athenaOne® is a centralized EHR solution, rolling many components of healthcare management into one. This platform is oriented toward the ambulatory space and has a robust billing system. You will find it in independent practices, large hospital organizations, and even retail clinics like Walmart. If you currently have athenaOne® or are considering making it your new EHR, you won’t want to miss this episode!
Staff Writer Holly Hurst sits down with EHR Consultant and athenaOne® Expert Billie Fusigboye-Oni to cover a myriad of athenaOne® capabilities, and its limitations, but also ways to respond to common challenges it may present to organizations like yours.
In this episode, you can learn about:
- What the three main modules are and how they integrate
- How the interface works
- How the billing process works
- The drawbacks of athenaOne®
- What optimization can do to make athenaOne® work best
Researching EHRs? Be sure to check out our episode about eClinicalWorks!
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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.
Rebekah Duke: Hello everyone and welcome back to the Medical Advantage Podcast. I’m Rebecca Duke here to introduce this episode all about athenaOne®. Back in November, we had a webinar all about eClinicalWorks and in similar fashion we’ll provide a detailed rundown of another EHR, athenaOne®. You know, EHR goals are different for every organization, but as far as choosing the best EHR brand for unique set of needs, or getting the most from your EHR, either way, you arrive at the same place, which is learning as much about it as possible.
So our staff writer, Holly Hurst, sat down with expert EHR consultant Billie Fusigboye-Oni, to talk about what makes athenaOne® different from other EHRs, what to expect, what challenges organizations may run into with athenaOne®, but also what solutions to consider to those challenges.
But before we get started, we’ll do a quick intro for first time listeners. This podcast is produced by Medical Advantage. Medical Advantage provides consulting designed to help practices improve care quality, reduced healthcare costs, and increased revenue. Our broad portfolio of services optimizes operations for medical practices, specialists, groups, and private equity.
So athenaOne® is a secure, comprehensive cloud-based EHR solution, tailored for practice management. It’s built to manage administration, documentation and communication involved in patient care, but also to streamline data management and provide secure access to patient information. Notable features include user-friendly interfaces that sync across multiple devices, making it easy to safely work with patient information from remote locations.
Plus a large library of integrations for medical billing, lab results, and third party applications. athenaOne® makes it easier for healthcare teams to work together efficiently. The features available through the solution are designed to be intuitive so that medical professionals can avoid common technology hassles that take time away from delivering quality patient care.
Now let’s drop in on what Holly and Billie have to cover.
Holly Hurst: So let’s just start with kind of the athenaOne® overview. You know, what sets Athena apart?
Billie Fusigboye-Oni: Yeah. So athenaOne® started off as a OB/GYN application. Athena is primarily an ambulatory based, well, it is an ambulatory based EHR application. I say primarily because a lot of times what you see is that organizations or practices that are using athenaOne® are partnering with hospitals that may be on a larger enterprise hospital systems such as Cerner or Epic.
And they also started off primarily focused on practice management. So Athena at its core is an amazing revenue cycle application and practice management application. And then later on they tacked on the clinicals portion and patient engagement applications. But they do revenue cycle very well. That is one of the biggest selling points.
How they bill as a company is based on how many claims go out the door. So if the claim does not go out the door, they don’t get paid. So if you can imagine majority of what they’re doing for the applications to making sure that the organization is set up or the practice is set up to get those bills out the door as cleanly as possible without errors.
The rules engine is something that they have created within Athena that allows them to pull information from all the different organizations or practices they work with to create rules based on payers, and so they know exactly what needs to be sent over to the payers on claims.
athenaOne® offers three different modules. They have multiple different modules, but the three major modules are Athena Clinicals, Athena Collector, and Athena Communicator. Athena Clinicals is your provider documentation, everything that goes into orders being sent out, received lab orders, imaging results, lab results coming back into the system. That’s part of the Athena Clinicals module.
Athena Collectors or billing functionality. So your registration and your scheduling, and then your claim submission.
And then we have communicator, which is your patient access model, which would include the patient portal things like Athena Mobile or Athena Patient Mobile. And like there are some result call features that go into the communicator model as well.
Holly Hurst: So what you just said kind of makes me wonder, so you’ve got these sort of three buckets within that Athena system, like how does the integration work with those degree buckets?
Billie Fusigboye-Oni: Yeah. And so prior to 2020, I say Athena allowed organizations to purchase either, Athena Collector on its own or purchase Athena collector. So they allow organizations to purchase whichever model they want, they can purchase collector, they can purchase Communicator.
