Crystal Run “runs” on technology

I recently participated in a NextGen Healthcare collaborative care webinar where I shared how technology has enabled Crystal Run to become an ACO and patient centered medical home.  Our journey has been based on innovation and a solid technology platform that has helped us to reach another milestone — Crystal Run has just been approved to have our own health plan. This is a trend I think we will be seeing more and more across the country with multi- specialty practices.


“We are becoming the servants in thought, as in action, of the machine we have created to serve us.”

John Kenneth Galbraith

Overcoming being “overwhelmed”

I’m an internist and I still see patients. We are immersed in a system that requires a lot of technology. Sometimes it feels like, “who is serving whom here?” Many doctors feel overwhelmed by the amount of technology now required for them to practice medicine. While we need all these tools to manage populations and better manage chronic conditions, how can we keep it all from overwhelming us?  Here are some of the strategies that we use at Crystal Run.

The buck stops with providers

Accountable care is synonymous with collaborative care, where physicians represent one part of the care team. In a collaborative care model, we need to leverage everything we can to care for groups of patients. Providers will be held accountable, not just for the patient in the room with them now, but for all the patients they currently care for who are not in the exam room …we’ll need to know how they’re doing.  We are part of a complex care system and the future is going to require managing care when we don’t have the immediate attention of the patient in front of us.  So, with that responsibility, the new requirements for primary care involve patient engagement through care coordination; managing groups or “cohorts,” and enhancing the patient/provider relationship so patients take your advice and tell you if something’s not feeling right.  As a practice, we have to make sure everybody’s rowing in the same direction; managing the finances, being accountable for outcomes and costs; and being sure to report outcomes and then applying best practices as we evolve.

Embracing technology as a means to an end

Do you feel that technology is making it difficult for you to relate to and care for your patients? Your answer depends on your worldview. Technology is everywhere. We need it, we use it every day – it’s ubiquitous. It’s in your car; it’s in your phone and in your office. While you do have to incorporate technology as a tool, it doesn’t need to “be all and end all.” It’s the means to the end, but it’s not the end itself. We’ve embraced technology for a long time and it’s allowed us to grow pretty rapidly.

Growing exponentially from seven to 350

When I joined Crystal Run in 1996, I was the second internist and seventh doctor and we had about 35 employees. We’re now at about 350 providers and have 1,800 or so employees. We’ve grown to be an ACO with about 35,000 commercial lives at risk. We’re also a shared savings participant with about 11,000 beneficiaries. We’ve been able to do all of this because we know exactly where we are financially, as well as clinically. Not to beat a dead horse, but the reason we know where we are is our extensive use of technology and analytics.

It’s like “Where’s Waldo?”

Our staff has been keenly focused on patient engagement using the Patient Portal and population health management.  We cannot afford to forget about the patient ― we need to know how they’re doing and how we can better engage them.  We need to understand the disease burden; who has what, what they have, and how many are out there? Where are patients going when they’re not going to us and why is that? We use risk stratification tools with modeling and we have a data warehouse. We have a dedicated business intelligence team and an analytics team that pulls information together and presents it in a way that we can make actionable decisions. As a clinician, as well as an administrator, we’ve been very focused on scaling technology so that it performs well and that it is readable and usable. It’s not just columns of numbers on an Excel spreadsheet. Well, sometimes it is, if that’s what’s needed, but usually it’s very visual. So you can make a decision with data and have it be a correct decision because the data is presented properly.

The tip of the iceberg

These are just a few of the strategies we employ to ensure our success as the healthcare market shifts towards a value-based system. It’s easy to get overwhelmed with all these pieces of technology.  What’s important to remember is that the whole is greater than the sum of the parts. You have to find solutions that help you aggregate information from all the different places it’s kept. There are volumes of information trapped in systems that don’t talk well to each other. The trick is getting to a place where you can connect information from various systems to help you take better care of your patients. That said, in future blogs I will be sharing more about some of the in-depth strategies that are working well for Crystal Run.

Watch Dr. Spencer’s Enlightened Provider webinar recording