ProtoVIEWS
Ho! Ho! Ho! Version
Nov-Dec 2002

ProtoMED Newsletter For The Online Medical Management Community

HAPPY HOLIDAYS!

Editor: Sue Germershausen

Contributors This Issue:

Timothy Griffith

Rick Greenberg

Larry Walsh

Special Thanks To:

David McMicken, M.D..

Malinda Evans

Don Shoen

www.ProtoMED.com

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Feature:
Go Paperless!
Acute Care Express

Acute Care Express is the brainchild of Dr. David McMicken, an emergency physician who helped "write the book" on the Emergency Medicine knowledge base of the Kurzweil voice dictation EM system more...

Click This! Help Desk Advice

Network Error Messages

David&Goliath Sales Tales

ProtoMED 4.3 Road Show
ProtoMED News - ProtoCHART EMR
ProtoCHART!
HIPAA Resources

Compliance Statement
Bow Tie Muse - Happy Holidays!

ProtoTALE for our never ending
Support Season

Feature: Acute Care Express
First "paperless medical practice" In Georgia

Acute Care Express is the brainchild of Dr. David McMicken, an emergency physician who helped "write the book" on the Emergency Medicine knowledge base of the Kurzweil voice dictation EM system (currently owned by Dictaphone) when used by InPhyNet Hospital Services, currently a Team Health Affiliate.

Dr. McMicken is a Regional MedicalOfficer for InPhyNet Hospital Services. He has written articles / chapters for the Annals of Emergency Medicine, Journal of Emergency Medicine, Emergency Medicine: Concepts and Clinical Practice, Principles and Practice of Emergency Medicine, and Emergency Medicine Clinics of North America. Physician's Practice Digest recognized his urgent care center, Acute Care Express, as the "first paperless medical practice in Georgia".

Dr. McMicken applied his emergency medicine knowledge and urgent care insights into the design and operation of Acute Care Express (ACE), a freestanding Occupational Medicine and Urgent Care Center that he developed from the ground up as a real-time, paperless, medical clinic. He researched this concept for two years before committing to its development. In 1996, his concept of a patient friendly, state-of-the-art Urgent Care Center materialized in the form of a beautiful facility that had every element from the building and staffing through to the Practice Management System (PMS) and Electronic Medical Record (EMR) integrated into his urgent care delivery model.

ProtoMED was selected as ACE's PMS after an exhaustive two year, national selection process. Dr. McMicken is no stranger to computer systems, and with the assistance of some technical advisors, he selected ProtoMED for its sophistication, ease of use, and integration capabilities.
"I wanted a company who understood how to be a partner with us. This was a big endeavor to me. I needed data entry as close to real-time as was possible. I needed a seamless interface with our Kurzweil EMR product. The entire PMS had to fit into the flow of our unique design. Most of all, we required responsiveness and assistance from our PMS vendor - support at the times that we needed it, not at the convenience of the vendor. ProtoMED has proven to be precisely the PMS product and vendor support that we require. Six years after we made the decision to go with ProtoMED, I remain pleased with the product's reliability and "uptime", as well as the performance of the support team. ProtoMED has been managing our billing from the moment we opened our doors - after all this time, I know that we made the right decision when we choose ProtoMED over the more recognized PMS vendors." - Dr. David McMicken.

Malinda Evans is the Administrative Director of ACE - she has over seventeen years of healthcare management experience with previous positions such as Chief Operating Officer, Horizon Physician Network; and Director of Physician Practice Operations, Columbus Regional Health Care System. Ms. Evans was accustomed to relying heavily on quality practice management systems to accomplish her management goals. She brought a wealth of experience with her from managing large practices with two of the largest PMS vendors in the nation: SMS and IDX.

Malinda was used to managing with PMS reports and tools provided in multi-million dollar systems. She recalls being somewhat shocked to see ACE running this little desktop system called ProtoMED - a system that she had never heard of before. Her first inclination was to replace this "no-name" product with a national PMS vendor. She soon discovered the value of all the PMS research that Dr. McMicken and his team had conducted many years before - the value of this "little system that could", called ProtoMED.

ProtoMED compared to Multi-million dollar systems:

We asked Ms. Evans her opinion of ProtoMED, anticipating a favorable interview and some type of comparison to the larger systems that she was familiar with. We were astonished to learn the details that she was able to offer regarding ProtoMED's value to the ACE operation. The following bullets provide a re-cap of ProtoMED features that Malinda likes with comparisons to counterparts in the "big systems" that she has used.

