An Inside Look at Intellicure Inc.

This month, we interview Caroline Fife, MD, FAAFP, CWS, chief medical officer.   Today’s Wound Clinic (TWC): How long have you been in wound care, and how did you enter this area of healthcare?   Caroline Fife (CF): I’ve spent nearly a quarter century in the full-time practice of wound care, beginning with my fellowship in undersea and hyperbaric medicine at Duke in 1988.   While at Duke, I spent time with Claude Burton, who developed the “Duke Boot” for venous leg ulcers. His clinic was the inspiration for the wound center I began at University of Texas Health Science Center in 1990. It was the first wound center in Houston and continues to serve the many institutions within Texas Medical Center.   When the Medicare guidelines for physician documentation were published, it seemed obvious that the system was so complicated that no doctor could consistently determine the correct level of service for a patient visit. I began working on a computer system to calculate the physician level of service, later joining forces with David Walker, who had already computerized hyperbaric documentation requirements.   In 1997, the Memorial Hermann Wound Center went “live” online with the first generation of what became Intellicure, making us the first wound center in the US to have an electronic platform. David and I later developed and validated a method for facility billing via “acuity scoring.” The electronic health record (EHR) internally audits the chart based on the nurse’s documentation and calculates the facility charge at the same time it is calculating the physician charge, so clinicians and institutions can be confident their documentation will support the charges they generate.   TWC: What are your highest-selling products or services?   CF: Intellicure 5.1. Our certified electronic health record (EHR) is popular because we ensure documentation compliance and medical record security. The ability of Intellicure to internally audit the record and calculate physician- and facility-level of service is a necessity for confident and compliant charge processing. Physicians are more likely to capture their HITECH adoption money since we offer the most options for meaningful use reporting, allowing providers to demonstrate up to 25 core and five menu-set objectives to qualify for incentive payment.   Once the electronic documents representing the clinical chart are generated, they are locked against subsequent alteration, stored, and secured just as you would have stored and secured paper documents (a requirement according to the Health Information Management Systems Society [HIMSS]).   LCD (Local Coverage Determination) Defender. This software product ensures expensive procedures, such as bioengineered skin, contain the elements needed for compliant documentation. Our unique internal calculations for debridement automatically select the correct paired codes based on wound size and percent debrided. We also ensure the physician’s and the facility’s documentation for debridement correlate. These unique safeguards protect facilities and physicians from potential repayments due to poor documentation should they undergo an audit by a Recovery Audit Contractor (RAC). The increasing scrutiny of wound centers by RACs is making LCD Defender popular.   Medical Quality Assurance (MQA). Clinics can contract for medical review of all initial consultations for a defined period of time. MQA fills a need for further wound care training after physicians have completed introductory courses.   TWC: Describe your day-to-day role.   CF: When I’m not practicing clinical medicine, I support the ongoing design and development of the Intellicure EHR so that it continues to be the best clinical documentation system. A major focus of my work is the incorporation of clinical practice guidelines to help standardize wound care. I work with our development team to expand our interactive quality-reporting features that allow stakeholders to find missed opportunities for improvement.   TWC: Why are you passionate about the work of your company?   CF: In 2005, Intellicure provided the data to CMS officials that demonstrated their proposed plan to reimburse wound centers by wound size would not result in a fair distribution of charges.   We created, validated, and published an alternative billing structure, which we termed “acuity scoring,” (a measure of staff work) that is now the most common method of wound center billing.   We are passionate about improving quality of care with our decision-support tools, thus decreasing total cost of care. We can measure patient outcomes with our interactive reports and benchmarking services. Because of its internal charge auditing, Intellicure is the ideal documentation system for future accountable care organizations.   TWC: How would you describe the overall mission of your company?   CF: To harness information technology to improve healthcare. This means ensuring patients have the best possible outcomes by making decision support available at the point of care and tracking physician compliance with practice guidelines.   Our goal is to optimize physician and facility revenue while improving value by decreasing waste. We also seek to advance the frontiers of knowledge with comparative-effectiveness studies based on real-world data.   