Solving Legacy Software Performance Issues

Monterey Peninsula was an early adopter of HST’s practice management software, reaping operational and efficiency benefits.

After implementing HST’s technology, their multiple facilities experienced:

Improved performance and ease of use
Seamless data integration
Cost savings

Center: Monterey Peninsula Surgery Centers

Featured products: HST Practice Management

Other products in use: HST Clariti

State: Tennessee

Customer type: Surgery Center

The Challenge

Case Study Overview: A sector leader addresses its legacy technology issues.

Monterey Peninsula Surgery Centers (MPSC) is an independent, multi-specialty ambulatory surgery center (ASC) with five locations on California’s Central Coast. Established in 1982, MPSC has long been an innovator in the ASC industry and was an early adopter of an electronic practice management solution. As the organization grew, however, it began to experience performance issues with its legacy solution. MPSC turned to HST Pathways for a comprehensive practice management solution that positions them for growth and innovation well into the future.

Situated at five locations around Monterey Bay, south of San Jose, California, MPSC has a history of innovation that dates to its founding in 1982, when it was one of the first ASCs on the state’s Central Coast. For example, in 2001, MPSC was one of the first ASCs to execute an all-inclusive, bundled payment agreement with a major insurance company. The company also pioneered price transparency by posting procedure costs on its website.

MPSC was also an innovator in medicine, introducing major spine surgery to the ASC setting in 2002. And it was also among the first ASCs to perform total joint replacement. Not surprisingly, MPSC was also an early adopter of electronic practice management software, reaping the operational and efficiency benefits that come with using a digital solution for managing the ASC. But, as an early adopter, MPSC’s solution was grounded in legacy technologies that did not keep pace with change.

Performance issues with legacy technology

“Our previous system served us well for a long time,” said Doug Stickler, Director, Information Technology for MPSC. “But we began to experience a number of issues that made us question whether or not that solution was going to serve us best in the long term.”

He pointed to several areas where MPSC began to experience problems:

Performance: The previous system was designed for on-premise deployment, with servers purchased and maintained by MPSC’s IT department. As MPSC’s volume of business grew, the system architecture contributed to performance issues. “We would try to run certain end-of-the-month reports, and the system would require us to kick everybody else out of the system in order to run the report,” Stickler said.
Service: As MPSC grew from a single facility to five locations the software couldn’t keep pace. “We had to log in to each site separately,” said Stickler. “The solution didn’t support needed data sharing between sites or at the enterprise level.”
Scalability: Ownership of MPSC’s legacy practice management solution changed several times over the course of MPSC’s use of the product. “The company seemed to lose a clear focus on ASCs,” said Stickler. “I had concerns they were going to change the product to focus on hospital outpatient departments and end up weighing down the software with a bunch of features that wouldn’t be useful for ASCs.”
Long-term direction of the supplier: “It was sometimes hard to get responsive customer support,” said Stickler. “And when we asked about possible improvements or reporting capabilities, it turned into a scope of work request that was basically a way of figuring out how much they would charge us for the improvements we requested.”

Evaluating the options

Because of these concerns, MPSC began to look at other options. Stickler identified several other ASCs with similar scope. “We looked for existing ASCs that had an enterprise arrangement like us. Enterprises with multiple facilities, that needed both site-level and enterprise-level data sharing,” he said. “We looked at everything from large vendors like Epic and Cerner to small, single-center type vendors.”

Based on his long IT experience, Stickler knew vendor presentations staged during the sales process do not always accurately represent an organization’s after-sales experience, so reference checks were an especially important part of MPSC’s research.

“We found that HST Pathways has a long list of happy customers and a history of doing right by their clients,” said Stickler. In the end, MPSC selected HST because of “their excellent references, the product features, and the cost.“

The Solution

Exceeding expectations

Stickler said HST provided plenty of support both before and after implementation of the new practice management solution. “Changing a practice management solution is always going to be disruptive,” he said, “but with HST Pathways’ support, we avoided the bumps in the road that you might expect after implementing a major new system.”

