Certified E.H.R. Software and $44,000.00 Stimulus Package, the Other Side of the Medal

:dropcap_open:P:dropcap_close:latinum System chiropractic software is one of the innovative success stories in the chiropractic profession worldwide. Today, we are interviewing Mr. Claude Cote, owner and founder of Platinum System E.H.R. software.
coteclaudepssTAC: Mr. Cote, for the benefit of our readers, could you introduce yourself and speak about your company:
MR. CLAUDE COTE: I am the founder and president of Platinum System C.R. Corp. I am the innovator of the famous Platinum System which is a fully automated Electronic Health Record system. Some of the modules I have innovated are the automated calling system which takes control of the chiropractor waiting room, the Chiropractic Health Card for patients, the automatic billing system where the billing is entered automatically from the doctor’s screen, the “one click” appointment generator, SOAP notes generated from a special touch-pad design, a very unique USA insurance management and automatic payment posting system in each patient file, an automated and fully integrated credit card processor system, and many more.
TAC: Since when has your company been in business and how was the evolution?
MR. CLAUDE COTE: Platinum System has been in business since 1989. As any other software of the time, it was only a billing and scheduling system for chiropractors. The constant growth started right from the beginning. In 1996, billing and scheduling was not enough for me. I knew I could do much more for chiropractors. I created a personal challenge for myself to make chiropractic the most advanced technology profession for office management. This in mind, I worked full time for years in designing and programming, with my development team, a full automated software system. The system was used for the first time in a chiropractic clinic on September 9th, 2001, exactly 10 years ago. This new revolutionary system was an instant and huge success. Since then, it has been installed in 18 countries over 5 continents and nationwide in the USA.
TAC: How did you come to work for the chiropractic profession only, as you could have many more opportunities in other health professions?
MR. CLAUDE COTE: I have 2 passions in life: Chiropractic and computers. I could not do anything else for chiropractic other than creating an extraordinary software system and could not do anything for computers other than programming for the chiropractic profession. I just had no other option. It was and still is the perfect match for me. Passion has run all my life and luckily I could combine both of my passions for one single purpose, serving the chiropractic profession to the best of my ability. Although Platinum System could be used by other practitioners, I do not plan to serve any other health profession other than chiropractic. Chiropractic has supported me during my entire career and I will be loyal to chiropractic forever. Honesty and loyalty are my 2 most important values in life.
TAC: In today’s world, many companies tend to automate their service and reduce operating cost by eliminating jobs. Your solution and help center answers the phone instantly for 99% of the calls. How can you achieve this hard task?
MR. CLAUDE COTE: Speaking for myself, I am sick and tired of waiting on line for service and hearing “Your call is important to us…” Well, if my call is that important, why don’t you answer me right away then? I hate wasting my time on the phone, waiting for someone to talk to. So the answer is very simple. I don’t treat other people how I don’t like to be treated. Money and savings is not everything in life. You need to commit to your promises. And we do.
This is part of my core values in life. Not only are clients answered instantly, but they are answered by an experienced and knowledgeably trained agent. Our clients love our service and it is one reason, among others, that they switch to our products and service and never leave us then after. My Solution Center team becomes part of their chiropractic team and both of us together lead to success for both sides of the partnership. We create a win-win situation.
TAC: What do you think about the stimulus package and the remittance of $44,000 from the government to chiropractors who will use a certified software system?
MR. CLAUDE COTE: I will give you my humble and very personal opinion on this topic. First, let me tell you that I have personally installed and trained hundreds of chiropractic clinics. I know very well how chiropractic works and how doctors run their offices efficiently. Many doctors are presently thinking that, if they buy a certified software system and install it in their clinic, they will automatically be paid back $44,000.00 from the government. This is not true.
TAC: What are the requirements to get the $44,000 then?
MR. CLAUDE COTE: To be paid, chiropractic doctors will need to show all the meaningful use objectives which apply to chiropractic using a full certified software system. Basically, it is not because you buy a certified software system that you will get paid, it is the way you will change how you practice chiropractic. As a very simple example, do chiropractors ask their patients if they smoke now and maintain the answers in a database? They will now have to in order to get the $44,000. My advice to doctors is to get familiar with all the required meaningful use objectives they will have to meet. The list of meaningful use objectives required is long. Doctors can find and read them on the internet at www.platinumsystem.com and click on “List of all meaningful use objectives”. Doctors, please go on that link and get informed on what you will need to do if you aim to get some incentive payments.
:dropcap_open:Also, doctors will need to show meaningful use for a period of 10 years or will be subject to reimburse the compensation:quoteleft_close:
Many doctors think they will have to show meaningful use objectives for Medicare patients only. This is false. They will have to show meaningful use objectives for all patients in their office, including cash patients. Also, doctors will need to show meaningful use for a period of 10 years or will be subject to reimburse the compensation. Chiropractors are to be very cautious with the $44,000 incentive. In my personal opinion, good chances are that it will cost much more than $44,000 for a doctor to operate his office in a meaningful use environment for 5 years. Doctors who want to do it have to do it for other considerations than money incentive or they may have a deception. Don’t get me wrong, I am not saying not to go certified. I am advising doctors to get informed well before committing to changing the way they practice.
TAC: Will it be mandatory to use a certified software system to bill Medicare?
