Medical Advantage Podcast Ep 14: Optimizing an EHR for FQHC Use

by | Jul 14, 2021

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Ensuring that your Electronic Health Records (EHR) system is properly set up is a crucial first step for any healthcare organization seeking the best possible performance in billing, care quality, patient satisfaction, and other areas. But each practice and healthcare organization has different needs – and may benefit from a different, more fine-tuned EHR solution. 

FQHCs – Federally-Qualified Health Centers – are no exception. Due to their unique business model, financing structure, and patient population, FQHCs have a specialized set of needs, and require an EHR that can keep up. In this episode of the Medical Advantage podcast, we revisit a conversation with Caitlin Schlappi, a registered nurse at the Alcona Health Center FQHC in northern Michigan, and Julie Chiesa, an EHR and NextGen expert at Medical Advantage, to hear how our consultants worked alongside the Alcona Health Center staff to ensure they were getting the most out of their EHR system’s workflows and capabilities. 

This is the fourteenth episode in the Medical Advantage Podcast, where each we take time each episode to discuss the ideas and technologies changing healthcare, and the best practices your organization can take to stay productive and profitable. Subscribe wherever you get your podcasts to ensure you never miss an episode. 

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Key Takeaways from Podcast Episode 14 Optimizing an EHR for FQHC Use

We spoke with Caitlin Schlappi, RN who works in the Health Information Department at Alcona Health Center (ACH), an FQHC in Northern Michigan. ACH has 17 sites across Northern Michigan and offers medical and walk-in services, as well as dental, behavioral health care management, and according to Caitlin, “A little bit of everything and a little bit of everywhere.” 

Caitlin handles training, workflows, simplifying and streamlining templates at AHC and has been working with NextGen software since it went live ten months ago.  

ACH recognized the immediate need for a platform change when the COVID pandemic hit and telehealth became vitally important. However, they needed help integrating telehealth with their EHR, especially with documenting consent and coding on the superbill.  

Making the Move to the NextGen Platform 

Julie Chiesa, NexGen Consultant at Medical Advantage, assisted with the implementation. She noted that NextGen has an initial onboarding training program, but “when it’s done, it’s done.” For new users without a lot of expertise, the post-deployment learning curve can be daunting.   

When Julie arrived, she built a customized telehealth template that was specific to the needs of an FQHC. Caitlin stated that, “We have a lot of customization requests and Julie gave us this little telehealth pop-up where literally all the documentation for a telehealth visit could be done on this one little screen. And that was huge – no extra clicks.”  

“We were really struggling with what to do, we just didn’t know where to start and then Julie came in and saved the day with her telehealth template,” she added. 

Fortunately, Julie also was able to help flatten the learning curve. Caitlin explained, “A lot of the things in the template that Julie built mirror what’s located in other places of NextGen. So, it was more streamlined and there wasn’t a huge learning curve.” 

Streamlining Workflows with Templates, Forms, and Questionnaires 

ACH knew that it also needed help with coding, including attaching CPT codes per payer. Caitlin explained, “We have a G code that needs to go in for every Medicare claim. Julie showed us how to pull in that G code so it will go per payer. We can pick exactly what payer and this is all on the template, this isn’t in the background, this is manipulated by us so we can change this if it needs to be changed.” 

Julie also helped streamline consent for virtual visits with a simple checkbox during Zoom appointments. Caitlin shares that Julie was instrumental with other telehealth solutions.  

“We wanted certain codes to show on this telehealth template, again based on payer so they would only be available when the payer was Medicare, we thought we had it, but we couldn’t quite get it. We have a little joke when we get stuck, we always say 1-800-Call-Julie. We sent her a quick e-mail and sure enough, an hour later we were on the phone, and we had it all fixed up in minutes. So, she walked us through how to do it and it made sense. We were almost there but there are a lot of little specific things like that change on a monthly, sometimes it feels like daily basis, that are specific to us that Julie has helped with.” 

Accurate Coding and Documentation with NextGen 

Much to the relief of Caitlin and her team, Julie was able to help ACH in other areas as well, including commercial or workers comp and Medicare.  

