When Quality Metrics Ruin the Quality of Care.

Sigh. We knew this would happen… traditional healthcare is getting in the way of itself again.

Quality measurement is a good thing on paper, and not something to be ignored. But implementation of it is, well, complicated. And according to some recent studies, largely unhelpful. When you get down to the nitty gritty, we’re not convinced it does more good than harm, and Dr. Don Berwick, one of the nation’s leading champions in high quality, patient-centered care agrees.

“I have tremendous doubts about the accuracy and utility and overall wisdom of quality metrics at the individual level,” Berwick says. “When it’s a ‘falling off a log’ standard that you know everyone would want the same way then it’s good to know we’re adhering to the standard. The problem comes when we don’t get a chance to modify them to fit individual needs. Can we really be smart enough to write rules that get down to the level of what’s right for each individual patient? So we have to be really careful about these rule-based standards.”

Because it’s true that “doctors are so much more than metrics.”  In fact, a lot of docs feel metric bloat has had a negative impact on quality care. Oh, and it’s not worth the money it takes to implement, either, apparently:

In 2015 the Institute of Medicine issued its own report on the proliferation of quality measures, which found that “the growth in measurement and reporting activities results in considerable expense and requires substantial time commitment, without a matching return on investment.”

It seems that spending too much time measuring the quality is actually ruining the quality. Suddenly this is all too convoluted and you’re thinking – there MUST be a better way. Enter stage right – Direct Care. Where quality is literally the foundation on which DPC practices operate. No need for measurements. Quality just… is. It’s baked into every part of a Direct Care doc’s day – from the smaller number of patients they see, to the longer appointment times, all the way to billing transparency and acute interest in saving their patients money.

Quality shouldn’t be measured in numbers, but rather patient satisfaction. And as more and more patients opt for a truly personal relationship with their physician, Direct Care smiles from ear to ear. Because it has everything we need to show patients what quality’s really like – without any of the controversy.

Connect With LabCorp and Work Easier

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There’s been a lot to be excited about recently — your ability to accept ACH payments at a reasonable price, an opportunity to save 40% on insurance and a forum to keep you connected to other DPC docs, but now, there’s a new way to make running your practice even better.

You can now integrate with LabCorp to make tracking, requesting, and printing labs possible right from Atlas.md. This new addition will provide you and your patients with more possibilities and more flexibility. You’ll be able to do the following, right from Atlas.md:

  • Request labs from LabCorp
  • Print specimen labels directly from Atlas
  • Retrieve and integrate LabCorp results into your patients’ charts

When you’re ready to sign up, connect with your local LabCorp representative. You’ll receive an Atlas account number so that you can streamline the ordering, printing, and tracking process, right from Atlas.md. If you have any questions about this process, or if you want to reach out about your practice, feel free to connect with us by sending a note to support@atlas.md.

Posted by: AtlasMD

March 16, 2016

Bringing Hospitality to Healthcare: An Introduction

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Hospitality. A noun. It means “the friendly and generous reception and entertainment of guests, visitors or strangers.” It’s being nice. It’s treating people with kindness whether you know them or not. It’s going above and beyond to exceed expectations. Make sure people are taken care of. Sounds amazing, doesn’t it? Literally, who wouldn’t want to be on the receiving end of that? 

It’s sad how little we actually see hospitality in action, though. We complain about its absence all the time. At the grocery store when the checkout person tosses our goods to the bagger and we’re just sure the pretzels have been crushed into teeny tiny bits. At the drive-through window, when the employee barely looks you in the eye as he hands you your drink… which happens to be dripping down the side… and then all over your hands. On the road when the kid on his cell phone pulls out in front of you without looking twice – or once for that matter. At the Dr.’s office as you’re shuffled in and out the door like you’re just another pretty face.

Think about each of these situations and how they make you feel. The lasting impact they have on you. Your mood. How you treat others as a result. It’s a slippery slope, and it all starts with hospitality. As a DPC doc, you can’t do much about most of those situations… except the last one. That might be the hardest one to remedy, too. The healthcare community isn’t taught how to be nice, so we tend to come off a little rough around the edges. You might also argue that while you didn’t go to school to fill out paperwork, you certainly didn’t go to school to learn how to schmooze and blow smoke, either. Read more

Launch Your Practice Prepared

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Have you been going back and forth between a few different EMRs but haven’t found your favorite yet? We know how you feel, which is exactly why we started Atlas.md. We wanted to share the excitement we felt when we created the EMR, which is why we’re proud to talk about the importance of trying an EMR before you launch your practice.

