Episode 59 - Rise to the Challenge When Disaster Strikes
On November 30, 2018, a 7.0-magnitude earthquake hit Anchorage, Alaska. Cecily Sheats, director of business operations at Internal Medicine Associates, LLC in Anchorage discusses the challenges that the practice faced in the days following the earthquake. Hear how the practice utilized Greenway Revenue Services, Greenway’s patient portal, and additional Greenway solutions to rise to the challenge when the challenge arrived. Plus, advice on prepping your practice for a disaster.
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Joe: Hi. You just never know when Mother Nature is going to rear her ugly head. And for one of our customers in Anchorage, Alaska, it was a 7.0 magnitude earthquake that hit on November 30th, 2018. I am joined by Cecily Sheats, the Director of Business Operations at Internal Medicine Associates LLC who experienced that earthquake firsthand. And Cecily, thanks for joining me this afternoon.
Cecily: Thank you for having me.
Joe: First, I, you know, and I still remember hearing about that earthquake when it, you know, as it was happening in November. Alaska, not a place you would think of for earthquakes. Correct?
Cecily: Well, honestly that was my thought exactly when I first moved up here in 2016. We moved up here as a result of a duty station relocation PCS and that was not something that was brought to our attention, was that Alaska is known for earthquakes, but they definitely are. It's not as commonly advertised of how frequent they occur but it was something that was very illuminated to me after this major earthquake that, "Oh wow. They actually happen very consistently up here."
Joe: Yeah. And let's get in now a little bit about the practice. You know, where exactly are you guys located? What are the services you offer? How big is your practice? A little bit about the practice.
Cecily: Yeah. So here at Internal Medicine Associates, we're a GI-focused multispecialty practice. We've been serving the Anchorage, Alaska and surrounding communities since 1972. We've been around for a really long time. We're located on the fifth floor of Alaska Regional Hospital, which has also been around in the Anchorage community for a really long time. Our current specialties include endocrinology and gastroenterology. Our patient volume averages about 2,000 to 2,500 appointments and procedures on each month and so we do serve a very large population. We currently have seven physicians, six of which are gastroenterologists. We are bringing a new GI physician on board with us this upcoming August. We are just recently expanded to Wasilla, which is about 30 miles away from Anchorage just to better serve our patients. It's really difficult commuting in the winter months. The roads are very icy. There's one highway that gets to Wasilla from Anchorage and sometimes that becomes a problem. So we definitely are always looking outside the box to better serve our patients to be more accessible, and we currently have 40 staff members.
Joe: Wow. So a large practice, and congratulations on the recent expansion. Sounds like you guys have a lot going on in 47 years of history and more here to come. Discuss how you partner, we talked a little bit about this on the intro. Discuss how you partner with Greenway Revenue Services.
Cecily: Yeah. So we actually partnered with Greenway Revenue Services. We were having some difficulty in navigating the Intergy system and trying to figure out how we can better optimize that. And so we actually reached out to our account executive and started that dialogue. And he had at the time offered to have Greenway come on board with us and do a survey of our practices, make recommendations for improvements to optimize our revenue cycle. At the time our billing office was very heavily staffed and yet we were finding that it seemed like more and more work was created. There was a lot of inefficiency and honestly, we just needed some outside help. After a lot of thought and consideration, we elected to move to partner with Greenway and it really was a tough decision for our organization to make. Again, we've been around since 1972 and we had never even considered the idea. It was really tough. We've learned a lot about the automated functionalities Greenway has to offer and really like being able to cater our reports to what we want to see each month end. All of the GRS team has been extremely personable, informative, and very helpful whenever we've had questions so it's really helped to make that transition all the better.
Joe: And just touching on some of what you talked about there, a tough decision to make and you also talked about a large billing team. Was there ever the thought of members on that billing team is, "Oh, this Greenway is coming in to replace what we're doing." How has it worked collaboratively with the team here with revenue services?
Cecily: So the revenue services team was very collaborative. We currently have two, what we title as billing liaisons here with our group and they partner extremely well with Greenway. There are some services that are all encompassed in the GRS package that we opted and so we do do some of these processes here in our office, but there is a lot of communication required and it is truly a partnership.
Joe: And then what advice would you have for practices who may be considering revenue cycle management? You talked about it was a tough decision to make. So, you know, practices who are going through that decision process, what would you advise them?
Cecily: I would just say, know practice analytics. If you don't know it, learn it. Pay attention to adjustments and don't be afraid to ask questions. I think it's so incredibly important that practices recognize there's still a need for internal monitoring to ensure that processes meet your organizational needs. GRS isn't a mind reader and it's important to keep that dialogue open. Also, we retained two billing staff, like I said earlier, and found that they still maintain a very full workload. Read the fine print to set your practice up for success and better manage those expectations.
Joe: And in setting it up for success, you found yourself in a place after that earthquake. Talk a little bit about, we'll get, you know, into the GRS and how that related to the recovery efforts, but talk a little bit, you know, bring us back to that. Do you remember that day? I mean, I'm sure it's one of those you remember exactly what you were doing, where you were and what was going on as the earthquake was hitting.
