Redox Podcast_US Heart and Vascular #50: Audio automatically transcribed by Sonix

Redox Podcast_US Heart and Vascular #50: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Cheryl Rodenfels:
Doctors are great at treating patients, and a lot of times, they’re not great business people. And so a lot of these organizations are finding that if you’ve got somebody who’s good at business, let’s get together with them so we can get back to treating patients, and that’s what a lot of consolidated organizations are doing, whether it’s us or even hospitals.

Niko Skievaski:
Hello, hello! Today we have something a little bit different for you. This is actually a recording from a recent internal all-hands team meeting at Redox. We often invite customers to these so we can learn more about how they’re using Redox, collect feedback, and better understand the impact that they’re making in the industry. Joining us in this meeting was Cheryl Rothenfels, who is the chief information officer of US Heart and Vascular, which runs cardiovascular clinics nationwide. We chose to share this conversation with you because of Cheryl’s unique perspective at the forefront of many emerging trends in our industry like practice consolidation, urgent care, the movement to cash-paid business models, and all of the technology implications that surround us. So let’s get into it.

Niko Skievaski:
To start off with, I’d love to just share a little bit of your background. If you can give us like the three-minute life history story, which I know is fast, but we can often glean a lot of context from that and just understanding where you come from before we dive into some of the more details around US Heart and Vascular.

Cheryl Rodenfels:
Sure, the speed dating version is, actually, I have a BA in psychology from the College of William and Mary and wasn’t quite sure what I wanted to do when I grow up. So what I did is, I got a job at a company called Cable and Wireless, and with that, I found that I loved the technology so much, I went back to community college and took electronics classes. So at the time, in the late 80s the, everything was still analog, and in order not to hurt yourself, you had to learn electronics, so I did that. But I liked it so much, I moved on from there and pretty much held every position in IT except for being a DBA. So I have a great respect for them, I’ve led DBAs and managed it and I work a lot in data, but it really that, that was the path I took. I figured I’d be a CIO at some point, so to me it was more important that I knew what other people were going through so I could help remove obstacles than it was for me to actually be hands-on forever in one particular discipline.

Niko Skievaski:
Awesome. And can you, just to start super basic, can you tell us what US Heart and Vascular does?

Cheryl Rodenfels:
Sure, we are cardiology practices. We’re backed by a private equity firm right now, and what we’re doing is we’re acquiring practices that were really mom-and-pop practices, and what we’re trying to do is modernize care. And I’ll give you some examples. Right now we are eight organizations in 75 locations, and my job is to take this crazy bunch of practices and get them effective so that all the systems interface, so that one, we can produce financials, and two, we can actually look at performance, are the doctors performing, are the clinics performing? And the other thing is we’re introducing innovative services. Cardiology is hot, Cardiology is necessary as the boomers age, and as everybody runs into something, you will most likely in your life need a cardiologist. And I think, like other doctors, the biggest problem we have is access. You go to get a specialist, and it’s, hey, that’ll be 30, 60, 90 days before you can see someone. So what we’re trying to do is get better access. And then the other two things we do, so one, we have the cardiology doctors, the second thing is we have onsite-based lab. Echocardiograms, PET scans, CT scans, stress tests, all these kinds of things, these were previously done in hospitals and in standalone clinics and the type of locations that we have, you can actually do them cheaper than you do in a hospital because you’re not paying for all that overhead. You got a strip mall location rather than this brick-and-mortar hospital. And then the third thing is ambulatory surgery centers. We can do everything except for open heart surgery in an ambulatory surgery center, so pacemakers, vein ablations, some people have those portable defibrillators. And then as we look towards innovative things, we have cosmetic vein centers that we’re opening and expanding because maybe you’ve crossed your legs for your entire life and you had those little spider veins, and you just don’t like how they look, that’s a cash business. Insurance doesn’t cover that. And then the second thing is urgent care. During COVID, you had stories, and you may have experienced yourself, you couldn’t get into the emergency room for anything, so people stayed home with, hey, I’ve got cardiology problems. What we’re finding is 90 to 95% of patients can stay out of the hospital unless they absolutely need open heart surgery. You can do stents, you can do other things, and there’s actually an organization that is, for the city of Albany is directing all of their traffic to these two urgent care locations. So we’re trying to stabilize and figure out what can we do to get efficient, and then we’re trying to innovate by offering these other services that treat patients where they want to be treated instead of in hospitals.