“We loaded the financial class to load the background of the template and that’s how it talks to the template and lets it know OK when I click this, make this happen when I click that, make that happen. We’ve been able to make it very specific to the Medicare payers, as well as being able to send over the appropriate modifiers when necessary because obviously some payers you know require a 95, some payers don’t. We’ve been able to program it all the way down, so again at the end user level. Doctors just click, I did a telehealth visit, they’re doing their documentation, they’re clicking. It was 15 to 20 minutes and they’re sending that code over and everything’s happening in the background that Caitlin and her team want to happen.” 

Best Advice for EHR Optimization 

According to Julie, the best advice is the simplest: ask for help. She said, “People are so receptive to learning, they really want to know the product and I am of the school of teaching folks how to fish. I think we at Medical Advantage want to meet people where they are. We don’t want to come in and say do this, this and this and then they just kind of answer.” 

Julie added, “In the case of Alcona, they’re like a perfect client because they came to us with a list, they know what they need, they sort of know how to do it, but they want some advice on how to do it. I find the collaboration between us really is very special and I love clients that come in with the mission and want to understand how to do it and not just what to do.” 

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Full Episode Transcript

Medical Advantage Podcast: Welcome to the Medical Advantage Podcast, where you can hear healthcare professionals, expert consultants, and industry thought leaders discuss the exciting new ideas and technologies that are changing the business of healthcare. Tune in to each episode as we hear from some of the most innovative minds in medicine about the future of healthcare and how your organization can stay profitable, efficient, and on top of industry best practices. 

Celina DeFigueiredo-Dusseau: Hello everyone and welcome back to the Medical Advantage podcast series. On this week’s episode, we’ve put together an audio version of Medical Advantage’s Webinar with Alcona Health Center. In this webinar, we sat down with Alcona’s, Caitlin Schlappi to discuss how Medical Advantage was able to assist their FQHC with their specific EHR and telehealth needs. 

This conversation was part of a larger webinar series, so to watch this and previous episodes, visit our website at or just sit back, relax, and enjoy the audio version of this webinar. Thanks for listening.  

Hello everyone. My name is Celina Dusseau, and on behalf of everybody here at Medical Advantage, I would like to welcome you to our webinar today on the Alcona Health Center and the NextGen EHR. Before we get started here, let me introduce our presenters today. We are joined by Caitlin Schlappi, our special guest, a member of the team at Alcona Health Center, an FQHC with many locations across Northern Michigan. We are also joined by Julie Chiesa, she’s a member of Medical Advantage and she is our lead NextGen consultant. For years, Julie has worked one-on-one with practices optimizing their EHR platform, as well as supporting telehealth technology. Myself and Bill are members of the marketing team here.  

Bill Riley: All right, thanks Celina. So before we dive in, just a little bit about Medical Advantage, who we are. We’re part of The Doctor’s Company which is now the largest physician owned medical malpractice insurer in the country with the presence in all 50 states. TDC now consists of several business units most of which are, are primarily focused on medical malpractice, insurance products, or patient safety products. Medical Advantage is the business unit specifically focused on working directly with practices. We provide a range of consulting services at the point of care doing whatever it takes to help the practice, the clinic, the center be successful. 

If we look at our services in a little more detail, they, they really fall into two categories, practice transformation, and the EHR services we’re going to talk mostly about today. In terms of practice transformation, it’s really just based on whatever the needs of the practice might be, whether it’s clinical, financial, office management opportunities, proper use of technology within the practice. We have some contracts directly with practices or health centers including those, increasingly those that are backed by private equity firms. We also work with payers to engage practices within the payers network, perhaps on behalf of the insurance company. 

We have relationships with several healthcare technology vendors, population health companies, data analytics vendors, particular EHR software companies where in fact we become an extension of their professional services team. Just making things happen at the point of care. From an EHR services standpoint, like I said, this is where we’ll focus most of our attention today with, with Caitlin and Julie. I think we all know the critical role of the EHR within any practice or specialty. There’s always an opportunity to help practices improve. Whether that’s staff training or streamlining, simplifying the interface, fewer clicks, fewer buttons for common operations making sure the data’s flowing correctly from progress note all the way through to claims and billing. Such that practices are getting credit for the good work they’re doing. Telehealth especially of late is an area where we’re spending a lot of time. And this is something we’re gonna talk about in more detail shortly, NextGen. In addition to NextGen, also eClinicalWorks, Allscripts and Greenway are the major ambulatory EHR platforms that we support.  

