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Navigating Healthcare in 2021: How Ambulatory Care Providers Can Utilize Innovative Tech to Improve Patient Outcomes
Episode

Michael Blackman, Chief Medical Officer at Greenway Health

Navigating Healthcare in 2021: How Ambulatory Care Providers Can Utilize Innovative Tech to Improve Patient Outcomes

In this episode, we are privileged to hear from Dr. Michael Blackman, Chief Medical Officer at Greenway Health. Dr. Blackman discusses how his company sought to find new ways to add value to what they provide to clients. He talks about several projects that ensure that clients have what they need like telehealth, collaborating with EHR vendors and stakeholders to keep abreast of fast-moving changes especially in regards to COVID-19. He also talks about transitioning from fee-for-service to value-based care, operationalizing it, and leveraging data to take better care of patients. Dr. Blackman also shares a heartbreaking story that helped him realize what it is truly important, and he’s now driving for improving EHR’s, getting them right to support both clinical workflow and billing. There are many amazing insights in this interview so make sure to tune in!

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Navigating Healthcare in 2021: How Ambulatory Care Providers Can Utilize Innovative Tech to Improve Patient Outcomes

About Dr. Michael Blackman

Dr. Michael Blackman is the Chief Medical Officer at Greenway Health. He brings an extensive background in health I.T. product management, along with his knowledge of outpatient and inpatient care. He believes health care is a team sport that requires the talents of all contributors working together to succeed. Prior to joining Greenway, he was Medical Director for Population Health of Allscripts. Before that, he served as the Chief Medical Officer for McKesson Enterprise Information Systems Division. He was an early leader in the development of electronic prescribing for controlled substances. Dr. Blackman earned his bachelor’s in Political Science from Brown University, where he also earned his Doctor of Medicine degree. He completed his residency in internal medicine and pediatrics from the University of Miami Jackson Memorial Hospital and also holds his MBA from the University of Michigan.

Navigating Healthcare in 2021: How Ambulatory Care Providers Can Utilize Innovative Tech to Improve Patient Outcomes with Michael Blackman, Chief Medical Officer at Greenway Health: Audio automatically transcribed by Sonix

Navigating Healthcare in 2021: How Ambulatory Care Providers Can Utilize Innovative Tech to Improve Patient Outcomes with Michael Blackman, Chief Medical Officer at Greenway Health: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Saul Marquez:
Hey, everyone! Welcome back to the Outcomes Rocket, Saul Marquez here and today I have the outstanding Dr. Michael Blackman joining us. He’s the Chief Medical Officer at Greenway Health. A primary care physician at heart, Dr. Blackman brings an extensive background in health I.T. product management, along with his knowledge of outpatient and inpatient care. He believes health care is a team sport that requires the talents of all contributors working together to succeed. Prior to joining Greenway, he was Medical Director for Population Health of Allscripts. Before that, he served as the Chief Medical Officer for McKesson Enterprise Information Systems Division. He was an early leader in the development of electronic prescribing for controlled substances. Dr. Blackman earned his bachelor’s in Political Science from Brown University, where he also earned his Doctor of Medicine degree. He completed his residency in internal medicine and pediatrics from the University of Miami Jackson Memorial Hospital and also holds his MBA from the University of Michigan. So, I mean, just an incredible individual with experience in both the provider space as well as the health, I.T., and EMR space. I’m privileged to have him here with us. Michael, thank you so much for joining us.

Dr. Michael Blackman:
Thanks, Saul. It’s my pleasure to be here today.

Saul Marquez:
Absolutely. So we’re going to cover a lot of ground here. You know, the EHR letters could be a pain point, but also the bottom line is we need them to operate in health care. And so before we dive into Greenway Health and the work that you guys are doing, talk to us a little bit about you and what inspired your work and journey in health care.

