SM: What are your future plans for the company? Where is Office Ally headed?
BO: We continue to find ways to reduce waste in healthcare. There is a concept called the accountable care organization. That is how doctors, ITAs, and health plans get paid. A health maintenance organization (HMO) works by having a group of patients, and the HMO is willing to pay a certain amount of money for that number of patients to doctors for patient care. In a standard HMO, care is restricted to the patient.
In an accountable care organizations there is a group of patients whose previous years medical costs are known. If the care providers are able to reduce the amount of costs associated with providing that group of patients with care, they can share in the savings. This is done through WellCare. What they are doing now is sending a letter to patients to tell them when to show for preventative care or to remind them to fill their prescriptions. That is inefficient.
With my system, when a doctor checks eligibility on a patient, we will show them alerts at that time. Doctors check the eligibility of a patient when that patient comes to see the doctor. Office Ally will tell the doctor before the patient arrives that he or she has outstanding or upcoming WellCare treatments. Active Health, another company, claims that through WellCare messaging that they can save the healthcare system over $8 per member, per month. That is a massive savings.
SM: So you are essentially building a health awareness management system?
BO: Yes. We work with various independent physician associations. They send us all their data, including lab and drug data, for the past two years on a patient. Patients can switch doctors every month if they want. That makes it hard for doctors to know what care patients have received. Our system knows and provides continual healthcare. We follow the patient, not the doctor. We tell the new doctor what care the patient needs. That provides massive savings to the healthcare system.
When the patient checks in at the front desk, the scheduler is advised of potential appointments the patient may need. When the doctor opens the EHR chart on the patient, we also tell the doctor about the recommended care the patient needs scheduled. We have a patient portal which is filled with information provided by the insurance companies. We essentially create a medical record for a patient in the patient portal which is free. When a health alert comes up, we send an e-mail directly to the patient as well. In all, the doctor, the patient, and the scheduler are all advised of the treatments and appointments a patient needs.
SM: Based on the work you have done for the past ten years you have a patient record for every patient you reach?
BO: Correct, we have never purged anything.
SM: So you have accumulated a lot of data about patients and you are now able to create a WellCare alert system?
BO: Yes. In addition to that, many of the insurance companies that are our clients have very high electronic record operation abilities. If a doctor submitting paper claims is a dermatologist who has picked up cancer on a patient and has submitted the info via paper, organizations like St. Joseph’s will send us a download of all the claim data so that we can capture the paper claims submitted.