They couldn’t purchase Communicator without clinicals cuz you need that functionality to work together but you could purchase collector and clinicals separate. Some organizations they were using a different billing software than the clinical software. Some were using a different clinical software than the billing software, right? So that, as you can imagine, caused a lot of different discrepancies and issues within the organization or within the organizations that were utilizing the disparate systems, right?
And so even in the EHR industry, there has been a push to integrate and make things easier for patients and providers, for documentation purposes, HIE purposes, continuity of care purposes. So Athena rebranded to what’s called athenaOne® and that athenaOne® package is what they’re selling.
So usually when they approach organization, the proposal that is given is athenaOne®, we’re gonna sell you all of these packages together. And so that you don’t run into the issues down the line that we’ve seen with other customers. And so that is how they’re overcoming that issue by selling it as a bundle instead of selling it as individual modules like they previously did.
They also offer, in addition to that, Athena Population Health, Athena Text, Athena Patient Portal. So there are a slew of other applications that you can add on to that athenaOne® umbrella if needed for an organization.
Holly Hurst: Something we didn’t touch on yet is the interface. How does that compare with other EHRs in terms of being user friendly?
Billie Fusigboye-Oni: Yeah, so a lot of the times when you are starting the use or starting to use another or transitioning to an EHR or implementing an EHR, that interface process or establishing those interface connections can be one of the toughest parts of that implementation.
But what Athena has done, it’s created those connections already. They’ve already built those interfaces native to their applications. So as you join as a practice or organization, they’re just adding you to that connection that already exists. So you’re not having to start this connection from scratch, which you have to do in a lot of the other EHR applications.
Athena is just literally adding you to their current ecosystem or ecosystem of organizations that are already partnered with that specific interface. So you would think things like Quest and LabCorp or any imaging, radiology facilities that the organization may interface with. And then they have an internal team within Athena that helps the practices manage their claims and their holds and issues that they may have with their claims.
So it’s a very, very robust revenue cycle application, but it also does clinicals very well. So when I say clinicals, I’m referring to the Athena Clinicals application, which is embedded within athenaOne® and I’ve always heard rave reviews from Athena Clinicals. From a provider or clinician perspective, it allows for seamless documentation of the patient ROS, HPI, physical exam and orders.
It allows, well, it offers organizations free interfacing with some of the largest, or free interfacing setup, with some of the largest interface vendors or lab and imaging vendors.
Holly Hurst: What kinds of organizations is athenaOne® best suited for?
Billie Fusigboye-Oni: So I’ve seen them provide their solution to smaller mom and pop, one to two provider practices all the way up to large enterprise clients.
Some of the ones that I am familiar with are Walmart Health. So Walmart Health, in a lot of their clinics, they were using Athena Health. So if you think how big of a Walmart is, they have clinics all over the country. And so they were using athenaOne®. I’ve been with practices that are, have up to, or more than a thousand providers that are using athenaOne®.
So I would say it’s an ambulatory based system. So your provider practices is where Athena is suited for, but it could be a small provider practice or it can be a large provider practice. But the ambulatory space is where Athena does really well.
Holly Hurst: Talking about athenaOne® in comparison to other EHRs, what are some of the things that you’ve noticed that are different about athenaOne®?
Billie Fusigboye-Oni: So I have a lot of experience using Epic and some of the other EHRs and they can be a lot more difficult to manage because they are database driven. I know some of them are starting to move to more cloud-based, but athenaOne® is one of the first EHRs that was focused on building their application on a cloud or a cloud-based structure, which allowed for implementation to be very quick and seamless.
Another thing, an implementation for Athena can take anywhere between 12 weeks to 26 weeks. So very short implementation timelines. 26 weeks being on, you know, some of those larger enterprise clients that have multiple different locations and maybe they’ll have multiple different go-live dates. A waved approach instead of a big bang approach.
And it’s what is different than a lot of other EHRs as well, is that everyone is on the same instance of the application. So three times a year Athena will push out upgrades and everyone gets the upgrades around the same time, within three days of each other.
So the upgrades are pushed out around the same time every year, and everyone is on the same instance of Athena, which makes it a lot easier to manage on an application or an analyst perspective, or a clinical support perspective. Because you are not responsible for the upgrades, which can be very, very labor intensive.
From an Epic perspective, I know that can take weeks or months to prepare for upgrades. From an eCW or NextGen perspective, I know that it’s a very, very labor intensive process to go through those upgrades with those other EHRs. But with Athena, very, very simple.
Well, the clinical support team really doesn’t have to do anything. Their main, you know, responsibility during those upgrades are to ensure that the users are aware of what’s coming down the pipeline and modify those workflows to fit any changes that may impact their workflows. So very seamless support and upgrade structure compared to some of the other EHRs.