Easier/Faster Data Input

According to Malinda, an IDX demographics screen required eight separate screens of data entry - and to her surprise, all of the same elements are provided on only one ProtoMED demographics screen.

It took over seventeen minutes for staff to prep new patient data in IDX compared to only four minutes in ProtoMED!

Easier Training Curve

Ms. Evans used to require at least one solid week of supervised data entry training with her SMS and IDX systems prior to allowing new staff to get into a production mode. She now subscribes to on-the-job training, placing staff into production during the first day on the job because ProtoMED is so "intuitive and easy to learn".

"Every new user that I have brought onto the ProtoMED from either Medical Manager, IDX, or SMS has marveled at ProtoMED's ease of use."

Easier Electronic Claims Processing and Claims Management

Electronic claims processing is much easier (you can't get much easier than one single push-button!).

"No other system provides the claims management capability of the ProtoMED claims manager" - Malinda monitors billing office follow-up activity and general A/R from her office with our claims manager.

Easier A/R management from on-demand reporting

No end-of-month batch processing is required to conduct ProtoMED A/R analysis reporting - the time and rigors of month-end is standard fare for most other systems.

Ms. Evans makes good use of the Collectability Analysis Report, available under A/R Analysis. She may be enamored with this report for a more personal reason that goes beyond its management value - it was designed with her direct input and modeled after reports and custom spreadsheets that she had developed to keep a grip on monthly collectability - we thank her for her management insight!

ProtoMED's Reimbursement Analysis reporting provides excellent measures of profitability by CPT codes and insurance payer.

Easier Software Upgrades

The quality of ProtoMED upgrades ranks high on Ms. Evans' list as compared to the down time experienced upgrading her multi-million dollar systems. All upgrades have always been accomplished via remote access - the most recent being accomplished via the ProtoWEB.

Easier data mining tools

Ms. Evans is a true manager - she is accustomed to measuring all that can be measured and squeaking out profit from wherever profit can be found. This pre-occupation with managing the details often warrants spreadsheet analysis. Malinda will develop Microsoft queries from ProtoMED and incorporate the data into her own spreadsheets through our ODBC interface. She actually likes writing queries. She couldn't begin to imagine doing this type of custom data mining with her SMS or IDX systems - not without some heavy custom programming expenses and a protracted development cycle.

Superior Support

ACE relies exclusively on the ProtoMED Help Desk team to provide technical assistance.

Ms. Evan's old multi-million dollar systems required onsite technical staff and immediate telephone support was not available!

Since ACE has a very nice T1 connection (full-time, fast Internet access linking them to corporate headquarters in Knoxville, Tn.), Malinda prefers using our Web-based support. She is always impressed with the quick turn-around for placing web-based support calls. "I know that if I submit an online support call, I had better stay put - I've tried to step out of the office after submitting a support call - I can seldom get past the door without getting a call from the ProtoMED Help Desk. ProtoMED's promise of immediate support is real".

Cost Savings

So, do all these features and efficiencies actually contribute to the bottom line? Ms. Evans, always aware of improving the bottom line answered with the following tangible examples:

First, start with the obvious - look at the savings comparing purchase cost between ProtoMED, IDX, SMS, or Medical Manager.

Second, look at the ongoing expense of system maintenance - you could probably purchase a small ProtoMED system for the monthly maintenance cost of comparable full-feature systems.

Now, get into specific operational details - we save approximately fifteen minutes for every new patient entered into our system compared to IDX.

We save approximately four hours a day in billing entry alone, vs. what any other system requires just to enter charges.

We would have to add at least one additional person in the billing office to manage claims follow-up, if we didn't have ProtoMED.

Compared with the multi-million dollar systems that I am used to, we would require one additional onsite person for support.

We can recruit good front office staff for significantly less money because they do not require the advanced understanding of medical billing typical of the staff we recruited with SMS and IDX.


Aware that all PMS products have unique features, we asked the following question: Would you say that ProtoMED does 60%, 70%, 80%, or 90% of what these "big systems" do with regards to necessary management reporting and accountability? Ms. Evans immediately responded with an emphatic "ProtoMED does 100% of what those other systems did regarding the management reporting that I need - and ProtoMED is easier to use and produces reports faster than most of the larger systems".

We thank Malinda Evans and Dr. David McMicken for their resounding endorsement.

