"Welcome to our company blog. Within these blog posts, we hope to share our insights on clinical quality management, the patient-centered medical home, chronic disease management in primary care, evidence-based medicine, and the use of technology in ambulatory care settings."

- David Morin, CEO and Donald Nease Jr., MD, Chief Medical Officer

This is exciting. Through our partnership with DrFirst, our customers will be able to e-prescribe right from Cielo Clinic. Here's an example of what that means at the point-of-care: Dr. Smith is seeing Pam Doe. Using Cielo Clinic on his laptop, he notices a reminder to prescribe a statin. So, on Pam's Cielo Clinic encounter form, he clicks on the eRx button. This automatically logs him into DrFirst, takes him to Pam Doe's eRx record in DrFirst and updates the eRx record with any changes (like an address change). Dr. Smith prescribes the statin through DrFirst. He then goes back to Cielo Clinic, where that new prescribed drug is now on Pam's active medication list. What didn't he do? He didn't have to jump out of Cielo Clinic, log into Dr. First and find Pam Doe. He also didn't have to update DrFirst with any record changes and he didn't have to update Pam's medication list in Cielo Clinic. For a busy doc seeing 30-40 patients a day, this is a significant time savings! We really think this sort of integration is important. Just a simple interface won't do - that doesn't make your job easier at the point-of-care. A subtle but important difference that Cielo MedSolutions understands. Dave Morin CEO and Co-Founder Cielo MedSolutions

Working and partnering with great physician groups is really important to Cielo MedSolutions. Here’s a quick intro to our latest group: Mercy~Physician Community PHO is a group of 31 primary care providers based in Port Huron, Michigan (a town about an hour north of Detroit). The PHO is led by Marianna Webb, their Executive Director and features a strong support team. The PHO recently went through an extensive review of technology options and vendors to support their quality initiatives; specifically, Improving Performance in Practice (IPIP) and Physician Group Incentive Program (PGIP), a BlueCross BlueShield of Michigan pay-for-performance program. After that review, they selected Cielo Clinic as their clinical quality management system (registry, clinical decision support and population management). The PHO will be using the product to track ALL chronic diseases, not just what’s required for their pay-for-performance programs, and utilizing centralized reporting to be proactive about screening, prevention and chronic disease management surveillance. Interfaces are being put in place with their various other health information technology solutions. They have decided to adopt a train-the-trainer model and will have a PHO staff member training the practices on using the product. And, they will be measuring the impact Cielo Clinic is having on care quality. Mercy~Physician Community PHO is doing all the right things to ensure success with our product. It’s wonderful to work with a group such as theirs that views quality improvement the way we do. Dave Morin CEO and Co-Founder Cielo MedSolutions LLC

I'm going to go out on a limb here and comment on a request we hear often: "can we just use your registry to upload to CMS to get our PQRI money?" Answer: yes, you can. But, think about this. If you do the minimum 30 chart pulls, abstract the data, key it in and upload it, you're probably looking at about a $1,000 expense. And, I haven't budgeted for the software yet. The average reimbursement from PQRI is $600. Your and your staff's time is VERY expensive, and valuable. Is this really the way you want to invest your time and money? Now, if you use a clinical quality management system to manage all your patients for all their needs, you not only get PQRI $$s, you get the value of any other pay-for-performance program, you build the base for your patient-centered medical home, and you prepare yourself for any other quality program that comes in the future. Your patients are better cared for, your practice is operating more efficiently and you may just be generating more revenue in your practice as you keep your patients up to date on their screening, prevention and chronic disease management needs. Shortcuts sound great, but they unfortunately don't work. And, in this case, I think they actually cost you more than doing things the right way. Dave Morin CEO and Co-Founder Cielo MedSolutions LLC

A question we get asked a lot is "what diseases do you support?". The answer is : virtually all. This is the beauty of a table-driven rules engine (our rules engine is the technology that manages all the clinical guidelines you follow. Based on a patient's information, it generates reminders for their due services). All you do is fill out a web form; put in the diagnoses, co-morbid diagnoses or clinical indicators you want to build the guideline rule around and, voila, the guideline is in your system, ready to use. You can set a whole host of other attributes around the guideline, but again, you are just filling out a form. No programmer necessary! Any disease management system that requires a programmer to "create the rule" is one that won't scale and will require dollars for support of that programmer each time a change is needed. "Next-generation" disease management systems are built with table-driven rules engines. Dave Morin CEO and Co-Founder Cielo MedSolutions

For those looking to adopt a clinical quality management system or registry, a new must read is available in Medical Care, September 2008 - "Impact of a Generalizable Reminder System on Colorectal Cancer Screening in Diverse Primary Care Practices: A Report From the Prompting and Reminding at Encounters for Prevention Project" (Medical Care. 46(9) Supplement 1:S68-S73, September 2008. Subscription required for fulltext). This study, funded by the National Cancer Institute and Agency for Healthcare Research and Quality, implemented Clinfotracker (the technology on which Cielo Clinic is based) in 12 diverse practices in Michigan to drive improvement in colorectal cancer screening rates. An average 9% increase was achieved in just 9 months. This paper studies the ability of a reminder system to improve care delivery and also reviews the ability of practices to adopt clinical technology. I think the second part of this study is just as important as the first part! Dave Morin CEO Cielo MedSolutions

State-of-the-art software solutions are today architected as software-as-a-service ("SaaS"). This means the software solution is: built from the ground up to be delivered via the internet - this is very different than a system delivered via application service provider ("asp"). An ASP-delivered system is one that wasn't built originally to support web delivery but is using additional technology overlayed on top of it to allow that to happen hosted at a 3rd party data center accessed by the user through a secure internet connection If you utilize a SaaS product, what does it mean for you? You don't need to buy additional hardware or systems software for your practice. You just need your PCs to be able to use an Internet browser and have Internet access. You don't need to manage a server and its backups. Updates are quickly available to you as they are simply installed by your vendor. You'll get better tech and user support, as the vendor can securely get access to the system and its server. Implementation is faster and easier because you don’t need to go through the effort of setting up all the hardware and doing all the installation of technology to use the product. SaaS will certainly be the future delivery model for many software solutions. It eliminates many of the soft costs of a technology implementation (usually a 3:1 ratio relative to software costs - you will spend $3 on hardware, infrastructure, support, etc. for each $1 you spend on a software product) and ensures you keep current on the latest software release. For solutions such as Cielo Clinic, SaaS is the best way to get the product in a user's hands. Dave Morin CEO Cielo MedSolutions LLC