Okay so with that, let’s get to our content for today. So again Caitlin, Julie, thank you so much for joining us today. Why don’t we start just by talking about Alcona, who you are, what you do, who you serve. Why don’t we start there?  

Caitlin Schlappi: Okay. So, Alcona Health Center we are an FQHC in northern Michigan. We have 17 actual sites across Northern Michigan. We have medical, we offer walk-in services. We have dental, behavioral health care management, we have behavioral health in 20 schools actually in northern Michigan. So we have a little bit of everything, a little bit of everywhere, as far as Northern Michigan goes. So yeah, so that’s the gist.  

Bill Riley: Okay, great. Can you tell us about your role at the center? I understand you’re an RN by training, but what are you responsible for?  

Caitlin Schlappi: I am, so I’m an RN. My background is clinical, obviously but I work in the health information department, so our department is all things EMR. My role specifically is the EMR coordinator. So I am all things EMR, whether it’s training workflows, simplifying and streamlining templates, that sort of thing. I’m all things EMR and that’s what our department does. We train new hires on the EMR and do all the background work as well.  

Bill Riley: Okay and speaking of that, you are on the NextGen platform. Can you talk a little bit about how, how long you’ve been on that software?  

Caitlin Schlappi: Sure. Yeah. We went live with NextGen in the beginning of September, so about about 10 months now. Still feels very new. It takes a long time to learn an EMR front to back, and so yeah, it still feels very new, but we’ve been on it for about 10 months and it’s getting, we’re learning more every day.  

Bill Riley: Very good. So, Julie, from, from your perspective, I know you have a way of looking at NextGen clients so maybe can you share your thoughts on folks that are fairly new on the platform versus those have been on in it a while?  

Julie Chiesa: Yeah. So what I find in a practice like Alcona is that really they just don’t know what they don’t know. NextGen has a great department when you first get the software, you go onsite or they come to you and they do a lot of training, but then when it’s done, it’s done. And NextGen has a lot of bells and whistles and until folks have someone that has an expertise, it’s a lot of learning on your own.  

So what I find with smaller practices or practices that have been on for less time is that really it’s more of a question, answer and teaching them what they don’t know as opposed to an older practice or practice that had NextGen for years and years where they’ve done a lot of customizations, they’ve done a lot of configuration, and now they go, they wanna upgrade or they wanna do something else and they need someone to help them sort of scale back into the program and how it actually works. 

Bill Riley: Very good, very good. And that’s really, I think one of the real features or differentiators of the NextGen platform. We see there seems to be a range, right? That where, where NextGen is very flexible, very customizable. It’s a platform where you can really tailor it to the specific workflow needs and the staff needs within a center all the way to the other extreme where other platforms we work with are very locked down and there’s very little opportunity for that. 

Okay, so Caitlin, why don’t we start with, with your scenario before you met Julie. What was going on? What were some of the challenges or issues that you were facing?  

Caitlin Schlappi: So before we met Julie we were beginning to implement telehealth. So this is when Covid hit and we were like, okay, we really need to jump on this telehealth bandwagon and serve these patients. 

So, as far as figuring that out, we can handle that. But as far as what to do in the EMR, we were a little lost, we need certain consents documented and certain codes to go with other codes on the superville. And we were like a little lost. And then Julie came in and gave us a telehealth template for our providers to document on and then helped us customize it specifically to what we needed.  

A lot of what we need can be different because we’re an FQHC, so what we need as far as billing and even documentation can be completely different from what the practice down the road needs, so we have a lot of customization requests and so Julie gave us this little telehealth popup where literally, All of the documentation for a telehealth visit could be done in this one little screen. 

And that was huge. That was huge for us, that the codes went, the documentation was done, the note was generated, and it was all from one nice little streamlined screen, no extra clicks. So we were really struggling with what to do. We just didn’t know where to start. And then Julie came in and saved the day with her telehealth template.  

