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.

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.

Down, Down, Down The Transaction Fees Go…

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We did it back in June, and it felt so good that we decided to do it again. That’s right – just in time for the holidays we’ve dropped credit card transaction fees from 2.5% way down to 2.1%. More money in your pocket, right when you need it most!

Remember the days when 3.1% was the norm? You probably didn’t really even notice it… after all, that’s what you’d come to expect. But in dropping it to 2.1%, we’re showing you just how committed we are to helping Direct Primary Care succeed. And just like DPC promotes in every detail of its model, we want the recipients of its care to expect better.

It’s a two-fold result, really. On the one hand, clinics who use the Atlas.md EMR know without a doubt they’re getting the most bang for their buck and that Atlas truly cares about saving money where it counts. And on the other hand, those same clinics are in an even better position to pass the savings on down to their patients. Just like that, everyone wins!

So you see, it’s more than lower numbers. With them come higher expectations and higher satisfaction.

What’s New in the Atlas.md EMR? Multiple Locations!

What’s New in the Atlas.md EMR? Multiple Locations!

The Atlas.md EMR has always been poised to scale gracefully alongside your practice, but now we’re stepping things up in a big way.

We’re thrilled to announce the newest feature of the EMR, which fully supports multiple practice locations. We’re talking management of multiple offices, several doctors and staff members, and efficient movement of patients as you transition them from one location to another. You probably won’t notice the launch of this new feature unless you’re opening a new location firsthand. But we’ve taken great care to integrate location-based details throughout the entire EMR if it pertains to you.

Some of the biggest perks of this new feature include assigning doctors to a specific location, which automatically assigns their patients to their location as well. Each location has its own specific inventory, so when you dispense for a particular patient, that action will respect the location the patient is assigned to. But don’t worry, you’re not responsible for remembering all this. We’ve set up prompts and reminders so when you take an action that will affect another location, you’ll know exactly what to do.

So dig in, and congratulations on the growth of your practice! All the details are right over here in this help article. >

The New ICD Billing Codes Have Launched… But We’re Still Celebrating!

Some establishments are still scrambling to make ICD ends meet. Some are just trying to recover from the bumps in the road uncovered during the October 1 launch. But Direct Care practices around the country reported smooth sailing so far – and even had some time to show off their support for DPC!

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We’ll continue to celebrate freedom from red tape and billing codes – you can, too! We’re still offering #IAmDirectCare T-shirts so you can wear your support all year round. We even heard some patients wanted shirts! Now that’s a party. Get yours over here, and see how Direct Care looks on you!

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Cheers to happy docs and happy patients.

The Pen and Paper Era was Accident Prone. How is Medical Tech Better?

The Pen and Paper Era was Accident Prone

“A study from the pen-and-paper era showed that 1 in 15 hospitalized patients suffered from an adverse drug event, often due to medication errors. A 2010 study (using data collected during the pre-digital era) estimated the yearly cost of medication errors in U.S. hospitals at $21 billion.” – Medium.com

Whoa.

When you look at those stats, it’s no wonder the industry couldn’t wait for a better way. Technology has done so much good in the way of standardization and reducing the margin of human errors. EMRs and the like have made it easier for docs to spend less time charting and more time actually with their patients. The benefits far outweigh any negatives, but that’s only if you use technology responsibly.

We can’t leave our jobs totally up to technology, as the story over on Medium.com illustrates perfectly. If we do, we’ll miss things like a massive accidental overdose (patient needed one pill, got 39 instead) and nobody wants to feel the guilt Nurse Levitt experienced so intensely. We’ll miss dangerous drug interaction warnings and potential allergy notifications. We’ll miss the opportunity to avoid life-threatening situations. Whether we’re in a hospital setting, or a clinic setting, this kind of attention to detail still matters. Immensely.  

We know this. And we, as Direct Care professionals, have adopted a business model that wholeheartedly embraces the very two things that can prevent errors like this from happening — even in the technology era. 

