Making a push for real-time health-care information

- Deborah L. Cohen covers small business for Reuters.com. She can be reached at smallbusinessbigissues@yahoo.com --

By Deborah L. Cohen

CHICAGO (Reuters.com) - Patricia Riskind prides herself on being a nonconformist. Her company's email-driven questionnaires and real-time analysis of patient feedback about doctors' visits have been pushing the envelope in health-care information -- literally moving it out of the picture in an industry that has historically relied on sluggish and costly paper mailings to glean data on customer service.

PatientImpact LLC, the company Riskind started out of her house in 2004 and bootstrapped with her own funds, captures reactions about everything from a doctor's bedside manner to wait time and tidiness of the front office. Since patients typically have a limited frame of reference for measuring the quality of outpatient health care, understanding these ratings is crucial if providers want to remain competitive in a market besieged by cost pressures, she says.

"We want people to actually use these measurements to clean up the bathroom, coach Betty Sue at the front desk not to crack her gum when she's answering the phone, tell the doctor he should sit down and look you in the eye," says Riskind, 43, emphasizing that her firm focuses on using information to improve behavior. Doctors that employ health-care information studies for training purposes tend to earn about $50,000 more on average than those who don't, she says.

Riskind brings more than 20 years experience collecting and analyzing information in the health-care field. She cut her teethe at the Sachs Group, a consulting firm that is now part of Thomson Reuters, and went on to work in progressively senior management posts for Dorenfest and Associates, a health-care data consultancy later bought by HIMSS Analytics, the American Hospital Association and Tiber Group, a management consultancy that has been absorbed by Navigant Consulting.

"I always knew I wanted to have my own company," says Riskind, who prior to launching PatientImpact co-founded 3d Health Inc., a consulting firm. "I always marched to my own tune."

It was in a business development position at the AHA that Riskind spotted an opportunity for her current venture: shifting traditional health-care surveying methods into the virtual realm. She helped convert a mammoth AHA annual hospital survey from paper to an electronic format. Capturing data electronically, she says, gives clients a more complete picture of their strengths and weaknesses.

The soup-to-nuts electronic data collection process is what she says distinguishes PatientImpact from much larger entrenched competitors in health-care information research such as South Bend, Indiana-based Press Ganey.

"The big difference we bring with an electronic survey is you can survey every patient every time," she says. "Our whole business model is different. Our clients pay a flat fee and they can survey as many patients as they can collect emails."

PatientImpact seems to have tapped a lucrative niche. The market to measure customer service in health care is growing, as institutions ranging from Medicare to health plans and large self-insured employers roll out pay-for-performance initiatives.

The company's sales have doubled in each of the past three years and are on track to double again, with a $2 million target for 2009, Riskind says. Its customer base has grown from just 20 imaging centers in its first year to nearly 2,000 facilities, including physicians' offices, medical centers and related outpatient sites, including well-known names like Concentra, Midwest Orthopaedics at Rush, and MinuteClinic, the walk-in health services center at CVS drugstores.

Clients say the data not only helps them improve their practice, it allows them to put their best foot forward at a time when consumers are increasingly savvy about their health-care choices. OrthoCarolina, a group of 13 North Carolina orthopedics centers, has plans to publish its progressively improving customer satisfaction scores on its proprietary website, says Amy Green, the group's patient services manager.

"Patients are going to become more selective as their health-care costs increase," says Green. "They're going to want to make an appointment with a provider that has historically given good care for the service and good value."

IN GROWTH MODE

Riskind, who formerly operated as a one-man band with periodic help from local high-school and college students, now occupies office space in Evanston, Illinois to support a dozen full-time staffers, including a resident statistician and an expanding sales team.

"We've been in a growth mode," she says, noting recent discussions with venture capital firms and strategic investors to raise an initial round of $2 million to $4 million in financing.

The changing face of U.S. health care, regardless of how it shakes out under the Obama administration, will call for more openness on the part of health care providers, she says, responding to a question about the House of Representatives' introduction this week of health-care legislation that would raise taxes on the wealthy and penalize employers who do not provide health benefits to workers.

"My prediction is the emphasis on accountability and transparency is going to continue," she says. "Therefore sharing clinical information, financial information and patient experience information are all going to be on the health-care reform agenda."

In a world where privacy is a growing concern, getting patients to turn over their email information is one of the toughest hurdles her clients must overcome. Typically one-fifth of patients overall respond to the questionnaires, which take two minutes or less to fill out and contain 10 to 30 questions. A minority of respondents fill out old-fashioned paper questionnaires.

PatientImpact uses standard questions to create benchmarks that show clients how they fare against competitors; customized queries allow each specific practice to dig for information unique to its situation. Clients have real time access to the data on line, which is managed by PatientImpact.

"Because our clients are looking at this on a daily basis, they catch things early," says Riskind, noting that respondents frequently provide lengthy and detailed responses to the open-ended questions. "It's almost like your own training manual."

The company is building on its reputation as a virtual data provider. Besides consulting, it offers a series of online training classes and is adding capabilities such as a service that allows health-care providers to communicate with patients in real time via email or text messaging, giving them a heads up if a doctor is running late or needs to cancel due to an emergency.

"We're continuing what we're doing, creating more stickiness," says Riskind.