Mid-Michigan and Central-Michigan District Health Departments blaze a trail with Patagonia Health adding custom electronic Health Record functionality specific to Michigan public health state requirements.
BACKGROUND / CHALLENGE
Mid-Michigan District Health Department (MMDHD) had their previous legacy Electronic Health Record (EHR) system for eleven years and found it wasn’t meeting their needs as far as program requirements and changing technology. After talking to several other health departments, they found Patagonia Health EHR and, in 2016, became the first Michigan health department to sign on. Central-Michigan District Health (CMDHD) soon followed their lead.
Some specific reasons both MMDHD and CMDHD needed to find a new EHR were an improved billing system, portability for outlying clinics, and more accessible data for better client interactions. “We wanted to improve efficiencies, and we needed to upgrade regardless. Functionality was not as easily available in our previous system for client interactions; especially with electronic consents, patient portals, emailing and texting clients, as well as some of the billing features. These features were not something we had in the previous system or available in the other demos we saw,” stated Kelly Conley, Personal Health Director/WIC Coordinator Central-Michigan District Health Department.
SOLUTION – Replacing a Legacy EHR
After looking at a number of other EHR systems, MMDHD’s selection of Patagonia Health, according to Andrea Tabor, Director of Community Health & Education, came down to four main reasons. “Patagonia Health is definitely a much more user-friendly system. It provides efficiencies in the clinic setting; everything is a click away. Once the encounter note is typed, it is signed and sent to the Electronic Super Bill (ESB) all within seconds. That part of the system is very streamlined. It is also affordable compared to what we had and other systems we looked at. And, the customer service is exceptional.”
Conley adds, “The interface with insurance verification was a big selling point. With the insurance interface, our clerks can go in and verify insurance before the client leaves the check-in counter. Before they get their immunizations, before their visit with the Nurse Practitioner, we know the services are going to be covered and can be sent through the Electronic Super Bill.”
Michigan health departments offer a broad range of public health services, and like in every other state, have some unique state requirements. During the selection process, Mid-Michigan and Central-Michigan District Health Departments involved their key staff to help with the selection and implementation of a new EHR to insure a successful transition. “When viewing demonstrations for Patagonia Health, we were shown the billing functions and thought they looked much more user friendly, which was one of the factors in our decision to the switch from our previous software,” said Melissa Bowerman, Administrative Services Division Director at MMDHD.
Through a user-centered design process, Patagonia Health developed a Michigan-optimized version of its EHR, Practice Management, Billing and Reporting software. Some examples of customization include:
- Integrated electronic forms and tracking services app for Maternal and Infant Health Program (MIHP)
- Integrated electronic forms and tracking services app for Children’s Special Health Care Services (CSHCS)
- Hearing and Vision App built-in to enable schools to test children for hearing and vision.
BENEFITS OF PATAGONIA HEALTH EHR
Ease-of-use and increased efficiencies were clear from the beginning for both health departments. A mutual benefit to the health departments is Patagonia Health’s web-based system. The set-up time was a lot less time-intensive and required less internal IT support compared to their legacy EHR, which took a year to get up and running. “Support with Patagonia Health staff was really receptive. There are regular updates to the system, and communication is really great,” stated Tabor. Patagonia Health was implemented in a phased approach, initially allowing them a quick win of revenue cycle restoration, and moving forward, the collaboration opportunities to help develop Michigan custom functionality.
CMDHD staff appreciate the monitoring dashboards for the clinics and programs. It is very useful and can be customized by user preference. Conley adds, “The performance-based analytics is great with the Reports feature. It allows us to do reporting and monitoring, which can be downloaded directly into Excel.”
“Patagonia Health has worked with us to build custom reports for monitoring caseloads and tracking client needs. When there were items that needed attention or new fields added to reports, they worked to get the best functionality for all of us,” said Janice Parrett, CMDHD. Patagonia Health provides report writing assistance at no extra charge to users.