Bill Riley: So great. Thank you Caitlin. So Julie, from your perspective, as you first met Caitlin and the team, what were you seeing?  

Julie Chiesa: Well, yeah. So, telehealth, the way it’s kind of gone down so quickly. I think none of the EHR vendors were that prepared. So it’s not like NexGen had an upgrade where they could provide a lot of these clicks and consent and things that are available. And if a practice chooses not to use their telehealth arm, like Alcona, who’s using a Zoom. I think, right, are you using Zoom for healthcare? There’s some documentation pieces that need to happen that are not as automated. 

So I had created a template for Medical Advantage to be able to distribute to our practices, and again, it is very portable, so I found that the Alcona folks, they knew what they needed, they just didn’t know how to implement it. So in giving them this piece, this starting piece, we were able to all kind of jump off at the same time and and figure out how it would work best for. 

Bill Riley: Very good. Yeah, so I think we hear this so often where practices go into telehealth. Thinking or fearing that just getting the technology to work, getting video calls with patients for virtual visits, making that happen consistently. Wow. That’s the hard part. But I think so often we find there’s all this other surround in terms of pre-visit consent forms and integration with the patient note that represents a lot of work as well.  

Okay. Very good. So Julie or Caitlin, can you talk a little bit more about just some of the specific things? Maybe just the next level of detail around forms or questionnaires or other things that you did.  

Caitlin Schlappi: Yeah, so for example there are certain codes that we had to have attached to other CPT codes per payer. So that was something that we were like, oh boy, what, where do we even start with, with this? Is this gonna happen in the back or can we do it with one click on the template? So we actually have a G code that needs to go for every Medicare claim. So Julie showed us how to pull in that G code so it’ll go per payer, so we can pick exactly what payer, and this is all on the template.  

This isn’t in the background. This is manipulated by us. We can change this if it needs to be changed so that’s one specific example. Another example is just a simple like a check box that indicates that the patient gave consent for a virtual visit. Things like that pull in the actual platform that we’re using. So, like Julie said, we’re using Zoom, so when the provider clicks that consent box, it’ll say the patient consents to using the Zoom platform for audio, video, whatever. So those are some specific examples. More recently this telehealth thing is ever changing, never ending. 

So, which is a great way for us to serve our patients. But there’s a lot that changes, especially with payers. So just yesterday, this is a really great example, we wanted certain codes to show on this telehealth template, again, based on payer. So they would only be available to select when the payer was Medicare. We thought we had it, but we couldn’t quite get it, so we. A little joke at when we get stuck and we say 1-800-Call-Julie. So we send Julie a quick email and sure enough, an hour later we were on the phone and we had it all fixed up in 20 minutes. So she walked us through how to do it so it, it made sense. 

And we were almost there but there are a lot of little specific things like that that change on a monthly, sometimes it feels, daily basis, that are specific to us that Julie has helped with.  

Bill Riley: Very good. So Julie, from your perspective how receptive did you find the team at Alcona? Again, here’s another example where we’ve had a wide range of some practices are very proactive and moving very quickly with telehealth. Others can be a little bit more resistant. So what did you find with Alcona?  

Julie Chiesa: Well, Alcona knew what they needed, they knew what they wanted, they just didn’t know where, where to do it. They didn’t know how to get there. And I found them super receptive. They come with ideas, they know what they wanna do. They understand the limitations or lack thereof limitations in NextGen and they come to me with, how can we do this? Or in the example from yesterday, it was a simple show, hide trigger that would show certain codes at certain times for certain payers and hide certain codes when it wasn’t, or a phone versus the video visit. 

And they had gone, they had taken it to the 99 yard line. They knew what they were doing and building it. They just couldn’t get it exactly the way they wanted. I just came in and took it over, over the the finish line for them. And really, again, they knew what they were doing, they just needed a little bit of instruction on the programming language behind the scenes.  

Bill Riley: That’s great. And especially just hearing what you did with the specific CPT codes by payer. I know a lot of people are struggling with that. Earlier this spring, we hosted any number of webinars, talking about telehealth, best practices, telehealth technology telehealth, billing and coding. 

