Caught between competing demands of Obamacare, private physician practices face increasing pressure to get rid of any unnecessary operational costs if they are to remain autonomous. Specialists in procedure-driven private practices such as cardiology, orthopedics and dermatology are feeling that pressure, too.
Orthopedic surgeon Jay Crawford believes that the business model for these types of practices is outdated. He’s developed a health IT startup, RockhopperZSG, which uses a patient booking system that ascribes a value to each patient and to help them buck the consolidation trend in healthcare.
“If you are going to have any impact on the physician practice business model, it has to occur before the clinical encounter,” Crawford told MedCity News in a phone interview. Rather than call the office, users submit requests for appointments and the circumstances for it. He has used the technology for his own practice — a recent survey showed patients liked the scheduling function. Now he wants to expand it to other practices.
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So how does an orthopedic surgeon entrepreneur in Knoxville come up with a name shared by a penguin? He sees it as a metaphor for specialist practices (the iceberg) and the challenge of balancing the needs of patients (penguins) — a private practice is like an iceberg occupied by patients (penguins). Crawford wants an iceberg populated by cooler penguins
Crawford says he wants to increase the high-value patients who come in for procedures or for follow-up care and reduce traffic from people who are self-referrals — the low-value patients. He acknowledges that the tool can be customized to help practices, say, reject Medicare patients. But the bigger goal is to create a better balance between high-value and low-value patients so the practice can prosper as a business.
Many see the healthcare industry as way overdue for technology upgrades. Health IT companies have looked to the hospitality industry for innovations in healthcare. Ratings websites, concierge medicine, patient satisfaction tools and emergency room wait time trackers are a few technologies that have been gaining traction in healthcare.
Crawford sees Rockhopper’s approach as the equivalent of the systems airlines use to allocate values to seats on a plane, although there are a lot more factors in play. If you book a flight weeks in advance, you generally pay less. But Rockhopper’s tool assigns a patient value that’s also based on the expertise of the physicians on staff and criteria that can be customized depending on the interests of the practice.
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Here are a couple of case studies Crawford uses to show how his algorithm works:
“Imagine a 45-year-old patient who complains of three days of low back pain and self-refers to an orthopedic surgeon. That visit, if it occurs, is really a complete waste of time for the patient, the doctor, and is a waste of valuable resources. There is no chance whatsoever that the visit is going to result in an operation.
“Compare this to a 60-year-old patient who has back pain radiating to the left leg for three months who is referred by his primary care doctor because he is not improving in physical therapy. That patient almost certainly needs a surgeon and an operation. My software uses a complex algorithm, specifically built for each individual practice, that is able to predict the value of the doctor/patient interaction and get the most appropriate patients to the doctor first.”
Physician practices are facing a tough battle for autonomy given the rate hospitals and health systems are acquiring them. Health IT tools like Rockhopper are providing a way to help them be more competitive.