By trying Atlas.md for free until you launch, you can ensure that your big day will be a big deal for the right reasons.

Get an EMR that lives in your browser – no fancy software. No confusing interfaces. This is an intuitive EMR that makes client communication, billing, tracking, ordering, and filing possible so that you can make all better possible.

  • Communicate where your clients are – You can tweet, email, call, or text your clients right from Atlas.md. That means you’ll be able to communicate with your clients as soon as they need you.
  • Make managing your practice possible – With Atlas.md, you can request, file, and ship prescriptions, you can bill your patients directly, set up automatic appointment reminders, manage your clinic’s schedule with an easy-to-use syncable calendar, and keep track of patient records.
  • Pre-enroll before your launch – Pre-enroll patients before your launch so that, when you open your doors, you’ll have patient data and scheduling information in place.
  • Organize before launch – Get used to scheduling, tracking, or communicating with patients before the big day.
  • Get the lowest billing rates in the industry – Accept automated payments, credit card payments, and ACH payments. No 3rd party needed.

Need more reasons to try Atlas.md’s? Check out our forum to see what everyone’s been talking about, or check out our features page to see what the big deal is.

What’s New in Atlas.md?

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A few new buttons go a long, long way in the latest feature release. Now you can do things like run a full report of earnings per doctor, export your inventory to CSV, and send shipping tracking information to your patients via email or SMS. We’d say the EMR just got a whole lot cooler, wouldn’t you?

Billing Report: View Charges by Type and Per Physician
Now when you’re pulling your monthly reports, you’ll have another helpful metric to analyze. The newest feature is the “Earnings per Doctor” report in Billing Reports, which does exactly what it says. This detailed report will break down each doctor in the clinic’s earnings into the following categories: subscriptions, labs, prescriptions, misc, shipping and total earnings. Just one more way to help you understand your clinic a little better. Read more about billing reports over here.

Inventory: Export to CSV Button
We know each clinic works differently, which is why we’re giving you more flexibility when it comes to managing your inventory. With this new Export to CSV feature, you can export your inventory as a CSV to be easily read by Excel or any other spreadsheet application. Here’s how. Read more

Posted by: AtlasMD

February 29, 2016

Two Step Authentication

Have you been wondering how to activate or deactivate two step authentication on the Atlas.md EMR? We just launched a new video that will help you with the process, and you can read more about it in the help section or shoot us an email at hello@atlas.md if you have any questions.

While some clinics prefer to activate two step authentication, it’s all about your personal preference. What do you choose to do? Feel free to follow up in the comments or check out the forum or leave a comment below to discuss and explore with other DPC physicians.

ACH Is Here and It’s Easier Than Ever To Accept Payments

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There’s a new way to accept payments through Atlas, and it’s going to make things even better for you and your patients. We’re excited to announce the launch of Atlas.md’s ACH acceptance.

Here’s the scoop. By now you know that you can accept credit and debit payments. And that’s been great. But ACH is a way for you to accept payments directly from your customers’ bank accounts. If you remember, back in November, we lowered your transaction payments from 2.5% to 2.1%, but this new addition makes it even cheaper to accept payments from your patients.

The cool thing about ACH (besides the convenience) is that the charge per transaction is only going to be 25¢, which is less than the current 2.1% + 30¢ per transaction for credit/debit card payments. While it does take about 7 days for your patients’ funds to go through, this can add a bit more flexibility to your payment acceptance options.

Accept Multiple Types of Payment

ACH acceptance is a win-win: it lets your patients send money directly from their bank, so they have less to worry about, and it allows your clinic to accept payments without paying high transaction fees. And it’s a win-win that includes no learning curve.

To accept ACH payments, just follow some simple instructions:

  • Go to the patient billing page, and then add a new bank account.
  • Enter your patient’s name, account number, and routing number.
  • You’ll receive a confirmation message that the bank account has been added and needs to be verified.
  • The customer will get an email with details about the process and a link that they can use to complete the verification.

That’s it! Go ahead and get set up with ACH today or read some more specifics about how ACH works here.

Posted by: AtlasMD

February 24, 2016

Atlas.md Podcast 24 – What’s After Meaningful Use?

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Direct Care continues to sweep the nation. Everywhere Direct Care is attempted in the right way is a smashing success! The interest from patients is definitely there – it just takes the proper implementation on the business end. Brand new clinics opening their doors across the country are proving it! Direct Care isn’t a niche anymore – it’s becoming a standard of care.

