Dr. Howard Rollins, EHRtv AIMS specialist and medical consultant, interviews Rohit Nayak, Vice President Physician Technology Solutions of Quest Diagnostics.
Dr. Howard Rollins: This is Dr. Howard Rollins with EHRtv. I’m here with Rohit Nayak at the HIMSS 2012 Conference. Rohit Nayak is the Vice President Physician Technology Solutions for Quest Diagnostics. Their product is Care360 EHR. Rohit, thank you very much for being here with us.
Rohit Nayak: Good to meet you.
Dr. Howard Rollins: So here we are at HIMSS. Tell me a little about why you’re here and what you’re showing.
Rohit Nayak: Well, HIMSS is the landmark show for the healthcare information technology industry as we all know. MedPlus which is creator of Care360 EHR is the fully-owned subsidiary of Quest Diagnostics. And it has been–– and it’s responsible for all the customer facing technology that Quest Diagnostics offers. Over the years, we’ve expanded our Care360 platform from being just a lab orders and results solution. We had an e-prescribing and over the last two years with the changes in the industry, we started to introduce our EHR solution.
Dr. Howard Rollins: So this EHR solution is rather new.
Rohit Nayak: It’s relatively new. We certified with the new certification standards at ONC in December of ‘09, I believe. So it’s two years in that range that we’ve been in the marketplace. And we believe that Care360 by itself has a footprint of over 200,000 physicians and 80,000 physician office that we’ve all debarked over the many years that we have. And so we see a natural progression for our physician customers to progress and migrate to our EHR solution.
Dr. Howard Rollins: It seems like it was– it would be a natural progression. As you say, you’re starting in the laboratory business with your experts’ had.
Rohit Nayak: Yes, we are.
Dr. Howard Rollins: And now here you are creating one of the very, very fine EHR. Tell me a little bit about what makes it special.
Rohit Nayak: Sure. Just based on the background again, I mean we have a lot of familiarity with the small physician practice, the independent physician practice. We built the solution from the ground up looking at the interest and the needs of the small physician practice which contrasts us tremendously from most of the players in the exhibit all here who were primarily solution providers for the larger physician practices. The biggest opportunity in the market, as you know, is in the small physician practice. We think the needs are dramatically different. The needs are dramatically different in the sense that we didn’t built–– build our solution from the standpoint of upcoding or just achieving a paperless office.We built it from the standpoint of providing clinical information to the provider at the right time and the right place so they can do what they need to do in an effective manner. We looked at it from a standpoint of understanding the workflow of what happens within the office rather than just trying to say what’s–– what’s the most effective or the most highest upcoded encountered note that one can give. So we believe that we’ve understood and adopted the adoption factors that are so important for us to achieve the successful adoption in the industry and we believe that, that given the track record and the progress that we’ve made in the last two years, that we have something special.
Dr. Howard Rollins: Can you give me an example of how Care360 will impact workflow in a doctor’s office?
Rohit Nayak: So the key point here is really the flexibility of that Care360. Care360 doesn’t necessarily dictate and say everything in the office has to be done in a–– in an automated manner. It doesn’t dictate that that there has to be one individual for scanning, one individual for writing a note, another individual for coding. If you think about the small physician office which I know is your background, you have one individual wearing multiple hats. And so you don’t want to create an artificial scenario just for the purpose of automation. So that’s the key input that we put in and basically says “Here’s the solution that gives you the flexibility to adapt your workflow as you must.” We recognize that, that there are some requirements that some workflow change is required but certainly not the magnitude that most of our competitors have worked.
Dr. Howard Rollins: Right. Now, I know with EHRs, one of the big–– it’s a detail that is very important is interface. Tell me a little about interfacing with Care360. Who can you interface with? What kind of data can you capture? And what kind of data can you send out?
Rohit Nayak: Excellent, excellent! Key points, I mean, I mean I appreciate you bringing this out. We see, from an EHR standpoint, three major tenets. One is what we call interoperability which is the point that you brought up. The second is what we call accessibility. How do people use it? Where do they use it? And what’s the usability of it? And the third is, is the clinical dimension. So clinical decisions or how do they use the clinical aspects of information that they have.Let me start to the first. On the interoperability standpoint, we’re clearly experts in the clinical transactions-based; the same network that Care360 EHR runs and it manages over a million transactions daily.
Dr. Howard Rollins: Uhum, right.
Rohit Nayak: So we have that expertise down and we provide interfaces using that platform, the same technology platform to other hospitals, to other labs, to radiology services, transcription services, and the like. So we have that process down in a very significant manner. In fact, what we do is we also offer a solution not just to individual practices, we also offer to solu–– to hospitals. Every hospital over the last 5 years has made some sort of a technology decision from an EHR standpoint.
