I was pretty much on my own four years ago, when I first started my direct care practice. Fortunately, with the increasing popularity of this practice model, many tools have emerged that make the transition much easier. To successfully run a direct care practice, the practice needs to do the following
• Maintain good records
• Manage memberships and handle monthly subscription billing
• Communicate effectively and securely with patients
• Handle phone communication
• Have high quality of care
Below is a list of online resources for each of these areas. The danger of making a list is that I am largely influenced by what I use, which may not be the best tools for every user. To even things out, I'll mention my approach to these tools and list some of the tools used by my direct care colleagues. Here's my list:
Medical Record Software
One of my favorite things about direct care is that I chart for patient care, not billing. I don't have to bury important information in all the computerized nonsense put there to justify billing. It's quite liberating. So, in choosing a record, I look for three main things: reasonable cost, ease of input, and ease of finding important information. The systems that meet these criteria are pretty much all online charting systems, and each has its own pros and cons.
• Elation (https://www.elationhealth.com/ ) - The system I use.
• MD-HQ (http://www.md-hq.com/ ) - Focuses on direct care practices and has built in messaging/billing
• Practice Fusion (http://www.practicefusion.com ) - Free, not real robust, but did I mention that it's free?
• Atlas (http://www.atlas.md/) - Built by direct care physician. Also does membership management and has integrated communication tools.
Membership Management/Monthly Billing
Billing systems are the heart of the business, and the business model is at the heart of what makes direct care so much better. You want a system built for direct care that is easy to use and powerful.
• Hint Health (http://hint.com ) - I use this. It is easy to use, powerful, and it integrates well with the other tools.
• Atlas (http://atlas.md ) - As stated above, this system combines EMR and billing
Secure Communication Tools
If the billing system is the heart of direct care, communication is the soul. Access is the thing my patients are most hungry for, and there are several good tools for this:
• Spruce Health (http://sprucehealth.com ) - I use this one. Integrates well with the other tools I use and can do video visits, virtual care, and mass messaging.
• Hale Health (http://hale.co )
Patients are often trying to communicate via email or text messaging, but there are several reasons I discourage this (besides the obvious HIPAA risk). First, email messages get buried in the rest of my email (and so messages are missed), and second, it is difficult to put these messages and their replies into the medical record.
There are two main options in setting up a phone system:
• Not having a phone system at all, instead using Google Voice (or comparable system) and cell phones to manage patient communication.
• Use a VOIP system which allows a small practice to set up a traditional phone system for a relatively low cost. This is what we do, using RingCentral (http://ringcentral.com )
Improving Quality of Care
This last category is broad, and I'll just share three tools I use, but be aware this is a significantly truncated list.
• Twine Health (http://twinehealth.com ) - Allows patients to input health data and manage medication reminders.
• RubiconMD– (http://rubiconMD.com ) - Gives practices access to online consultations with physicians from nearly all specialties and get a "curbside" consult. This is amazingly powerful and lets me save time, money, and give much better care.
• Hint Community – (http://community.hint.com ) – Learn from those doing it in real life. This is a community built both to make it easier for new direct care physicians and to raise the ceiling for experience physicians.
There's a lot there, and there are many out there who are interested in helping docs interested in making the jump. The good news is that these tools can make that jump a lot less scary.