President/CEO David L. Piccoli, II. (left) pictured with Discovery House founder (and father) David L. Piccoli Sr. (right)
In 1991 David Piccoli, II began working as an Administrative Assistant at Discovery House. Soon after,he was inspired to increase the clinic’s efficiencies. He thought there must be a better way to manage the facility’s endless flow of patient records, billing, and paperwork. “It was very chaotic,” Piccoli recalled. “Nobody had access to information quickly.” However, Piccoli wasn’t satisfied with any of the electronic-records products on the marketat that time. The majority of EHR’s focused on just one piece of the business, such as third-party billing or clinic records. “No one ever really combined everything” henoted.
So, Piccoli decided to create the EHR he wanted. He partnered with a computer programmer and family friend, Paul LeBeau. Together, they built a new clinic management software application for Discovery House. The idea was to digitize and automate a facility’s paperwork, from patient dosing and drug testing to scheduling and third-party billing. It worked so well that they formed SMART Management, Inc., to offer the program to other clinics. This EHR, the SMART Solution, was an integral part of making Discovery House such a successful organization. So,SMART continues to grow into a highly regarded EHR solution for OTP’s.
Simplify patient dosing and reduce risk
Substance abuse treatment clinic dosing window
The medication management and dispensing module in SMART’s EHR Software uses automation and built-in checks and balances to simplify medication management and virtually eliminate medication errors.The software automates dispensing and medication inventory for methadone liquids and solid forms including Suboxone, Subutex, Zubsolv, and generic buprenorphine/naloxone films and tablets. Use of Vivitrol (injectable naloxone) is also supported.Automated medication dispensing, auto patient check-in queue, dose verification signature, ID verification, and automated nursing notifications promotes patient safety and helps to limit the risk to both the patient and the agency.
Additionally, inventory management reports enable quick and accurate information gathering, improving inventory control. Moreover, SMART’s Electronic Health Record Software provides you the tools and automation to be ready for DEA audits at a moment’s notice.
HIPAA compliant hosting to protect patient health information
SMART’s cloud-based EHR is powered by Amazon Web Services (AWS), a world-renowned and trusted hosting solution. AWS is HIPAA compliant, helping covered entities subject to HIPAA regulations process, maintain, and store protected health information securely. Learn more about the impact of HIPAA on end-users and EHRs.
Furthermore, Amazon is known to have some of the best data centers in the world, providing multiple sources of redundancy to keep your servers up and running. In the unlikely event that a database restore is necessary, SMART’s Aurora database platform provides precise data protection with nightly back-ups and point-in-time recovery typically within 7-10 minutes. Learn more in the article, EHR Downtime. Impact, Recovery, Preparedness.
Other Benefits of Electronic Health Records
Features of the SMART Solution help increase admissions, streamline medication administration, promote team collaboration, expedite test results, and maximize revenue. Learn more about SMART’s Cloud-Based EHR Software.
Cornell Scott Community Health Center implemented the digital medical records software, The SMART Solution. They now use SMART’s EHR to streamline drug testing, dispensing, and inventory management. The drug testing module helps guide treatment decisions. It automates functions with customizable random drug test frequencies, specimen-due notifications, and reports and statistics. Additionally, the medication inventory management module helps to save time, reduce dosing errors, and prepare for DEA audits.
Established in 1968, Cornell Scott serves its community with a wide range of treatment options. They provide alcohol and drug addiction treatment, and prevention, education, and outreach services to the population of New Haven County. Cornell provides services including counseling, detoxification, and methadone maintenance.
After this EHR implementation, Nurse Erica Conte said the SMART Trainers were “very helpful and concerned about making sure we knew the material and felt comfortable with our set up before they left. Sandy worked diligently to make sure the company as a whole was operating efficiently with the SMART system. Amy was there every step of the way helping and guiding nursing and other staff to properly use the system.” SMART is excited to serve as Cornell Scott’s EHR partner and looks forward to assisting with their future needs.
