Industry Insider: An Inside Look At Intellicure, Inc.

  Intellicure is located in the Research Forest of The Woodlands Texas, a planned community 15 miles north of Houston Intercontinental Airport and 35 miles north of the famous Houston Medical Center. Intellicure is a privately held Texas corporation that was incorporated in 2000. The corporation has 17 full time employees and contract and part-time staff as needed for training. Key departmental heads include President and CEO, David Walker; Chief Medical Officer, Dr. Caroline Fife; Chief Information Officer, Brett Thomson; Director of Operations and Compliance, Toni Turner; and Director of Quality Reporting and Business Services, Vonda Wall. Today’s Wound Clinic spoke with Caroline Fife about their operation.

  Today’s Wound Clinic (TWC): Please describe Intellicure’s greatest strength.
  Caroline Fife (CF): Experts in wound care who know programming, not the other way around.

  Since its inception, Intellicure’s greatest strength is that we are a company of wound and hyperbaric medicine experts who know computer programming, rather than a company of programmers trying to learn wound care. Our other great strength is that we have personally opened or managed many wound centers ourselves. We know what it is like to actually care for patients, to use our own documentation system in patient care, to create and use management reports, and to live the daily reality of running a wound or hyperbaric center. Every software feature or report was created specifically to answer a need we recognized in personally operating a clinic or actually taking care of patients.

  TWC: What do you find most rewarding about providing products to medical directors and wound care clinicians?
  CF: Wound care clinicians are dedicated professionals who chose the field of wound care because they were attracted to the sense of satisfaction, which comes from seeing patients heal, or alleviating suffering in those who can’t. However, wound care clinicians are often frustrated because the burden of documentation and the complexity of billing saps the joy from careers which would otherwise be hugely rewarding. The Intellicure mission is to enable these dedicated professionals to succeed both clinically and financially within the current healthcare framework by harnessing state of the art technologies to make their jobs more efficient and productive. It is hugely rewarding to be able to advance their efficiency, alleviate their concerns regarding billing and coding, improve evidence-based care, and facilitate clinical research. We are simultaneously improving the lifestyle of our clinicians and the quality of care of their patients, ensuring the financial viability of their practices and hopefully the future of healthcare for all of us.

  TWC: Describe your company mission or vision?
  CF: Harnessing Technology for Healthcare:

  Our mission is to assist healthcare providers in harnessing technology to optimize patient care. We live at the intersection of healthcare policy, technology and evidence-based patient care. Our goals are to provide software, which meets current national standards, to train healthcare providers to use technology optimally, and to incorporate best practices into healthcare software. This means providing a certified EHR, incorporating it into proper clinic workflow, helping clinicians derive benefit for their patients at the point of service, sharing the information acquired with other entities in useful ways through computer interfacing, and then demonstrating that process through quality reporting. By standardizing patient care through “point-of-service” recommendations within the EHR, the cost of wound care is reduced. Computers should be tools, not obstacles. Documentation should work for you, and not make more work for you.

  We are also committed to the idea that practice based evidence, obtained from pooled healthcare records, can expand the knowledge base in wound care and hyperbaric medicine. Comparative effectiveness data derived in this fashion can improve health outcomes and reduce cost of care. This is the reason we created and operate the US Wound Registry that has been used by many organizations including CMS and numerous pharmaceutical companies for wound care research.

  Our vision is to utilize cost effectiveness data to allow healthcare providers to prepare for inevitable changes in reimbursement policy. As payers move to a new reimbursement policy, users who provide the most efficient care will be the most financially successful and will be providing the highest quality care.

  TWC: What products or services do you make?
  CF: Software Products and Services:

  EHR for Outpatient Wound and Hyperbaric Centers:
    •IntelliTrak: complete wound care documentation, e-prescribing, CPOE.
    •HyperTrak: complete hyperbaric documentation.
    •Inventory Manager: tracks par levels, orders supplies (uses handheld barcode scanning technology).
    • Front Office Manager: scheduling, insurance management, Referral Management, billing management.

  In Patient Wound Care EHR:
    • IntelliTrak: complete wound care documentation, which is streamlined for the inpatient arena including support for production selection and support surface algorithms

  Nursing Home Wound Care EHR:
    • IntelliTrak: complete wound care documentation specific to the needs of the physicians seeing wound care patients in this setting with a specific documentation of procedures and dressing orders to be followed by staff.