Dr. Michael Blackman:
Well, sure, I love to talk about that for a minute, but you mentioned, you know, EHR and those three letters, you know, electronic health records. Electronic health records, I think, unfortunately, are the things that doctors often like to hate. But I think we can work to make them better, really make people see value in using them, and really improving patient care. But as I think about what inspires my work in health care prior to going into medicine, I used to work in information systems consulting and I was working at the time. And it’s part of what drove me sort of, in some ways, to medicine. I was working on a project for a mail-order pharmaceutical firm. And I found I was just far more interested in what the drugs did and how they affected people than what I was personally working on. And additionally, you know, then as a full-time physician and working with an early EHR, I frankly was one of those people who would look and say, you know, did anybody clinical look at this before it went out the door? Because some of this just doesn’t make a lot of sense. And that really, in a lot of ways drove me to where I am today.

Saul Marquez:
That’s fascinating. That is fascinating. Dr. Blackman. So you actually started in information services and went into medicine.

Dr. Michael Blackman:
I did. Yeah, it was. It was a little bit of the reverse.

Saul Marquez:
Yeah, right? Because usually the other way, you know, a physician becomes an informatic assist and kind of goes that way, but you actually did it the other way around. So that’s really interesting. Yeah.

Dr. Michael Blackman:
And even though I’m, you know, no longer seeing patients full time, you know, this really does still enable me to what I sometimes referred to as practice medicine at the macro level and really have an impact on health care across the board, and how do we improve providers lives, which frankly then improves patients lives totally.

Saul Marquez:
And had to your point, the beginning of our chat had the physician and caregiver workflow been considered a little bit more I think EHRs would mean something completely different today and so awesome that you’re at the helm there and the CMO role. So let’s hone into it. Let’s hone into Greenway Health and how are you guys adding value to the health care ecosystem today?

Dr. Michael Blackman:
Saul that’s really a great question. I’m really proud of the work we’re doing here at Greenway, especially some work we’ve done recently, frankly, in part driven by, you know, unfortunately, the COVID 19 pandemic, and throughout we’ve really sought to find new ways to add value to what we provide your clients. And so a couple pieces there and frankly, the beginning of the pandemic, you know, internally at Greenway, we established a cross-functional task force really to say, where can we help people? How can we make this better? And there were two products that really came out of that. One is our Greenway telehealth offering and the other is Greenway GRS Express, which stands for Greenway Revenue Services, as well as, in addition to that, a partnership with Amazon Web Services, which I’m happy to talk about in a little bit. But frankly, right now, obviously, COVID continues to be a hot topic, and we’ve been focusing to ensure that our clients have what they need to appropriately, you know, obviously responsible for giving the vaccines, but they have to be documented appropriately with the appropriate codes, and that information needs to be communicated to the state registries. And you know, it’d be nice to say that every single state registry was the same. They’re not. So we have to make sure that we’re covering them, you know, across the board. And it’s part of that. We’ve worked with other EHR vendors and partners and participated in discussions, you know, with the CDC, HHS, and others to really keep abreast of those fast-moving changes. And we try to bring patients or clients rather up to date on where we are with that and convey that information as best we can.

Saul Marquez:
Yeah. And I appreciate that and the environment is quickly changing. And you know, you mentioned COVID, and there’s a lot of things that came about with, you know, regulation around what can physicians and providers do with telehealth? How do you build it? Covid testing? What’s billable and what are the reimbursements? So, so many things to keep track of. And on top of that, you know, taking care of patients that are in a new environment with COVID among us. So there’s just way too much for a one-person practice or even large IDN to handle. How do you guys make things different or better for the folks using your systems?

Dr. Michael Blackman:
Well, in some ways, especially around some of these fast-changing things around COVID, making sure that we get them the information they need and the instructions to make appropriate updates in the system so things that they can do without necessarily waiting for us, which makes it much faster to deliver changes and let them make adjustments. And that’s especially true for clients that you take care of their own upgrades, and that sometimes takes some time. So we really decrease the time lag there to get stuff done, making sure that we provide all of the necessary code sets everything else. And then equally, you know, you talked about telehealth, you know, being honest with them about the billing challenges we telehealth, letting them know about those new regulations, how those are changing, what they need to be able to do with that. And you know, that’s incredibly critical. I mean, health care is absolutely indeed about taking care of people, but there has to be money to support that. I’m blanking on her name right at the moment, but there’s a former nun who ran a health care system who used to say no margin, no mission, and I really wish I remembered her name so I could attribute the quote appropriately. And that’s very true. I think back to when I was first in full-time practice and I was looking through some codes that want an insurer that will remain nameless, and I noticed there were some telehealth codes and I was like, wow, we could do that. And they were actually telephone codes back in those days and called the insurance. Can we actually use these? They said, No, they just exist, but we don’t actually pay on them. But the fact of the matter is, especially as we think about telehealth and this is work we’ve done to really help our clients is to make sure we can get telehealth truly integrated into the workflow so it can work both when you’re doing just telehealth or mixing between patients in person and patients via telehealth. And there are lots of things, lots of patients where telehealth is perfectly appropriate and quite efficient. And I think we’re going to be seeing a lot of telehealth even after we move past the pandemic.