Digital Medical Records for Clinic Mangement
SMART’s EHR does more than collecting and storing digital medical records. It is a comprehensive clinic management solution for opioid treatment programs domestically and internationally. Also, a highly experienced team of industry, clinical, operational management, and technical experts provide exceptional EHR support services to every customer served.
What the difference between having paperless health records and being 100% paperless?
The difference between being paperless and having 100% paperless health records can be game-changing. Being 100% paperless means there are ZERO physical patient charts or paper forms. You process every document in your clinic electronically. However, if your staff documents everything on paper and then scans it into the patient chart, you may be considered “paperless,” but not 100% paperless. Also important to note, scanning hand-written patient information means it’s not searchable and deriving metrics would be a tedious, manual process. The data is “invisible” to a computer if it’s hand-written. Whether you are partially paperless or are considering going paperless, it’s important to understand how to get the most out of your record keeping-system.
What issues are most common amongst clinics that aren’t fully-paperless?
Time and time again, we’ve seen EHR users taking actions (or not taking actions) that hold them back from being truly 100% paperless. The need to continuously file paper patient charts may not seem like a big deal if it’s what you’ve always done but; think about the alternative.
When a 100% paperless clinic switches to a new form, it is automatically utilized across all patient files. In a partially paperless environment, different staff members might be using different versions of the same form.
Managing quality of services can be challenging regardless of how you keep your records. However, this process can improve by doing it all electronically. For example, SMART’s EHR can be set to schedule all regulatory services as soon as the Admit and Discharge buttons are clicked. This feature enables clinical and medical staff to run their Service Due Reports. Management teams also can run quality control reports to ensure patients are receiving the right services.
Auditing paperless health records are also simplified when everything is easy to navigate and available electronically. Since everything is accessible remotely, quality control teams don’t need to travel to the clinic. Moreover, the QC reports in SMART’s EHR make it easy to located and focus on problem areas.
Data collection standards
Creating service type templates can significantly improve data collection. You can build-in the questions you would like your treatment teams to document for each service delivered. Additionally, statistical and patient population data collection is easily usable. These templates make completing grants as well as state and internal reporting much more efficient. No more sorting through and keeping Excel documents up-to-date.
What is holding you back from having 100% paperless health records?
Access and outage concerns
Often there is a fear of not being able to access electronic patient charts when the power is out, or a system is down. Fortunately, you can protect against this and run at optimal efficiency by implementing safeguards, like the ones mentioned below.
Important considerations with paperless health records:
Establish more than one internet network connection. Configure a redundant Internet connection to ensure that there is one connection to the internet at all times.
Have a back-up generator. In nearly all scenarios, your operations will cease in a power outage. For this reason, you should secure a generator for the most critical aspects of your clinic and, especially, with paperless health records operations.
Hardware inevitably fails, seemingly at the worst possible times.SMART’s Cloud-Based EHR, powered by Amazon Web Services (AWS), takes your hardware concerns off the table. SMART operates a fully-redundant AWS cloud environment which leverages layer upon layer of redundant technology. With these measures in place, the odds and impact of a connection failure are minimal.
Prepare for disasters with automatic backups. As a 100% paperless chart, SMART’s EHR software secures all data in the cloud. Backups run every 30 seconds reducing the risk of data loss. Having owned and operated clinics in the past, SMART is intimately familiar with what can happen if a clinic experiences a fire or other disaster. Being paperless, with automatic backups means we avoided losing access to crucial information.
Another deterrent to migrating 100% to paperless health records might be the expense of servers, PCs, signature pads, label printers, pumps, etc. making it is easy to put off the transition. However, the drawbacks of not being 100% paperless far outweigh the costs of transitioning. With SMART’s cloud-based solution, your EHR becomes an operational expenditure instead of a capital expenditure. Monthly billing allows you to subscribe only the number of users you need and we can adjust as your needs change.
“SMART integrates every facet of our clinic from dispensing, to counseling, to administration.”