Listen to Atlas Podcast 24 here. >

Meaningful (less?) Use.
Dr’s Josh and Doug talk about their reservations about what will come next after Meaningful Use has gone by the wayside. They feel true innovation comes from the ground up and challenge Direct Care docs to be agents of change. Listen in as they discuss how to unleash organic ingenuity in your own community.

If You’re Gonna Do It, Do It The Right Way.
Every step forward we take benefits the next person. And of course, our goal is to propel the DPC movement forward in any way we can. But you don’t have to go around feeling in the dark. Atlas offers so very many resources! Including your very own personal Easy Button named Kirk Umbehr, a community forum, a career center, and a 12-part Direct Care Curriculum.

Beware of the Competition. 
Atlas aims to keep the DPC market pure. Dr’s Josh and Doug discuss what to watch out for in the competition. (Spoiler: certain membership requirements, mandatory third party intrusions, and plain old bad advice.)

Posted by: AtlasMD

February 15, 2016

Hitting Measurements and Failing Patients

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We recently posted about The Virtual Quality Myth, so we were really excited to see this New York Times article about how measurements are failing our doctors and teachers.

When Measurements Don’t Cut It

Most of the doctors that we talk to on a daily basis understand this basic principle: measurements that are based on outdated standards can’t possibly lead to positive patient results. The NYT brings up a good point: With all the rules and paperwork and documentation, doctors still speak to their patients — they still consult and provide treatment, but now they have to be really accurate with how and when they mark this information down. It becomes nearly impossible to have a long conversation with a patient when you’re worried about tracking every issue, instance, and idea. Once the systems entered the game, the personal interaction and connection moved out of sight.

We saw this as a problem many years ago, though it seems like the idea is spreading a little quicker now that we’re seeing the failure of the “measurement method,” as we’re calling it.

“…the objections became harder to dismiss as evidence mounted that even superb and motivated professionals had come to believe that the boatloads of measures, and the incentives to “look good,” had led them to turn away from the essence of their work. In medicine, doctors no longer made eye contact with patients as they clicked away.” (New York Times)

We’re obviously behind Robert M. Wachter, the author of the New York Times article, and we were excited to read this quote in particular, since it’s exactly what we try to do with our DPC:

“Last week, Andy Slavitt, Medicare’s acting administrator, announced the end of a program that tied Medicare payments to a long list of measures related to the use of electronic health records. ‘We have to get the hearts and minds of physicians back,’ said Mr. Slavitt. ‘I think we’ve lost them.”

The best part about this is that DPC doctors are already doing exactly what this NYT article is hoping for:

“In health care, [minimization of measurement burdens] will come through advances in natural language processing, which may ultimately allow us to assess the quality of care by having computers “read” the doctor’s note, obviating the need for all the box-checking. In both fields, simulation, video review and peer coaching hold promise.

Sometimes it’s good to know that we’re doing the right thing. And we think other DPC doctors will be excited to hear that their choices are not only positive, but they’re measuring up! Check out some more ideas and see how our EMR can help you get your practice moving.

Posted by: AtlasMD

February 5, 2016

Save 40% on Insurance

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While all doctors can benefit from malpractice insurance, it’s rare to find a company that offers insurance specific to your clinic’s needs. But we set out to change all that. We’ve been working closely with a national malpractice carrier to give DPC clinics a discount.

With the support of Atlas, the Cunningham Group has negotiated for an exclusive medical malpractice insurance program with an A-rated medical malpractice insurance company.

In our own practice, we saved a total of $13K a year by working with the Cunningham Group. When you sign up for discounted malpractice insurance with the Cunningham Group, you can expect the following:

  •  An ability to save 40-60% off medical malpractice insurance.
  • An ability to work with a carrier who understands your DPC needs.
  • An ability to receive quality malpractice coverage.
  • An ability to receive coverage with an Atlas.md-endorsed carrier.

By receiving insurance through Cunningham, you’ll work with a company that is dedicated to serving your unique needs as a DPC practitioner. You’ll also work with a program dedicated to bringing DPC and concierge care into the mainstream. Once patients and business owners start to see that DPC and concierge care are very real and are a beneficial alternative to traditional practices, they’ll be more likely to participate in a DPC program.

When you’re ready to save money on your medical malpractice insurance, or if you have any questions about your options, check out the Cunningham Group today.