Note: ACE still had one more "endorsement" up its sleeve - they have agreed to purchase our new ProtoCHARTproduct to begin replacing their Kurzweil voice dictation with our tablet-based system. We thank them for their continued confidence in us.

More about Dr. McMicken - truly a resource regarding Emergency Medicine, EMR, and Urgent Care:

Dr. McMicken has been active in professional societies such as the American College of Emergency Physicians where he served as Councilor and sat on the Government Affairs/Reimbursement Committee; the Georgia College of Emergency Physicians where he served as President (1991-93); and the Medical Association of Georgia where he has served as a Delegate and was a member of the Legislative Committee for several years. Dr. McMicken also served as Medical Director for Evergreen Medical Group (1998-01), one of three Georgia provider sponsored healthcare corporations with 11,000 HMO and 62,000 PPO covered lives. In addition, Dr. McMicken sat on the Physician Council for Georgia First/Medical Resource Network, a consortium of 22 Georgia hospitals and 2,500 Georgia physicians (1998-01).




ProtoFEATURES are NOT paid endorsements - features are either informational in nature, or candid interviews of successful ProtoMED clients and are presented to promote the exchange of ideas within the online ProtoMED community.


HIPAA RESOURCES

Further information (including the HIPAA Privacy Assessment Tool) is available at www.mhcc.state.md.us.

You can also download the Privacy Assessment Tool directly from this newsletter by clicking on the title.

Other recommended sites are:

www.mhccm.org - Medicaid - great site with many cross references to all HIPAA information presented in graphical format.


www.cms.hhs.gov - The Medicare site where you can electronically file for an extension (if you haven't already done so).

www.wpc-edi.com - The definitive publishing source for HIPAA


Click This! - Help Desk Advice

Common Network Error Messages

Common Network Error Messages

Two of the most common network related error messages are the "Errhnd.prg" and "driver or network connection not available". Clients can save time by using the following protocols to trouble-shoot these errors that appear to be "ProtoMED errors", but are usually the result of minor network issues.

File 'Errhand.prg' does not exist

This error pops up when you first open the program. There are 3 possible reasons for getting this error.
1. The server is not on or is locked up. This message is stating that it can't access the information which is stored on the server. RESOLUTION: log off all workstations, re-boot the server, then log back into the workstations.
2. One workstation is not accessing the server. This might be due to your shortcut. It might have been changed during the boot up of your machine. If you ever get a message asking to fix a shortcut, DO NOT SAY YES. If you do, Windows will assign your shortcut to something else, thereby making your ProtoMED unaccessible. RESOLUTION: You might need to reboot your machine and try again.
3. One of the databases needs to be fixed. Sometimes a database can become corrupted by an inappropriate termination of open files, usually related to network failures. RESOLUTION: If the other 2 reasons don't appear to be the problem, call the help desk. We will need to connect to your pc to fix the problem.

The Driver or Network Connection is Not Available

This is not a program error but a Windows message that comes up when you attempt to open the program. This message is stating that you are having a networking problem. Either your machine is not on the network, or the server is off or locked up. RESOLUTION: Logoff and reboot your workstation first. If you still get this message, have everyone logoff all workstations and reboot the server - check the hub to see if all lights are on. You might even need to check the network cable connection on the back of your PC. If you still can't get your machine to access the network, call the help desk as we can provide direction or refer you to a hardware specialist for assistance.

- Timothy Griffith, Training Specialist



Bow Tie Muse Rambling Thoughts From The Protoman

"I came to see, in my time at IBM, that culture isn't just one aspect of the game - it is the game. In the end, an organization is nothing more than the collective capacity of its people to create value." - L. Gerstner

Lou Gerstner, recently retired CEO of IBM, has a book out about the dramatic turnaround that he directed. I couldn't get past the inside cover without being struck by his quote regarding the significance of corporate culture.I found this quote so relevant to Protologics (not exactly an elephant amongst PMS vendors). Our marketing efforts are focused on our products - unique features, new releases, and new design initiatives. This marketing strategy seems appropriate, since we have been able to consistently deliver quality designs that are either unique to the marketplace, or provide substantial improvement over similar features offered by the competition. Such promotion fails, however, to advertise the true strength of this company - our commitment to our clients - our corporate culture of "advocacy to our doctors and their staff" - an asset that cannot be manufactured, purchased, or easily copied.