And no matter what the session was, overwhelmingly, we got the most questions around coding and proper coding, proper documenting. So it sounds like you have automated a lot of that, Caitlin, right?  

Julie Chiesa: Yeah, we’re looking at it from the financial class. So in NextGen things are putting commercial or worker’s comp and Medicare. So actually we took it, we loaded the financial class to load in the background of the template, and that’s sort of how it talks to the template and lets it know, okay, when I click, make this happen when I click that, make that happen. So we’ve been able to really make it very specific to the Medicare payers as well as being able to send over the appropriate modifiers when necessary, because obviously some payers require a 95, some payers don’t. 

So we’ve been able to program it all the way. So again, at the end user level, doctors just clicking on “did a telehealth visit”. They’re doing their documentation, they’re clicking, it was 15 to 20 minutes and they’re sending that code over and everything’s happening in the background that Caitlin and her team want to happen. 

Caitlin Schlappi: Yeah so essentially on some telehealth visits, you can have two to three codes each with a different modifier. And the way that Julie was able to help us set it up is when that provider clicks submit, they all go, every single one, the modifier, the code. So nobody has to worry about it. So that’s been, you can imagine on the user end of things, that’s such a relief for our clerical staff, our billing staff, our providers, they don’t have to think about that.  

Bill Riley: Yeah, that was actually gonna be my next question. So what’s the result about all this? How, what, was there a learning curve or training that people had to go through? And how’s that worked since?  

Caitlin Schlappi: Yeah. With the telehealth template specifically we rolled out telehealth since we have 17 locations and a limited number of people in our department, we rolled it out kind of site by site. So we did a day or two at one or two sites and made sure we knew what we were doing and then we rolled it out to everybody else. So there was a little bit of training, but honestly, not a lot because a lot of the things in the template that Julie built mirror what’s located in other places in NextGen. 

So it’s was more streamlined. There wasn’t a huge learning curve because they were still documenting in the same pop-ups or the same templates. It was just consolidated so they didn’t have to go all over the place, if that makes sense. So that again, made it so much easierbecause we didn’t have to, being so spread out sometimes, training can be really difficult, on new templates or things. So that made it a lot easier that the providers who tend to pick up quickly on those things had no problem at all.  

Bill Riley: Great. And now Caitlin, had you guys already been doing telehealth visits and then they increased or?  

Caitlin Schlappi: Yeah, so we’ve done telehealth for years a little bit differently. We’ve have behavioral health providers where the patient actually comes to our office and sees a behavioral health provider in like Ann Arbor. So it’s a little bit different in that we can use different platforms and things because it’s all within our own Alcona site, since the patient is here on site. 

So it was a little bit different. So the actual, for lack of a better word, real telehealth where the patients are in their home and the providers here was a little step up from what we were doing. 

Bill Riley: Okay, great. So any other, in terms of results, anything else Julie or Caitlin that you wanna mention in terms of, we talked about the staff and their receptivity, maybe the physicians, maybe patients, any other feedback to share?  

Julie Chiesa: I mean for, oh, sorry. Go ahead, Caitlin. 

Caitlin Schlappi: Oh no, go ahead Julie. You’re good.  

Julie Chiesa: I was just gonna say I think the streamlining of it from the end user perspective also goes all the way through the billing department. So we are programming it on the EHR side, the EHR team is saying, okay, this has to happen, when this happens, and that happens. 

And that crosses over to billing and kind of takes a lot of work out of their day in having to a, either, manually code, which gosh we don’t wanna do that. And also kind of takes the errors out of it where the billing stuff really just has to go kind of confirm that the documentation meets what somebody sends, as opposed to kind of having to do all that. So in addition to sort of helping the EMR people, we’re helping the practice management people as well, just by doing some of these tweaks.  

Bill Riley: Very good, okay, so why don’t we talk about, we’ve got any number of I think we have a mix of folks on the line just looking at the the current folks who’ve signed in a mix of NextGen practices as well as some FQHC. 

So, Caitlin, from your sense, are there any lessons learned or any free advice if you had to do this all over again? Things that you might do differently or suggestions that you could offer?  

