Dr. Eric Fishman, CEO EHRtv interviews Sunny Sanyal, Chief Executive Officer of T-System.
Dr. Eric Fishman: This is Dr. Eric Fishman with the EHRtv at HIMSS 2012 and I have the pleasure speaking with Sunny Sanyal, CEO of T-System. Sunny, it’s an honor to have you here and I thank you very much.
Sunny Sanyal: My pleasure.
Dr. Eric Fishman: If you’ve been in this industry, you’ve heard your name. You’ve been doing a lot of great things with very large companies. And for the last two years, you’ve been at the helm of T-System obviously, your premier place in the emergency department. Tell me what made you decide to move to T-System.
Sunny Sanyal: Yeah, absolutely. So first and foremost, I’ve been in the healthcare space for 23 years and each year has been more exciting than the previous year. And as I looked at my career and as I looked at what where the industry is headed, what I realized was that there’s a tremendous amount of opportunities in electronic medical records in the emergency medicine. One emergency medicine overall was behind in terms of adoption and the curve in terms of the use of clinical documentation and systems. But secondly, it’s a very important hub for care delivery you know frankly, all of us are motivated by how we impact healthcare and then when I see my – the thing that T-System can do, a company like T-System, we feel like we make a tremendous impact in the delivery of care delivery through emergency medicine and through the use of systems improve the way patients are taken care of in the ED setting. So I decided to come out of a big company and join a small company like T-System where I can have a personal impact and where we can make a big impact in medicine.
Dr. Eric Fishman: And T-System must be doing something right. They’ve got over 40% of the market share I understand. What do you think some of the features and functionality are that make it so pervasive in the ED?
Sunny Sanyal: So T-System was founded by two ED physicians and they came at it from a perspective. They wanted to make their lives easier. So as physicians, they knew exactly what they wanted to be able to take care of the patients, to go home on time and to be able to document what they did during the day so that they can get paid accurately with their work. It was that simple and so they came up with a technology that was very simplistic, that pretty much allowed them to capture everything that they did during the care delivery process without having to spend extra time. So they focus very, very heavily on the ergonomics, on the human factors elements of electronic documentation system. So they develop the system that was very fast, very quick, very simple and efficient for the physician to use that made sure that they would be able to build code correctly, bill correctly and at the same time have all the necessary regulatory information captured and have it be comprehensive and accurate so it can stand up in case of a litigation.
Dr. Eric Fishman: How does the documentation accomplish? Is it point and click? Is it handwriting? Is it speech recognition? Is it a combination?
Sunny Sanyal: So it’s all of the above. But basically, all the clinical knowledge of everything that goes on in an emergency room is organize by what we call chief complaints.
Dr. Eric Fishman: Right.
Sunny Sanyal: So there are 58 chief complaints and everything that can possibly happen in an ED and all the care processes that are needed to take care of patients are organize around these chief complaints. And so what the founders did was created a workflow paradigm and the user-interface paradigm where you circle something if it’s a positive indicator. You put a backslash on something if it’s a negative indicator. So it’s a combination of circles and backslashes and the whole premise was you shouldn’t have to click more than two times or three times to get something. You should be able to do everything you need with one click. So the whole user-interface was designed for speed, efficiency and accuracy only to a simple check marks and backslashes to capture what you’re doing.
Dr. Eric Fishman: As we were discussing, slowing down even for a minute can be a tremendous issue in ED.
Sunny Sanyal: Absolutely. And ED goes in the patient volume in ED comes in bursts.
Dr. Eric Fishman: Right.
Sunny Sanyal: So one minute, your mob and the next minute, it’s a little – you’re free. But you have to design a system for that high activity period. So you want to make it as efficient as quick as possible.
Dr. Eric Fishman: Obviously, the ED is not the place that most people, their preferred location for care. They need to get information to be brought in. And so what mechanism, what utilities do you have to bring information from the outside world into the pad?
Sunny Sanyal: And so, when someone comes into the ED. The system –
Dr. Eric Fishman: And they have a primary care physicians and it’s 9:00 to 5:00 Monday through Friday.
Sunny Sanyal: Yes.
Dr. Eric Fishman: And so, they have lab data. They have images. How does it get brought into the system?
Sunny Sanyal: Yes. So when a patient shows up in the ED, we’re able to first of all, through the registration process, their basic demographic information is capture and comes into ED. If they were already been there before so that information is already there. If there are patients medical records available in other parts of the healthcare delivery system, we can integrate with those systems to bring back in that information like lab information, prior visit information.
