Robert Gleeman chats with emrupdate Sponsor, David Dickson, President of TSI Healthcare

This is a transcript and audio interview by Robert Gleeman of emrupdate.com with David Dickson, President of TSI Healthcare, Inc. in Chapel Hill, North Carolina. TSI Healthcasre is a value added reseller providing EMR solutions from a number of different vendors supporting NC and the Doctor's practices across the East coast. TSI Healthcare are also a proud Industry Sponsor of emrupdate.com.

Click the play button below to listen to our interview

This is the transcription from our interview:

Robert Gleeman: This is Robert Gleeman with EMR Update. I'm talking today with David Dickson, President of TSI Healthcare in Chapel Hill, North Carolina. Thank you for being with me today, David.

David Dickson:  Thank you for having me.

Robert:  David, I understand that TSI Healthcare is a value added reseller, a VAR. Is that correct?

David:  That's correct, yes it is.

Robert:  Now, most VARs sell only one brand of medical software, but you don't. You sell several different types of software, don't you?

David:  That is correct as well. We represent several product lines, and several different areas, both product‑wise and territorially.

Robert:  Although you're located in North Carolina, you work all up and down the East Coast, don't you?

David:  We do. Primarily, though, we are concentrated most heavily in the Southeast and Mid‑Atlantic regions.

Robert:  One thing that I noticed from looking at your material is that you are very service‑oriented, and you have a philosophy. If I can sum it up, it is that the philosophy is that if you don't fully utilize the EMR it can be disruptive. Can you tell us how that can be?

David:  Well, I would say your summary is right on target. In particular, I think there are a number of good products that are out there that are what I would refer to as a mousetrap, in that you can have a super product, but if it's not implemented correctly and fully, and it's not implemented with a commitment to results, then you end up with just another piece of software that will sit unutilized, undervalued, and overpriced.

Robert:  How do you go about doing this? What is your approach to implementation and training?

David:  I think that there are philosophical issues at hand first, before the implementation process begins. When I refer to philosophical issues, I'm referring to a commitment at the front line all the way to the back line that we're not just selling systems, and implementation plans for practice management or EMR.

Anyone can sell a computer system, and anyone can get out there in the market today and sell practice management or EMR. The commitment to making it work for that client, we consider a responsibility to them, and so when someone comes on board with us, they have our commitment that we're going to take whatever that product is that we've recommended for them, and implement it to its highest possible utilization.

Robert:  Now this is a dedication and a passion towards the full utilization of the product. Do you sell the hardware as well as the software?

David:  We do. We are a one‑stop shop for any practice that has those needs. Most of our client base is in the five to 15 doctor range, and do not have the resources to have their own IT departments, nor the expertise necessary, in most cases, to ensure that what they're getting is compatible with either what they have or what they're going to be getting. So we do provide assistance in that area.

It's not a revenue income area for us, but merely another convenience that we pass on to our clients, should they have those needs. We also house a very, very robust application services provider system in‑house for clients today where most of our clients in the last few years, in fact all but one, have gone on our ASP system rather than putting in‑house servers in the practice.

Robert:  Why do you suppose that is? Why is the ASP side getting stronger?

David:  That's an interesting question as well. I've been in the business now for 26 years, and I had always believed that having your data in‑house was an advantage, because that's what I grew up in. So when we looked into the ASP business a couple of years ago, I was very much against that liability on our end, because mostly I did not understand the technology and the backup mechanisms that are in place to provide complete protection for the clients, that would then become our responsibility.

We actually purchased a company about three years ago, that owned their own ASP, so all of the sudden we were in the ASP business, and I grabbed onto the walls and sat back waiting for the worst to happen. The realization over time that, for instance, in the first two years we had a total downtime of less than 15 minutes that was unscheduled.

As more and more practices ‑ and this is to answer your question ‑ are implementing, or attempting to implement electronic medical records, no longer is it acceptable to come in on a Monday morning and find out that your power went off over the weekend, that your servers are down, or your ability to send claims is not able to be dealt with immediately. Those are the kinds of questions that typically can wait for a support person to call back. But when a doctor comes in on Monday morning at 8:00 or 9:00, or is trying to dispense a medication or prescription refill over a weekend, and he or she cannot access that server for the patient's chart, you've got a whole 'nother ball game.

So with that said, the fact that our ASP environment provides a 24/7 monitor on the equipment, on the data, every line and character of data is backed up and backed up and backed up again to ensure ourselves, not only against routine down‑time, but natural disasters, which we have seen, obviously, affect health care around the country, particularly in the Gulf areas. So, that sort of paranoia has driven us to a whole 'nother level of providing ASP services for our clients.

