Challenges Imapacting Medical Practice Management System

Michael B. Marchant has spent the last 20+ years working in Healthcare IT in roles with technology vendors, provider organizations and government. His expertise in the area of data integration has been built in connecting systems in a myriad of standard and non-standard ways throughout his career. Michael was a member of the HIMSS Interoperability and HIE Committee and currently serves on the BlockChain Task Force helping HIMSS establish direction and messaging for HIMSS members and leadership. His current role as HIE and Integration Director for UC Davis Health keeps him solving the day to day interoperability problems for a leading academic healthcare organization.

What are some of the challenges impacting medical practice management space?

From a medical practice management standpoint practices like primary care practices are attempting to get their patients in to see specialists the process with the payers and with the refer to organizations can be cumbersome. This is because a lot of practices are still using facts or paper referral processes that can extend the amount of time it takes for patients to be seen. To solve this problem we at UC Davis Health have been working with a project called  Da Vinci project. It is an HL7 accelerator to assist with authorizations for referrals, and actually accelerating patient access to primary care specialists. Also, this will enable patients receiving care via telemedicine, whether it be through e-consultants or other visits for patients who may require a higher standard of care or more engagement in particular. These are the two key issues that practitioners engaging with patient care outside of the confines of their individual office must address.

How do you envision the future of the space?

We've seen through the pandemic and even post pandemic that patients are receiving care where they are, whether it's through remote patient monitoring, hospitals at home, telemedicine visits for primary care, or even ancillary services. This was possible because a lot of technology has help patients and healthcare worker stay connected to receive services and  access information about the care they're receiving or access the doctors or specialists who are providing that care rather than where the doctor or practice is .

Moving ahead with the advent of smartphones and the proliferation of connectivity for the industry there will be more chance for patients to receive care at their convenience as opposed to the convenience of the provider.

Today organizations need to be a little more sophisticated in how they engage  with their patients and what options they present to those patients to connect remotely. One of the projects we're working on is a two-way messaging service for patients. Patients are asked to reply to the questionnaire by text, and professionals having access to that information can quickly determine whether further action is necessary.

What are some of your recent project initiatives?

Most of the doings that we are doing today is around access to healthcare.  We have partnerships with a couple of the FQHCs here in Sacramento where some of our medical professionals now work in those facilities.  The patients on a managed care plan receive ancillary services from our company. Additionally, this includes the ability to exchange information. i.e being aware when a patient from the FQHC enters the emergency room and notifying their primary care doctor and being proactive in scheduling follow-up with those patients.

We also have a few other things that  we're  doing. We are doing shared care contracting in the community, providing clinical expertise and resources to community outreach services. For instance in covid we had essentially street teams out helping to vaccinate the homeless or setting up clinics in local churches. We're really trying to expand our influence in the community by enabling and providing those resources where they're needed most. 

What would be your piece of advice for budding professional in the field?

We all get caught up in the day-to-day responsibilities of the job that we're in and how to best serve our organization. But sometimes really taking a step back and looking at how we're serving the community and making sure that resources in community hospital are best deployed is a good approach we all should take. We also need to prioritize extending and expanding the care continuum outside of the organization by bringing up patient friendly technology  and not growing the digital divide between the haves and have nots. Also, we must ensure that serving the patient and the community comes before having the newest, coolest equipment possible.