Addressing EMR-Related Issues with A Care Management Platform

Introduction to cliexa’s Care Management Platform

There is a need for additional digital health and care management platforms to alleviate some of the burdens of the electronic medical record (EMR) through enhanced customization, streamlined data collection, and integrated compliance algorithms into a digital patient intake and remote monitoring platform, like cliexa.

cliexa’s care management solution is designed to increase clinical efficiency by providing digitized intake forms and qualifying patients for reimbursements automatically. This process aims to streamline the documentation and data collection procedure so that providers spend less time documenting, and more time with their patients.

Through an automated process, clinical metrics and quality data, via patient-reported outcomes, integration into the Merit-based Incentive Payment (MIPS) quality reports can be done in the EMR to maximize compliance and reimbursements. This technology empowers clinicians to make intelligent correlations between: 

  • Medical History
  • Clinical Assessments
  • Surveys and Questionnaires
  • Connected Device Data
  • Payor Claims Data
  • Medication Adherence

How are the barriers to EMRs for the physicians addressed by cliexa?

Coordinating care for better diagnosis 

Patients can check their progress from their handsets or tablets, which is subsequently sent to their physicians in a consistent and objectified approach in order to measure their disease activity scores. This information is then passed through the cliexa Cloud into the provider’s existing EMR system.

Along with serving as a chronic care management system, a care management platform like cliexa, are employed for clinical trials, to process digital forms which are sent to an existing EMR system, for the remote management of patients’ progress.

Improved accuracy and reproducibility of data

Patient-reported outcomes (PROs) measure any phase of a patient’s condition and health status directly from the patient, regardless of the analysis of the patient’s responses by a clinician or anyone else. This naturally advances the precision of how, why and what the patient is going through and can be interpreted into disease activity scores to evaluate the severity of the disease. 

Reduced external pressures on Physician-Patient relationship

Physician burnout, compressed clinical grids, greater medical complexity, EMR coverage, increasing costs, variable medical data, reduced reimbursement, advertisement and marketing are the identified external pressures on the physician-patient relationship. Smart systems like cliexa, address these issues through the implementation of PROs.

Clinicians have found PROs to be a useful mechanism for shared decision-making in the right environment with the right workload. This facilitates achievable endpoints that promote the physician-patient relationship by better time management, a common platform for patients and clinicians to trace and envision their disease activity and simplified documentation.

Less time consumption and ease of implementation 

Flawless integration into the current workflow, customizable evaluation and questionnaires configure effortlessly with your EMR system. The cliexa Cloud passes the information responded by the patients in the care management platform directly to your EMR, customized depending on your preference.

The system sets in with no disturbance in your workflow and requires approximately one day to set up without any IT commitments. The information is sent to the clinicians’ files in the formats of your choice to verify data quality before full integration.

Customizability is how cliexa deals with all the reservations over implementation. The platform is structured according to the requirements of the physicians, patients, and the healthcare composition, without the need for an on-site IT team. The staff training can be done in a day along with minimally invasive implementation, meaning simplicity throughout the course of implementation.

Cost-effectiveness and reimbursements 

The healthcare systems are known to have the following reservations with PROs; high capital investment needed, physician engagement, information management requirements, integration of knowledge, privacy considerations and the management of critical or missing information.

cliexa attends to these considerations through a reimbursement structure and flawless integration. Although investment is one of the key considerations, the software links providers and payors to rationalize the process of Content Management System (CMS) and payor compensation.

cliexa has formulated the ROI calculator on the platform for the people who choose to go for its reimbursement structure. The physician engagement and management requirements are addressed by focusing on time management and easing the procedure as per the interest of the physicians.

Better patient experience and versatility of use

cliexa is a free-to-use care management platform for patients, available on the App Stores for all mobile platforms. This includes devices such as smartphones or tablets that consist of the app store for download. Unlike other patient platforms, cliexa is independent of clinics or healthcare offices. This means that it is available for the personal use of the patients.

Even if the physician’s office does not use the software, patients can still track their condition and its progress by using this versatile software. With the application storing your history, you can have your data accessible when switching over to a new clinic or healthcare provider simply but updating the care treatment plan.

Privacy and confidentiality

All the rules of privacy and security laid down by HIPAA guidelines are followed in order to protect your information. It is further ensured that any data is not being shared with anyone other than your healthcare providers. The software in the clinics and on patients’ devices is updated automatically by a remote device management system.