Dr. Eric Fishman: And that’s if the information is in a data format.
Sunny Sanyal: It’s electronic.
Dr. Eric Fishman: In fields, supposed it’s a PDF, a scanned image of something. Do you have mechanisms of importing that type of data into data fields?
Sunny Sanyal: Absolutely. So information is available either in the form of films or –
Dr. Eric Fishman: Right.
Sunny Sanyal: It may not be digital images. It might be films. It might be in the form of paper documents. We can scan external documents in into our system and bring them into our system. If the patients had previous history of medications fulfilled from an outpatient setting, we can bring import that in, into our systems by querying those external systems. So there are many ways of bringing information into the ED when the patient comes in.
Dr. Eric Fishman: And now, let’s talk about the opposite of that. There are some new announcements about the continuity of care getting the hand off because the ED is not the final place of care for most folks and they’re going to go to see specialist, their internal medicine physician. Tell me about that new product sleeve.
Sunny Sanyal: Absolutely. So the patients like I said they don’t come into the ED as a destination. They’re there to transition to some other place and that some other place might be their home. It might be an admission to a hospital. It might be to a skill nursing facility. So the information has to flow with the patient. So what we do is when the patients first of all, when the patient comes in, if they have a primary care physician, we can inform the primary care physician that their patient has showed up at ED.
Dr. Eric Fishman: And that’s an electronic way.
Sunny Sanyal: That’s in electronic message form. When the patient is in the ED, the primary care physician can see that they’re in the ED and they can have access to some of the preliminary reports from ED.
Dr. Eric Fishman: And you tell medicine capabilities?
Sunny Sanyal: Yes and no. In that it’s not something we natively offer but if they wanted to use Skype, they can absolutely hook that up into our system. But the key here is that we can engage the patient’s care delivery team. So if they are the physician, the specialist, the care coordinator can all be engaged. When the patient is discharged, the information from the ED, the reports can be sent to their primary care physician. If they don’t have a primary care physician, we can assign them one. The hospital can set it up that way. If they wanted, the hospital sometimes will use these systems to then organize a follow-up visit with that primary care physician or with the specialist. And all of this facilitates that transition of care for that patient. What you want is a warm hand off of that patient to another caregiver. In a previous paradigm buzz, you just discharge them to a curve – the curve side and then, you don’t know what happen to the patient after that. That’s not acceptable, what we’ve – what the industry is looking for is a way to have a full close to loop care continuity system and our technology facilitates that.
Dr. Eric Fishman: It’s good to have you do that. That was last month’s announcement. Tell me what you’re envisioning in the next 6 to 12 months.
Sunny Sanyal: What we’re envisioning is that we’ll continue to evolve around our capabilities in the ED itself so we will continue to provide functionality that helps physicians, clinicians, nurses get more – become more efficient and be able to take care of patients more effectively. You’ll see more decisions, support capabilities coming from T-System. But then also equally what we want to do is provide the entire solutions that help both physicians and hospitals maximize a true put and revenue cycle capabilities. So from the point where a patient walks into the ED or comes as brought into the ED to the point where money is collected, you’ll see solutions for T-System that takes care of the entire supply chain.Secondly, it’s very important for hospitals in the future if you look forward, let’s say a couple of turns whether or not ACOs manifest them also the way it’s envision, there are still a very big need to maintain for hospitals to keep patients within their referral network. You will see us continue to evolve and develop solutions that helps us provide care coordination services for the patient. There are a variety of clinical services that also are important and the T-System will overtime build on this current platform of continuity to provide the services like follow-ups, like medication compliance, like ensuring that the patients are -- have access to that caregivers, have access to their information. So we’ll continue to evolve along those lines.
Dr. Eric Fishman: Sunny, this is an exciting time to be in this industry and I can tell just by your voice how excited you are about it.
Sunny Sanyal: It is a very exciting time to be in the industry. You know, our employees want to make a difference. Everyone wants to change healthcare but I believe, the people that can change healthcare are the ones that are a part of the healthcare. If we see our systems handled over close to 40 million patients a year, we think we can touch the lives of 40 million patients and that’s what excites us.
Dr. Eric Fishman: Sunny, thank you very much.
Sunny Sanyal: Thank you.
Dr. Eric Fishman: I appreciate it. This is Dr. Eric Fishman with EHRtv. We’ve had the pleasure speaking with Sunny Sanyal, CEO of T-System. Thank you.