Niko Skievaski:
Nice. I’m noticing kind of two trends, as you described, that I’d love you to speak on more kind of from a higher industry level. The first one, we hear a lot about consolidation in the healthcare space. On the IT side, we’ve seen a lot of our customers consolidate and become bigger customers. On your side, we’re seeing practices merge, and that obviously affects the IT systems. But yeah, why does it make sense right now, or what’s going on in the industry that’s driving consolidation and makes sense for businesses to be merging?

Cheryl Rodenfels:
One, you have the mom-and-pop shop, people that have been running doing it the best they can, and they just can’t keep up with the technology, they can’t keep up with all the regulations, they can’t keep up with the reporting, they can’t keep up with all the macro MIPS and all the things that all the programs that used to be meaningful use and interoperability now for physicians to get paid. I think the second thing we’re finding, especially in any of these practices, and you find organizations in any discipline, Orthopedics, my husband just told me about a group that his, one of his coworkers is going through dermatology. Doctors are great at treating patients, and a lot of times, they’re not great business people. And so a lot of these organizations are finding that if you’ve got somebody who’s good at business, let’s get together with them so we can get back to treating patients, and that’s what a lot of consolidated organizations are doing, whether it’s us or even hospitals, you see somebody who’s got a little bit deeper pockets. Maybe you’re in an underserved area, and you’re, always have the worst, because you don’t have the skills, you don’t have the same kind of budgets. Well, a bigger organization can move a little more money to you to get you up to what their standards are, and then it helps you perform better. So that’s what we’re seeing with the consolidation, is we have some shared services that help them get up to speed, and really, they can focus on the patient, and then they can focus on creating value in their organizations.

Niko Skievaski:
Love it. Can you dive a little bit deeper on your strategy around consolidation? It sounds like you’re merging kind of horizontally, similar practices, but then you also talked a little bit about labs and back office consolidation. Like, yeah, what does that generally look like and how are you helping these practices achieve more value in their health?

Cheryl Rodenfels:
So a couple of things, because say every time I get to a practice, I open the junk drawer and I have a rubber band, and I have a paperclip, and I have a leaky pen and a hairy skittle, and every single organization has some version of the junk drawer, and it’s the same way with everything else they have. It’s not just, this one doesn’t have charge capture, so they go into a hospital, and they are doing things on paper. We’ve actually got doctors that are, you come in to get your pacemaker checked, and he’s putting it in a spreadsheet. There are a lot of things that aren’t happening and aren’t best practices. So what we can find is, let’s say, let’s go through charge capture revenue cycle, right? Let’s go get the best practices out of our organization and make that our standard and help bring everybody else so that, guess what? We can collect payments better, faster, cheaper, so we have less outstanding in our books. One of our practices right now has 16,000 unprocessed claims. You know how much money sitting out with that? A lot of money, yes. So let’s bring in the people that can help with that, let’s bring in some expertise. And the same thing, if I were to show you my strategy, it’s, I’m working on speeds and feeds. I’m working on IP addressing schemes, I’m working on, I’m not going to, Active Directory, I’m going to a cloud directory structure, interface engine because that’s, there’s a whole lot of reasons for that, manage backups, these kinds of things. If I can normalize the operations, then I can spend time on creating value and helping them get more out of consolidating systems and consolidating processes, and really making it easy for them to provide that patient care. But right now they’re so distracted because technology fails or because they have to do things so manually. Oh my gosh, they are so ripe for automation and optimization.

Niko Skievaski:
So you mentioned it a little bit, your interface engine, and all the reasons why that makes sense. It’s a wonderful parlay into talking about Redox and where that fits into your game plan. Just from what you’ve said so far, I imagine there’s a lot of integration of your many EHR vendors that I’m sure exist across the practices as well as external systems. But like, yeah, what are your hopes and dreams for our relationship?