So, if you were to do a comparison between Epic and Athena you know, they both have a large share of their respective markets, but they overlap a little bit. And one of the major cons that I hear from people is that Epic has a lot more functionality than Athena does.
But if you think about it, you don’t need as much functionality in the ambulatory space as you would need in the inpatient environment, right? Because you have a slew of different specialties in inpatient, you’re dealing with different, you know, providers and locations and it’s just more robust in inpatient setting. Where ambulatory, usually your patients, you know, come in for their check-in, for their visits and they’re not inpatient. They’re not spending a lot of time there.
So just those basic workflows are all you need. So I think for an ambulatory application, it does the job very well. But if you were to compare it to another larger application such as Epic, then it wouldn’t be considered as robust.
Holly Hurst: The customer support. I know that with some EHRs, particularly larger ones, some of the bigger ones, that can be a pain point. Do you feel like athenaOne® has maybe superior or, you know, very, very good customer support with their help desk and documentation?
Billie Fusigboye-Oni: So, yes and no. So from a documentation perspective, Athena does a really good job of providing their clients with step-by-step workflows on different different portions of the application.
They have a lot of tip sheets available but regarding customer support, that’s a complaint that I hear a lot from customers that I work with is that the CSC, so customer support center which clients can call in to the CSC or create tickets within the community portal and log tickets or call in issues with Athena and it’s a hit or miss.
You can call in and get someone that’s very experienced and can help resolve the issue at hand very quickly. But then sometimes you’ll call in and unfortunately you’ll get someone that is not able to help as much as you would need or to be able to resolve your issues.
So, there’s no consistency in the support. So a lot of clients, a lot of customers, they complain about the CSC or the customer support center and not being satisfied with their being able to resolve their issues.
So another thing that I would add to that, is that because of those standard upgrades, right? So you as a client of Athena do not have a choice to what is implemented or upgraded within your application that your organization is using. So there are one-offs that you can opt into or opt out of but essentially it’s going to be pushed out to you regardless, and then you have to opt out of it if you don’t want it.
But that’s not common. You maybe, like in the upgrade, you have like 50 different things that’ll change and maybe you have an option to opt out of maybe one or two. That being said, there are a lot of request for modifications to the applications that are submitted via that customer success portal, excuse me, and some of those requests have been sitting out there for five years, six years, without being implemented.
And so when, as a client or as a customer, I’m submitting a request because something’s impacting my workflow. I would wanna improve my workflow in some way, and I’m offering a suggestion to Athena to implement that but it goes on a voting. So the amount of votes that request gets determined how far along it’s pushed out or how far along it’ll go in the process of being vetted and then implemented as part of one of those upgrades.
So with other applications such as Epic, you can typically make those changes on your own. I mean, there’s some changes, of course, that the application just cannot do. And then of course they go through a process of trying to see how they can get that in there. But there’s more control with some of the other EHRs and what your practice sees within the EHR and not so much with Athena.
Holly Hurst: Okay. Well, let’s see. You’re so good, Billie. You just already answered my next question, which was really about the cons of the athenaOne® system. And it sounds like one of the bigger cons is maybe a lack of ability to customize. Is that kind of where we’re going with this?
Billie Fusigboye-Oni: Yes. Because you can customize the system.
It’s more of, can you improve the system based on findings? Like you’re trying to improve the system based on your workflow, but you can’t improve it, Athena has to go through that process of improving it for you. So because you can customize things, you can customize your templates, you can customize your workflows, you can customize a lot of different things within the application. But how the application functions and what features are available in the applications are where you cannot customize.
Holly Hurst: So can you tell me just about maybe like two or three common challenges that you run into?
Billie Fusigboye-Oni: Mm-hmm. Yeah. So one of the biggest ones from a clinical perspective would be that task management system.
Athena has something well, the task management workflow is inclusive of what’s called a task assignment override TAOs. And if not managed Correctly, it can get out of hand. And so if you don’t manage the task routing process at the beginning of implementation and have checks and balances in places so that redundant routings are not in place, that can cause a really big issue in the organization.
And what we see is that some of the larger enterprise clients, when I’m thinking 400 plus providers, if we don’t have a strong structure in place, things can get literally crazy. And you have tasks being routed to different users, task sitting in inboxes that no one is reviewing, providers that have over a hundred plus open encounters.