This issue's feature article compares our product with a few of the top-ten PMS vendors. I have often seen us in a "David & Goliath" situation when competing with the "big players" - we have consistently delivered the "next slingshot", even though they have immense resources and we are literally outnumbered by odds of 1000::1 in both staff and economic resources. Why do we continue to succeed? Our secret weapon is not our design strength, but rather our "culture" - our "collective capacity of our people to create value" - in short - our secret weapon is our team commitment to serve the ProtoMED community. I'd like to share an "insider story" regarding two recent incidents that exemplify our commitment.

The Protologics Tech Center is located on a main street in one of the many "towns" that remain within the zip code boundaries of Baltimore. It is an old bank building converted into retail and office space, servicing mostly tech and healthcare businesses. Late last year, all businesses along the main street corridor were devastated by a week-long failure of all phone service for the area! Road construction accidentally ripped through telephone lines that serviced most of the businesses in our area. We run a service business - as with most businesses, our phones are one of our most important business tools. Why didn't our customers experience any "downtime" regarding support? The answer is our "secret weapon" - our staff, their resiliency and commitment.

We were still bringing clients online with our new ProtoWEB Eclaims initiative. Our Internet lines were protected, but how were we to perform support when most of our clients use the phone lines for support? Sue Germershausen (that friendly, first voice that you hear when you call ProtoMED) immediately had all of our lines forwarded to her personal cell phone. LaMonte Odum (our Operations Manager) sent the support team home to perform service from their residences over dial-up lines and their personal computers. Intra-office communication links were maintained via Internet Email and personal cell phones. Our clients never experienced any delay of service during the entire week that our business was stranded without phones! Our ProtoMED team and their commitment to service - their "never say die" attitude and preoccupation with providing value persevered to produce one of the proudest ProtoMED moments that I can remember. This team spirit is an excellent example of the real strength behind our software.

Within the last few weeks, the Baltimore area had a heavy snow storm and it was clear that the roads were not ready to support morning traffic. I called LaMonte at 7:30 in the morning to call off work due to foul weather - a call that I've only been made once before - over five years ago. LaMonte was already in route, furthermore, half the support team had already left for work to insure an attempt at support. Harry Abramson, our Northeastern Regional Rep had already forwarded support calls to his cell phone, anticipating that the office would be closed. The snow storm was followed by one of the fiercest ice storms that has hit this area of the country in over twenty-five years - Protologics stayed open for business - to serve clients in its nine state region.

These two examples are not uncommon, nor are they limited to the names mentioned in the article - there isn't a week that goes by without a member of our team making decisions to go "above and beyond" what they are "required" to do. Resiliency and commitment truly exemplifies the real strength of this organization. I'd like to take this opportunity to say thanks to everyone on our very special ProtoTEAM and to re-commit our efforts to provide the very best service to our clients in the coming new year.

Merry Christmas and Happy Holidays
We look forward to serving you in the New Year!


Larry Walsh
CEO, Protologics Corporation



David & Goliath - Stories from the Sales Team
Adding The Personal Touch - Announcing Our ProtoMED 4.3 Road Show Seminars

The first ProtoMED 4.3 user group seminar took place on October 8, 2002 in the Woodbridge area of Northern Virginia and judging from the response of the 17 users that attended it was just what the doctor ordered.

DeDe Kruger from Dr. Peter Bryce's office couldn't wait to write us and say, "Just wanted to let you guys know the meeting was wonderful yesterday. As you know, I will be taking over the front office, and the upgraded system is perfect for me. It is very easy to use and self-explanatory. The guide book on the system is wonderful as well. I was able to print out some reports for Dr. Bryce this morning that we have been unable to do previously. Thank you again for the upgrade and I'm looking forward to using the on-line billing method as well."

The Road Show continues this November in Washington, DC, the Eastern Shore of Maryland in January, and the Baltimore area in February.

We look forward to meeting all of you one-on-one.

If you are interested in either hosting, or attending our free 4.3 Road Show seminars please contact me

If you are interested in either hosting, or attending our free 4.3 Road Show seminars please contact me at 800.648.4836, or you can click on this text and Email me: Rgreenberg@protologics.com .

Rick Greenberg
Regional Director, Business Development
Protologics Corporation


ProtoMED News - ProtoCHART Is HERE!

November 2002 - Protologics and Medinotes Join Forces For ProtoCHART:

Protologics Corporation has joined forces with MediNotes Corporation, an Iowa Electronic Medical Records vendor with installations nationwide, to sell Charting Plus, the Medinotes EMR and to produce ProtoCHART - an Electronic Medical Record with seamless integration into our ProtoMED practice management system.