Cheryl Rodenfels:
So a couple of things. One, right now, I have eight EHRs, eight separate. A couple of them are same, but they’re different versions, and they’re all hosted, and they were all set up by different people and so forth. I want that to be a non-issue right now. I want the practices, they have enough changes going on, so what I want to do is make the back-end more efficient, and they don’t have to worry about it. And really, a big part of that is Redox, because if I have one revenue cycle vendor that I can funnel all that, we can funnel all the transactions to, then we have really more people to throw at getting those claims work, right? They’re not changing anything on the front-end process, but on the back-end we’re able to get them industry-standard people or industry-trained people who can actually crank out that work and reduce that deficit. I think the other thing is my whole, and I have this beautiful slide of a pyramid because they make you have pyramids, is I have to have interfaced and integrated systems and services so that I can facilitate month-end close, I can facilitate consolidated revenue report. I can facilitate any of the research that we do, I can facilitate getting them the information that they need to run the business. And for me, I actually put you guys on my first slide like day two, and if you look back, I probably called Eric on day two or send an email to y’all and said, I need somebody. Because for me, the whole environment starts with the data and if I can’t get to the data and I can’t do all of this behind the scenes, then I’m not very good at my job. And so the goal is I need all those integrated systems, and I think that EHR is secondary. Leave them, do what they need to do, they’re having enough change, so let me go behind the scenes and make sure we’re doing backups. And you guys have the expertise, and I have a buy-versus-build strategy. I want the experts in whatever category they are experts in, and that’s why I called you. Part of the challenge is with those 8 EHRs, I have no staff. It’s not one person that is an employee of US Heart and Vascular that is an expert in eClinicalWorks or NextGen or Athena or name all of these smaller systems. If I had to go out and find somebody, I would have to find somebody in each of these disciplines, but you already have it. Except for this booger of a system called Gems that nobody’s heard of that you guys have to do a custom interface for. But really for me, you already have done that hard work. All I have to do is pay for it, right? And then on the other side, I have the connectivity. You are making it so that whatever services I have in the future that require, whether it’s ADT or any of the HL7 information, you’ve made it so that I can enter, I can work on getting the processes and the procedures and the information to the people that need it, and you provide getting the data to the people that we need to process it.

Niko Skievaski:
Nice. We have a lot of interest. We have our team asking questions here, and there’s a lot of interest around just the process you went through in choosing to work with Redox. So yeah, what did that vendor evaluation process look like?

Cheryl Rodenfels:
So I’ll be quite honest with you, I have been recommending your service as a consulting person before this for a couple of years. I was stuck with legacy products before, both of them begin with a C, and the biggest thing I had were people are not good at that discipline. And so I’ve got financial systems, and I’ve got lab systems, and I’ve got pharmacy and every odd whatever system that has to feed in. And when you get to the interface, the biggest problems you have are the interface pukes. I have been recommending y’all for a couple of years because I was stuck with those other guys. And every time you have a system outage or interruption, what do you do? You sit and watch the transactions catch up. You hate life when there’s an outage because you’re like, okay, you’re putting the pig through the python. Here you go, here’s lab coming through, here’s pharmacy coming through, here’s whatever coming through. And the challenge, I see that, what we have is if it’s the next-gen system in Tucson, they’re using the onboard interface for that, it’s terrible. I’ve got doctors who are taking PDFs from places that they’re not interfaced, and they’re typing the values back into the report poll, right? So what I did is I also, and thank you, Eric, he helped provide me with some of the data. If I had to buy this myself again from those other people that began with, here’s what it would take again, employees, it would take hardware, it would take expertise. And again, they have no people and no expertise in it. So it was pretty much a no-brainer. The other thing is, you’re really good at this. I know a lot of folks that use you, but you’re really good at it, and that is what I appreciate. And I’ve come up with a couple more interesting requests as I want to move into analytics. I don’t want to be a reporting organization, I want to be an analytics organization, that you have some interesting partnerships that I would like to pursue. I’m working on table stakes right now, just getting people so we can get the data where it needs to go. The next thing is now how can I bring value to the organization? And that’s what I’m looking for. So long story, but I’m sticking to it.

Niko Skievaski:
Nice, and it sounds like it might be a little premature to talk about some of the analytics partnerships you’re thinking of, or because I know that’s, like the cloud partners that we have is a really big interest of ours this year, and thinking about how customers are thinking about pulling their data together to do analytics is something I know that’s a big interest to folks. Can you shed a little more light on that?