And so in my optimization experience, that has been one of the biggest challenges is really working with these enterprise clients that have so many departments that have so many providers. And typically you’ll only have a small team, maximum, I think I’ve been on a team of seven analysts that are managing this, and so if not managed appropriately from the beginning it can cause a big issue. So that was the task management workflow and Athena, specifically TAOs and the clinical inbox.
The second thing is billing. Athena has what’s called a co-sourcing model, right? So I don’t know if you’re familiar, the contract that Athena billed is per patient or per visit. So for every claim that’s dropped, Athena gets a percentage of that claim that is dropped.
And so their goal in the co-sourcing model is to make sure that, you know, that practice is able to get as many claims out the door. And so that’s why they’re very involved in that billing process. They have a team that really helps define a lot of the rules. They have a very, very robust rules engine.
And so that rules engine, what it does is that it identifies commonality throughout the Athena ecosystem. So all practices that are using Athena, they review and analyze payers procedure codes, CBT codes and how those rule, how those claims need to be sent out the door. And so a lot of organizations really don’t understand that co-sourcing model or don’t spend the time to understand what their responsibility is and what Athena’s responsibility is in that billing process.
Holly Hurst: So are there any other cons that you can think of?
Billie Fusigboye-Oni: Another big one is roles and permissions. So all applications, all EHRs are going to allow for roles and permissions to be defined based on your employees or your resources level of access needed within the application.
But the way that Athena’s roles and permissions are built, it’s really hard to find specific permission. So they bundle their permissions in a way that it’s very, very difficult to understand who has access to do what. And so that is one of the biggest cons or a big con that customers typically have is that, for example we need an NP to be able to review a specific type of record, right?
And so we would give the NP a specific permission, but that permission that we give the NP gives her more access or gives them more access than they should have. And so, even Athena doesn’t even understand all of their different permissions and what’s embedded in their permissions. So it can often be a juggling act to identify what permission should be given to each user so they have the appropriate amount of access to the system.
Holly Hurst: I was just going to ask about kind of workarounds or how you see solutions to some of the issues that we just talked about.
Billie Fusigboye-Oni: So the roles and permission. So typically what I see is that organization will take on maybe months. It can take a while to really narrow down the permissions that are needed within for the different resources.
So they could take a while. So it’s usually a project that’s implemented by the organization including different teams to make sure that the appropriate level of permissions are applied to the resources.
Unfortunately, some users will have more provisions than they actually need, but just based on the way that Athena’s built you just try your best to limit the amount of permissions that they have.
Regarding the upgrades it’s really nothing that you can do as a customer of Athena to manage those. Again, those are mandatory upgrades. You have no choice of what’s being pushed out. So you just you work with your team, your internal teams to ensure that they understand what’s coming down the line and how it’s gonna impact their workflow.
So I think that knowledge of how it’s going to impact their workflows is probably the only way to kind of mitigate that regarding the client support team, like not having a, you know, As well as a support team or support system as you would need, as a customer and client.
I mean, that’s where I come in as a consultant or an analyst. So I’ve worked with multiple large enterprise clients and then I would use my experience to help resolve some of those issues that would not be addressed in a timely manner. Or effectively by using Athena’s client support center.
Holly Hurst: That’s perfect Billie, cuz that kind of brings it full circle right to where, here’s where we come in and we can help out with some of these issues. Can you tell me about the services that we offer to our clients?
Billie Fusigboye-Oni: From an optimization perspective, we’re coming in and assessing the organization’s current table structure. So the database in Athena’s called a table. And then every client has their own table space. So from an optimization perspective, we are assessing their billing, clinical, patient access functionality within the Athena application. And in that we would take some time to really ensure that the organization is using the Athena functionality to the best of their ability.
Things that we would review from a clinical perspective would be the clinical inbox. So their task management system, it’s called the clinical inbox in Athena. We would review their templates to make sure that the templates are, and when I say templates, we’re referring to their physical exam templates, their ROS templates, their HPI templates, those provider documentation templates that are used to capture the patient information as they’re going through the workflows.
We would assess that and make sure that, you know, there are not any redundancies and the organization has utilized templates to capture all the information needed for billing purposes. And then we can offer suggestions for improvement. We would look at their patient access functionality.
Are there allowing patients to register a schedule appointments fee of the portal? Are they using a lot of the Athena functionality that can improve how the patient interacts with the organization? We would review from a registration perspective looking at what their registration scheduling workflows are currently, and ensuring that they’re utilizing it to the best of the application’s ability.
Sometimes in the beginning of an implementation, organizations are not sure what they need. Right. They have these specific workflows that identify at the beginning of the implementation, but as they start utilizing the application, they realize that there’s other things that they would like to have implemented as well.
