Funding technology with ASP Economics: small but growing Atlanta pediatric practice plans its future IT capabilities with the help of outsourced ASP services - ASP/internet: case history - La Clinica del Nino, P.C.,

Health Management Technology, Oct, 2002

Financial factors are often the leading obstacle standing between physicians and the adoption of advanced technologies. In a recent study funded by the California Healthcare Foundation that included 365 medical groups and 60 clinics, some 85 percent of survey respondents indicated financial factors as the top obstacle.

Operating revenues serve as the greatest source of funds for technology system purchases among most medical groups. But when a physician is just starting out, purchasing the best technology can force entrepreneurial practitioners to take on more debt than they should or settle for less IT than they would prefer.

For many medical groups, information automation through technology is often touted by larger healthcare systems as the answer to a better run and more efficient organization. However, in some cases, the up front monies required to purchase a system that will schedule appointments, register patients, and process and track claims can run between $50,000 to $150,000 in software, hardware, training and implementation.

New Pediatric Clinic

In the case of La Clinica del Nino, P.C., a new pediatric clinic in the Atlanta, GA, area, the physicians knew that starting with the right technology and support would help them achieve their mission over the long term. But how to afford the technology they needed and wanted--was another matter.

Suzana M. Montana, M.D., F.A.A.P, board certified in pediatrics, is the director and practicing physician at La Clinica del Nino. "We saw a great need to provide high quality pediatric care to Atlanta's growing population of Latin children," she says. According to a recent census, there are 583,000 Hispanics in metropolitan Atlanta, and Georgia ranked among the top three states with the highest growth rate in Hispanic population in the last decade.

Eduardo Montana, Sr., M.D., M.B.A, who directs the business and financial operations of La Clinica del Nino, has more than 30 years of experience in private practice and more than 10 years of experience in medical management. "With such a growing demand for quality care, we required a system that would efficiently handle a high volume of patients. We also knew that, to fund the system, we could not rely on operating revenues. Many of the parents we serve make minimal wages and, if there is coverage, it is most likely Medicaid," he says.

Today, Dr. S. Montana might see 35 to 40 patients per day, based on a patient panel of about 1,000 children and growing. Many new patients start as walk-ins, so the physicians believe the patient panel will expand considerably in the future. They are planning, over time, to open five clinics to serve Atlanta's growing Hispanic population, so their choice of practice management technology must serve them well into and through expansion.

ASP Economics'

The physicians looked at many different practice management vendors. The majority would require the physicians to pay hardware and software expenses up front, including server expenses, or risk the burden of large lease payments. Then the physicians came across an ASP-delivered practice management system powered by IntegriMED Inc.

The IntegriMED hosted practice management system offered the physicians the functionality they wanted with less hardware expense than traditional client/ server applications. In the end, the physicians made a different choice. They elected to purchase practice management software they believed would be the most productive for their practice, and to avail themselves of numerous hosting, hardware upgrade, maintenance, back-up and support services available to them on an outsourced basis through IntegriMED's ASP model.

For a monthly subscription fee, IntegriMED hosts the Montanas' software from their data center. "The system is only as good as the supporting services and so far, we have had no complaints," says Dr. E. Montana, Sr. From La Clinica del Nino, office personnel use the Internet to access their practice management software on IntegriMED's servers. The outsourcer handles all hardware service, upgrades and maintenance, and backs up the clinic's data.

For security purposes, the Drs. Montana get the benefit of 448-bit encryption, rather than the standard, recommended 128-bit encryption. They also have the option to keep monthly backup tapes in their office, if they desire.

The arrangement works well for La Clinica del Nino because it accommodates the clinic's future expansion plans. It allows the physicians to relocate their current practice to another physical address, and also to add new sites as the expansion proceeds--but without having to plan for or make significant hardware or support investments beyond buying PCs.

Investing in Patients

La Clinica del Nino, P.C. selected the ASP-based IntegriMED in the summer of 2001. Before the system was installed, training took three days and implementation of the system onsite took two days.

In November, the first practice opened its doors to the Latin community and after more than six months with a steady increase in patient visits, the Drs. Montana feel their decision to invest in an ASP-based practice management system gave them access to advanced technology usually awarded to only larger practices.