MR. CLAUDE COTE: No. Absolutely not. Again there is a big confusion around the Medicare billing. Doctors will be able to bill Medicare with paper if they wish to. Medicare is talking about a penalty of 1% starting in 2015 with a maximum of 3% in 2017 for non certified doctors. Financially, I figure doctors will save much more than 3% of their Medicare billing by not supporting the cost of a certified software system.
TAC: The chiropractic profession is submerged with promotions about the $44,000 incentive. What do you think about all these advertisements?
MR. CLAUDE COTE: Lately, I went on the website of a certified software system. I read: “At …., we don’t think any doctor should buy practice software simply to take advantage of the government’s up to $44,000 incentive.…. For a limited time, D.C.s are eligible to receive incentive money from the government by implementing a certified EHR (Electronic Health Record) system within their practice.”
There are two major interpretations that need to be said about this statement. First, they tell you something like “There is no guarantee that you will get paid, but if you don’t get paid, don’t be angry about us because we told you”. And second, they use the word “implementing”. For most people and doctors, the verb “implementing” means more like “installing” a certified software system. This looks very simple to do. But, in this case, implementing means much more. It means buying a certified software system, installing it, learning it and using it the way the government told you by showing all the meaningful use objectives.
TAC: As a software developer for over 22 years, what is your opinion about the structure of a certified software system?
MR. CLAUDE COTE: I see a major problem with this certified system project. The problem resides in the fact that every office will have its own database. As an example, a patient who will see 20 different health professionals (chiropractors, medical doctors, etc.) within 20 years will have 20 different patient files with different information in each one of them. None of the professionals will have the entire health history of the patient. Let’s say a new patient goes to your office and you ask him “What is your smoking status?” The patient answers “Non-smoker”. While in real life he could have smoked for 25 years and quit 6 months ago, he may have stopped and restarted smoking 50 times during the last 20 years, etc. To be useful, a database needs to be updated and kept accurate.
TAC: Does a certified software system have the function to exchange patient information with other professions and other chiropractors?
MR. CLAUDE COTE: Yes, absolutely. When was the last time a chiropractic doctor received a referred patient from a medical doctor? With a certified software system, how many patients do you expect from medical doctors? Since 2003, the chiropractic profession has the possibility to exchange chiropractic patient files electronically between them with our Platinum System. Chiropractic is way ahead of the stimulus package with a certified software system on this function. Last year, I saw over 4,000 Platinum System patient files exchanges between chiropractors who work in 18 different countries. Chiropractic is a long-time leader in patient files exchange.
TAC: Financially, don’t you think the $44,000 will help chiropractors?
MR. CLAUDE COTE: Ok, let’s talk about money only. My answer to this question will surprise many readers. NO, no and absolutely not. The $44,000 stimulus is a great marketing help for psssoftware companies. Let’s say a doctor buys a certified software system. Then, after, he will have to pay for service. After he is in with certification, the doctor cannot back off or he will have to reimburse the incentive. Then, what prevents software companies from raising his service fees to maintain certification? A new job called HIT, which stands for Health Information Technology, has been created to help doctors implementing all the meaningful use objectives with their certified software system. But these guys are not free.
Doctors will have to pay for this service too. What about if the government adds some meaningful use objectives in the future or changes the way they are now? The certified software companies will have to spend big money to keep up and guess who will pay the bill at the end? Sorry but this $44,000 will not be given free by the government.
Have you ever seen your government send you a check for nothing? Personally, I can see Medicare saving tons of money if they can audit certified offices electronically and remotely. I would guess they can ask doctors with a certified software system to send them patient files electronically for reviews. They could save a tremendous amount of money there. What do you think?
Chiropractors need to promote the benefits of chiropractic and need to get new patients in their clinics to go through this bad economy. Doctors need to get their monthly bills paid on time. In my opinion, this is what doctors really need.
TAC: At the end, do you think all or most chiropractors will adhere to the stimulus package and certified software?
MR. CLAUDE COTE: No. Nobody really knows how many chiropractors will go for it or not. Right now, for all these reasons above, less than 5% of all the doctors I know are going certified. And most of the doctors who go for certification are doing so for the $44,000 incentive. What will be the use of this project if less than 80% get their certification?
Again, these questions about the stimulus package reflect my own and very personal opinion. My dream project would have been a central database, where every patient gets one single health file and all doctors get the updated file as well as a complete patient health history. This central database would not be used for financial audition in any way and would serve for health purposes only.
In this software certification project, I see chiropractors as being the judge and they will have the final answer. This interview is giving me the opportunity to give chiropractors the other side of the medal about the stimulus package. This is my humble opinion on this subject and the future will give us the final answer.
TAC: To end this interview, what would you like to say to the chiropractic profession?
MR. CLAUDE COTE: Being a chiropractor is not an easy task right now. The economy is bad and it does not seem like tomorrow will be much better. Lately, we have heard we could face another recession. Insurance companies are more and more demanding in order to get paid. Doctors have pressure to spend more time on administrative tasks, thus reducing time to do what they love; helping patients to restore their health. The good news is technology is growing and is assisting more and more doctors to achieve what they need. Help is just around the corner.
Claude Cote is an expert in EHR systems, insurance billing and chiropractic clinic management for 22 years. He has installed EHR system in 18 countries over 5 continents and nationwide in USA. He is the President and Founder of Platinum System C.R. Corp (www.platinumsystem.com). For comments or questions, please email to [email protected]

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