We just completed a five year study of 1,300 addiction treatment facilities using Kipu through 400,000 episodes of care. The study revealed that Kipu EMR clients grow 36% in the first 12 months after installing Kipu and an astounding 69% within 24 months of implementation. That’s pretty amazing — so amazing, in fact, that our accounting department audited and certified the numbers. It’s totally expected and there’s a very good reason why our clients do so well after implementing our technology.
It’s no great secret that healthcare costs have been skyrocketing for decades. They’ve jumped from $27 billion and 3.1% of GDP in 1960 to $3.35 trillion and 18.1% of GDP in 2016. It’s projected that total will rise to 20% of GDP by 2020. It’s out of control, and unsustainable. We know that increased use of technology is the lever for lowering costs and increasing quality, but the execution doesn’t always work because it requires The Right Technology™! A great example of this is the failed political experiment called “Meaningful Use” that was introduced by the Obama Administration in 2009.
Here’s what happened:
The “Meaningful Use” Experiment.
In 2008, only 9% of hospitals in America used EMR (Electronic Medical Records) Software. So in 2009, as part of the American Recovery and Reinvestment Act (ARRA) the government earmarked $35 billion (and actually spent $27 billion) to incentivize physicians and hospitals to implement EMR’s and demonstrate “Meaningful Use” of that technology starting in 2011. At the time, that made all the sense in the world, since a 2005 RAND Corporation Study predicted that EMRs would save the country $81 billion per year in health care. When one considers that The U.S. Government foots the bill for half of all health care spending (primarily via Medicaid, Medicare, and The VA), the EMR incentivization program was a no-brainer, projected to save many times it’s cost in the first year alone. The adoption incentives worked, and by 2015, 96% of all hospitals had implemented an EMR system. But the anticipated savings never materialized.
What went wrong?
The problem stemmed from the fact that the Meaningful Use incentives created a land grab with a limited time duration. The reimbursements ranged from $44,000 per physician and up to $2.2m per hospital. It phased down, and ran out after a few years. So hundreds of old and lots of new EMR vendors flooded the marketplace with mostly “One Size Fits All” EMR’s. The real problem is that Ophthalmologists and Otolaryngologists, Podiatrists and Psychologists all have varying needs in an EMR, just like different departments in large hospitals have different needs — the clinic is different from cardiology.
One size does not fit all.
EMR’s are not a “One Size Fits All” business but if you want to go from 9% to 96% EMR penetration in a few years, you’re just not going to get much specialization.You know what happened next…physicians and hospitals implemented new EMRs, sometimes kicking and screaming along the way, because those systems weren’t very easy or intuitive. Of the $81 billion per year expected in savings, much was attributed to “interoperability”, the ability of disparate EMR’s being able to “talk to each other.” That never materialized either. This problem is best summarized by a Brookings Institute report stating that many EMR suppliers effectively operate as “protective silos, holding patient information for ransom”.
The whole thing starts to unravel.
As a result of the rush to install, mismatch of EMR’s with users, and failure to achieve interoperability, the healthcare community is not getting the highest and best use of its human capital. The ARRA and it’s $35b of funding was well intentioned, but it created a Gold Rush for EMR companies without enough consideration for installing The Right Technology™! A study widely publicized by Dr. Kevin Pho, MD highlighted the failure of the broad based EMRs stating that “43% of an emergency physician’s time is spent typing into a computer with only 28% spent face-to-face with a patient and, in a typical 10 hour shift, that physician clicks a mouse over 4,000 times.” The old saying about the pendulum swinging too far is especially apropos here. Doctors are over technologized and less efficient with The Wrong Technology, complaining that it often takes five minutes to renew a prescription; something that used to take five seconds. I remember reading a press quote from Former Acting CMS Administrator, Andy Slavitt last year regarding the curtailing or canceling Meaningful Use incentives, in favor of a whole new payment system tied to quality of health, and risk based outcomes. The press quote said “We have to get the hearts and minds of physicians back. I think we’ve lost them.” ARRA is out and MACRA (the new payment incentive program) is in…but that’s a whole other subject.
Back to Kipu.
We’re not a “one size fits all” EMR. We were built in Addiction Treatment, for Addiction Treatment in something called “Agile Development“.
Here’s what “Agile Development” means:
When we started in 2011, we got a couple desks in a Detox Facility and built Kipu alongside the users. We built it the way they work, using their flows, and their procedures. We invented new technology and new ways of doing things along the way, with visual queues, TJC, CARF, DHCS and DCF requirements, and intuitive and easy, but powerful software written in the cloud, in modern, fast, versatile programming languages. Then after a year in a detox facility, we went to a TJC accredited residential treatment facility where we again, built more into Kipu, alongside a clinical staff that averaged 67 years of age. That’s partly why Kipu is so easy to use and intuitive; we needed to win the hearts of a clinical staff that was not, and did not want to be computer savvy. And the story continues, our third client had all levels of care — both in and out of network, where we honed more of the “magic” Kipu is known for, like urgent alerts. Today, we not only follow our roots of “Agile Development” but also deploy and implement in the same Agile Methodology, working with your staff every step of the way so that the final customized implementation works the way you work, not the way some programmer somewhere imagined you’d work. We’re also the only broad available software in addiction treatment that is highly specialized for Addiction Treatment. You just can’t expect practice management systems, or behavioral health systems to work well in the highly specialized world of Addiction Treatment — because they don’t. That’s what went wrong with meaningful use, after all…
And finally, because we’re so intuitive and easy to use, staff turnover is reduced because staff is just plain happier. And as you grow, you’ll find that training new staff on Kipu takes a few hours, not days. All that efficiency translates into better care, and more time your staff can spend on treatment, instead of fighting with a computer or paperwork, and that helps you grow!
It’s cause and effect, not coincidence.
I was talking to an old friend the other day who is a therapist at a large, multi-facility treatment center who uses one of those “Behavioral Health” systems who “faked their way into addiction treatment.” She said she spends all day re-typing things over and over in their clunky, “legacy” system — which leads to decreased job satisfaction, reduced efficiency and increased turnover. She mentioned that she, like many other staff cannot wait to move to a facility that uses Kipu. Remember: lower staff turnover = better staff = better outcomes.
More than just an EMR, The Right EMR. You end up with a system that works — it delivers the efficiencies that you expect. From reducing admission time by 67%, to reduction of paperwork for Group Sessions, through our Golden Thread, that helps document “Evidence Based Treatment,” which Accreditation Agencies and Insurance Payors are increasingly requiring for payment. Even our UR System and VOBGetterSM software make you more efficient and help you collect more from invoicing — and that helps you grow too!
Leading the fight against addiction.
At Kipu Health we are “all in” the fight against addiction. We built Kipu EMR to provide a solution, not just a service, and we keep on improving upon it all the time. That’s why we bought PingMD; to give Kipu EMR Telehealth and Secure Messaging, and InRecovery Magazine to help communicate with addicts and their families in order to reduce the shame and stigma associated with addiction and encourage more of the 27 million addicts and abusers to get help. And why we rolled out Lab Interface 2.0. All that helps you grow. It’s all part of our commitment. We continue to innovate to stay one step ahead, not just because it’s good business, but because that’s what the fight against addiction requires. Together, working smarter, we can have the same kind of transformational impact general medicine is having to stem other chronic diseases.