During the implementation time-frame, both MMDHD and CMDHD experienced budget cuts and retiring staff members. “We needed to find other ways to be more efficient, and because of the new system efficiencies, we have not needed as much clerical support. Now, the clinical staff does chart notes and bills at the same time so the clerical staff only needs to review and approve them. The Patagonia Health EHR system has allowed us to not have to replace staff during our budget shortfalls,” states Conley.
Portability was another key improvement, allowing users direct access to the EHR while at a home or any remote location. “The portability to literally take Patagonia Health wherever you go has been a great asset. We have been able to do charting on home visits, set up clinics in a non-clinical location, and even work remotely while out of the office,” states Conley.
CCDHD staff set up an immunization clinic at a factory with over 400 employees. They planned, implemented and executed the off-site clinic within just 48 hours. Coney adds, “We wouldn’t have been able to that with the other system. It wasn’t portable or cloud based.”
As the data shows, the switch to Patagonia Health has made a huge difference in billing results. Improved billing means increased revenue.
| MMDHD Averages | Statistics using Legacy EHR | Compared to Patagonia Health |
| Average time to Bill Claims | 30 days | 5 days |
| Average days for payments | 88 days | 11 days |
| AR Balance | $100,000 | $28,000 |
“Overall, the process has become very streamlined,” says Bowerman. “If there is an issue with an insurance company, the issue can now be resolved more timely; therefore, the number of rejected claims is less. Claim rejections can now be worked in a timelier manner as insurance companies have time limits on paying claims.”
CONCLUSION
Patagonia Health worked closely with CCDHD and MMDHD to build programs not already in the EHR. All forms were created and uploaded and all state requirements were reviewed and included where necessary throughout the EHR. Conley concludes, “I can’t think of a time where Patagonia Health was not able to help us without any problems. I am confident we can get any new programs into the system moving forward. They have never told us ‘no’.”
Today, more than ten (10) Michigan health departments reap the benefits of Patagonia Health’s Michigan-specific features. They join together as one group at their state User Focus Groups. Michigan-specific needs are met in custom software and services and are the key reasons why Patagonia Health continues to be the EHR of choice for multiple Michigan health departments. “All agencies using Patagonia Health in Michigan have built relationships to help each other. The system works the same way for each agency, so we have plenty of resources for advice and/or helpful hints,” said Sarah Doak, Community Health and Education Division Supervisor, MMDHD.
“Why do we love Patagonia Health? Let me count the ways…”
- Patagonia Health staff are easy to work with and willing to make changes specific to our needs.
- We can communicate with other staff members about clients through messages on dashboard.
- It’s easier to track No Shows, Cancellations and Walk-In appointments.
- Uploading scans of insurance cards/drivers licenses/previous medical records etc. is quick and easy to get them into a patient’s chart.
- Dispensing medication is easy and directly connected to inventory and eliminates the need to frequently hand count inventory.
- HL7 messaging was quickly set up with State registry.
- Patagonia Health takes care of updates with CPT codes and system updates are released every 6 weeks without fail.
- Processed claims can be reviewed for payment for each CPT code which allows us to calculate exact reimbursement for each separate CPT code
- In Patagonia Health, billing is not “batched” – each claim is submitted individually. This was a big change but has resulted in timelier billing.
- The clearing house is built into Patagonia Health, meaning there isn’t an extra step to actually bill.
“Patagonia Health has helped very much from a Director’s level. The monitoring of staff schedules and efficiencies, billing errors and rejections, audit trail reports for compliance issues, and many other high level functionality features has made the management of both the revenue cycle and program compliance much easier than past EHRs.” Kelly Conley, CMDHD
“The best part of Patagonia Health is that, as a management tool, I can audit charts, review documentation for meeting state requirements, and monitor ongoing quality improvement projects from one location. This is a great time saver.” Janice Parrett, CMDHD