Brett Brickey, CIO at Tidewater Physicians Multispecialty Group in Virginia, shares his organization’s experience so far with the group’s patient portal—and their working optimizing it.
According to a 2020 Accenture study, 52 percent of patients believe that a negative digital patient experience makes their entire medical experience unfavorable. In today’s healthcare landscape, organizations cannot risk losing patients to a sub-par patient portal that lacks the features patients want and is not inclusive with other engagement activities.
But modernizing an organization’s portal can be time-consuming and challenging. Still, some IT leaders at large medical groups are figuring it out. Among those organizations making good headway is Tidewater Physicians Multispecialty Group, a multispecialty medical group based in Newport News, Virginia, and which encompasses 220 providers, of them, 160 who are physicians, and a total staff of 1,100 across 85 offices in the Tidewater region of Virginia. Tidewater Physicians was founded in 1992.
Brett Brickey, CIO at Tidewater Physicians Multispecialty Group, spoke with Healthcare Innovation Editor-in-Chief Mark Hagland, recently, to discuss his organization’s forward evolution in this area. He and his colleagues have partnered with professionals at the Charlotte-based InteliChart, a solutions provider focused on patient portals and patient engagement. Below are excerpts from that interview.
Tell me about your IT management at Tidewater Physicians?
I’ve been here 16 years. When I joined Tidewater Physicians, I became the fourth member of the IT staff. I was initially brought on to buy and implement an electronic health record and a practice management system. We now have 30 IT staff here.
What have been your biggest challenges and opportunities in engaging patients on your portal?
Variety of specialties makes a big difference; we’re a NextGen shop. So getting everyone to agree on specific things like height and weight measurement—getting everyone on the same page. We are owned by doctors, the doctors are the only shareholders. So every doctor is one of the bosses.
How did you connect with the InteliChart folks?
We were a little frustrated with NextGen’s progress on their internal patient portal. We were looking flexibility and for integration into NextGen; we didn’t want them to have to go another website, so integration was key. We looked at four different products. They had their own template within NextGen, and had just started an integrated solution; we were one of their early adopters of their integrated solution with NextGen.
What were you looking for in terms of patient engagement?
Well, InteliChart has a full catalog of solutions; we started with the patient portal. It was better for the patients, offered more data, was quicker to use. And we knew that InteliChart would work with us.
What were a few of the things you were looking to work on together?
The population health aspect; we were an early ACO [accountable care organization participating in the Medicare Shared Savings Program]. So it was communicating with the patients while not creating more phone calls. We were the MSSP for five years, and this year, we joined ACO REACH.
You were looking for enhanced communication between the patient and care team?
Yes, and customization. Some doctors want the messages to come to them first; others want them to go to the nurse or the physician assistant. The same with phones and any other medium of communication. But if there’s any downtime, I’ll get a message from a doctor saying, I haven’t gotten a message from a patient, what’s wrong?
One of the challenges of HIT in a multispecialty group is achieving hyper-efficiency, correct?
Yes. From a doctor’s viewpoint, we’re a cost center. Just knowing the medications and the allergies—just knowing that, for example, a cardiologist might have prescribed something that might interact with what the patient is already taking. And we’re talking about network redundancy, and how many network connections can you have? We’re a Citrix shop. And we have a software-defined wide-area network. We don’t have dedicated fiber between our locations.
How has the implementation of InteliChart worked out?
We had an excellent startup; we had a lot of communication with patients, explaining why they needed to switch over. We had just created a marketing department, and they helped. Then it became a matter of, we have 85 offices using a portal, because phones are a bottleneck. Anytime a patient has to call the office, as an IT person, I feel as though I’ve failed. Just to make it easier for the doctors, to be able to rick-click in a portal. With the federal regulation saying that everything has to be seen by patients—everything goes to the portal. The efficiency does cause lab and diagnostic imaging results to get to the patient before the doctor.
The Activate Model, the population health part of it, is defining cohorts and campaigns that automatically renew and send out. Participating in ACO REACH really justifies the level of communication with patients, getting their blood pressure checked, having their diabetes checked. And once we started having these measurables for quality programs, we started seeing the results, and that equates to shareholder savings in value-based contracting. And we have to be subtle, because we don’t want to overwhelm the patients. And InteliChart is good that way: we share ideas with them and they share ideas with us that they’ve implemented elsewhere.
They extract the data; it’s almost like an EHR-lite sitting there. So they have a lot of data and a query pool for patient campaigns. And based on our claims data, how do we find out a patient has gone to a non-TPMG location, and why? That was all outside our data. So one of the biggest items that InteliChart has done is to build our own cohorts based on our analysis, and upload lists of patients—maybe it’s ACO REACH patients who are high-risk, whom we haven’t seen in four months. Let’s contact just that group and remind them to come in. It really goes back to eliminating phone calls.
The core issue becomes the impingement on the time of the individual physician in their day, correct?
Yes, and right now, in the portal, we’re guiding the patient around medication refill, appointment, physician question, and billing.
You’ll probably refine how you direct even the physician questions, over time, correct?
Yes. And when I started this job, I was working with the Virginia Beach public school system, and was contacted by this organization. And I was told, we want you partly because you’re coming from outside of healthcare, with ideas. So I had 11 years as a consultant, 11 years at VBPS system, and now, 16 years here. And yes, we need to redirect messages. And hopefully, InteliChart can build that in.
How do you see what you’re doing, evolving forward over the next few years?
We’re trying out different dictation products. A lot of vendors are saying they have AI built into it. And that’s where I think we’ll be—but it’s uncomfortable for the patient. And we monitor our SQL Server closely; and if a doctor is waiting more than 3 seconds for any result or information, we monitor that and try to correct things. And I really think that AI and integration into dictation, will be big for our doctors. It has a lot of advantages. The patient gets to hear it, and the doctor has to verbalize what they’re thinking, and the patient gets to ask questions back. It’s a win for everybody.
What do the senior leaders want to achieve in ACO REACH?
It’s a bit of a contest to show that we can do it better than other groups in the area. A healthy patient doesn’t call you as often. And if we can keep the patients out of the EDs. Really, we’re looking for compliance; and with the care coordinators embedded in our offices, it’s about compliance. That can solve so many problems.
This article was originally published on Healthcare Innovation on October 23, 2023. You can view the article here.