Our mission is to assist providers in harnessing technology to optimize patient care. Our goals are to provide the tools needed to deliver evidence-based care, ease concerns regarding billing and coding, facilitate clinical research, and make life easier. Intellicure was developed by clinicians, for clinicians. Every software feature, clinical document, and management report was built to answer a burden or meet a real need while running a wound care and hyperbaric center.   TWC: What’s most rewarding about providing for your industry?   CF: We help clinicians take better care of patients. We believe making decision support available at the point of care and providing clinicians with report cards on quality measures will improve patient outcomes and reduce cost. Through MQA we ensure specific patients who might have rare or particularly challenging problems get oversight from more experienced practitioners.   With our internal chart billing functions and auditing services, we ensure practitioners are reimbursed fairly for the work they provide and are protected against subsequent recoupment. With the US Wound Registry, we can advance the frontier of medical science to determine which modalities offer the most benefits in the treatment of the challenging patients we care for.   Thus, the way in which Intellicure has harnessed technology can improve the lives of patients and the clinicians who care for them.   TWC: How is your company unique?   CF: We’re run by clinicians, for clinicians. Our corporate officers have actually run wound centers and cared for patients. We have changed dressings, performed documentation, and used management reports. Each aspect of Intellicure is designed to maximize staff efficiency. For example, Intellicure EHR functions like a paper chart that moves seamlessly from field to field, not as a series of forms you must repeatedly “submit.” Intellicure is unique because we designed our documentation type commands. The use of these menus helps drive our unique interactive reporting features.   Compliance: We insist that we support compliance with billing and coding rules. There are some “features” we don’t allow because they breach standards for medical records or billing compliance. Intellicure is designed from the perspective of the advanced practitioner and meets those medical and legal requirements, locking and securing signed documents against subsequent alteration. We follow HIMSS standards for all our medical record documentation and storage policies.   Commitment: Through our support of the US Wound Registry, a nonprofit foundation that houses de-identified EHR data, we provide benchmarking services and validation of quality measures, just as we previously validated facility billing with our acuity-scoring tool.   TWC: How do you ensure proper training on products and services?   CF: We provide a training program designed to assist clinicians at each step of EHR adoption and implementation. We begin weeks prior to “go-live” with your clinic manager coming to our office for three days of intensive orientation. This is followed by three days of onsite training with all staff. After “go-live,” charts are audited remotely for completeness and trainers provide feedback to clinicians for eight weeks regarding their documentation quality and to answer any questions. Educational videos covering documentation issues, quality measures, meaningful use, and other topics are available on the popular “member’s portal.”   TWC: What are your future goals?   CF: Our suite of software is set up to meet the needs of growing wound care clinics. We continue to diversify our services to assist clinicians with durable medical equipment ordering, billing compliance, and medical quality assurance, including quality measures and registry reporting upon which future reimbursement will be based.   TWC: How are you approaching challenges in wound care?   CF: Outpatient “fee for service,” as we know it, is going to end soon. Payment for wound care and other areas will be linked to performance. We are leading the way in helping to navigate this change. Because Intellicure’s programming internally audits the chart, it accurately calculates charges and determines resource utilization. We have incorporated evidence-based decision support logic within our EHR for all major wound diagnoses to drive quality of care. Our reporting capabilities enable stakeholders to find missed opportunities in delivering quality care and to understand physician and staff quality metrics. We are engaged in the development and testing of wound care quality measures upon which future reimbursement models will be based, and we offer the only wound care specific EHR that is a CMS-recognized registry for the physician quality reporting system upon which a percentage of Medicare payments will be based.   TWC: What’s new in 2012?   CF: RevenueTrak™: Improve the bottom line of your healthcare practice with the new, automated revenue cycle management software. Our claims-scrubbing features with continuously updating rules engine will help save money.   WoundSnap™: Our new, secure photograph transport system allows pictures to be transported from your smartphone camera to the patient chart. This feature is EHR integrated and HIPAA compliant.   TWC: How can clinicians contact you?   CF: Call our sales team at 800-603-7896 or email sales@intellicure.com.