Paul J., Administrator (former), Addiction Treatment Center of New England
Fear of change
Overcoming staff opposition to change can be a challenge. The first step is shifting your focus to educating staff about the benefits and added productivity of a paperless environment. Leadership can ease the transition by promoting positivity and cultivating user perceptions.
Even so, adjusting to a new system can still be challenging; especially for those accustomed to paper as their primary means of record-keeping. SMART helps to mitigate these fears with our implementation process which is designed to get teams up and running quickly and with confidence. Once you commit to implementing an EHR, it is essential to work with your vendor to ensure that your staff is informed throughout the process helping to avoid resistance and confusion.
Successfully implementing paperless health records
Goals and communication
Successful implementations rely heavily upon continuous and clear communications between the EHR vendor and EHR users. Before the implementation begins, set a solid foundation by providing a clear understanding of the process. Every member of both teams should fully understand all requirements and who owns what responsibilities.
Having a complete procedures checklist goes a long way toward keeping everyone on track with what tasks are due and what is upcoming. Part of the checklist procedure is to identify forms, templates, and systems settings.
“They made us feel completely confident in the system in a week. They are all exceptional.”
Heather, Clinical Director, Acadia Healthcare
Training and support
Another critical step is customizing comprehensive training before and after go-live. For our partners, training is delivered both on-site and remotely by our team of training experts. After implementation and training are complete, our Partner Support and Partner Success Teams take charge of the clinic’s ongoing care.
“I really like the new SMART System. It makes our job that much easier. The trainers were all friendly and helpful. They made our transition to SMART very easy.”
What You Can Expect from HIPAA Compliant Cloud Storage
Amazon Web Service (AWS) offers a broad set of global services. These include computing, storage, database, analytics, application, and deployment services. This helps organizations move faster, lower IT costs, and scale applications. Moreover, AWS is a trusted and proven solution used by hundreds of thousands of business, operating in 190 countries. Incorporating this technology enables SMART to deliver the most powerful EHR solution yet.
It also improves the speed and performance of dosing and reports by enabling simultaneous read/write processes to occur across multiple replicated endpoints.
“I love the fact that the billing on Monday is incredibly fast. I mean unbelievably! Tasks that usually take 15-20 minutes now take under a minute!”
Deb R., Acadia Billing Manager
Enhances data protection
SMART’s new cloud also leverages Amazon Aurora, a database engine that delivers high-performance and reliability with real-time redundant backups and 99.995% uptime. Moreover, recovery from physical storage failures is transparent, and instant failover typically requires less than 30 seconds. Aurora’s storage is fault-tolerant and self-healing. Amazon continuously backs up six copies of your data and replicates them across three availability zones.
Amazon Aurora also provides SMART’s EHR users multiple levels of database security. The first level is network isolation using Amazon’s virtual private cloud (VPC). Access controls and boundaries from other networks in the AWS Cloud protect Amazon’s VPC. They closely resemble a traditional network that you would operate in your own data center with the benefit of the scalable infrastructure of AWS. Next is encryption-at-rest using keys you create and control through AWS Key Management Services (KMS).
Lastly, the encryption of data in transit using SSL. On an encrypted Amazon Aurora instance, data in the underlying storage is encrypted as are the automated backups, snapshots, and replicas in the same cluster.
SMART’s shift to the highly-scalable, fully-managed AWS cloud database affords partners several advantages. Such as exclusive access to the latest developments like the SMARTBridge™. It also saves on operational costs by decreasing the need for equipment upgrades, IT resources, and EHR updates. Learn more about SMART’s Cloud-Based EHR Software.
Albert Einstein College of Medicine partners with SMART Management for Electronic Patient Record Management. SMART’s EHR facilitates their needs with a clinical operations software package. Einstein is one of the nation’s premier institutions for medical education, basic research, and clinical investigation. Further, they operate six community health centers in addition to the University Hospital and treat approximately 3200 patients per year.
