Episode 65 - Fueling the Success of Tribal Health Communities
Greenway combines EHR and community health management to drive the highest levels of care for tribal health partners and the communities they serve. Micah Petoskey, IT site manager, discusses how KBIC Health System uses Greenway's solutions to meet the needs of its tribal health communities.
Joe: On this episode of "Putting Possibility into Practice," we're talking about Intergy and additional product solutions that are available for your tribal health community. Plus, we'll tell you what a tribal health community is and how it may be similar or different from the private practice and providers that you see on a regular basis. And we'll talk about what else is in store for a customer of ours as they look ahead to the future and continue to grow their tribal health community to enhance the patient care they provide each and every day to their community. This is "Putting Possibility into Practice," and it starts right now.
I'm Joe Agostinelli, Social Media Manager. If you are a returning listener, thanks once again for tuning in. And if you are a new listener, we are glad you found us on your platform of choice, and we'll go into those platforms and how you can subscribe to our podcast coming up a little later on.
This episode, we're talking about tribal health communities and we will feature one of our customers who has been a partner with Greenway Health since 2014 and how Intergy helps them to provide excellent patient care every day in their community and how other tribal health communities can benefit from incorporating Intergy into their practice. So I would like to welcome Micah Petoskey. Did I say that right?
Micah: You did.
Joe: Perfect. Spoiler alert, we rehearsed off-air. So I figured I would get at least that part right. Micah, first, why don't you introduce yourself, your title, the practice that you're with, where you guys are located and all of the background of the tribal health community.
Micah: Sure. My name is Micah Petoskey. I'm the IT Site Manager for KBIC Health Systems. We are a tribal health clinic located in the village of Baraga which is in Michigan's upper peninsula. And we are a family practice. We have dental, behavioral health, community health, WIC. We have medical, dental, pharmacy services. We serve just under 3,000 patients. We've been growing in place here since 1971. We currently have nine providers. We have a potential of adding a couple more in the next couple of months.
Joe: Oh, that's great to hear. And we'll talk about expansion plans a little later on. First, for those who may not be familiar with tribal health communities, how do they differ from, you know, a private family practice I may go see or another provider that someone may go see for a condition that they're suffering from or how are they similar?
Micah: Well, the way we're different is we are focused on the tribal population. Even though we're a family practice, we're not open to the public. We are here to service the tribal population here on the reservation. So we operate under an IHS program that subsidizes the cost of health care for our patients. So the money that they give us, we use to staff providers, but also so that our patients don't pay anything out of pocket for the care they receive in our building regardless of their insurance situation.
Joe: What are the biggest challenges?
Micah: Provider recruitment. You know, we're in a very rural area. Even though that's the case, we compete with other medical facilities, public and private, for doctors, FMPs, nursing staff. I mean, it can be tough to get them and keep them. This is a really small town, far away from everything else. For some people, that's an attractive thing, but for a lot of our professionals, it's tough. It's tough to get them up here.
Joe: And playing off of that, you know, obviously, that's, I think, a health care trend right now is physician recruitment. How is the community dealing with that, and what do you do on a daily, you know, re-occurring basis to attract providers?
Micah: Well, it's just the recruitment never stops. You're always looking, because, you know, even if you've got enough providers for your clinic, you know, they may get another offer somewhere else and, you know, they're contractual so when those contracts are up, you're hoping that they stay. But if they end up leaving, you've got to have someone else around to fill in. And, you know, from a pharmacy standpoint, some of the other parts of the building, we may need on-call people as well, because we don't have multiple providers in those areas. So it's ongoing. That never stops.
Joe: Do you have tools or resources that you use to recruit the providers?
Micah: Basically, we reach out to our partnerships with state and federal agencies to make sure that people know that we're still looking. Sometimes we use recruiters. We have our online postings and we post on job sites. The U of M Medical School, we post down there for their graduates. Like I said, you kind of spread it out and do it everywhere you can and get as much exposure as you can.
Joe: Discuss your partnership with Greenway, we mentioned that it's been a partnership that's just about five years old now, the solutions that your providers use each day to provide excellent care, and other ways that you partner with Greenway.
Micah: We started using Intergy in September of 2014. Since then, we've added Revenue Cycle Management, Patient Messaging, and the new Patient Portal. Talking again about being a tribal health clinic, and I know, for any tribal health clinic staff that's listening to this or does hear this, we wear a lot of hats here. I'm the IT site manager, but depending on the day, I might be doing something else within the building, it's just…you never know. And so having those types of services that allow us to fill in what could be holes in our department, it's been invaluable.
Revenue Cycle Management's been great for us. Patient Messaging has taken a huge load off of our front-desk staff. And you know, the Patient Portal is, really, it's a requirement for Meaningful Use and have been, you know, for years now. You know, having that here and integrated into the product is, of course, great.
Joe: We'll touch on each of those products and how they enhance the care they deliver, but let's first talk about Intergy now on five years. How is that used on a daily basis by your providers?
Micah: They're in there constantly, all doing chart lookups, but also adding to encounter notes as they see patients. And a quick plug for Intergy, you know, one, I can tell you, if I don't like something, I'll say it. But where Intergy is concerned, we have a doctor who only works for us part time, two weeks a month, and he has told us on many occasions that Intergy's the best product he's used. So you know, for some of our staff, they went from the IHS-subsidized software, RPMS, to Intergy and that's a pretty big jump, both in technology and capability. But to hear that from an outside source, you know, someone who has used many other products that other health systems was a pretty big endorsement, I thought.