  Reporting/Benchmarking:
    • Intellicure provides standardize reports, which supports the management needs of wound clinic administrators. In addition, special reports can be requested and generated on a monthly basis for individual centers or when multiple locations are overseen by a management group as a cumulative report.

  Billing Feeds and Hospital EHR Interfacing:
    • Intellicure has successfully linked with all major hospital EHRs and has the capability to link with any software, which utilizes HL7 language.
    • PQRI: Registry reporting services for Physician Quality Reporting Initiative (PQRI) are provided at no charge to physician users. Physicians receive bonus payments based on their total Medicare volume.
    • Business Services ("Meaningful Use" Consulting): These services promote integrity in documentation and revenue cycles. We consult with you regarding how to integrate the EHR into your clinic work flow and then perform chart audits to determine whether you have implemented the EHR completely and are using it correctly.
    • eDME: You can send orders to a DME for the specific wound care dressings you want the patient to have, simultaneously notifying the patient’s insurance, then obtain verification of the order, and then receive verification that the supplies have actually been shipped to the patient.
    • Medical Quality Assurance: Wound care training is difficult to find and physicians often feel uncertain regarding their capabilities when they begin practice. Due to the complete nature of the Intellicure EHR, Dr. Fife can remotely review all initial consultations and provide weekly feedback to clinicians regarding their billing, coding or clinical management. This is combined with monthly Webinar’s on topics, which arise during MQA evaluations.

  The US Wound Registry: A complete database of pooled, de-identified medical record data available for medical research.

  TWC: What would you say makes your company unique?
  CF: “Meaningful Use” Expertise: Intellicure was one of the original 32 companies recognized by CMS as a “registry,” making it through the complex vetting process to send physician quality reporting data (PQRI) to Medicare on behalf of our doctors. Our doctors receive this service at no additional charge and receive several thousand dollars per person for participating. Participating in Quality Reporting programs like PQRI is one of the criteria for meaningful use of an EHR.

  We provide “Decision Support,” a Requirement of Meaningful Use in the HITECH Act: The EHR offers clinical practice guidelines to help physicians provide evidence based care, as well as advanced programming which helps clinicians select the best dressing options based on the documented wound characteristics. Furthermore, we can send data to the patient’s own “Personal Health Record,” another requirement of the HITECH Act.

  Automated Billing Features (Compliance Audits): When using our software to document the hospital outpatient facility charge, Intellicure evaluates more than 200 individual elements of work within the EHR and internally calculates the facility level of service based on the documentation provided by the staff This means that you do not need a checklist to “add up points” to see what level of service to charge, or a compliance auditor to ensure that the documentation correlates with your billed charges. The EHR itself provides the compliance audit, because Intellicure automatically audits the chart and drops the facility charge that is justified by the documentation. Intellicure also internally calculates the physician charges ensuring that the billed physician level of service will be supported by documentation. However, rules for billing and coding differ greatly depending on the location of the service. Our Compliance and Business Services team can evaluate the complex issues that surround the entire revenue cycle and not just the specific encounter that was documented.

  Structured Notes: All the elements of documentation, which Medicare requires are available using pre-programmed menus that the clinician uses to customize an appropriate and complete note for each procedure. In some cases, more than 14 different elements are needed to assure reimbursement for even a simple debridement. Open “text fields” which may be convenient for “cutting and pasting” do not provide a method for automated compliance auditing which is why Intellicure does not use “free text” fields.

  Automated “Wi-Fi” Photographing: Intellicure makes use of a proprietary interface with commercial “Wi-Fi” camera technology that allows digital photos to be automatically transmitted to the right place in the EHR and then removed from the camera memory, thus complying with HIPAA security and privacy requirements for photographic storage.

  TWC: Please tell our readers something about your company that they may not know?
  CF: Intellicure is the only wound care EHR, which is also a CMS Qualified Patient Data Registry for PQRI reporting, so our doctors get bonus money from CMS for the quality reporting we do on their behalf. This is one of the many ways we provide expertise in the area of “meaningful use.”

  Intellicure created and validated the acuity scoring system for facility billing, which has been adapted by almost every wound center in the US, publishing this in OWM in 2007. We performed the original data analysis, which showed that billing by wound size, as proposed by the AHA and CMS, would not work as a method for wound care reimbursement. Our data provided the breakpoints for the scores, which would produce a “normal” (bell curve) distribution if our system were followed as we originally designed it. (Ostomy Wound Management, 53(1):34-44, 2007.)