All of the aforementioned points are promising ways through which the EMR-related issues can be potentially addressed. However, cliexa or any other smart software is not a direct and the most precise way of diagnosis, rather it is a means to follow the health progress, functioning alongside primary care. Thus, if you are experiencing consistent symptoms of a chronic condition or a health issue, make it your first priority to visit your healthcare center for a checkup by the primary care provider.

cliexa announces new partnership with Colorado Clinic on innovative solution for interventional, chronic pain management
cliexa announces new partnership with Colorado Clinic on innovative solution for interventional, chronic pain management

We are thrilled to announce we have teamed up with Colorado Clinic to redefine their data collection and documentation process using the cliexa platform. Colorado Clinic is a leader in combatting the opioid crisis by offering cutting-edge, non-narcotic solutions for holistic interventional pain management. The cliexa platform enables patients and physicians to track disease activity and leverage proprietary technology that makes intelligent correlations between medication dosage, frequency, and heightened or reduced symptoms. Together, we partner to offer an innovative solution for chronic pain management with the cliexa-EASE platform.

With the cliexa-EASE platform, Colorado Clinic patients will be able to digitally complete the entire intake process upon arrival to the clinic. This digitized process includes consent documentation, chief complaints, and screener questions such as the Screener and Opioid Assessment for Patients in Pain (SOAPP-14) to monitor at-risk patients. The SOAPP model is a 14-item, self-report measure designed to address the appropriateness of therapy for chronic pain patients.

Clinicians will receive a full report delivered directly into their athenahealth electronic medical record (EMR) system with auto-generated treatment recommendations determined by the Colorado Clinic staff for each individual patient. 

cliexa has also developed a proprietary risk stratification model for Colorado Clinic to determine the level of risk for patients taking opiates. Based on the calculated risk level, urine analysis frequency recommendations will be generated in the clinician report in accordance with Colorado Clinic’s clinical guidelines report.

Through cliexa’s computer adaptive testing system and individual patient matching, patients will be able to complete standardized assessments that are triggered by the chief complaints and responses in the SOAPP-14 assessment. This method allows Colorado Clinic to deliver a highly personalized patient experience. cliexa empowers providers with compliance algorithms built-in to the platform, enabling them to see billing recommendations based on the patient inputs, allowing them to gather accurate reimbursement metrics to sync with the MIPS quality report.

With this collaboration, the cliexa-EASE platform will be available soon at all 5 of Colorado Clinic’s locations including Aurora, Colorado Springs, Greeley, Loveland, and Thornton. We can not be more excited to collaborate with the team at Colorado Clinic, and we look forward to providing more content about the project in the coming months.

Is your practice using the athenahealth EMR and want to learn more about how to enable cliexa? Check out our quick, 5-step setup guide!

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Overview of the Physician Burnout Problem

The demanding work pace, time constraints, and emotional fatigue are the aspects that make physicians vulnerable to burnout. Symptoms caused by long-term stress such as depersonalization, low sense of accomplishment and emotional disparity due to work-life imbalance make the doctor prone to exhaustion leading to a feeling of quitting.

The WHO terms burnout as an ‘occupational phenomenon’ which, in its latest update of the definition, is referred to as a ‘syndrome’ that occurs due to chronic work stress that is not effectively managed.  The physician burnout is metaphorically referred to as the bank account of energy.

There are three main types of energy; physical, emotional and spiritual energy that keeps on adding up and depleting with time and circumstances. The highly demanding doctors’ profession and the workplace norms generally have a downward trend towards energy levels that puts clinicians at a high risk of burnout. 

According to a study published in the Annals of Internal Medicine in 2019, Physician burnout costs around $ 4.6 billion to the United States. Dr. Lotte Dyrbye of Mayoclinic opines that whoever enrolls in medicine is aware of the fact that it is a demanding and stressful profession.

Over the past years, the sprouting cases of physician burnout have led to cynicism about its repercussive effects on patient access to care, care quality as well as patient safety. Burning out inflicts the doctors to quit their jobs making access to care, less likely. Lack of attention and focus, as well as memory constraints, hamper patient safety and quality of care.

According to several studies, 1 out of every 3 physicians is suffering from burnout at a time. Thus, every physician precisely is at risk of burnout and it rightly needs to be dealt with as a crisis. Although the physicians can take the necessary steps themselves to improve the work-life conditions and keep the burnout symptoms at bay, big changes are needed at the institutional level to bring forth evident outcomes.

A recent report from Harvard states that physician burnout is a public health catastrophe that urgently needs a solution. Among the recommendations stated by the report, changes to the practice of Electronic Medical Record (EMR) or Electronic Health Record (EHR) are declared to be a significant measure to provide a medium-term solution for physician burnout.

Problems that are focused on EMR-related issues

The patient record used to be written on paper for ages and has consumed an ever-increasing space and remarkably deferred access to proficient medical care. As of today, EMRs collect individual patient data and clinical information electronically, facilitating immediate accessibility of this information to all healthcare providers. It is thus said to assist the provision of coherent and regular care.