Dr. Howard Rollins: Right.
Rohit Nayak: But if you ask them what their pain points are, they’ll tell you that independent of their amount of money that they have spent, or the amount of time that they spent on it, they were only have about 10% to 15% adoption in terms of the overall implementation of the EHR.
Dr. Howard Rollins: And why is that?
Rohit Nayak: We believe that is because of all the factors that I just talked to you about. A lot of these solutions are A – expensive. Ask for a lot of commitment from the–– in the part of the users in terms of disrupting their office, changing their office, and these are all based on the encountered notes, right?
Dr. Howard Rollins: Right. And I’ve–– I’ve certainly heard a lot of that from my colleagues when–– when a new system comes into the hospital. So clearly, the important thing is to make it easy and not interrupt with doctor’s workflow and it sounds like that’s what you pride yourselves on.
Rohit Nayak: Absolutely, absolutely! One of the key things and we’re all learning in this marketplace. One of the key things we learn over the last few years is, is especially to the advent of the iPhone and the iPad, phenomenal devices.
Dr. Howard Rollins: Right.
Rohit Nayak: In terms of the usability and the accessibility and our solutions, although we still call it as an extension to our primary solution, have gained vast utilization, much more than we find–– we expected, frankly. We have physicians and you know, I mean you’re a physician. Most physicians are not the first to pick up a piece of technology and say, “I’m going to use that.”
Dr. Howard Rollins: That’s right.
Rohit Nayak: We have physicians calling us and saying “How can I start using the solution tomorrow?” They have their own devices, they have their own phones, they have their own iPads, and we build a native application that’s for those devices. So we’re seeing a lot of change in the industry that–– that is phenomenal, that is going to drive that adoption of that. I think we’re all looking for it.
Dr. Howard Rollins: So a hospital goes ahead and makes the commitment to bring Care360 to their facility. Tell me about the implementation. What can you do for the facility and how do you make it work?
Rohit Nayak: That’s a great question, great question. So that’s been one of the hurls, right? I mean so how do you actually A – get to the buy in from the physicians, B – get their cooperation in terms of implementing. Based upon our experience and what we’ve seen as with our light touch solution that we have which is, which is the software as the service, cloud-based solution, the level of touch points that we need for the physician office can be pretty small. It doesn’t have to be the same, engaged one week, two-week, three-week intense shutdown your office training exercise.So the way we do it is we use a combination of online training, the use of combination of remote training and on-site training. So we have the ability to do all for all of that over a 4-6 week period. And we feel confident that at the end of the six weeks, our physician practices are ready to begin the recording process that is required for a meaningful use data station. That’s–– that’s the level that we believe that we can get our physicians to and we’re so confident about it that as a result of that for this show, we announced the promotion that guarantees our hospital customers the 30-day implementation cycle.
Dr. Howard Rollins: I heard about that guarantee and I wanted to hear you say it here to me about that and have–– was that a new–– that’s a new offer?
Rohit Nayak: It’s brand new. We just went out today. And so we believe we’re touching a nerve that is at the core of the needs of a lot of the attendees at this medical conference.
Dr. Howard Rollins: Right.
Rohit Nayak: And–– and, and so we–– we’ve seen evidence of that behavior and so we certainly believe that it’s going to provide a lot of benefit for us going forward as well.
Dr. Howard Rollins: Now, with it being cloud-based, let’s talk a little about protective health information and what Quest does to make sure that this information is completely secure.
Rohit Nayak: There are well-regulated and documented rules in terms of what are the access requirement. So every user has their own log in and a password. The data that is transmitted between the end user connection and the host systems is secure by the highest security standards. So we feel as if based on our experience, we’ve always offered a cloud-based solution. We have a secure network and we do enough to provide secure and controlled access to that particular network for our users. So we’re pretty confident about our ability to adhere to their A – the privacy laws as well as the security laws that are associated.From a privacy standpoint, sometimes that’s the tougher challenge because, because there are a lot of people that work around a physician practice or a hospital that want access to that data. And we take a lot of pains, sometimes not very favorably, to make sure that that we have the right consents and authorization before we do any of that information. We, we manage because we control and manage so much patient information for the millions of patients that we deal with on a daily basis, it’s a very important factor for us as Quest Diagnostics.
Dr. Howard Rollins: That was a great answer. And we covered a lot of information that it seems that we’ve chosen the right person at the company to speak to. We’ve got the answers. I want to thank you very much. It’s very exciting what you mentioned and I wish you the best of luck.
Rohit Nayak: Thank you.
Dr. Howard Rollins: Thank you. Rohit Nayak, Quest Diagnostics.