Safeguarding Healthcare: Combatting Cyber Threats in Medical Practice with Juli Quinn

Witness the unveiling of healthcare's hidden shield as I, Dr. Sapna Shah-Hawk, join forces with Juli Quinn, the trailblazing President of GoSource. Together, we dissect the critical safeguards every medical practice must employ to combat the alarming rise of cyber threats. When a cyberattack brought a top clearinghouse to its knees, the ripples were felt across the medical community, straining cash flows and intensifying physician burnout. Our conversation pivots around these harrowing tales to convey the non-negotiable need for resilient backup systems and redundancies that promise to uphold the stability of healthcare services, come what may.

As we venture through the labyrinth of medical practice security, we shed light on strategic foresight that is as crucial to healthcare as a surgeon's steady hand. The digital realm's leaps and bounds present both an opportunity and a challenge—preparation is the key to turning potential pitfalls into a seamless continuity of care. Julie and I bring you a blend of anecdote and expertise, arming you with the wisdom to navigate the technological tightrope with confidence. Tune in to safeguard your practice's future and cement the uninterrupted delivery of patient care.

Connect with Juli:
https://gosource.in/

Though I am a physician, this is not medical advice. This is only a tool that physicians can use to get ideas on how to deal with burnout and/or know they are not alone. If you are in need of medical assistance talk to your physician.


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Transcript

Dr. Shah-Haque: 0:01

In today's society, with medicine and the trajectory we're on, what does it mean to have medical practice safety nets? What would that mean to the physician and to the practice? Welcome to another episode of the Worthy Physician. I'm your host, dr Sapna Shah-Haque, and today we have president of GoSource, juli Quinn, with us to really discover some of these ideas. These are things that we really don't talk about in healthcare, and how does it relate to burnout? We're reigniting the humanity and passion for medicine, trying to bring back some creativity, trying to bring back some humanity to medicine, but also being smart about things and, just because we've always done it the same way, trying to break that cycle and use our thinking caps. Julie, thank you so much.

Juli Quinn: 0:58

Hi Dr Sapna. It's really nice to join you again today, and this is a fun topic because it's not something that we hear much about in our area of healthcare. But it's really important that we are planning ahead for small delays or hit-dumps, or larger ones.

Dr. Shah-Haque: 1:20

Right before the recording, you were sharing a big one with me and that just completely blew my mind, because we can't stop seeing patients. Can you share with the audience what you were sharing with me?

Juli Quinn: 1:35

Sure, absolutely so. We have clearinghouses that all of our claims, whether it's professional facility or pharmacy claims, are routed through a clearinghouse that then disperses our claims to the individual insurances. The largest clearinghouse in the country has suffered a cyberattack and so they had to shut down on the 20th to days the 4th, so that's 14 days, and we still don't know when they're going to open up again to be able to process claims. That's 14 days that any provider that uses CHHealthcare as their clearinghouse associated with their software is absolutely stalled as far as claims going out right now.

Dr. Shah-Haque: 2:28

So what I'm hearing you say is we can submit claims, but if they're going through that clearinghouse, nothing has been processed, so we're not getting paid for the work that we do.

Juli Quinn: 2:41

Correct and actually this clearinghouse has. They're not accepting any new submissions. So your software is producing the, generating the claim, but it's not being able to go out. And if you're with one of the other clearinghouses, then we think, oh, thank you, it wasn't mine that got affected, so we submit to our normal clearinghouse and we think everything's good. However, there is an arrangement on the back end where these clearinghouses collaborate with each other for certain routes to certain insurances. So it is affecting everyone. Just to what degree, we don't know. Little as five or 10%, or it can be as much as 50%, or, unfortunately, if you are signed up with that one that is shut down, it's 100% of your claims are just sitting in your software and they shut down because of cyberattack.

Juli Quinn: 3:41

Correct. So cyber attack can happen to any software, cloud based or server hosted, and we hear about it in the news for years now and it's on the rise and I feel like lately healthcare has been more targeted in the reports that a pool is being held either just the obtained information or they're being held hostage. You may have heard of some of your colleagues that their EHR, their full system, is locked and there's ransom requesting that they pay this large ransom to be able to have access to the data again and unfortunately I know of some practices that paid the ransom and then the data was damaged. It was not usable, so very unfortunate. So we need to have backup plans, we need a safety net, and this is just one example of how we should be planning for what if your EHR were down? What if your claims are not going?