Electronic Medical Records (EMRs) are automated medical information systems that assemble, store and present patient information. They are a way to produce reliable and structured recordings to access clinical data about patients. Hence, EMRs have replaced paper-based medical records which most practitioners have been long familiar with.

There are a number of potential advantages EMR is known for. These include

  • Optimizing the records of the patients
  • Improving communication of patient data to clinicians
  • Improving access to patients’ healthcare information
  • A substantial decline in errors
  • Optimizing payments and advancement in reimbursement for services
  • Formation of a data storage area for research and quality enhancement
  • Reduction of the use of paper

EMRs are envisioned to have great potential for enhancing quality, stability, protection, and efficacy in healthcare. These are the reasons why they are being implemented throughout the world.

In spite of the high expectations and focus on the technology worldwide, there are several EMR-related issues associated with them that have kept their overall implementation rate relatively low. They are viewed to oppose a physician’s customary working style and also entail the following barriers to acceptance by physicians.

  1. Financial Barriers

    EMRs necessitate a greater competence in dealing with computers. Further, installing a system entails significant financial resources; high startup expenditure, high maintenance cost as well as uncertainty about Return on Investment (ROI).

  2. Technical barriers

    Lack of computer skills of the clinicians and the other staff, deficiency of technical training and support, complexity and limitation of the system, etc. are the factors considered as technical barriers to EMRs.

  3. Time constraints

    The physicians find it too time-consuming to select, purchase and implement the system, to learn the system, to enter data, to convert the records and requiring more time per patient. 

  4. Psychological barriers

    Based on their personal reservations, understanding, and perceptions, clinicians have concerns about using EMRS. Their observation of the uncertain quality improvement associated with EMRs and doubts about the loss of specialized autonomy lead to a lack of belief in the EMR.

  5. Social barriers

    The social barriers include uncertainty about the vendor, lack of support from external parties, from other colleagues and from the management. Also, the physicians find EMR to be a system that interferes with the doctor-patient relationship.

  6. Legal barriers

    Clinicians think that keeping the patient records and medical information safe is vital to avoid legal issues. Nonetheless, there is a lack of clarity about the security standards to keep the patient records safe and confidential. 

  7. Organizational size and type

    A small practice is estimated to face greater difficulties in working out the financial issues than a large practice.

  8. Change process

    Implementation of EMRs in the medical practices demands a major change for clinicians who have their own working styles developed over the years. This renders them unwilling to adapt to variations in their methodology of work. Therefore, the change process is a challenge as well as a problem at the same time. Problems that occur during the change process include a lack of suitable organizational culture, lack of incentives, lack of leadership and reluctance in participation from physicians, nurses and other staff members.

According to a study, the slow rate of EMRs adoption implies the fact that resistance amongst medical doctors is strong. This is because the clinicians are the frontline users of EMRs and whether or not the other user-groups like nurses and administrative staff support and use EMRs, largely depends on EMR’s acceptability by the clinicians. Consequently, doctors have a great influence on the adoption level of EMRs. 

Additionally, a study found that most of the physicians who are stressed out are due to the work conditions and time pressures. The family responsibilities, time demands, chaotic environment at workplace, lack of control of the pace, unfavorable institutional culture; all are attributes associated with dissatisfied and stressed out doctors who inculcate a feeling of switching fields. However, these factors, not necessarily translate into poor patient care by the doctors. However, when a drop in the patient care quality was seen, it was rather due to burnout caused by the organization than by the doctors themselves.

The study also found that the implementation of the EMR contributed to burnout instead of reducing the stress levels as it was hoped. It was claimed that practices that implemented EMR caused an increase in stress to the doctors, the levels of which then reduced as the use of EMR matured. However, the stress level was never found to drop to the lowest. Furthermore, it was found that the fully established EMR systems, particularly coupled with shorter visits caused burnout, stress and an intention to leave the practice.

Causes of the EMR-Related Issues

Like all other technologies, EMRs can be used in a variety of ways for a variety of purposes. In regards to our current healthcare structure, one important performance requirement of EMRs is to generate clinical revenues. This means that it should support physicians’ billing and documentation to produce as much revenue as possible for each medical service. Moreover, EMRs should also help clinicians meet regulatory necessities that may have monetary or endorsement implications.

This implies that existing EMRs are not designed in a way so as to support many of the matters that clinicians, patients, and policy-makers value including improved care experiences, decreased cost, improved care quality, and inhabitants’ health management. Current EMRs have not been created to facilitate the physicians to improve in their diagnoses or become more cost-effective prescribers. This is because the present-day health care system generally does not compensate for these actions.

Having said so, EMRs have very minimum capacity pertaining to clinical decision making (which increases the quality of care), for the data collection on duplicate and needless tests, or on the collective health of the patients.

