Moving GI data to the cloud in the era of healthcare consolidation

Technology is one of the biggest complexities and costs for physician practices. The cost of running efficient, effective and compliant medical practices has become challenging for solo practitioners, small groups and even large groups across the country, driving consolidation among specialists, including gastroenterologists.

This article was sponsored by Modernizing Medicine Gastroenterology.

According to PricewaterhouseCoopers, in the third quarter of 2017, there were 200-plus deals in the healthcare space for the 12th consecutive quarter and approximately 13 percent of the deals involved physician medical groups. The 28 deals among physician medical groups during the quarter represented approximately $1.3 billion, which shows a clear trend toward physician practice consolidation. As physician practices transition from one- and two-member groups to larger organizations with 20, 50 or 100-plus members, practices need more sophisticated technology to optimize workflows, capture data, standardize treatment and deliver better-quality care across all providers.

Proactive medical groups, such as Washington, D.C.-based Capital Digestive Care, are transitioning their organizations' servers to cloud-based technology to save time and money and ultimately prepare for future growth. In early 2017, the contract for the group's old servers was up for renegotiation, and the group realized it would need more server space as it continued to grow. The group could either replace or expand its server or in the alternative, transition to cloud-based technology; the answer was clear to Michael Weinstein, MD, President of Capital Digestive Care.

"We were using our hosted services out of northern Virginia that needed to be replaced, and replacing the servers would be a relatively big cost," he says. "Our connectivity to that server had not been completely reliable; whenever there was a glitch in the access to our medical records, it was our responsibility to diagnose if it was a server or software problem. By choosing to go with just one vendor, we were able to turn the responsibility over to them. That, among other reasons, is what made us decide to move to cloud-based technology. "

Making the switch: safety and logistics
Capital Digestive Care is a 60-physician, 300-employee organization with 18 sites, including eight ASCs. Making any changes to an organization of that size takes considerable preparation and meticulous attention to detail, ensuring all the information and interfaces are accurately, appropriately and safely transferred. Capital Digestive Care Chief Innovation Officer David Smith led the three-month transition effort, which included a trip to Florida to consult the engineers at Modernizing Medicine Gastroenterology. Modernizing Medicine Gastroenterology provides gastroenterology practices with GI-specific EHR software to help them gather and manage data, streamline workflows, enhance profitability and meet MIPS requirements.

Beyond logistics, patient information security is paramount for any healthcare organization. There were nearly 400 data breaches of healthcare organizations in 2016, according to the Identity Theft Resource Center. Switching to the cloud can help improve patient data safety as compared to the organization having its own server. In fact, some government agencies even decided to move patient data to an integrated cloud-based platform in mid-2017 for more secure data sharing capabilities.

"It becomes necessary for practices with multiple sites to move to the cloud for efficiencies with different carriers," says Dr. Weinstein. "The government is on the cloud — if it's good enough for the Centers for Disease Control and Prevention (CDC) and other government agencies in Washington, D.C., then it must be reliable enough for a GI group. I'm confident enough about the technology being the direction that big businesses are going."

Capital Digestive Care transitioned to the cloud on a Friday, providing engineers ample time to iron out any issues before the practice reopened on Monday. Capital Digestive Care hasn’t looked back since. “The transition was smoother than I expected, and we haven’t had any trouble getting data into the system,” says Dr. Weinstein. “Most of the physicians didn’t even know we had switched; they don’t usually access the system over the weekend, so it was completely seamless for them.”

The transition took less than 24 hours, and then the system was up and running again. Initially, physicians were concerned that the cloud might be slower than their servers and the interfaces would disrupt workflows if they were too different from the group's previous interfaces, but this did not occur. While Capital Digestive Care's IT staff assured Dr. Weinstein and his partners the cloud would be able to refresh pages quickly, it took a leap of faith to fully jump on board without prior cloud experience.

"There isn't a guarantee that it will be faster until you are doing it," says Dr. Weinstein. "The cloud isn't hugely faster, but it's much more reliable. We haven't had nearly the downtime that we had before; even when Hurricane Irma hit gMed in South Florida, we didn't have access problems."

Outcomes: efficiency and cost savings
During its first half-year of using Modernizing Medicine Gastroenterology's cloud-based solutions, Capital Digestive Care has already experienced several benefits and is now poised for scalable growth in the future. Some benefits include:

• Enhanced reliability
• Lower overhead cost
• Efficient interoperability between locations
• Single vendor for software and cloud servers
• Simple backend management

"Accessing the cloud is more reliable than accessing other site engines," says Dr. Weinstein. "We were also able to save because the comparative cost we were looking at for replacing our servers was $100,000 per year. Mr. Smith knew the cost analysis clearly favored the cloud over continuing server use, and the IT staff feel the cloud is actually simpler." Further, since the servers and the software are all located on the cloud, David Smith need only call one number for assistance with interface issues.

"If you are dealing with the same vendor for both software and [cloud] servers, you know the vendor can access your servers to solve the problem," says Dr. Weinstein. "The experience of being able to have one phone call if something isn't working or the print queue is clogged has been great. We are really happy with it; on a scale from one to five, we are close to a five. The cloud technology makes interface integration easier and simplifies some of the complexities."

Future growth: scalability with the cloud
Dr. Weinstein sees his practice growing over the next three to five years, and the cloud allows for a scalable business model. The speed and reliability associated with cloud-based technology is the same whether there are five, 65 or 105 users.

"We want to scale our practice and were trying to figure out how many virtual servers we needed to handle the number of people we currently have, with the goal and strategy to get bigger," says Dr. Weinstein. "We want to expand our footprint in the region. We had to ask ourselves how we would handle getting bigger if our servers were racked; our old servers definitely weren't big enough. The cloud was definitely a better long-term solution."

Moving to the cloud may not make sense for every practice; but for a growing practice or one that doesn’t want to manage their IT themselves, moving to the cloud may be the best option, especially if the group wants to keep services in-house. However, Dr. Weinstein cautions groups to trust the right personnel with making IT decisions.

"Doctors only see what comes up on the screen; they don't know what goes on behind the curtain. It's too complex for the physician to handle, but the IT professional knows how to navigate it," says Dr. Weinstein. "When you get big enough to have the opportunity to use cloud computing, make sure you have the right people making decisions about your IT."

Dr. Weinstein and his partners decided to invest in their own IT team with the support of Modernizing Medicine Gastroenterology and its cloud-based technology. Since implementing Modernizing Medicine Gastroenterology's cloud-based solution, Capital Digestive Care has reported increased efficiency and will be ready to expand in the future.


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