Cheryl Rodenfels:
Sure, we know we have a placeholder with this product. It’s called DashboardMD, and I call it TrashboardMD because it’s just terrible, right? But it’s a placeholder, and you can quote me on it, it’s a placeholder, but I’m looking for one of the bigger platforms. So just for grins, DashboardMD is running, they’re running their data every night, and it’s 16 to 20 hours to run reports for two sites. I’m not kidding. So I’m on the phone with them every day. That’s, most of my job is take my shoe and try to beat them till they get it right. But anyway, so I’ve got them on the phone, and my boss is going, can you please talk to somebody else? So I pulled Gartner and whatever and hey, here, look Appian and Redox, … a little Gartner, digital health place, digital health platform. So I was very excited of looking at that to say, All right, you’re working with some big people. And really, when I talked to Eric the first time, or one of the first two times, he said, yeah, we also have interfaces to all the big players, whether it’s Azure, whether it’s Google, whether it’s whoever. So for me, I need to get the requirements of what we really want to do, but I’m excited because you have that experience going to that next level that I really need to be at.

Niko Skievaski:
Nice, one of the things that’s newer for us here at Redox is offering professional services along with our traditional product. Why did that make sense for you as you looked at working with us?

Cheryl Rodenfels:
So back to, I have no staff. The other thing is, in healthcare, we don’t always, we get people that are experts in their environment, we don’t get industry, right? So I get a lot of homegrown people inherited every time I go to an organization, and you’ve seen this, right? When I was at Methodist, that guy’s Methodist smart, but he wouldn’t know an enterprise organization if it came up and sang to him. So the thing is, you guys have opportunity, you work at a strategic level with customers, and then you also help with the operational things. And for me, you’re helping me strategically set this up, then you’re going to help me operationally run it. And I look at both of those because I don’t have an architect, and I don’t have an engineer, and I barely have analysts that we’ve inherited throughout. So that is what I like about it, is you have the experience, you’ve worked with real live other customers. I’m going to look like small potatoes compared to some of them, except for Gems, but matters to me because you can help me get what I need to get done better, faster, quicker than me having to bring somebody up to speed who might not.

Niko Skievaski:
Gotcha, that makes a ton of sense. I’m going to ask Sarah Bachen to come off mute. She’s dumped a few questions in here, and I want to let her just have the opportunity to ask the question that’s top of her mind.

Sarah Bachen:
Wow, you’ve asked a lot of that. And Cheryl and I have met, so nice to see you again. I would love to hear in the overall process of getting to know us if there was anything surprised you, delighted you, or displeased you.

Cheryl Rodenfels:
Kind of all, but not disappointed. I’m just the little engine that could because I think you can and want to find out how we can. I’m a what can we do person and I hear a lot of that. Sometimes you’re cautiously optimistic without saying, yeah, hey, we can do that, and I get it because I want to push the envelope. So to me, it’s, I want people as excited about work every day as I am. It’s like, hey, come on, let’s go figure this out, right? So I get a lot of that, but I also get the reality from the team that says, okay, slow it down a little bit. We can do this, or here’s what we can do with these caveats or whatever. So it’s bringing me back to reality and also realizing, okay, some of this stuff maybe we haven’t touched or, hey, this is a new partner, but most of it is a similar requirement that other people have, ours is just a little bit different flavor, so like that. And the second thing is you were able to move quickly, so delighted at that. I’ve been on the ground at this company since the 14th of November, and like I said, I think I called you the second day, and I continue to call out people that says, I want to get you on my team, and I want to get you lined up soon, because if I can get these sorts of services done, then I can actually move on to fixing applications or whatever that next thing is. But no, everybody has, super helpful, and everybody has been really interested in what we’re doing.

Niko Skievaski:
Nice, so if you think about what we’ve told you Redox does, what would be your biggest wish of things that we potentially don’t do now but you would love us to do?