Dr. Shah-Haque: 4:52

What could you do? And this might sound a little and it's not paranoia, it's not, oh my gosh, doomsday prepping for clinic, right? This is real time. At the time of this recording, this clearinghouse has been shut down for 14 days and as physicians, as with the hospitals, we're not going to quit seeing patients. That's 24 seven in some areas and clinics are going to shut down because they can't bill. That's not part of what we see as patient care, but on the business side, that means we're not going to get paid for what we do in a timely manner, potentially and it's unknown how long that will be down what that relates to is no cash in, Even if the patient is paying their copay or their deductible. That's a fraction of what we're billing out. Since you told me, I'm still flabbergasted, but this is not something that we really think about. How do we even start to have those conversations about preparing?

Juli Quinn: 5:56

I had a few thoughts, and back in the old days we had paper charts, we had our book, our calendar appointment book. Of course we're not suggesting we go back to that, but to have that available for a short term replacement is better than nothing. So one of the things I did when I was a practice manager is I printed out a week's worth of schedules. Just have a hard copy in case I came to work in electricity route or the internet were down, because you can't access your calendar without those two things. And this would at least let us know who's coming in and be able to prepare a paper progress net for them that could then be added to the system when it was back online.

Juli Quinn: 6:50

So that's. And then don't forget a super bill. Have a paper super bill that you can at least circle so that billing can still happen. Maybe you hold on to it for a day or two, but if it gets to be day three and your system's not generating claims, then we need to have a backup for getting those claims out. So you have to be a little convenient. An idea I had on that is if you have either in house or a billing service that you do your claims with. Why not have redundancy of a second billing service? That maybe just does a small amount, but you have now that established relationship that if something happened let's say this clearinghouse were associated with your current billing you could now divert to your backup, who has a different clearinghouse and can get claims going.

Dr. Shah-Haque: 7:51

So you're not advocating for paper charts and the way that it had been done, even though I think that would really take a lot of the burden out. I know I'm for going back to paper charts. Having said that, what you're talking about is having a contingency plan so we can still operate and we can still get Services rendered, taking care of the patients, but also get paid for our time in order to keep those doors open. Going back to our previous conversations, and so it's not a transact we take care of patients in that I'm not trying to make it sound like a transaction, but in order to keep the doors open, we do have to get paid. So it's having that contingency plan and having that almost like a fire escape route. We have those fire drills back in school and sometimes at work, and so I think it'd be the same thought process or equivalent. Where do we start having those conversations? I'm employed by choice. How do I start having those conversations? With admin or with a C-suite, or with the practice manager?

Juli Quinn: 9:00

To be able to just start with in your case at the local level saying, hey, have you thought about this?

Juli Quinn: 9:07

And then they can take it to their professional organizations they belong to different organizations where they're talking with similar entities and then they can say what are you doing? Maybe we could collaborate with each other. One of the examples we talked about before we started recording is whether you might live in an area of tornado season and your electricity goes out, where, if you had a collaboration with a very similar entity that is not in the tornado area, they would still have their electricity. So we could have this mutual prior arranged agreement that hey, if my power is down, can I tap into your resources to still get those claims going out, because they can access a cloud based system from where they're located and we could help each other. And maybe they live in hurricane country and when they're having hurricanes we would be their backup when we're in the tornado country. This type of thing to just be able to help each other, because we're all in this together and we need to go back to helping, being neighborly and being supportive for all of our survivors.

Dr. Shah-Haque: 10:33

I love how you say that, because medicine really has become more of operating in a silo, I think, and not just being a physician or not just with billing. But it is so sometimes demoralizing to because it's so isolating. But one thing that we did learn from the pandemic is that there are certain jobs that can be done remotely. I don't think that is to be overlooked, because it can help increase your outreach and maybe the net that you cast for possible hires, but also geographically different hourly rates, and I think that's something that's not to be discredited.