Saul Marquez:
I agree. I agree, Michael. And you know, I actually pulled it up. By the way, I love that quote. No margin, no mission. It’s one that I’ve actually like subscribe to for a very long time. I never actually thought about where it came from, but when you mentioned that I looked it up. It’s Sister Irene Krauss.

Dr. Michael Blackman:
Thank you. I appreciate that.

Saul Marquez:
Yeah, no worries. But it’s so true. You know, it is so true. And you know, at the core of everything that we do is the money. You know, the money trail is the health care story. And I think that those of you tuning in and obviously everybody here included, we’re not naive in that reality. So being able to do as Dr. Blackmon said, is, you know, try to connect the dots and tie those services to the correct reimbursements. It’s not all the way there yet. We’ve come through a drastic acceleration with COVID, but a lot of room for growth there and making it clearer. But hey, why not partner with somebody that could help take out some of that gray area? And so as you reflect on the work that you’ve done as a provider and now with Greenway, what would you say is something that you guys are doing today that improves outcomes for people or makes business better for them?

Dr. Michael Blackman:
Well, one thing we’re doing is really frankly trying to help that continued transition from fee for service to value-based care and whatever flavor value-based care one thinks we’re going to have as we move forward, I do think that the direction to value based care in a way for fee-for-service is absolutely clear. So one of the things we’ve done there is partnered with Amazon Web Services on a platform called Greenway Insights, which we’re starting, which is our new platform for regulatory reporting. That’s what we’re starting it with. And it’s going to expand to being a reporting platform across the board, so it really becomes a function of how do you leverage your data? How do you learn from your data to take better care of patients? You know, you have lots of stuff where you know you have the patient in front of you, obviously critically important. But what about the patients who aren’t coming in? How do you identify them, reach out to them appropriately? And that’s really important. As part of that? But you know, as we think about making the business better, you know, telehealth is a big piece of that. You know, the tight integration. And I think back since telehealth was launched sometime in the middle of the summer of 2020, you know, we’ve implemented over 50 practices, and the clients have noted that it’s really made a difference for them. It’s helped their workflow. It’s enabling them to feel like they’re greeting patients, doing their usual check-in the nuts and bolts of checking a patient in, you know, verifying their demographics, verifying their insurance. You know, you mentioned the money. Yes, money is important. So can you collect your co-pay, address any open balance, assuming that’s obviously appropriate and the feedback has been frankly great. A couple of you know, client quotes, one person said you know, Greenway Telehealth has been like having the patient in the office. And in addition, you know, we’re there behind them, you know, in the support team is helpful. And a comment that I very rarely hear around EHRs one person and I’m not adding extra words here. The quote is the writer’s love, love, love it.

Saul Marquez:
Wow, that’s awesome. Well, if you compare it to what’s out there and you know you guys are easy to use solution that takes friction away rather than adds it in, I think that that’s something many, many would love. So, you know, it’s difficult to just, you know, I guess, be specific, I guess, about what this value-based care shift means for people. And, you know, you called it the flavor or whatever flavor you want of it. Do you find that there is a trend toward maybe like a particular vehicle that’s kind of taken center stage or not yet?

Dr. Michael Blackman:
Not yet. You know, if we think back to where a lot of some of this started, you know, with some of the initial reporting programs, they weren’t, you know, sometimes got referred to as, you know, pay for performance. They weren’t so much pay for performance as they were being paid for reporting. As long as your report it, you got the extra money in those days and it didn’t matter whether the results you reported were good, bad, or indifferent. But certainly, as things have changed over time, payments getting more tied to what are the outcomes you’re able to provide? Are you getting done the things that we know make a difference. And we could certainly go back and forth a little bit about whether those are the right measures or the wrong measures. But I think we’re seeing improvement over time as people sort of say, OK, this really does make a difference for patient outcomes versus this, frankly, is really just a process measure.