Joe: And you talked about Revenue Cycle Management. You also had talked about the wearing the many hats and, you know, despite what your title may be, you may be doing something else on any given day. How important, from a revenue cycle management perspective, is it to have that team in place to assist the practice, especially when you have so many responsibilities?
Micah: Well, it's a big job. You know, for anybody out there working in health clinics like ours, revenue cycle management is a long arduous process. You know, you go from the charting of the doctor, signing of the note and the application of charges, well, now, you're shipping them out to the insurance company, and we all know that insurance companies will deny a certain percentage of claims, they just do. And then you have to see why it was denied, track it down, call them back, make the changes, and try to get your money.
And for a small staff, a relatively small staff of people at a health clinic like this, we just don't have the manpower to do that. And so having Revenue Cycle Management in place to basically chase that money down for us, even though we're paying a percentage to Intergy, overall, we're collecting far more money than we used to. So it was a huge win for us to get it.
Joe: And what advice would you give other tribal health community centers who may be considering a partnership with Greenway, whether it's to utilize Intergy, Revenue Cycle Management? You talked about Patient Messaging and the Patient Portal, and even utilizing something like that when you're in a rural area like you are.
Micah: Yeah, honestly, I feel like the package we have is the one that every tribal clinic should have. When you add the Intergy desktop, which is where you're doing your scheduling and registration and everything, and then you have your EHR where you're doing your clinical work, and then you have Revenue Cycle Management helping on the billing side of things, you know, Patient Messaging, like I said, it's, again, you have that small staff and, you know, calling everyone every day to remind them of their appointment two days from now or four days from now, or whatever interval you have set up, it's a big job, or it can be.
You know, you've got 10 providers in a building that's seeing 10 to 15 people a day, you end up with a lot of calls to make for 1 or 2 people that might be in the reception area available. It was another big thing that we just needed to get us over the hump and get us in front of some of the problems that crop up with, you know, patient no shows and cancellations. So that was a big thing for us.
And then the Patient Portal itself, you know, we have an older patient base here and that has been a little bit of a slow uptake but the service itself is fantastic, when you look at it. The fact that you can request appointments, you can request prescription refills. You can send your doctor messages. It's a really comprehensive service, and so we've been really happy with it.
Joe: And you talked about growth early on. And any goals for the next 12 months as you look to add more providers, expand your services or so how some of those tools that you already have in place from Greenway assist with the growth of the community?
Micah: Well, one of the things we can do as a tribal health facility and, like I said, for any tribal people that are listening to this, they already know this, but our tribe has the right to define who its population base is, under the IHS guidelines. So what they call that is close social and economic ties, so you can see non-tribal member families who are…whether it's a non-tribal spouse or children who are not considered tribal members but dependents, you can add them to your population base. You can also add people who work for the tribe, who are non-tribal otherwise. So all of those people can then come to that health clinic. For us, that would double or triple our population base.
Obviously, we'd need to add more providers to handle the influx of patients, but that's kind of our goal is to, at some point, service all of those people here at our health clinic. In order to do that, yeah, we're gonna have to expand either from this building or into another building or we're just gonna have to look and see what options we have to accomplish that.
Joe: And then discussion on patient engagement, and trying to expand and grow what you already have in place, what have you seen in the changing industry that has helped you guys stay on top of the technology needs to meet the needs of your diverse patient population?
Micah: Well, for that, it's Practice Analytics. Practice Analytics is one of the best reporting tools I've ever seen. I've worked in a few different areas. I worked for the Federal Government in different positions. Practice Analytics is fantastic. So there is a pretty wide array of places that we have to report to, whether it's for PCMH, or to an insurance payer or to the Federal Government or to the state government or to our own tribal administration. And so to have a powerful tool that we can adapt to pull the information we need for those people has been huge. A big part of getting Intergy is getting Practice Analytics. It's one of the few things that a tribal health clinic can utilize to satisfy the National Data Warehouse requirements for reporting. So it's a must.
Joe: And you guys are actually on the…and I know this was prior to the partnership but I think worth mentioning, you guys are actually on the forefront of becoming a PCMH, correct, back in 2012, one of the first amongst tribal health communities?
Micah: Yeah. We've kind of been on the front of a lot of those things over the years. KBIC has done a good job of pushing the boundaries of, you know, those types of programs, but also the technology needed to accomplish it. We also have one of Greenway's partners, HealthAsyst. We utilize them to help with our patient registration and check-in and that utilizes iPads to collect information. But also, you can do surveys on them, you can do all kinds of things. But they are a partner that we met at one of Greenway's events.
Joe: Well, great. Well, excited to hear about all the good things going on at KBCI Health Systems and everything you guys are doing to enhance patient care every day. And we thank you for your partnership and we look forward to continuing in helping fuel your guys' success.
Micah: All right, thank you.
Joe: Once again, that was Micah Petoskey. He is the IT Site Manager for KBIC Health Systems as we talked about Intergy and different product solutions that are available for the tribal health communities. For more information on the products that we discussed on this episode of our podcast, "Putting Possibility into Practice," I invite you to visit our website at www.greenwayhealth.com.
And as I mentioned early on, if you are a new listener and looking to subscribe to our podcast, and we hope you do, you can find us on your platform of choice and subscribe to get notifications of new episodes when they're published each week. Our podcast is available on iTunes, Google Play Podcasts, SoundCloud, Libsyn, Spotify, Stitcher, TuneIn Radio, and iHeartRadio, and look for more podcast platforms coming soon. Once again, this has been an episode of "Putting Possibility into Practice." I'm Joe Agostinelli, the Social Media Manager at Greenway Health. Thanks for listening.