Juli Quinn: 11:25

I agree We've never thought of healthcare as being a good model or an industry to use remote workers as their model, and during the pandemic we were forced to do that and give split. It's actually a really good idea in some cases of course, not everything, but this is an area that we should look at our operations and really analyze what could be done remotely. Remote workers can be just not coming in to the office or they might be anywhere geographically, rather that be in your state, another state or maybe even another country. We have amazing resources everywhere and why not tap into that instead of limiting ourselves to who can drive within a 30 minute commute to get to our job? So remote workers also will give you if your power is out.

Juli Quinn: 12:32

There's possibly isn't, and in certain areas they could be much more affordable than and more readily available. Some areas we're experiencing serious deficiency of available staff. We have a shortage. We have a staffing shortage, but people are looking for work. Great opportunity to say these three positions could be outsourced and then the people that you do have in-house, they're filling those positions that have to be in-house and it's a win.

Dr. Shah-Haque: 13:09

Yeah, absolutely. This is a global economy and I think the more that we lean into that again when it's strategic, when it's strategic, the better, because it is also keeping doors open and it is also keeping the finances going which allow us to take care of patients, because there is again, it is about a patient-physician relationship, but it is also everything on the back end that we have discussed prior to and even now that allow that to happen. Unless they have a different model, which we won't get into today, but for pretty much the standard fee-for-service model. This is definitely something to think about. And also, like you said, outsourcing to help with those buckets. That might be 120 days plus, but you can actually still collect and again, that adds to what helps to keep a practice or a clinic or a hospital running. Why do you think that people in the medical field are so slow to change?

Juli Quinn: 14:24

Great question. I read articles periodically that talk about how health care is low in embracing and change technology. We've had AI, for instance, in other areas of our life for years and we love it, but now we're just starting to have those conversations in health care. So I don't know the answer to that. I don't know that anybody does is probably why there's so many articles that talk about it. But I think one reason might be because you, as a doctor, you're trained to be a healer. You're trained to be this champion for this other person, all these patients, for their well-being, whether it's mental, physical in not focused as much on the business side. It's all take care of the patients and the business part. I've got a couple of staff that'll make that happen. That used to work. It's now not working and it's time that we put equal emphasis on the business side, because otherwise we're not going to survive and to be open doors to take care of these patients.

Dr. Shah-Haque: 15:46

And that's exactly the way we're having this conversation is to shed light on it, not to call anybody out saying you have to, but it's looking at safety nets to ensure that you can keep your doors open, to make sure that you can keep doing what you love. That's what, at the end of the day, that's what it's about and about patient care. But whether we like it or not, this is the way that the American Health System is. And even if you were doing, if anybody does direct primary care or direct patient care, there's still an exchange involved, so it is still a business. So I'm not trying to money in front of patients, but I do want to have these conversations. That we're not taught in medical school and hopefully it provides value to those listening.

Dr. Shah-Haque: 16:34

Again, we're awesome at what we do. We need to get paid fairly and there are so many roadblocks that can obviously prevent that from happening. So it's okay. How do I identify those? How do we potentially come up with a plan B, plan C to keep us doing what we love, what we were called to do? So, julie, if anybody wanted to reach out to you, what's the best way to reach you?

Juli Quinn: 17:04

Thank you. We are Go Source, our website is Go Sourcein and you can contact me through the website and we are an outsourced medical billing service. We'd love to continue the conversation with any of your listeners.

Dr. Shah-Haque: 17:22

Thank you for that. That link will be in the show notes. And one question I always ask people what is one last pearl of wisdom?

Juli Quinn: 17:31

Plan ahead because anything should happen that will be a disruptor. So let's plan ahead so that it's not as disruptive.

Dr. Shah-Haque: 17:41

And that would definitely speak to physicians, because we're planners for the most part. So, again, this is not to bring up any pain points, but as we move forward and as technology comes in, I think this is just going to be more and more of a daily subject, to be honest. So thank you for your insight. If you found this helpful, subscribe, share with a friend, because we can all use camaraderie.