Paul LeBeau, SMART’s VP of Software, stated, “We are extremely pleased to have this association with the prestigious Albert Einstein group. The addition of Primary Care to our SMART paperless clinic package enables us to become even more useful in medical treatment.”
Moreover, EHR users receive personalized live and on-call support 24/7/365. SMART’s knowledgeable Support Team provides services personalized to customer needs. Additional services include training, CARF audit preparation, network management, system administration, and custom development.Learn moreor get to know more of SMART’s EHR partners.
Acadia chose SMART’s electronic health record for its 100% paperless functionality. This EHR solution is a reliable, secure, and flexible cloud-based paperless software. It improves ease and speed of access to patient records, allowing for increased collaboration amongst treatment team members. Additionally, the billing module helps OTPs maximize revenue by processing insurance billing in-house. It also enables authorization management, self-pay billing and account management, unit-based fee for service, payment due notifications, and reporting to both cash- and accrual-based accounting.
Going paperless in Tacoma
Simplifying Electronic Health Record Implementations
Following the earlier Spokane, WA implementation, Office Manager Tami said, “This was a fantastic training team, great software, and overall very positive experience.” This reaction is precisely what SMART’s Team strives for in every implementation of the SMART Solution. Being in business for over 25 years and having operated a network of treatment facilities, SMART knows the challenges that can occur during implementations. That is why SMART has established a thorough and continuously vetted process to ensure that clinics get up and running quickly and efficiently.
Support for Clinics using Addiction Treatment EHR Software
Genuinely understanding the unique operational needs of opioid treatment programs, from one state to the next, requires dedication. This commitment ensures that SMART stays current with Partner’s requirements. Ultimately, their needs drive development and inspire continuous improvement.
SMART upholds this everchanging understanding by providing:
The short answer is yes, but the level of security depends on how your EHR is hosted. If it’s cloud-based, there are many failsafe measures in place to protect your clinic and patient data. On-premises solutions, on the other hand, are less advanced and don’t have the capabilities to stay current with security, performance, and reliability.
Whether a substance abuse treatment clinic’s data is hosted on-premises or in a cloud environment, hackers will try to find a way to ruin your day. Recovering from an attack can be significantly more challenging for on-premises users. Let’s discuss two real-life scenarios we’ve encountered.
On-Premises Electronic Health Record Security
Scenario #1 – Clinic’s central server infected during a ransomware attack
In the middle of the night, a ransomware virus infected a clinic’s central server, encrypting any file that was not actively in use. Fortunately, the SMART database was in use at that time and thus impervious to infection or alteration. Had it not been in use, SMART would have also been susceptible to the virus. They were able to copy their SMART data to a secure location and restore their entire server from a snapshot made the night before. If the virus had affected their SMART database or if a server backup wasn’t available, the results would have been very different – the clinic would be forced to pay the ransom for a decryption key or lose an entire day’s worth of data.
Scenario #2 – Clinic’s entire server and workstations infected by a ransomware virus
A different clinic got hit quite a bit harder. A ransomware virus infected their workstations and their entire server. This affected their main SMART folder and database. Next, it spread to their external backup device encrypting all previous backups.
The clinic had two choices – they could either pay the ransom and hope to get a decryption key or start from scratch with a blank database. At this point, they did not have access to SMART for over two days. If they could not decrypt the data, they wanted to be ready to start from scratch. SMART worked with the clinic to help build out a new server. After two days, they finally received the decryption key and access to their files. In total, they were unable to use SMART for four whole business days.
This was a frustrating and time-consuming situation for both organizations. On-premises users are responsible for recovering from these attacks. Not only must they worry about getting SMART back up and running, but they also must repair and restore any infected workstations.
How cloud-based EHR protects patient healthcare data
Security concerns with cloud-based users are much different. Since SMART’s Cloud launched in 2016, there have been zero attacks on cloud partners. It is important to note that if a virus infects a cloud-based user, there is still a chance of unauthorized patient information access. However, the odds of this occurring are far less likely because of the separation between user and data as well as the inherent stringent cloud security measures.