  Intellicure Leads the Industry Data for Wound Care Research: Intellicure has published more than 25 articles using data from the US Wound Registry, and has been the recipient of numerous grants (see our website for more details). A running two-year slice of data now contains more than 750,000 visits with complete cost-and-charge data as well as all medical record information.

  TWC: Please describe any of your company’s goals for the future that you would like to highlight.
  CF: Physician Reimbursement for Meaningful use of our certified EHR: We look forward to our physician users getting their EHR adoption incentive money.

  Expanded quality reporting: Intellicure is working with CMS and the NQF towards a “measures set” for wound care, which will improve bonus payments to wound care clinicians. We are using the US Wound Registry data to provide the needed validation data for new measures.

  Comparative Effectiveness Research: Expanded use of the US Wound Registry for Comparative Effectiveness research in wound care.

  TWC: Looking ahead, what are some initiatives that the company is working on for 2011 and beyond?
  CF: Our focus for 2011 is to make sure all our clinicians meet the requirements of “meaningful use” of our certified electronic health record and thus obtain their bonus money for EHR adoption. Meaningful use includes participation in PQRI, using e-prescribing and computerized provider order entry (CPOE), and following clinical suggestions embedded in the EHR. Clinical suggestions will also assist with correct dressing product choice based on the description of the wound.

  In keeping with the HITECH Act requirements, by April 2011, Intellicure will be able to transmit data to patient created, “Personal Health Records.” Looking beyond 2011, we have designed wound care PQRI measures, which are linked to evidence-based guidelines. This will enable us to determine whether the incorporation of clinical practice guidelines into the Intellicure EHR will actually improve patient outcomes and reduce cost of care. We will use these data to validate wound care PQRI measures in hopes of getting CMS to adopt them.

  TWC: Are there any trends in wound care that you and your executives are monitoring closely?
  CF: The reimbursement model for outpatient wound care is going to change drastically within the next five years. The current “fee for service” model of outpatient wound care, which rewards inefficiency will be replaced by some other model. The structure of that new model has not been determined, but successful programs will be those, which can provide good outcomes in a cost-efficient manner. Control of data will be the key to success in that model. This means having access to accurate, detailed cost-and-charge data which only Intellicure is able to supply.

  Few healthcare providers understand that the fine print of the HITECH Act allows actual clinician notes to be transmitted to payers along with their bill. Thus, “interoperable” data fields like the ones we use, which allow easy transmission of clinical notes, will make the difference between financial success and failure for wound care clinicians.

  TWC: We continue to see increases in the amount of wound care clinics that open each year as well as rising numbers of wound care patients. How will this affect how your company operates its business in the future?
  CF: We anticipate that the need for electronic wound care documentation in hospital based outpatient clinics will continue to increase, but we anticipate an expansion in acute and long-term care as well as doctor’s offices, so we have a suite of software that meets all of these needs. In addition, we continue to diversify our services to assist clinicians with DME ordering, billing compliance, and medical quality assurance. We anticipate that the need for these services will grow just as fast.

  Our unique software platform allows automated analysis of outcomes reports and remote surveillance of documentation. This makes Intellicure the ideal choice for hospital managers and management companies, which need to evaluate the performance of multiple clinics or providers simultaneously.

  TWC: Do you have any advice for clinicians who are unsure about what products or services are best for their wound care clinic?
  CF: Intellicure is predicated on the concept of point of care documentation (which is required to meet the requirements of “meaningful use” of an EHR). Clinicians who are not willing to adapt their practice habits to make optimal use of technology by using point of service charting (e-prescribing, quality measures, clinical suggestions, etc.) will not be able to obtain bonus payments from Medicare or realize all the benefits of a certified EHR. Also, since Intellicure automates billing functions for the facility and the physician (often directly interfacing with hospital billing software), point-of-service documentation is even more critical for accurate billing. Facilities or clinicians that are not yet ready to make the commitment to point of service documentation, billing feeds, interfacing with the hospital EHR, quality reporting and other opportunities may not be ready for to meet the meaningful use criteria, but Intellicure can help you at every stage. Clinicians new to wound care should strongly consider our Medical Quality Assurance Services which provides mentoring and oversight as they gain experience in the field.

  TWC: How can wound care clinicians get in touch with a representative to learn more about your company and products?
  CF: For more information contact Intellicure, Inc. by phone at: (800) 603-7896, visit our website at www.Intellicure.com, or by email at:sales@intellicure.com.