Simply put, the advancement of the EMRs will necessitate the changing of prime considerations regulating their design. This includes moving towards risk-sharing by clinicians and eventually, some form of potential reimbursement rather than the current fee-for-service culture. Till then, optimizing the usability and worth of EMRs will be an ascending effort.

READ NEXT: cliexa Partners with the athenahealth Marketplace Program

Researchers Receive $1 Million Grant to Study Digital Screening Intervention Tool for Adolescents and Young Adults

cliexa is excited to partner with the University of Northern Colorado (UNC) with a grant from the Department of Health and Human Services’ Office of Adolescent Health that provides nearly one million dollars over the next two years for the implementation of cliexa-OPTIONS, a digital screening intervention tool that fosters earlier identification of high-risk adolescents in a clinical setting. The funding supports independent evaluation including, cost-benefit analysis and randomized controlled trial of the cliexa-OPTIONS risk screening tool and MyPLAN mobile health follow-up. The Principal Investigator for the project at UNC is Dr. William Merchant. He is the evaluation professor in the Applied Statistics and Research Methods program in the College of Education and Behavioral Sciences. 

The cost-benefit analysis assesses cost savings between the cliexa-OPTIONS risk screening against current paper pencil and verbal screenings. Also, the cliexa-OPTIONS risk screening identifies 30- 50% more risk in adolescent populations fostering early identification of adolescents at highest risk for acquiring an STI or experiencing an unplanned pregnancy. Improving quality in clinical workflows for adolescent and young adult populations is timely, given that sexually transmitted infections for young people ages 15 -24 are at epidemic proportions.

Saving time and keeping providers satisfied with new technology in clinical workflows is no simple task. The cost-benefit analysis will also assess the benefits of early identification of adolescents at highest risk for adverse reproductive health outcomes, substance use, mental health, and wellness.

Read the full article at: //www.unco.edu/news/newsroom/releases/million-dollar-grant-digital-screening-intervention-tool.aspx

cliexa is now available in the athenaHealth Marketplace

Today, cliexa Inc., a thriving producer of mobile health care management services, revealed a partnership with athenahealth, Inc.® through athenahealth’s “More Disruption Please” (MDP) Marketplace program. As an MDP partner, our cross-communication platform developed for chronic pain patients and providers, cliexa-EASE, is now immediately available to athenahealth’s network of 100,000+ providers and countless prospective clients. EASE enables patients and clinicians to make intelligent correlations between medication dosage, frequency and heightened or reduced symptoms by leveraging an application that functions as a pain assessment model for chronic pain management with seamless scalable EMR integration via API and global HL7 connectivity.

cliexa provides the ideal pain management application to leverage patient-reported outcomes to improve treatment decisions and patient experience, while also maximizing compliance and reimbursement. cliexa-EASE is designed for chronic pain management, podiatry, and general patient wellness. cliexa-EASE allows providers to gather digitized intake data and customize assessments to correlate data that best adheres to their patient population.

In order to provide physicians with high accuracy metrics, cliexa-EASE uses patient reporting methods on visual body maps, and pain expression in voice, face, and body movements. This allows physicians to view the physical attributes of pain beyond self-reported descriptions which can often be difficult to translate into clinical diagnostics terms. Tracking these markers allows physicians to use patient-reported outcomes to treat the “whole patient.”  One of cliexa’s existing clients, Anderson Podiatry Center, is already seeing the benefits of using the cliexa platform with a custom digital patient intake and screening process, also digital consent forms, integrated to their athenahealth electronic medical record (EMR).

The athenahealth Marketplace partnership opens up a hyperconnected, national network of healthcare professionals providing chronic pain management. With this partnership, the two companies align to provide measurable financial and clinical results for providers. cliexa is a real-time data provider for future medicine and will continue to build on our vision to increase patient-provider engagement and compliance through mobile health solutions.

“We are excited to partner both with athenahealth and Anderson Podiatry Center to deploy cliexa platform into the marketplace as this is the first of many subspecialties we currently have in our portfolio. We are looking forward to implementing other subspecialty applications to the athenahealth marketplace which will strengthen our partnership in healthcare space,” says Mehmet Kazgan, Founder and CEO of cliexa.

Eric Seyler, CEO of Anderson Podiatry Center, says, “The transition to a digital patient intake has given us more opportunities to help our patients than we had envisioned. Our patients have spent less time in the waiting room with more time delegated to their doctor’s visit. The integration is done in real-time which supports our goal to be more efficient with clinic resources while helping to provide the best possible patient experience.”

cliexa enables patients to track their chronic disease activity by quantifying symptoms using scientifically-proven and clinically-validated scoring models. cliexa delivers quantified disease activity and documentation through real-time integration to athenahealth electronic medical record, which streamlines processes and increases efficiency in population health management.

View our listing here: //marketplace.athenahealth.com/product/cliexa