MGMA 2010 – Scott Decker (NextGen Healthcare)

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Eric Fishman from New Orleans at MGMA 2010 speaking with Scott Decker, President of NextGen Healthcare

Category: Featured, MGMA 2010, Tradeshows
Date: November 5, 2010
Views:21,868 views

Dr. Eric Fishman: Hello. This is Eric Fishman from New Orleans at MGMA 2010 and we have the pleasure of speaking with Scott Decker once again. He's the President of NextGen Healthcare and we're joined by Richard Yonis as well. Scott, I thank you very much for taking the time.

Scott Decker: Thanks for your time.

Dr. Eric Fishman: I'm sure MGMA is a very busy time of year for you.

Scott Decker: Yes.

Dr. Eric Fishman: A tremendous amount is happening in the industry and we've got a lot to talk about. Why don't we start with stimulus funding and how NextGen is taking advantage of the requirements and how you're allowing your technology to help physicians through Meaningful Use.

Scott Decker: Well, as you know, we've been on this Meaningful Use track for about 18 months now and we're just delighted that we're finally coming to conclusion of all the effort that’s gone into it with the final regulations coming out three months ago and us now getting our certification in the first wave in the last 30 days. So we're hoping that this is going to break the dam of the people who've been on the fence waiting to see exactly what we need to do and certainly we see that with our clients and prospects all over the country.

Dr. Eric Fishman: Now, you've been providing a guarantee if you will that your physician clients will be able to prove Meaningful Use. Now that the final regulations are out, is that even a stronger guarantee?

Scott Decker: Hopefully, our guarantees were always very strong.

Dr. Eric Fishman: Fair enough.

Scott Decker: So we're still very confident with our 100 percent guarantee but yes certainly with certification being done it pretty much makes it a slam dunk for us. We feel like we have all of the right parts. Now interestingly, the guarantee really applies going forward so this is going to get tougher and tougher. The bar is going to start getting raised. So round one, everybody hopefully was confident. We're pretty confident on part two and three though also.

Dr. Eric Fishman: And Richard will have a couple questions in a few moments about your technology and the SAS but let me start with the breadth of NextGen product line. You can take care of a small practice; you can take care of hospital systems. Maybe you can briefly go through the product line if you would.

Scott Decker: Sure. As you said certainly our bread and butter and our history has been for the physician practice and everything from the small practice to the large practice. Over the last couple of years, we've really expanded that and now we have patient portals who can communicate with patients, an HIE product so you can build connected communities and exchange data with each other and most recently, really getting into the inpatient side of the world with our hospital based products as we see patient centered home and accountable care organizations really becoming the future, we think it's critical that we can go across that entire breadth.

Richard Yonis: So talking about the product base and the client base, traditionally practices have known what a great job NextGen has done in the larger practice size. Any plans to deploy an SaaS model for the smaller practices so they can have the same advantage as the larger practice does?

Scott Decker: Yes, absolutely. So even over the last six months we've started to have quite a bit of success with SaaS model of computing and so a lot of our small practices are definitely leaning towards that solution where they can get in for just a low monthly fee type of approach. No capital requirements, no staffing. The other thing we've really emphasized for the small practices is working with our affiliated hospital systems. So we spend a lot of time and even more so lately using the hospital system as almost the catalyst to help get our product out to the smaller practices around the country.

Richard Yonis: Are you deploying it as a browser base or using Citrix behind the background?

Scott Decker: A little bit of both because our product's in a migration path right now on what technology. So some of our product is absolutely web-based. So like our patient portal product and our HIE and our new mobility products. Our core products are still behind the Citrix cloud but that'll start to move over the next 18 months also.

Dr. Eric Fishman: As your going into the cloud, talk about the implementation process for a smaller practice because historically NextGen is in larger practices. You bring people in and there's a formal implementation process and there seems to be a trend of more web-based training and a fast implemention.

Scott Decker: Yes and we've definitely applied that model to our small practices. So I think the two things we really emphasize there are more of a turn key approach because we have a lot flexibility in our product which is nice but also can be dangerous and especially for a smaller practice. For our smaller practices, we much more like them to go with kind of the in the box approach and lets get started there and that helps. And then we also very widely use web-based training and implementation. In fact, we use a totally different model for them that they can have as much training and implementation help as they need. It's all just a fixed cost. So they can keep coming to the webinars.

Dr. Eric Fishman: That's I think a great idea. At this point in time, a small one, two three physician practice non specialty oriented, about how frame will be between signing any agreement that they need to do with you and going live and actually being implemented both the practice management and in the EHR?

