“We're looking to be proactive with technology and actually take care of patients before they get sick, not after; and improve their lives. That's the ultimate goal at ChenMed.” ChenMed’s IT team, led by CTO Serge Perras, is aiming to transform preventive healthcare. It’s a mission based on relationships and putting the focus on the needs of patients not processes.
“Our mission is to develop a company culture centered around the patient and making sure everything we do - from the clinical process to the technology deployed – improves health outcomes for our patients,” maintains Perras. He notes that, especially during the testing times of a global pandemic, reinforcing the bond and connectivity between patient and physician is of paramount importance.
The practice of medicine is very different at ChenMed, explains Perras. “First, our primary care doctors serve a maximum patient panel of 450, not the 3,000+ patients that so typical for family doctors working in fee-for-service practices. With patient panels just one-fifth the industry average our doctors are able to nurture amazing doctor/patient relationships. They get to earn trust with every call and every appointment.”
Perras adds: “Patient trust is vital to any at-risk medical practice. Without it, patients are going to go frequent emergency rooms and urgent care facilities where doctors do not know them as well and where cost of care is dramatically higher.”
There are a number of facets to indirect and direct interaction with patients at ChenMed. Analytics is allowing Perras and his team to better understand the patterns of data provided by the U.S. Centers for Medicare and Medicaid Services (CMS) associated with key health conditions.
“By using analytics our doctors can optimize the patient experience by providing the right care at the right time in the right amount,” notes Perras. “We’re able to use algorithms to enhance medication compliance; to better manage the frequency of both telemedicine and in-person appointments; and to better predict no show appointments so we can increase patient-relevant touch points to improve diverse quality measures.”
Reacting to the challenges facing medicine in a COVID-19 world, ChenMed has broadened its video telehealth capabilities to give patients easy connects with their physician without having to leave the comfort and safety of their homes. “Yes, there’s a limit to how much a doctor can accomplish during a virtual encounter, concedes Perras. “But telehealth is considerably better than no encounter at all. The underlying thread is to continue optimizing all touch points with our patients.”
We keep finding smart ways to use technology to reduce friction across systems. We keep making it easier for primary care providers to better meet patient needs, while investing substantially less time doing administrative work.
Infrastructure in the Cloud
ChenMed formulated a multi-year plan to migrate from a monolithic, tightly coupled, on-premise solution to microservice-based cloud implementation giving it the flexibility to scale its infrastructure.
Now 100 percent Cloud-based, its last data center was closed in January 2020. “We have the agility to pivot quickly,” adds Perras. “Our CareSuite Platform, the next generation of our EMR, was rolled out to physicians across the organization. We’ve got the capability to do the input monitoring and maintenance to make sure those systems are up and running and available. Reliability is key.”
Perras recalls that just four years ago, paper processes, and all of their manual inefficiencies, were still in place. Since then his team has improved the experience of physicians, front desk staff, medical assistants and care providers. Better healthcare worker experience quickly translates into better care for patients. The goal is to support mobile capabilities to provide access to changing patient data in real time.
“While supporting physicians with the ability to cross reference previous treatments on the database, we’re aiming to develop our self-service capabilities too,” says Perras. “Patients will be able to visualize their own care path and see that history from medications to interventions.”
“The big trend is growth,” affirms Perras. “If you look at primary care as a whole, and then focus on the strong health outcomes being achieved by ChenMed and other value-based care providers, it is clear why Medicare Advantage insurance receives strong support from public policy makers.
Competition motivates us to find better ways to modernize and transform care. Historically, there was a belief in a 10-year lag between current technology and the technology that most health care organizations were utilizing. That gap has closed significantly, partly because of the influence of the value-based care model. A limit on resources means that when we’re optimizing it’s with a focus on what’s actually going to make us more efficient and profitable, so analytics and technology are vital.”
Data science has come a long way and is now capable of delivering the right information at the right time because, as Perras rightly states: “Reports and information are useless if they're not actionable.” For ChenMed it’s the big driver for decision support, analysis around existing data and the management of unstructured data in the healthcare space to help improve patient outcomes.
The culture of positive change at ChenMed extends to the way technology partnerships have become collaborations in pursuit of providing the best healthcare outcomes. Trexin Consulting provides the strategic staffing services that allow ChenMed to scale and deal with spikes in capacity.
“With the rate of change we’re experiencing it’s difficult to cover every competency in-house,” concedes Perras. “You’ve got to have a trusted partner that can service those needs and provide guidance. We’ve worked with Trexin for four years now and the quality of people they bring to the organization has been second to none. We can trust them to deliver and their flexibility and support has allowed us to take on new initiatives with confidence. They have consultants out there across the industry which feeds back great insights for ChenMed, helping us to plot our path.”
Perras notes Trexin is involved with ChenMed’s RPA initiative – an automation exercise netting hundreds of thousands of dollars of savings by automating manual processes. “They pivot quickly and keep up with our agility,” he says. “It's a real success story, because going forward, not only are we reducing costs, but we're actually allowing ourselves to scale more effectively because we're massively reducing manual processes.”
RingCentral provides ChenMed’s video conferencing services. A long-established relationship has seen the healthcare provider working with the California-based company during its product planning and beta platform development to gain valuable insights.
“They’re more than just a vendor to us,” explains Perras. “We get visibility on how their technology is developing and how it can help us. It’s technology like this, particularly over the past year, that has proved to be crucial. It’s been the cornerstone for our remote approach during the pandemic and something we can rely on. They’ve helped several of our business units transition smoothly from 100% in the office to virtually 100% remote.”
Another key partner for Perras and his team is SHI International; helping ChenMed consolidate vendor handling for simplicity. “SHI has provided us with a one-stop shop to manage vendor relationships” he confirms. “It lends itself well to one of our guiding principles in IT; it's always easier to maintain and manage simple systems than to have to worry about complexity.”
The Future for Healthcare
Gleaning better insights from data in real time requires a lot of processing time and power, but remains key to ChenMed’s aspirations for supporting physicians while achieving the best possible outcomes for patients.
“During encounters with patients, we see data as a way to enhance physician decision-making real time. “So, we’re making a big effort to restructure, better store, and better segment data across our enterprise. We’re focused on dealing with the technological implementations required to speed real time and highly relevant data sharing of best practices to consider as our amazing doctors personalize care for each patient.”
The future for Perras and his team is about streamlining and reducing friction to better achieve ChenMed’s goals. “We want to go faster but we don't want to do so by brute force or by increasing the effort. We want to go faster by reducing the resistance across the board in our development lifecycle and how fast we can get tangible and transformative products through our pipeline. We want that pipeline to be even more effective through greater automation of testing, code verification and quality controls to meet our main goal of daytime deployments on demand.”
ChenMed is going through evolution rather than revolution to ramp the maturity of its development process to realise major benefits for both patients and practitioners.
- Serge Perras