Cecily: Yeah, yeah. So the day of the earthquake, I was actually not at the office. I'm was home getting ready to leave for work at the time of earthquake. I think it hit at about 8:30 in the morning. But a lot of our team was already at the office. This major event just shook our entire community. I remember visiting our practice the Sunday after the earthquake thinking to myself, "Oh my goodness. How are we going to fix this?" Our office was a total disaster. I have never seen anything like it. Again, we're on the fifth floor of Alaska Regional Hospital and the hospital is actually situated on rollers. And so, I mean, our entire suite just completely shifted as a result of the earthquake. GRS help site allowing our revenue cycle to continue functioning while we handled our other priorities at the time. Their call center went above and beyond. They really helped us to triage calls and informing our patients of these updates as it related to our office. If we had to have a closure for continued construction, I mean, things were constantly changing as a result of changing needs or things that were identified that need to happen right away. And they were truly a partner in helping us to communicate with our patients and then also assuring us that, you know, payments were still able to be posted. We were still, you know, able to send out statements. It was, you know, definitely, there would have been a lot more hiccups in our revenue cycle if they wouldn't have been aboard.
Joe: Did the practice have, and maybe it's part of the hospital's, any type of a disaster plan or what to do in a crises situation like this before this event took place?
Cecily: Yeah. So our organization specifically, we did not have an official disaster emergency plan. During the earthquake, we followed our normal safety protocols for evacuations, evacuated our staff and patients. What we ended up doing the next several days was designing processes to allow us to continue serving our patients while our office was under construction. We partnered with a few other practices that are here actually situated at Alaska Regional Hospital campus where we were able to continue servicing our patients and we devised processes to communicate changes and scheduling and things like that so that we could move forward progressively and make sure that we were still able to take care for our patients.
Joe: And in an ever-changing situation like that, talk a little bit about the patient and making sure that patients were aware of changes in schedule, changes, you know, with the practice in their care.
Cecily: Yeah. So as far as communicating those changes, I think we definitely very quickly got a handle on communicating with our patients. We were working around the clock. We do have that patient portal setup and that was invaluable. We actually really have a high volume of utilization for that platform. Very much helpful. We use social media definitely, our after hours answering service was able to relay information. And then again, the Greenway Revenue Services call center was able to relay information. Internally we devised internal schedules so that we knew who was going where and doing what and how we were going to service our patients. I mean, we updated that daily to offer the flexibility of making those last minute adjustments as were needed during that time.
Joe: So I asked you for advice on, you know, revenue cycle management before and now I'll ask you for a little bit more advice. Going through what you went through, and it may not just be an earthquake for our listeners. It could be, you know, we're based in, in the Tampa, Florida area and many of our practices down in the south and southeast have to worry about hurricanes during the summer months and in our colder weather states, snow storms and blizzards. What advice would you have for practices who may not already have some type of a disaster plan or crisis communications plan in place? You know, should an event happen where something like this, the practices and the care of its patients could be greatly affected on a daily basis?
Cecily: Yeah, absolutely. I mean, this was a real eye-opener for us. I mean, obviously, we do have protocols in place for, you know, evacuations and ensuring both staff and patient safety. But as far as a specifically outlined contingency plan for something like this, we didn't have it. And if we had, I think things would have been a little smoother. We definitely were able to rise to the challenge when the challenge arised. We didn't have a choice in the matter, but being that, you know, we're talking about something that may or may not occur in the foreseeable future, I mean, definitely get on board, definitely get something in place. Now is, you know, this, this definitely served as a reminder is that it, that it is super paramount. One of the other things that I would recommend, you know, Greenway had that patient portal. They also have that patient messaging system that we are actually working to implement here in our office, and that can further offer the opportunities to ensure streamlined communications during times of unexpected closures or natural disasters, communicating with our patients, especially in the social media age that we are in today, it's just absolutely paramount to keep up with the times and move forward progressively in that direction.
Joe: And into incorporating the patient messaging and a patient portal as you mentioned, is that in response to a situation just like this?
Cecily: So we were actually before the earthquake working to implement patient messaging. We had implemented the patient portal, I think it was closer to the end of December 2017. We loved it, but our implementation, we staggered it to do the patient portal first and then patient messaging. We were working to implement the patient messaging right before the earthquake happened and it was totally derailed and we were thinking to ourselves, "Oh my goodness. Wouldn't this resource be just fantastic if we had had that during the earthquake." And so it's definitely sparked our priority as far as getting that implemented because it is a very valuable tool.
Joe: Well, great. Well, thank you for all of the great information, and thank you for spending time on this episode of our podcast just to discuss. And we're glad to hear that you guys made it through and continue to thrive in this area.
Cecily: Thank you so much for your time.
Joe: And once again, that was Cecily. She's the Director of Business Operations of Internal Medicine Associates, LLC of Anchorage, Alaska. We thank her for taking time on this episode of our podcast, "Putting Possibility Into Practice." For more information on Greenway Revenue Services and patient portal, patient messaging and all that we've talked about and how they can help your practice not only when disaster strikes, but each and every day, you can visit our website at www.greenwayhealth.com.
And a reminder that you can subscribe to our podcast and receive notifications when new episodes are uploaded each week on your platform of choice. And we're on a number of the platforms now. You can find us on Apple iTunes, Google Play podcast, FM Stitcher, Spotify, SoundCloud, Libsyn, TuneIn radio, iHeartRadio, and look for more platforms coming soon. I'm Joe Agostinelli, the Social Media Manager at Greenway Health, and this has been another episode of our podcast, "Putting Possibility Into Practice."