Saul Marquez:
Got it. Yeah, I was just curious, you know, I don’t know that I have seen or heard any particular direction and we’re still figuring it out.

Dr. Michael Blackman:
Yeah, we’ve tried a number of things over the years, you know, from fee for service to a lot of people tried capitation with some fee for service. We sort of shifted away from capitation in a lot of ways. And now we’re looking at value-based care, which at least in my view, puts the goal in the right place. It’s about how do we take care of patients? How do we improve overall outcomes? And then the question next question becomes, how do you do that equitably? How do you measure them? How do you ensure that people are getting the care they need or not and not being excluded from care? Because if the outcome is strictly, you know, did everybody have a good outcome, you know, following surgery? Or, you know, as a primary care doc thinking about treating patients with diabetes? Do all of my patients have hemoglobin A1C is under a certain number? Well, what you don’t want to do is discourage people from taking complicated patients just because they’re going to hurt their numbers, even if you do everything right?

Saul Marquez:
Totally. Yeah, that’s super interesting. I was having a discussion with a professor of value-based care in Michigan, and he was kind of chatting about different models around total cost of care and, you know, giving patients basically some legislation around making those chronic condition treatments pre deductible. and including them in some sort of like bundle payment to the practice. Have you seen any of that active yet or still early stages?

Dr. Michael Blackman:
Not so much around chronic conditions, but absolutely as we’ve seen as part of the Affordable Care Act around general preventative care.

Saul Marquez:
Ok.

Dr. Michael Blackman:
I think the question then becomes how you extend it, you know, is it beneficial to make sure you’re tetanus shot is up to date, your flu shot is up to date as we go forward, your COVID shot is up to date. The answer is absolutely those things make a difference and certainly in the case of, you know, chronic conditions, you know, there are certain things you want to make sure that all diabetics get to get that all patients with congestive heart failure get and certainly from an EHR point of view and workflow point of view, whether there will be term preventative care, which is, you know, generally age and or sex-based versus chronic condition care, which is obviously chronic condition-based. The way you accomplish that technically is pretty much the same. So we can really create nice workflow providers for providers that work in both situations.

Saul Marquez:
Fascinating. Very cool. Yeah, you know, it definitely not easy, but I feel like it’s around the corner and it’s great that you guys are thinking through ways to operationalize it and make it easier for people. What would you say is one of the biggest setbacks you’ve experienced Michael and a key learning that came out of that?

Dr. Michael Blackman:
Yeah. So I’m thinking about that. As a medical resident, I had one particular case that’s still, frankly occasionally gives me nightmares. I was working in the neonatal ICU and we had a pair of extremely, very low, technically very low birth weight twins that were unfortunately just given their size. They were born at twenty-two and five-seven weeks gestation. So if you think about normal gestation being 40 weeks, you can get a sense of how small these kids were. Yeah, and the chance of them having a good outcome was extremely small. And I do mean extremely small, and a lot of interventions were attempted to try to see what we could do. And approximately a week later, but both of them died. But I came out of the experience sort of thinking about, you know, what matters? You know, how do we really help patients help their families? You know, what’s the right thing to do? Because in a lot of ways, and this is not to make light of the situation or anything like that, but the week with those twins was extremely difficult for the staff, was extremely difficult for the kids, I am certain, and it was unbelievably difficult for their parents. And you know, who knows what the outcome would have been. You know, the outcome was, you know, you never know anything with 100 percent certainty. But it was a tough week. And so learning to think about what’s important.

Saul Marquez:
Yeah, you know, I mean, those types of situations are unfortunate and they happen, you know, they happen. But when you’re personally involved, it’ll make you think a lot and, you know, definitely make some decisions to help the overall situation that you’re in and try to learn from it so that it doesn’t happen again and you’re the route you took Michael is you made the jump back to business to help work on those workflows and ways to help people and clinicians. So now that you’re you’re doing the work here at Greenway with value-based care and telemedicine. What are you most excited about?