Scott Decker: I would say in general three to six months for a small practice.

Richard Yonis: In terms of revenue cycle management I know that NextGen has acquired several ventures to expand your product line there. Do you envision offering that service to the small practices as well as the large?

Scott Decker: We certainly can. We actually find that probably the market for that is though on the larger practices at least that's the way it's playing out that they find a better economy of scale for what you get in that kind of service but it certainly scales down and once again I'll go back to the hospital model because we are finding a lot of traction with hospital systems as they are acquiring malpractices, then wanting to outsource the components rather than build up those new departments for their own. So we have a couple very nice RCM contracts in that space.

Dr. Eric Fishman: Let me go back to patient portals. That's been a particular interest for me. It has shocked me over the months and years how few physicians utilize them. It seems like such an economy to have the patients doing the work instead of a physician staff. Do you find an uptick in your physician clients utilizing the patient portal technology?

Scott Decker: It's also been shocking to me because I think between this venture and my previous one, I've been trying to do patient portal for 10 years and it always seems like a no-brainer. But as you said no traction at all.

Dr. Eric Fishman: Why?

Scott Decker: I don't know because every place that I've ever seen do it, also has success. So it's not like there's just bodies out there of places it didn't work. It does work. Now I think what we have going for us is the Meaningful Use criteria. So they know it's coming and this is finally the catalyst. It's probably off the charts versus the last three years how much traction we're getting on patient portal now which is I think great for everybody.

Richard Yonis: Is the patient portal designed so patients can actually fill out their histories and information or just more as a communication tool for appointments and reminders?

Scott Decker: All the above because we have it so integrated into the product which it gives the ability that you can actually take the templates that you build for NextGen EHR and build templates for your patients. So you can do any kind of data gathering you want and have it go directly into the product itself and into the record. We're doing online scheduling now and I think we're one of the first vendors to do that, once again. So you could actually get on the books and do your appointment right online.

Richard Yonis: So typically, during an implementation process, one of the big hurdles of course is moving the practice from paper to electronic. So if a practice uses the portal the patients can actually fill out the review of systems, past medical history, social history, allergies, meds, the whole nine years to take that burden off of the staff?

Scott Decker: Absolutely but it's more then mentality right? Will they actually do it than is the technology there.

Richard Yonis: Can the practice customize it so that if you've got an orthopedists separate from a cardiologist - they usually gather different informations in terms of the histories - can they customize that or is that something that you do for the client?

Scott Decker: Both. So once again we have our whole template building tool that we use on the EHR side it's the exact same product that's being used for the patient portals. So you can customize any template you want, send them straight out to the patient, patient fills it out, it gets imported right back into the EHR.

Dr. Eric Fishman: As you said, the customization has always been a strong point of Nextgen.

Scott Decker: Yes, absolutely.

Dr. Eric Fishman: What do you envision in the next timeframe of 18 months both for NextGen and the industry as a whole?

Scott Decker: Well, I think we have a lot of blocking and tackling because we still have 25 percent penetration of electronic health record and I have some of our largest clients coming to us now going well, we have 1,000 physicians to bring up in the next 12 or 18 months; we thought we were on track, we're not on track, what can you do to help us? And I think the industry as a whole, as this Meaningful Use is coming down the pipe, I think that's the name of the game.

Dr. Eric Fishman: So Dr. Blumenthal projects a shortage of 50,000 health IT workers. How are you addressing that issue?

Scott Decker: Two things. One, we feel pretty good right now for the volume that we can keep up to it and it'll probably pick up and we'll probably start to feel some of the pain but I wouldn't say that we feel that kind of skill gap. The other thing we rely on a lot is just our partnership networking. You know we have 15 years of building up a pretty nice network of partners.

Dr. Eric Fishman: You could very well resell a network.

Scott Decker: Right, resell our network and distributors and trainers that we can tap into both large and small, everything from the small companies up to the Perot type organizations. So that's not the part we're panicking over at this point.

Dr. Eric Fishman: Scott, anything else you'd like add?

Scott Decker: No. I think everything's going great at this point so I think we all have a busy couple of years ahead of us.

Dr. Eric Fishman: Absolutely. Scott, thank you very much for your time.

Richard Yonis: Thank you.

Scott Decker: Thanks.

Dr. Eric Fishman: This is Dr. Eric Fishman for EHRtv with Scott Decker at MGMA in New Orleans 2010. Thank you very much.

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