Holland Physician Hospital Organization (HPHO) is a clinically integrated network that encompasses both independent as well as employed physicians as well as Holland Hospital. It has about 156 full physician members. HPHO cares for about 74,000 attributed lives. So that means the primary care physicians associated with Holland PHO have 74,000 patients across Medicare, Medicaid, commercial, self-pay, in their practices.
Paul Clippinger is the Executive Director of Holland Physician Hospital Organization. He started out in staff model health maintenance organization. He ran several physician hospital organizations in Indiana prior to coming to Michigan. He also served in administrative roles above and beyond his physician hospital organization experience in various hospitals in Indiana, anywhere from a small county hospital to a quaternary health system in Indiana. And the common theme was managed care throughout his career. He has been in his current role for almost nine years now.
HPHO learned about Health Focus through an email outreach from Health Focus to the president and medical director of HPHO. The timing couldn’t have been better because the organization had been going through an extensive review of other registry solutions. HPHO had been using another platform for several years, were not very satisfied with that platform and had been in search of an alternative. As they had gotten farther down the evaluation process, they had determined that the return on investment just didn’t look like it was there with the other more desirable of the solutions that they were then evaluating. And at that point in time, Health Focus made the outreach and they began to look into Health Focus as an alternative and quickly realized that much more so than anybody else that HPHO talked with, that Health Focus understood the needs and the business model for a physician organization and/or a physician hospital organization, which they are.
Asked about what was wrong with the other solution, Paul says: “Anytime that we needed any kind of a modification, it was a long process in terms of could there be a modification if there could, it was going to cost an arm and a leg to be able to do that modification. Nobody seemed very interested in doing those modifications. The interface, the usability of the product was such that we never handed over the keys to the product to any of our offices because we felt like it was so clunky that it wasn’t worth handing over the keys for end-stage users. And so, whenever we did use it we would kind of generate reports out of the system and provide them to the offices because we didn’t feel like end-stage use was very practical for our offices.”
HPHO employs numerous electronic medical records. Unlike a big system that may have a common electronic medical record for both the hospital and the employed physician practices, the various independent practices are on a variety of electronic medical records. The hospital has a different EMR for their practices as opposed to the EMR that the hospital itself uses. One of the main goals of HPHO is to improve quality and efficiency in the population health space where their mission is. The focus here is that in the primary care offices HPHO needs to have a handle on and focus on improving the quality of care being delivered in all offices as well as to work on efficiency to bend the cost curve. Paul says: “And we felt like we were better able to do that with Health Focus. A part of that with Health Focus was supplemental data feed to the payers to be able to provide additional information to claims data to fully paint the picture of the quality of the care that was being provided for our patients. It also didn’t hurt that Health focus helped to ensure that HPHO was not leaving any services unbilled and collected.”
The organization had come to the conclusion that it needed to go in a different direction. HPHO had talked to its board about kind of the vision of where it wanted to head with regard to a patient registry solution. HPHO used a project management individual from the IT department at Holland Hospital that walked the team through the process. And since that group assessed IT solutions for the hospital all the time, they were the facilitator to make sure that the process kept on track.
The evaluation committee had a small group within the PHO as well as this facilitator from the IT department were the initial reviewers. And then the group started to expand and provided some overview information to some physicians and provided some of the lead physicians and provided some information to some of the people in the physician offices. This was due to the fact that the organization felt like the quality and useability of the solution required the end-users ro be a part of all demonstrations and let them react to what they were seeing. And then ultimately it was the decision of the board at the committee’s recommendation to move forward with this project. The decision across all constituents was unanimous.
HPHO has now been using Health Focus for four years. Paul says the initial implementation was smooth and painless. He adds: “We continue to be pleased with the interaction with Health Focus. We have weekly meetings with them and our needs are listened to on an ongoing basis. The capabilities of the system are modified or enhanced as we talk back and forth on a week-to-week basis. We have always been very highly impressed. I honestly can’t think of another vendor I’ve ever dealt with that is more customer focused in terms of responsiveness, understanding our needs and addressing our needs. I cannot think of another vendor that’s done a better job than Health Focus.”
HPHO needs to integrate with a variety of payers. This is critical for the success. Health Focus has built the interfaces to make this work. Paul says that he has many users spread over a wide variety of locations. He says that he receives positive comments from his users and that they are pleased with the user experience of the product, the support provided by Health Focus and the reports and charts automatically produced by the product. He says that Health Focus is a mission-critical application and provides huge value to the organization.
When asked about what benefits the organization has derived from Health Focus, Paul says: “One of the things in particular has been the ability of the practices to actually use the solution so they can actually look from even a payer agnostic perspective across multiple populations and look at different metrics for targeted patients. The fact that Health Focus had usability at the practice level was critical. Historically, our employee practice had a more robust electronic medical record. When we were involved with the prior vendor that they really didn’t pay attention to anything related to reports or anything from that tool because they had a fairly robust EMR that could create a lot of the data mining that they needed. We were encouraged that when we moved to Health Focus that it not only was helping out the independent offices who either might not have had the depth of understanding on how to use all of the bells and whistles of their EMR and/or they may have had more limited capabilities in the version of the particular EMR that they had purchased.”
He goes on to add: “Everybody seemed to be benefiting from the ability to use this solution on their own. That was one thing we were particularly impressed with. One of the other things that we continue to evolve with Health Focus is working on dashboard types of reporting to be able to understand from an efficiency standpoint, how are we doing relative to other things, whether it’s our pharmacy spend or our inpatient or outpatient spend or our professional services spend. Another thing that we’ve been working on to evolve into use through the solution was tracking our use of our self-policing of imaging clinical decision support in terms of how are we doing in terms of the scores that we’re getting, as well as just the use of the solution by our providers.”
Paul goes on to add: “We are automating a lot of manual work through Health Focus. But anytime we come up with some kind of an idea, the Health Focus team is all about trying to help us to implement and to expand the capabilities of the solution. Most recently, we’ve been delighted at the interaction that Health Focus has been having with Priority Health with regard to understanding that they needed capable partners in the EMT and population health space to better work with the physician organizations. The fact that Health Focus is a credible vendor has worked well on our behalf given that we have a large number of Priority Health patients that we’re involved in. We were sufficiently impressed with Health focus that we guided another physician organization to them. This organization was evaluating and had adopted another solution ended up converting over to Health Focus. We had evaluated the other option that they had evaluated and showed them that there was not a return on investment on the alternative product but was with Health Focus So , this shows how happy we are with Health Focus.”
When asked if there were any surprises about Health Focus, Paul says: “I guess, is I’ve just never seen a group that’s been so responsive. I just haven’t. And if other vendors were responsive they would say that this is going to cost you another gajillion dollars to change or add. Not Health Focus.. I think that as we come up with ideas for them to implement and this has assisted Health Focus too. I think Health Focus starts working on the dashboard, for example, and are trying to figure out how to format things. And we will add, “Well, this is the way we would like to see it go.” And so I think we’ve kind of been a pilot for them in terms of things we come up with.”
Paul states that he would certainly recommend Health Focus to any organization thinking about a patient registry for value-based care. He says: “They’re wonderful and you couldn’t do better in terms of a population health management tool, that they understand the needs… particularly if it’s a physician organization… they understand the needs, they get the business model. I’ll tell you, as we went through the winnowing processes as we were looking for other solutions, nobody understood our business. Some people were way far afield, some people were kind of close, but as we evaluated different options, that people, they just didn’t get it in terms of what we needed and what we didn’t need. They were trying to fit their solution into our business case and their solution as it stood, without customization, it just didn’t meet our needs. Health Focus perfectly fits our needs.”