Protologics selected the Charting Plus product for its vast knowledge base (we can deliver specialty specific content right out of the box!), ease of use, Windows platform, relational database, WYSIWYG templates, and E&M coding wizard. Medically reviewed specialty templates are available for: Primary Care, OB-GYN, Ophthalmology, Optometry, Neurology, Dermatology, Orthopedics, and Cardiology.

The ProtoCHART EMR product shall allow for seamless integration of ProtoMED patient demographics and billing information captured from the clinical record. While billing information is provided during the patient encounter by the EMR, charges can be reviewed by the billing team before being posted to a patient's account. ProtoCHART employs the best of both worlds: real-time, compliant coding from the EMR and batch review by the practice billing team - all with minimal data entry on a wireless tablet based system.

Donald Schoen, CEO of Medinotes Corporation (left in picture inset) is a pioneer of real-time data capture. He had founded a company that produced one of the first hand-held, real-time inventory control systems. The company's growth made the venerable "Inc. 500" list before Don sold his interest to pursue the Medinotes venture. Lawrence Walsh, CEO of Protologics Corporation has stated that "the two companies share a similar software development history, many common values, and the same entreprenual spirit - we look forward to a fruitful relationship". Judging from the enclosed "proto" photo, the CEO's share more in common than business values - it appears as though they also share the same hairstyles!

ProtoCHART shall be available for in early January 2003 with the release of ProtoMED version 4.4
. Demonstrations are available now - call Protologics at 800-648-4836 to request a demonstration, or Email sales@protologics.com.

October 2002 - Protologics Publishes HIPAA Compliance Policy:

Policy Statement - ProtoMED and HIPAA Compliance - October, 2002

Covered Entity or Business Associate?
Protologics Corporation has filed for an extension regarding HIPAA compliance. The ProtoMED product appears to fit better into the HIPAA 'BUSINESS ASSOCIATE' model than the definition of a 'COVERED ENTITY'; therefore, it has been argued that we are not required to be 'HIPAA compliant' as a 'COVERED ENTITY'. We have chosen to represent ourselves as a CLEARINGHOUSE to CMS, instead of a Practice Management Vendor, thereby placing ourselves into the HIPAA 'COVERED ENTITY' model. We have chosen to subject ourselves to the added scrutiny as a matter of confidence and security to our clients.

Clearinghouse Accreditation:
Most Practice Management Vendors will rely on clearinghouses to translate their claims into the HIPAA x12 transaction standards. As BUSINESS ASSOCIATES they are not held to the same level of accountability as a COVERED ENTITY. Most Practice Management Vendors do not own their clearinghouse operation, so they have no need for further accreditation. Protologics Corporation is currently in candidacy status for accreditation by the Electronic National >>>>>. This, we believe, should provide our clients with additional confidence to no that their PMS vendor holds itself to national accreditation that is usually reserved only for national Clearinghouses.

Claim Submission Protocol:
Presently, ProtoMED exceeds HIPAA security requirements regarding encryption for transaction processing. Claims are passed through the Internet at a 128K encryption level - twice that required by the HIPAA standard. We plan to further secure the transaction channel by including a Secure Socket Layer (already developed - just waiting for implementation).

X12 Transaction Standards:
ProtoMED currently batches its claims into the National Standard Format (NSF). The new HIPAA format uses various transaction sets outlined in the x12 specification. ProtoMED will continue to rely on the translation of its NSF format by its BUSINESS ASSOCIATES until later next year. ProtoMED will produce and process all necessary transaction sets within x12 specification by the end of 2003. Protologics will, however, continue to submit claims to Payers in whatever format that is dictated by the Payer. Obviously, if a Payer or Clearinghouse cannot process an x12 transaction set - or is asking its BUSINESS ASSOCIATES to retain the NSF standard, Protologics will accommodate the ASSOCIATE to insure clean claims processing and payment.

Business Associates and Chain of Custody Agreements:
While it is up to each provider organization as a 'COVERED ENTITY' to secure both the Business Associate and Chain of Custody Agreements with its trading partners, Protologics is happy to provide both agreements to our clients as a matter of convenience and for mutual compliance. The agreements are available via download by clicking on the appropriate hyperlink, or from the client download section of www.ProtoMED.com.