EMR Benefits as a CEO by George Joseph
I remember my first job in the field of addiction as a night shift technician at Powerhouse, the halfway house I graduated from. Truth be told, I was more like a “glorified” babysitter, and I learned many valuable lessons that have stayed with me throughout my career. I can still picture the old binders that held the client’s paper charts in a large file cabinet that also doubled as the medication storage area.
With this experience, and a continued desire to help those in need of substance abuse treatment, I continued my training and education. Upon receiving a license, I was fortunate to work for five years at Parkside Lodge. This company was amazing! Extensive training, four weeks-vacation each year and, at its peak, Parkside had over eighty facilities across the country.
The curriculum was well planned and manualized. We had talented counselors who did outstanding work with clients yet had difficulty with charting and struggled to keep up. I took pride in my efforts and did my best to always stay ahead. I knew the importance early on of documentation. I recall filling in at our facility in Denton, Texas and walked into a case load of 15 clients. The number of clients was not an issue; however, the fact the client records were a mess was a big issue. I worked diligently to get the charts in compliance. I helped for four weeks and wanted to leave with all charting current and a little ahead. Back then most facilities had Medical Records clerks reviewing charts nightly and putting notes in your box when you were out of compliance. This facility had the best clerk I have ever met. I swear she was on speed! She was amazing. I never wanted to get a note from her. I think everyone gauged how well they were performing by the number of “notes” they received. I got only one in my four weeks, and I was crushed; however, to this day I take pride in knowing that it was a treatment plan update that was done, but just filed in the wrong place!
After I left Parkside I went to take over the Right Step, which at the time it operated closer to a half-way house. I was blessed to have a wonderful team and took it from one location to twenty-one in approximately 19 years. We had over two hundred beds in five inpatient facilities and sixteen free standing outpatient offices. We went from treating hundreds a year to thousands and from 300K a year in revenue to over 35 million.
How did we do it? Credit goes to the team, but also to an amazing electronic medical record we created. Do you believe one person billed insurance for about 85% of our 35 million in revenue? Having an integrated EMR helps all information flow positively forward. This is from intake through clinical, to billing, collections, and follow-up. Allowing the system to do “the work” eliminated employees doing administrative work and afforded more time for meaningful clinical work to be done. The automation in the revenue cycle management meant less utilization of FTEs with improved collections. We quickly learned that the better your services both clinically, and from a customer services standpoint, the more referrals. The more referrals the better we did financially.
With my love for learning and improving, we began creating Lightning Step. I took my experience and my motto which is simply – automation, if it takes 5 clicks, let’s figure out how to go to 4, and if 4 let’s go to 3, and so on. We wanted to look at all areas of a treatment operation and incorporate outside vendors electronically when possible. We chose Dominion and Quest as our lab partners, QuickBooks as our accounting partner, and Zirmed as our billing clearinghouse. Lightning Step incorporates a CRM; however, when requested we can also link to Salesforce.
Let’s streamline the addiction business, utilizing an EMR that is specific to us, and use it to improve outcomes both clinically and financially.
I’m proud of what we created, but always willing to learn how to make it better from our users. Our consumers’ super users provide valuable feedback. Facilities that use Lightning Step have had successful accreditation surveys and site visits from The Joint Commission and Managed Care Companies. The surveyors are quick to compliment on the documentation, and then I smile remembering the old binders and file cabinet at Power House!