaller ends of the spectrum. Community hospitals have several options to sift through: large and complex hospital solutions being adapted for the community space, a product built specifically for community hospitals, or a small hospital solution that is gaining attention from mid-size institutions. This document will discuss the middle of the HIT market and the options available to hospitals there.

How big is the community and mid-size hospital market?

Challenges and Opportunities

The smaller community hospitals have budgetary constraints which are more restrictive, thus their preferences are heavily impacted by price and contract structure, yet they are forced to implement solutions which can help them achieve clinical milestones for meaningful use; solutions which often require the utilization of consultants and implementation services in order to augment (typically) scarce internal IT resources.

Despite these challenges the mid-size and community hospital space has become a prime market, and thus burgeoning with options, for enterprise HIT vendors due to a combination of available budget and market turnover.

The Middle Ground

This large group of community and mid-size hospitals covers a broad swath of the HIT landscape. Because of their wide-ranging (albeit nuanced) demographic, they are caught in the middle of two forces:

  1. Vendors with solutions initially tailored for smaller hospitals moving up to larger community hospitals.
  2. Vendors with the more complex, large hospital solutions moving down into the community space and adapting delivery models.

In our next post, we’ll take a look at which EHR solutions fit the market and what’s on the horizon for community and Mid-Size hospitals.


Guest Post: Jeremy Bikman is Chairman at KATALUS Advisors, a strategic consulting firm focused on the healthcare vertical. We help vendors grow, guide hospitals into the future, and advise private equity groups on their investments. Our clients are found in North America, Europe, and Asia. www.KATALUSadvisors.com

Why U.S. Enterprise Health IT Companies Struggle for Success in Europe

Posted on November 22, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The U.S. market for new sales of enterprise health information technology (HIT) in large hospitals is dwindling, despite the incentives heaped upon the market by the Health Information Technology for Economic and Clinical Health (HITECH) Act. While buying has picked up a bit, this uptick is universally acknowledged as a short-term blip which will run its course as timelines expire and federal funds are depleted. For U.S. vendors of HIT, a logical question arises, “where do we go next?”

The Middle East garners some attention, but Europe is a natural choice for market expansion given the comparable standard of living and adoption of technology. Yet, despite years of effort and millions of dollars invested there, U.S. companies struggle to gain a real foothold in Europe.

All Politics is Local

Each country in Europe has its own healthcare climate due to differing approaches to healthcare administration. For example, France would seem to be an inviting market due to its size, amount of money dedicated to the healthcare system, and relatively high proportion of private hospitals. However, U.S. companies unexpectedly struggle to make inroads due to the strong French preference for a local company with local staff. If foreign companies want to sell there, whether American or European, the company must have a local office with local executives, at the least.

Italy also represents a large market, but does not represent a single HIT market. The healthcare governance system has, in effect, created twenty regional markets where each administrative zone has authority to set unique rules and guidelines, thereby influencing vendor selection criteria and funding capacities. Vendors which decide to build a presence in Italy will need to create regional strategies for each administrative zone.

The Right Price

Compared to their counterparts in the U.S., hospitals in Europe typically purchase enterprise HIT at a significantly lower cost. These prices range widely depending on geographic region and hospital type. Also, because of political issues with local, national, and European Union tender processes, the sales cycle can take two to three times longer than even the largest IDN deals in the U.S.

Hospitals in the Netherlands expect to pay a price that is nearly on par with what a comparable hospital in Canada would spend on an enterprise solution. Yet, across the border in next-door Germany, that same product would have to be priced nearly eighty percent lower for consideration.

Relative HIT Prices for Large Hospitals

HIT Priorities Vary

European hospitals have a set of functional priorities which diverge from the priorities which U.S. hospitals have. The following are a few of the more prominent examples:

  • Nursing: While CPOE is a huge priority in the U.S. and a centerpiece of meaningful use initiatives, European hospitals and vendors have focused more attention on automating nursing functions. That is not to say they do not have physician ordering tools, which they do, but nursing has been more of a priority.
  • Closed-loop medication administration: U.S. vendors would be treated as second-rank if they did not have closed-loop capability with tightly interwoven pharmacy functionality. Not so in Europe where lack of closed-loop is fairly common and is not a high priority during the tender process.
  • Connectivity: Beyond robust data flow within a hospital, sharing clinical information regionally within countries has long been a priority in Europe. Several countries have constructed digital spines to which vendors must connect in order to allow client hospitals to share clinical patient information with other hospitals, regions and government agencies.

Who has crossed the pond?

No U.S. firm has yet to find cross-national success in Europe with enterprise clinical solutions. The best-selling large-hospital vendors in the U.S., Cerner and Epic, have found very limited success in promoting their clinical application suites to European hospitals. Cerner initially won business with the NHS Trust in the UK, but those implementations were not particularly successful. Epic seems committed for the long haul in Northern Europe but its growth has been modest thus far. McKesson seems to be withdrawing from certain European markets, and Meditech isn’t spoken of much in Europe. Some U.S. companies may decide to acquire their way into Europe, like CSC is doing via the acquisitions of Scandihealth and iSOFT. Despite the challenges, this much is certain: U.S. HIT firms must continue to explore and expand in Europe as the U.S. matures into a total replacement market. The key, as always, is to do it right.

Chris O’Neal is Managing Partner at KATALUS Advisors, a strategic consulting firm focused on the healthcare vertical. We help vendors grow, guide hospitals into the future, and advise private equity groups on their investments. Our clients are found in North America, Europe, and Asia. www.KATALUSadvisors.com

Pressures on Critical Access Hospitals – IT Budgets, Competition and IT Talent Retention

Posted on September 15, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The acquisition and implementation of enterprise solutions is a daunting process for any healthcare provider. Critical access hospitals usually find the task even more nuanced given unique pressures, some of which include:

  • Constrained budgets: Compared to other facilities, critical access hospitals typically have the smallest IT budget, as a percentage of overall hospital budget and in gross numbers. Budget constraints are also exacerbated by low volumes, rising number of uninsured, recession related unemployment, and a patient mix with a high Medicare/Medicaid presence typically found in rural geographies.
  • Increased competition from larger IDNs: Competition can come in the form of IDNs opening/acquiring rural clinics, as well as from Federally Qualified Health Centers (FQHC) which often have greater access to grant funding and better medical liability coverage. This makes future growth plans hazy given that critical access hospitals can be challenged in projecting consistent market share given the changing competitive landscape.
  • IT talent retention: Attracting and retaining talented IT personnel is one of the prime concerns for critical access facilities. Some have turned to IT outsourcing, but this also carries its own risks and costs.

In effect, critical access hospitals are feeling fiscal pressures from all sides – in changes to federal reimbursements, a patient population hit hard by recession, rising labor and structural costs, as well as from legislation which requires a higher level of IT adoption within an arbitrary timeline.

In our next post, we’ll look at which Health IT trends working in favor of small hospitals

Chris O’Neal is Managing Partner at KATALUS Advisors. KATALUS Advisors is a strategic consulting firm focused on the healthcare vertical. We serve healthcare technology vendors, hospitals, and private equity groups in North America, Europe, and the Middle East. Our services span growth strategies in new and existing markets, M&A due diligence, market analysis, and advisory services. www.KATALUSadvisors.com