Robert Gleeman:  And you actually provide the ASP servers? You run the center, itself?

David:  We sure do.

Robert:  So, with that much control over the system, does this help you in training and bringing people up to speed?

David:  Well, to answer your question again, yes it does. And, once again, years ago when people were running off of an AIX or Unix box, you had the manufacturer of the equipment and the originating authors of the software. You had two people to point a finger at. Introduce the Internet, Microsoft Windows, Citrix, Terminal Services, Microsoft Sequel, application software, all the EDI services that are now available, and nobody knows who to point a finger at anymore. This is one more level of ‑‑ again ‑‑ single source provision that we can offer to our clients that they're not pointing, is it hardware or is it software? Once again, that ball is in our lap to resolve regardless of what that issue is.

And most of the people out there in our business do not have that luxury. They farm it out to someone else and you've got a hardware company pointing at the software people, the software people pointing at the hardware people, and meanwhile, the client is in the middle with a down system. And this does happen.

Robert:  So, with TSI Healthcare, you only have one neck to choke. Is that what you're saying? [laughs]

David:  That's what we're saying. One head to grab by the hair.

Robert:  [laughs]

David:  We make two promises to our clients, and it's the same two promises that I've made since I've been in the business and working for my father many years ago in this business. The first promise we make [to] any client is that they are going to have problems. The second problem, on top of that and equally important, is that they will not regret their decision to do business with us. We're not just selling systems to every physician that wants EMR.

In fact, I can tell you and list them off and name them right now, how many people have called us in the past 24 months saying, "We need EMR."

Our first question is, "Why do you think you need EMR?"

"Well, because we're going to be forced into it at some point."

Well, to us, that's not enough of a reason to go into this paperless environment. The bottom line is that we want to find out what their needs are, why they think they need a particular product and/or service, and if we can do the job then we will take that task and we will take that assurance to the client that if we "jump in bed together", if you will, that we'll both be glad we did.

We always welcome new inquiries. We are a growing business. We employ, not only our own technology group with TSI Healthcare, we own a major billing service that also handles the billing service requirements for our clients. So, we're kind of a multi‑faceted business. But, I will tell you this, that out of 1, 000 or so physicians that we serve, we've only got ‑ to the best of my knowledge ‑ one client that I would consider as not referenceable ‑‑ and that's a pretty good hit rate. I would say most physicians would be thrilled, out of 1, 000 patients, to have one that would not come back.

Robert:  That is excellent. Do you accomplish this by a combination of finding highly motivated physicians to work with and your unique approach to service? Is that how you do it?

David:  This is a whole new plank that these physicians are walking down, today. And yes, there are some of those that are, either young, and we've had some that are in their 60s and 70s pushing hard to go paperless...go paperless...go paperless. Well, you know as well as I do that there's no such thing as being paperless. We're not in a paperless world and the illusion that you're going to be paperless ‑‑ it is not going to happen, and probably not in our lifetime.

However, there are economies of scale and some maximization of the efficiencies, if you will, in these practices, that can be realized. Again, to better answer your question, if people who have an interest or are interested in learning more about what does this really means or what can an EMR do for that specific practice, that's where we come in and look at their situations. Find out, is there, first of all, a way to provide a financial return on the investment while, at the same time, not disrupting the practice beyond a reasonable level?

If you've got four doctors in a group, for instance, you're going to typically have two of them that are the older ones and two of them that are the younger ones. You may have two that really want to jump on and two that just are so close to retirement they may not even bother with looking into an EMR ‑‑ they're too far into their careers. We try to take that into account before we make a recommendation for a practice.

And as I said earlier, on a number of occasions, maybe now is not the right time. If that's the case, we advise our clients of such and check back with them ‑‑ maybe it's a couple years, maybe it's a couple of months; at a more appropriate time. But, we're not taking all comers.

Robert:  David Dickson, President of TSI Healthcare. Very interesting and thank you for being with us at EMR Update.

David:  Thank you so much for your time today.

You can contact TSI Healthcare at the following places:

TSI Healthcare
811 Ninth Street, Suite 200
Durham, North Carolina 27705

p: 800.354.4205
f: 603.676.5695

e: info@tsihealthcare.com
w: www.tsihealthcare.com

To read more of our EMR interviews, visit our Interviews blog here. If you have an interesting story to tell, why not get in-touch our resident journalist Robert Gleeman by email here.