Dr. Michael Blackman:
Frankly, really most excited about what we can do as we, you know, looking at what’s the next frontier? How can we use health care technology to help people, to help providers, to improve patient care, and make EHR is something and the associated technologies the clinicians like to use. I mean, one of the reasons I think that people don’t like them is, you know, come back to the point we’ve sort of touched on a couple of times is the money because most EHRs and it doesn’t make them bad, just make it what it was, we’re designed to support billing and may support billing very well, but that doesn’t always align as well with the clinical workflow, I think. But if we get the clinical workflow, Right. really support people. We can still support billing correctly. And frankly, there were some changes this past January with the way billing codes work for professional fees that I think are going to help a lot really letting people focus more on what’s important, rather than simply documenting extra information simply to justify a billing code.

Saul Marquez:
Yeah, that’s interesting.

Dr. Michael Blackman:
You know, equally excited about hearing Greenway. We’re collaborating well, you know, across the organization to get things done. We have a clinical advisory team internally within Greenway that reports to me that we’re trying to embed as early in the development process as possible. The engineers obviously aren’t clinicians. I wouldn’t expect them to be clinicians, but so we can help them make better decisions, help the product team make better decisions. So as we go forward and the earlier we do that, the better off it is for our clients.

Saul Marquez:
Yeah, that’s fantastic, Dr. Blackman. And you know, it’s great to hear that you and your team are incorporating some of these changes and getting ahead of to provide a suite of tools for people to stay ahead of the game. This collaboration that you have with Amazon certainly sounds exciting. It’s about gathering the data and being able to be smart with it. And ultimately, those are the types of capabilities that we’re going to need to make value-based care a reality. So I certainly appreciate you sharing the innovation, really clinician-centered innovation that you and your team are up to. Why don’t you leave us with the closing thought something we should be thinking about here as we part? And then the best place for the listeners could get in touch with you and learn more about the work that you’re doing at Greenway.

Dr. Michael Blackman:
Sure, I think two things. So first, you know, the United States spends more per capita on health care than any other country, and many metrics show that we don’t have the best health care outcomes. And you can look at a variety of different metrics in that way, depending on what you want to pick. But we just don’t. So the question is why, you know, how can we use the tremendous amount of money we spend more effectively, how can we improve those outcomes? I mean, frankly, if we had the best outcomes in the world and we spent the most money, you could argue that’s not a bad trade-off. But part of my goal is really to ensure that we and the rest of the health I.T. community really continue to focus on providing innovative solutions that improve patient outcomes and by extension, improve patients’ lives. Because at the end of the day, at some point all of us are patients, whether that’s for a routine annual exam or if unfortunately, we become ill.

Saul Marquez:
I love it. Yeah, well said.

Dr. Michael Blackman:
And then finally, you know, listeners can get in touch with us at the Greenway website. That’s Greenway Healthcare on Twitter, at Greenway, or simply searching Greenway Health on LinkedIn or frankly, on the web.

Saul Marquez:
Thank you, Michael. Really appreciate that. And folks, take advantage of this opportunity. Connect with Michael and his team. They’re doing billing and telehealth in a very unique way. So certainly worth a visit. Greenway Healthcare. We’ll provide all the links that Dr. Blackman provided here on this podcast inside of the Show notes, so make sure you check those out. Click on it. Really easy. And man, just an incredible review here with you. Michael, thank you so much for the opportunity to collect these insights from you.

Dr. Michael Blackman:
Our pleasure. We’re really working to make health care better, you know, providers, for payers, for everyone, as we make as we move forward. Because as you mentioned upfront, health care is a team effort and we all have to do this together.

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Things You’ll Learn

  • Had the physician and caregiver workflow been considered a little bit more EHRs would mean something completely different today. 
  • Most EHR’s are designed to support billing but don’t always align with the clinical workflow. If we get the workflow to really support people, we can still support billing correctly. 
  • Health IT communities should continue providing innovative solutions that improve patient outcomes and by extension, improve patients’ lives.
  • Health care is a team effort and we all have to do this together.

 

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