Cheryl Rodenfels:
I don’t know what I don’t know when it comes to that next analytics platform. I don’t like somebody to say, okay, hey, I heard you’re looking at this, can we give you some good advice? And not from a pure technology, but here’s an advice or here’s what we’ve seen other customers do. I really like, I’m always looking for a mentor, it doesn’t matter in what subject. So for me, it’s here’s some guidance, we see your organization do this, have you ever considered this thing? And to me, may or may not have, but it would be good, just some executive mentoring or coaching to me that says, you’re running 90 miles an hour, if you did this, it would take three less things away from you.

Niko Skievaski:
Awesome, I love that. Yeah, it’s an interesting line that we walk because we do see so many different things, but we try to have a, or in the past we’ve tried to have kind of a neutral approach of just helping people do what they want rather than being more forceful around like, actually this works better than that. So I think that’s great feedback to us, to have an opinion sometimes.

Cheryl Rodenfels:
Well, it is because you see the pain that people go through, and you do want to fulfill their needs, but I think that’s part of consulting. I think the thing that I found about consulting is, the good news is I had influence but no authority, and the bad news was, I had influence, but no authority. Can’t make it happen, but if people are really listening and they’re really looking for growth and looking for innovation and better ways to do things, then they’ll listen to your advice and they’ll follow it.

Niko Skievaski:
For sure, so final question to wrap us up. I always like to ask executives in our industry this, but there’s a lot of changing right now, and over the past few years, in healthcare. If you were to look ahead, like what are you most excited about as far as how the industry is changing? And this could be pertinent to you specifically in your role or in your organization. It could also just be like, what’s going on generally in the space?

Cheryl Rodenfels:
I’m really excited more about these sorts of things that we’re doing where people get treated where they want to be treated or they receive care where they want to be treated. Just, tell you, I’m working with a group, HIMSS group that, I was a HIMSS reviewer and I’m mentoring them, and they’re doing remote patient care for the underserved communities. And one of the things that they did, these little community hospitals, not everybody lives in a big metropolitan area, but the thing is, people already discount those places. It’s a nice little 25-bed hospital or whatever, but the first thing they do is airlift you or ship you off to some other bigger center, when instead if they use some of this telehealth and they’ve got an expert who can look at you and listen to breath sounds and these kinds of things, you can be treated where you live. You don’t have to go to the big city for it, you can do that. I’m very excited that there’s people out there doing that. I’m very excited for things like our ambulatory surgery centers where you’re in a place that is it’s not as scary as a hospital. … Hospital usually is pretty overwhelming for a lot of people. So people getting care where they need it through this innovative technology that can really ease their minds, make it more comfortable for them, and at the same time, it costs a lot less. So, and again, back to that thing about access. You can see a cardiologist today rather than waiting 22 days and hoping for the best.

Niko Skievaski:
I love that. It’s honestly one of the reasons why I love working at Redox, because we get to see kind of some of the most innovative technologies around that area, as well as innovative business models like yours and trying to improve access, improve cost of care, and all of the like. So thank you very much for reminding us of why we do what we do and some of the impact that we have even a few steps removed. But yeah, thank you so much for coming and joining us today.

Cheryl Rodenfels:
Yeah, so welcome, and really appreciate everybody, and know that I do like to move fast and you’re moving fast with me, and thanks so much.

Niko Skievaski:
It’s our pleasure. We’re happy to move fast. We’ll race you.

Cheryl Rodenfels:
All right, take care.

Niko Skievaski:
Well, there you have it. That was Cheryl Rodenfels, CIO of US Heart and Vascular. I want to thank Cheryl again for coming to our meeting and giving us the okay to share this conversation with all of you on the podcast. If you’re interested in learning more about US Heart and Vascular, check out their website, it’s USHeartandVascular.com. And of course, you can always find Redox, this podcast, and loads of information about the interoperability landscape at RedoxEngine.com. This has been Niko Skievaski, and thank you for listening to our podcast.

Sonix is the world’s most advanced automated transcription, translation, and subtitling platform. Fast, accurate, and affordable.

Automatically convert your mp3 files to text (txt file), Microsoft Word (docx file), and SubRip Subtitle (srt file) in minutes.

Sonix has many features that you’d love including collaboration tools, automated translation, upload many different filetypes, powerful integrations and APIs, and easily transcribe your Zoom meetings. Try Sonix for free today.