The fact of the matter is that cloud security is far more advanced than traditional on-premise tactics. Choosing a cloud-hosted environment means increased security, period. Security is one of the most significant benefits of moving to the cloud, along with uniformity, operational cost savings, and scalability. Learn more in this article’s top ten benefits list.
The first layer is the Virtual Private Cloud (VPC). Data is stored in an encrypted environment. Only SMART data can pass in and out of this environment. Custom-built firewall rules allow us to prevent unwanted access.
SMART Dedicated Servers
The servers that run SMART in the cloud are “purpose-built”; they run SMART only. This prevents the risk of end-users downloading malicious files from the internet. If a user opens a bad email or web link, only their computer will be affected.
In a shared environment, downloading a corrupt file or opening a malicious email can cause a virus to spread throughout the organization bringing productivity to a halt.
Amazon Aurora provides point-in-time recovery for cloud-based customers. In the unlikely event that a database restore is necessary, the latest backup is no more than 7 minutes old with the next-oldest full database backup being from the previous night.
SMART maintains one year of daily database backups and migrates older backups to the AWS Glacier for long-term retention. Specific data is retrievable from any of the available backup copies. *A fee applies for this service.
Trend Micro is a leader in providing cloud system and application security. This solution equips our servers with antivirus and malware protection, as well as intrusion detection, file integrity monitoring, and vulnerability scanning.
Armor Cloud Security
SMART has teamed up with ARMOR to take our cloud security to the next level. ARMOR provides SMART with Security-as-a-Service.
A team of security engineers continuously monitor the environment responding immediately to potential threats and provide recommendations based on the latest developments in cloud security. Their expertise in the security field helps prevent attacks before they happen. They were able to detect and prevent the WannaCry virus two months before it spread worldwide. Armor allows SMART to focus on delivering the best application experience while also providing an industry-leading security solution.
Best EHR Security Measures
In conclusion, the best EHR security measure that you can take is to choose a cloud-hosted environment. In the event of an attack, cloud-based EHR users are only responsible for their local environment’s security. SMART takes ownership of getting the EHR back up and running. Learn more about SMART’s Cloud-Based EHR Software.
SMART is showcasing our new EHR platform at the AATOD Conference, March 10-14th in New York City. Since 1991, our EHR has evolved from an on-premise to a cloud-based software solution. Now, Amazon Web Services (AWS) hosts SMART’s cloud-based EHR. Hundreds of thousands of business, in 190 countries, trust AWS for their hosting needs. This technology helps us deliver our Partners the most powerful EHR solution yet.
Benefits: SMART’s New EHR Platform
Our EHR Partners enjoy enhanced information security in AWS. This includes real-time redundant data backups, network isolation, and data encryption. Another benefit is scalability. This is especially important for large enterprise organizations. The size and performance of their data network adjust, as they expand, with no downtime. Partners using SMART’s cloud-based EHR also save on operational costs. Such as equipment upgrades, software updates, and IT resources. And, SMART EHR Partners enjoy the improved efficiency. On AWS, our EHR increases speed and performance and automates key processes.
More on AATOD 2018
Every eighteen months the AATOD brings together national and international opioid treatment professionals. The conference focus this year is on Advancing & Integrating Specialized Addiction Treatment & Recovery. Presenters and attendees explore the latest in evidence-based treatments, techniques, and collaborative strategies.Learn more
SMART Associates and Partners during Strategy Summit
SMART Management, Inc. considers our partners an essential element of being the best EHR Software for opioid treatment programs. Because of this, in late-September, SMART hosted the 2017 SMART Strategy Summit. The Summit brought together leadership teams from SMART Partners all over the U.S. to collaborate on the evolution of the SMART Solution.