1. We’ve gotten rid of red tape and policy that does nothing but convolute the simplest of tasks. In fact, we’ve taken it upon ourselves to build the EMR that we want, and have thus turned it into a product incredibly useful for hundreds of other Direct Care practices, too. It’s based on accuracy, simplicity and ease of use. There are people working around the clock to make sure these things work together in tandem. 

2. We have time. Time to think through every prescription we order and dispense. Time to double check dosage. Time to actually pay attention to the alerts that fire when an irregularity has been electronically recognized. This gift is not something we take lightly. 

Technology can certainly make our jobs — our lives — easier and more efficient. For that we’re thankful on a daily basis. But we mustn’t forget that we are the threshold for which all medical decisions must pass. We can’t check common sense at the door in lieu of an app that thinks for us. And because we have a business model that allows us to work to the best of our abilities, we love our jobs… and therefore don’t want to just go through the motions. 

So thanks to technology, for all you do for us. But more importantly, thanks to Direct Care, for existing so that we may also operate as the best versions of ourselves. 

Posted by: AtlasMD

July 6, 2015

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Medscape: Why Internists Are Number One in Physician Burnout

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It’s a simple truth: nobody wants to feel burned out. Nobody wants to lose their passion, feel like a failure at their career of choice, or feel like nothing more than a cog in the wheel. But that’s exactly what 50% of physicians in internal medicine are experiencing, according to a new study published by Medscape. Many of you reading this know the feeling first hand, which is what lead to you to Direct Care to begin with. But fifty percent? That burnout rate is higher than the rate of other U.S. workers… So what’s the deal? Why internists?

Among the 26 specialties surveyed by Medscape, “internal medicine faces the highest combination of prevalence and intensity of burnout,” Dr Hood pointed out. He speculated that this may be an unfortunate by­product of “a high idealism among internists, who not only chose what they wanted to do in their professional lives but accepted doing this work knowing that they were accepting a lower relative evaluation of their services, economically and noneconomically.

“Idealism,” Dr Hood noted, “can predispose for disappointment, particularly when the locus of control is outside that of the physician.” 

Time is also to blame for such a high burnout rate. This is ironic, because in DPC, time is the very thing that breathes life back into medicine. But the traditional healthcare environment fosters a “hot but slow burn. The endless flow of forms grinds physicians down.” Plus, as the task of certificate maintenance is adjusted for a higher level of difficulty, it only “adds fuel to the fire.”

When you look at it that way, it kind of makes sense. You put up with the “stress, depersonalization and emotional exhaustion” for years and years – by the time you call it quits you can’t cut into your retirement cake fast enough, right? Wrong. Internists don’t have to wait until retirement to hit the brick wall of burnout. It’s happening to docs 35 years of age and younger. That astronomical fact is mind blowing because by the time you graduate from med school and complete your residency, that’s barely enough time to get your feet wet in the real world before you’re ready to throw in the towel! What makes sense now is that aspiring internists are thinking twice before jumping in at all.

The Real Burnout Villain

It’s true, internists have a lot working against them right off the bat. One internists lays it all on the line:

“What’s going wrong? Really? How about what’s not going wrong? Insurance companies playing doctor; federal and state lawmakers who openly junketeer on insurance and pharma dollars, then pass legislation that blatantly benefits those industries; federal agencies and private certification bodies that actively engage in racketeering practices targeting physicians; and a general public that thinks Dr Oz is the bee’s knees.” 

That sounds like enough to send someone running in the other direction. And if it weren’t for their innate, undeniable, inherent desire to help others, many probably would. Even that sentiment is being shoved under the rug, as more and more healthcare professionals observe that patient care doesn’t really matter anymore.

Let The Light Shine!

It’s time for a little optimism here. Burnout is depressing, something we’ve all admitted we want to avoid, right? Well thank the stethoscope gods there’s a way. In fact, one of the internists Medscape interviewed put it quite succinctly.

“The most effective way to combat job burnout is to quit doing what you’re doing and do something else, whether that means early retirement or changing careers.” 