Caitlin Schlappi: I guess my biggest suggestion would be as simple as it sounds, ask for help, this Covid thing is, I think has taught us all that this is uncharted territory and we’re all kind of in it together, trying to get through it day by day, take care of our patients, keep our employees and our providers safe and telehealth has allowed us to do that.  

So we didn’t know, we were confused, didn’t know what we were doing, and we asked for help. And it has been just tremendous. I just don’t know what we would’ve done really. I mean, it would’ve been so much more work, honestly on the back end of things with billing, like Julie was saying because these changes go from the EHR all the way up to the clerical side, all the way through to the billing side. 

So my biggest suggestion is ask for help. And if you don’t know, that’s all right, ask for help. If your EMR is kind of formattable like NextGen is and you’re just not quite sure how to get there, ask for help and get it done.  

Bill Riley: Very good. And Julie, any thoughts for practices like Caitlin that have been on the platform? 

Julie Chiesa: Yeah they are so receptive to learning. They really wanna know the product and I am of the school of teaching folks how to fish. I think we at Medical Advantage wanna meet people where they are, we don’t wanna come in and say, do this, this, and this. And then they just kind of answer. In the case of Alcona, they’re like a perfect client because they have come with what they know, what they need, they sort of know how to do it, but they want some advice on how to do it. And they would rather kind of make the attempt to do it themselves and have me come in and for lack of a better term, that cleanup on what they’ve done and I find that the collaboration between us really is very special and I love clients again that kind of come in with the mission and want to understand how to do it, not just what to do.  

Caitlin Schlappi: Yeah. We’re definitely all about being independent. So it sometimes takes us an hour of looking at something and then we’re like, all right, Julie, could I have this done? 

We need to just ask when we’ve hit the wall. We need to ask for help. But yeah, we’re very willing to learn. We wanna know how to do it ourselves. And that’s what’s great about working with Julie too, is she walks you through step by step what she’s doing and why, and why it works this way and not this way? So in the world of triggers and getting all of the coding right in the triggers, it can be a little much, it can be a brain overload sometimes, but Julie walks us through it, so we know how to do it. After we get off the call with her, which is really great, right? 

Julie Chiesa: So some practices, we go in and we do the work, right? They assign us a project and we do the work and we kind of do it independently and we come back to them. When it’s done with Alcona, I’m actually doing the work on screen. And explaining the why and explaining, okay, this trigger works like this because of this, or it works like that. 

Because of that, and it really works well and I think again, it works for them in learning. They’re getting training, not where you kind of come to a class and someone says, okay, click this to do this. They’re bringing me their real world problems. What their issues are, and then I’m helping them to come up with best practice as well as how do we solve this? Do we have to do a template edit? Is this something that’s configurable? Is there something in the EHR that already does what you’re looking to do? Because again, I call the EHRs, like our brain, right? We use 10% of our brains. I feel the same way about the EHR. Especially when you’ve got a multi-specialty situation like Caitlin does, sometimes folks don’t know that, “Hey, we’re already doing this on the GI templates, you’ve just never looked at that before. So let’s go pop into GI and let me show you this functionality. And then we could retrofit it into your workflow.” So I think that that’s a big part of it as well. 

Bill Riley: Okay, great. As we start to wrap up here, why don’t we take a couple questions? Celina, can you let us know if we’ve had any questions come in? 

Celina DeFigueiredo-Dusseau: We sure have. Thank you to everybody that has submitted questions so far. And Julie and Caitlin, thank you so much for sharing everything that you have. 

One here to start for Caitlin. “So we’re an FQHC in Ohio. We’ve had some issues getting telehealth to work consistently. Can you share any tips that made it successful with your staff and patients in terms of the technology working consistently and getting your staff to buy-in?”  

Caitlin Schlappi: Yeah, so like I mentioned, we kind of started with one or two sites, so our sites are spread all over, and that’s kind of a model that we’ve followed with some other rollouts that we’ve done where we choose, we call them our classic sites and our northern sites. So where we choose one of each and and start slow, but not too slow. So we give ’em a day or two so we can internally work out the kinks and see what works and what doesn’t, and then disperse. So I would say give yourself a cushion and also make sure that you have something, make sure you have a plan for your EMR so you don’t want to say, okay, we’re going to use Zoom, and we have that, and then get on your telehealth call and be like, well, what now? And have your providers free texting and consent and crazy things like that. So have a plan but also be flexible, be willing to roll with the punches.  