Historically, SMART’s EHR software has been an on-premise solution. Today, it is is a 100% paperless cloud-based tool that does so much more than just patient record keeping. Small clinics and large enterprise organizations rely on the SMART Solution to help streamline operations and provide best in class patient care.
What exactly is SMART doing to be the best EHR software for OTPs?
Partner discussing needs with SMART’s IT Director, Mason Snyder
Listening. We take what we learn from our Partners and work with our Development Teams to integrate their feedback into our electronic health record. The result is a continuously improving technology that grows with the treatment facilities we serve. Following our SMART Strategy Summit in 2013, we set in motion a variety of Partner requests. The request for increased EHR speed is one example.
SMART’s New Cloudproduct addresses the requests to increase EHR speed. Several of this year’s Summit attendees have migrated to the cloud while many others have not. Partners who have migrated thoughtfully shared their experiences with everyone in an open forum. Then SMART’s IT Director, Mason Snyder, followed with a deeper dive into the new SMART infrastructure, discussing the power and benefits of integrating Amazon Web Services (AWS) and Aurora. Companies such as Philips, Netflix, Instagram, and Dropbox, trust these integrated services to increase speed, lower costs, and improve scalability.
SMART’s shift to AWS will afford partners several advantages, most notably:
A highly scalable fully managed database service
Six real-time redundant backups
Immediate access to the latest SMART features
Reduction in equipment cost and maintenance responsibility
Improved reliability, security, and performance with up to 99.99995% up-time
More “Agile” than ever
New cloud calendar sneak peek at SMART Strategy Summit 2017
Another Partner request is for more predictable development timeframes. SMART is focusing on a new method of software development to be more predictable than ever. From here, we can provide more accurate estimates and plan our development to meet the strategic planning goals.
Saying that we listen and incorporate Partner feedback is nice, but how exactly does that work? In one word; Agile. SMART has adopted an Agile development methodology. This is a proven method used by companies like Adobe and GE. It allows our teams to be agile and respond to the continuously changing needs of our Partners. Moreover, Agile is about working smarter and generating more value. Because of this, SMART Partners benefit from an EHR that has greater flexibility and is delivered more predictably.
Glenwood Life Counseling Center, which provides compassionate addiction treatment and prevention services, is now partnering with SMART for their EHR needs. They chose SMART for our reputation of excellent partner service. This partnership also supports their need to move to a 100% paperless treatment facility. Moreover, our optional billing feature provides them the ability to eliminate the need to outsource their insurance billing.
SMART provides automated solutions to address the critical business functions of opioid treatment programs. This includes insurance billing, admissions, clinical and medical service delivery, incident report management, and quality control reports. These EHR capabilities empower treatment providers, like Glenwood Life, to deliver exceptional care with efficiency.
SMART’s training team recently visited their Baltimore, MD clinic to provide EHR training to their staff. Following the training, Executive Director Lillian Donnard said: “Michael (SMART’s Implementation Director) was great both as a SMART trainer and as an inspiring leader.” CFO Frank Satterfield added that “Michael seems to know almost everything there is to know about SMART and can convey this to the users. He is patient and very direct, which we needed. His familiarity with CARF and how to run a program is very helpful. This was an excellent training.”
About Glenwood Life Counseling Center
Glenwood Life is a CARF-certified ambulatory opioid-agonist treatment program. This Baltimore Maryland based substance abuse treatment and prevention services organization was established in 1971. They work to medically stabilize their patients allowing them to engage in recovery and rehabilitation processes more readily. It is also their mission to respectfully deliver quality medication-assisted treatment to those affected by addiction.
The SMART Solution is a 100% paperless electronic health records (EHR) software. This digital health record specializes in opioid addiction treatment programs providing methadone and buprenorphine maintenance. Substance abuse treatment programs choose SMART to improve clinic management and workflow automation. Contact us to learn about streamlining admissions, billing, inventory management, and more.
SMART Management, Inc.
66 Pavilion Avenue 2nd Fl
Providence, RI 02905