And so working through understanding what those wishlists are and ensuring that the questions are addressed. A lot of the times what I’ve seen an optimization perspective is users are frustrated with the application or certain aspects of the application, but they don’t know how to get to a resolution.
So from an optimizations perspective, really spending time with the end users and the practice managers and the providers that actually using the application on a day-to-day basis and seeing how we can help them use the system to the best of its ability.
They have a lot of organizations bring individuals like myself and companies like Medical Advantage when they’re really struggling to understand how to effectively use their patient access or Athena Communicator functionality in Athena.
Are they bringing the portal correctly? Do they have the correct forms available on the portal for the patients to sign? Do their staff really understand what the self-checkin process is to allow patients to check in via their application or on the web.
So really sitting down with the team and really understanding how they’re using, using Athena Communicator and seeing how we can improve the use of that application.
You know, one big thing that I’ve realized just in the industry in general is the use of third-party applications. So what I’ve seen commonality in a lot across the board in tech is that their organizations are gonna focus on their core applications, right? Athena is an EHR, we are gonna focus on building out this EHR to the best of its Ability, but then we allow other organizations to come in that are better suited to handle such things as maybe scheduling capabilities.
We have applications such as Frisia and Epeon that are doing so well in this scheduling registration space that Athena’s not spending time in. Right if they can give you a basics of scheduling registration, but there’s other systems that come in and help out. There’s a lot of organizations that are providing billing support, there are organizations that are just, there’s so many different types of third-party vendors that integrate with Athena.
And I think that’s something that we can mention as well as Medical Advantage to say that we can help assess what application would work best for your organization. Like we have the experience based on working with prior organizations to say this application worked and this one didn’t. This one integrated with Athena well and this one didn’t. Or you know, the implementation or integration process with this organization was a lot smoother than this one.
Like if you think about like LK and you know, the data migration process, what does that look like? Right. So with our experience, we can give the organizations or our clients confidence that as they move forward with these third-party integrations, this is what it’s gonna look like, this is what to expect. Will it be a smooth process? Do we need to stay on top of the project management team? Giving them that insight is also gonna be very important or very helpful.
Holly Hurst: For sure. One more question. And that’s about implementation and training for staff. Can you tell me a little bit about that process? Like what are the benefits? So you’ve got this athenaOne® package, you know, why do you need Medical Advantage consultants to come in and help? What is it that we do from a training and implementation perspective? And optimization too, I guess down the road.
Billie Fusigboye-Oni: Exactly. Yeah. So Athena as an organization they will come and provide training on the functionality of the application, right? What is a typical workflow for an MA? What is a typical workflow for a provider? What should you expect as you move forward with your transition from your legacy system to Athena? They’ll provide that foundational training. They actually call it Foundation Foundational Training. They have an Athena Health Learning portal, and so prior to go live, the users of the organization can log onto athenahealth.com because it’s a cloud-based system, and they can start their training, their foundational training, so they understand the foundations of how to utilize the system.
But where consulting companies come in is we add that additional layer. To advise on the organization’s current workflows, right? Their current processes and how it’s going to fit into Athena. For example, what needs to be documented at the time of a patient’s registration?
Should emails be captured? Are there any specific notes that we wanna capture from the patient and document within the application. Where are we documenting that? Right? Because the ultimate goal is standardization across the board. In order to do that, it starts from training, right? So we’re training our staff on exactly what needs to be done at which stage in the process from an intake process should the MAs? Are the RNs be responsible for capturing the quality measures for the patients? Or is that something that the provider should be responsible for? So that’s where an organization like Medical Advantage would come in and say we’ve assessed your previous legacy system and we understand what the workflows need to be as we move forward with your implementation of Athena.
Now let’s create workflow documents. Let’s create training sessions that are really tailored to what needs to happen for billing and clinical documentation processes within your organization. So we add that extra layer of specificity for the organization as it pertains to their workflows.
Holly Hurst: You know, for administrators and people who are making these decisions. It’s gotta be hard when there’s so many options out there. It’s reassuring to have someone come in and say like, This is what you want. We’ve seen it before. We’ve been there, done that. Like we can help you with this. So that’s, that’s a really good add to the conversation, Billie. I appreciate it.
Billie Fusigboye-Oni: You’re welcome.
Rebekah Duke: And that’s it for today. Thank you so much, Holly and Billie, for bringing these insights to the surface to better understand athenaOne® and what it has to offer. And thank you audience for joining us today. Should you have any questions about improving your EHR experience or any ground we’ve covered today, go ahead and reach out to us through our website, medical advantage.com.
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