What Works: Cloud computing

In January, Creative Treatment Options (CTO) suffered a devastating building fire that completely engulfed its Arvada, Co., offices. While the physical structure and all of the equipment furniture within were lost, the substance abuse and mental health services provider did not lose its patient records. The company had been using a cloud-based storage platform so all of its patient records and other data resided on offsite servers. Such cloud servers can be access from anywhere, anytime by authorized personnel.

Leveraging the cloud, CTO was able to relocate within two days after the disaster and offer a full schedule of services a day later. Within 13 days, all services and facilities were fully operational, and, most importantly, the company didn’t lose any patient data.

According to Bryan Standley, director of operations and technology, CTO moved to a cloud-based records case management system in 2012.

“Before that we had a computer-assisted case management solution, but all of our records were on paper,” Standley says. “So we moved to a cloud-based application, and then began scanning records that required signatures and attaching them to electronic client records.”

The shift to cloud-based solutions was actually a secondary consideration, Standley says. Originally, the company used a proprietary computer system that had been designed specifically for CTO.

“We were beginning to exceed the capacity of that solution,” he says. “The more work we had to do with insurance billing and reporting, the more updating and changing had to be done to the system. With a development team of one person, you risk a lot of downtime and errors just to evolve that system.”

Finding an electronic medical record solution that was appropriate for its specific needs was challenging. The cloud platform seemed be the most appropriate option.

Record storage

Standley initially had some concerns about accessing the application and storing records in the cloud. He was skeptical whether it would be reliable to keep data on a hosting service, but the  certifications for compliance with industry standards related to back-up services, crash recovery, encryption, and reliability were there. The hosting service and application are compliant with HIPAA, as well as with PCI security standards, and SOC 2 accounting standards.

“They are audited, and there is an alternative back-up site for their servers so if the main location goes down, they can switch over to the other site within 30 minutes,” Standley says.

By automating record keeping and allowing counselors to type their notes directly into the patient record, he says efficiency has improved and paperwork was reduced by 75%.

While a possible advantage of cloud-based solutions is to reduce the IT costs specifically associated with maintaining applications and servers, CTO’s IT costs were not very high to begin with.

“The big savings came in moving away from the custom solution,” Standley says. “We were paying a programmer by the hour to develop and update that system.”

Now the cloud system costs amount to a few dollars per client per month without upfront costs for operational maintenance and updates.

Standley has three key pieces of advice for others considering a similar upgrade:

Consider pricing

Providers should evaluate the upfront costs associated with the system, as well as conversion and ongoing operations costs. “These systems are pay-as-you-use-it, so the more you use it, the more you pay. For our industry, within margin, that is a good idea,” Standley says.

Staff must be properly trained

“You can’t put people who can only hunt and peck on a keyboard, and expect them to takes clinical notes that way for every session and treatment plan,” Standley says. “If you can’t get the words into the system, you won’t meet those insurance or Medicaid requirements. The staff has to have the right attitude, and be trainable in terms of using computers for their work.”

Not every electronic medial record is appropriate for behavioral health

“There are some types of systems that are virtually useless for behavioral healthcare,” Standley says. “There are lot of characteristics in our industry that are not included in the data structure or logic of those medical systems. You can install those solutions at a huge expense, and then have to uninstall them because your staff can’t use them.”