Celina DeFigueiredo-Dusseau: Excellent. Thank you. And we have a couple questions here regarding the NextGen upgrades. So Caitlin somebody asked, “It’s interesting to hear that your staff is starting to take on some of the NextGen updates. Can you talk a bit about the backgrounds of the staff performing this work? is it IT and technical or clinical?” 

Caitlin Schlappi: It’s actually, it’s a little bit of both. So everybody who does anything with templates specifically like Julie and I have been speaking to, we don’t necessarily have an IT background. Like I’m a nurse and Andrea, who I work with closely, my colleague, her and I are the main ones who do templates. She’s been in the health information department. So we don’t necessarily have like an IT background, we do have an EMR background specifically.  

So the way that our departments are set up is we have our information systems and then our health information, and we work really closely together, but we work specifically in the EMR. So actually no, there’s really not a lot of IT background, we’re just learning from Julie.  

Celina DeFigueiredo-Dusseau: That is awesome. Good for you guys and this one’s for Julie. So can you share any thoughts on upgrading to the latest big release of NextGen and some of the concerns regarding the loss of custom templates? 

Julie Chiesa: Sure. So as a lot of NextGen folks know or don’t know, there’s an update that’s coming down the pike and there’s a more recent update where the the backend is changing, the architecture is changing, they’re changing from the KBM model, which was our knowledge-based model, which was our really open source template system to what they’re calling the ACE content but it’s gonna be a little bit more locked down. So ,folks are a little concerned “What’s gonna happen to my custom templates, how am I gonna work this? I’ve done so much.” And what we are doing at Medical Advantage is really to help folks to figure out what they can still use, because some of it is gonna be more configurable. 

It’s not that they’re locking the whole thing down and you’re never gonna be able to do anything again. It’s just how do we work smarter? How do we work so that we’re future casting and that we can say, okay, when we take spring release in 2021, how is this going to work when we get to spring release and this particular template is locked down too?  

I also know just from listening in on some webinars, that NextGen may be coming up with a tool to allow us to edit or to be able to manipulate that content a little bit more. So I think it’s kind of ever changing, even on the NextGen side. 

But right now, this. The thing that I tell most folks is take an inventory of what you’ve done, make sure you have a really good change management documentation, and then we can come in and gap and say, okay, NextGen solved this issue. You built this four years ago, not in the case of Caitlin, but you built this particular template X amount of years ago, NextGen has this now, so let’s sunset yours. And start to use NextGen’s functionality and see where we need to tweak, and again, building things that what I call portable development, where we know we’re gonna be able to bring it into that next version and the next version, and the next version without a lot of impact. 

Celina DeFigueiredo-Dusseau: Excellent. Thank you Julie. We do have a few more questions here, but in the interest of time, we’re gonna wrap up with the Q and A. Anybody that has submitted questions that we didn’t get to today, I promise we will be reaching out one-on-one to be sure that all of those are answered for you.  

Bill Riley: All right, thanks Celina. So as we sign off, just a couple quick points. First the blog section of the Medical Advantage Group website. We’re publishing quite a lot of content specific to EHR best practices, NextGen opportunities. It’s typically one to two times a week. We’re putting up new content from members of our team, such as Julie and beyond.  

All right, so with that Caitlin on behalf of Julie, Celina and I, we really wanna thank you for joining us today, sharing your thoughts. Thanks a lot.  

Caitlin Schlappi: Of course.  

Celina DeFigueiredo-Dusseau: Thanks for listening into some of the key points from our webinar. Discussing our work with Alcona Health Center. To view the full webinar, additional entries in the series and further resources regarding Medical Advantage’s in-practice technology service offerings, please visit our website at See you next time. 

Medical Advantage Podcast: Thanks for joining us this week on the Medical Advantage Podcast where we discuss the ideas and technologies changing healthcare and what they mean to your organization. For more information, visit us at and make sure to subscribe to the podcast on iTunes, Spotify, or wherever you get your podcast, so you never miss a show. 

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