Stickler identified six general areas where HST shone:

Performance: Moving from on-premise deployment to a hosted solution resolved MPSC’s performance issues as well as offering additional benefits. “The hosted option is really good for us, from a systems management perspective,” said Stickler. “It’s better protected security-wise than what we could afford to do on our own. System maintenance, system updates and program updates are all now managed for us through the hosted side, which is great. We don’t have any more performance issues, either. Now, if I run a report, it’s not going to slow anybody else down.”
Cost: “HST Pathways’ hosted solution is also more cost-effective,” said Stickler. “On the system side, the cost of ownership of the hosted solution is better for MPSC than the on-premise situation because we no longer have the cost of buying and maintaining those servers or the cost of the staff time needed to maintain those servers.”
Bespoke Design: HST’s practice management solution is designed to support enterprise-level management specifically for ASCs. “HST has improved our ability to manage our business as an enterprise,” said Stickler. “Better enterprise information helps us make better decisions. The system administration capabilities helped us with standardizing supply lists across our facilities, with physician preference cards, with payer contracts and fee schedule updates. All of those things take a lot less time now than they used to.”
Ease of Use: “Users of all abilities—from the tech savvy, to the not-so-tech savvy— have been able to easily find the information they need without becoming technology experts” remarks Stickler. “The reporting is not hard for people to figure out, either. That has been a net positive for the organization.”
Data Integration: As MPSC’s director of IT, Stickler especially appreciates the ease of data integration with HST’s solution. MPSC chose to integrate the system with four other solutions: IOS Envi (supply chain management), One Medical Passport (patient engagement/ pre-admissions), MedTek (transcription) and ePay Loyale (patient financial engagement). “HST’s solution is fabulous at data integration and interfaces,” said Stickler. “That is a key highlight of the solution.”
Customer Service: “Customer support is a definite strength of HST Pathways,” said Stickler. “We almost always get a live person when we call. If we do have to leave a message, we get a call back the same day. We throw some pretty random stuff at them sometimes, but I am happy knowing that anybody in the organization can call that number and get support.”

Understanding the ASC Sector

“We are very happy to be involved with a company that is focused specifically on the ASC industry,” added Stickler. “The leadership of the company gives us confidence that over the next decade, we are not going to have to worry about changing our system. We don’t have to worry about features not keeping pace with the changing industry or prices going out-of-control. Our future looks good with HST Pathways.”

“We found that HST has a long list of happy customers and a history of doing right by their clients.” – Doug Stickler, Director, Information Technology

Solution

HST Pathways’ ASC practice management software, which provided numerous business benefits, including:

Enterprise-wide data sharing that supports data-driven decision-making
Hosted system that enhances data security and system integrity
Intuitive, easy-to-use design that improves workflow
Excellence in data integration that facilitates systems integration with other best-of-breed vendors
Lower total cost-of-ownership with a hosted solution
Commitment to ASC industry evident in solution design
Timely, responsive customer service

We are very happy to be involved with a company that is focused specifically on the ASC industry… our future looks good with HST Pathways.

Doug Stickler
Director, Information Technology

About Monterrey Peninsula Surgery Centers

MPSC has been leading innovation in the ASC industry since 1982. It was the first ASC in the US to execute an all-inclusive bundled payment agreement with a major insurance company, and pioneered major spine surgery and joint replacement. MPSC was named 2017 ASC of the Year by the California Ambulatory Surgery Association.

Services and facilities

MPSC is composed of five facilities, with a total of 16 operating rooms, along the Central Coast of California. MPSC has more than 200 surgeons on staff, who perform more than 16,000 cases a year across 12 specialties. MPSC is the sixth largest provider of outpatient surgery procedures in California, behind Stanford, UCLA and three Kaiser Medical Centers.

Objective

To improve operational efficiency and enterprise management by implementing a high-performance ASC practice management solution that supports facility-specific workflows, enterprise-wide data sharing, and data integration with other vendor partners.

Changing a practice management solution is always going to be disruptive, but with HST Pathways’ support, we avoided the bumps in the road that you might expect after implementing a major new system.

Doug Stickler
Director, Information Technology