Now, we happen to think your talents should not go unused, which is why it’s a good idea for you and your career to spend a little time in counseling together before you part ways. That passion is still there. You still want to help people. You still care about others. Getting back to the solution to burnout… Direct Care is waiting with open arms. This business model wants you to succeed. It urges you to spend more time with your patients. It implores you to run an in-house pharmacy and handle your own billing. It desires your happiness and the happiness of your patients. It welcomes your intense attention to personalized care. It rewards you for doing what you always wanted to do in the first place.

We hate to admit it – burnout is real. But it doesn’t have to be the end. In fact, it’s really just the beginning…

Celebrating Freedom!

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This year, Direct Primary Care Practices have put down roots in more towns across the U.S. than ever before, and if that’s not a massive reason to celebrate freedom, then we don’t know what is. But let’s take a minute to examine those freedoms a little bit closer.

DPC does more than give patients an alternative to traditional healthcare. It obliterates endless minutes spent in waiting rooms, hidden costs and anxiety-inducing response times. It provides a platform where patients truly feel like the priority they are instead of just one of thousands of folders in a filing cabinet. With the freedom to use means of communication like text, email, and Twitter DM, all roads lead to a better patient/doctor relationship. That being said, the patient isn’t the only one who benefits from DPC freedoms.

Providers in the DPC realm are happier than those within the walls of traditional healthcare. They have control over their schedule, never have to rush patients out the door, and have literally been given the gift of time. It’s no wonder they’re falling in love with medicine again!

The freedoms of Direct Care result in a better healthcare experience for those on the giving end… and on the receiving end. This weekend, celebrate being free to choose DPC.

The Atlas.md EMR is Lowering Credit Card Transaction Fees!

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After much internal consideration, research, and full-circle thinking, we’re in a really exciting position to show you just how much we care about the success of your Direct Care practice. The credit card transaction fee in the Atlas.md EMR has dropped from 3.1% to 2.5%.

We’re Putting Ourselves in Your Shoes

At the core of it all, we’re only giving you what we would want if we were in your position. And that’s to know the company behind the product is thinking about us all the time. We’ve lowered the fee to make all the features you’re privy to more affordable and cost effective. It’s worth the loss in profit to us to know you’re getting the most bang for your buck!

We’re a Business, But…

Our driving passion isn’t to make money. It’s to help you build and run a successful DPC practice that will give you the life you want, and your patients the care they deserve. The whole point of Direct Primary Care is to lower overhead and cut red tape. Actions speak louder than words, which is why we dropped that number. A transaction fee may seem like a small thing, but we know it’s huge to you.

Thank you for being loyal customers of the Atlas.md EMR. We hope we can remain by your side as you continue to breathe life into Direct Care.

Direct Care is a Slow Tsunami.

Overwhelming. Unstoppable. Enveloping.
Direct Care is taking the nation by storm, but unlike a tsunami, it’s not of the destructive variety. Rather than water, the country is being steadily blanketed with a refreshing alternative to traditional family medicine. As it slowly (but oh, so surely) spreads from town to town, city to city, more and more people realize how much they truly benefit from the patient-centric healthcare model.

Docs are getting excited, too. Every time they hear from a happy patient they wonder why it took them so long to transition in the first place. But even better, all the great feedback they’re hearing just validates they’ve done the right thing – not only for their patients but for themselves as well. Their quality of life skyrockets and their passion for medicine reignites. Once they’ve transitioned, it’s hard to look back at their old lives and remember how negatively they felt way back when.

Dr. Catherine Krouse has gone Direct Care precisely because of the difficulty of that old life. “You just end up getting drained and drained and drained. And then when your cup is completely empty, then you just get guarded and angry. And then you put up walls, and that really creates barriers.” Read her full story here and learn about the newest Direct Care practice in Falmouth, Maine called Lotus Family Practice.

 So as this #slowtsunami continues to commence with many more stories just like Catherine’s, the Direct Care community expands with confidence and the staying power to make patients and physicians happy for the long haul.