Administrator, Southwind Medical Specialists

It’s definitely a new day. When there’s something not-so-good in their neighborhood, medical institutions, organizations or groups don’t call Ghostbusters, Zorro or the A-Team. Today, the heroes they call on to clean up Dodge and restore order, prosperity and efficiency to their practices are experienced troubleshooters like Jason Barrett.  

Barrett tackles 21^st century management problems by applying his skills as a Six Sigma Black Belt (rather than the ‘Fists of Fury’ variety); he combats contemporary administrative crises with IT firepower and original Android apps rather than a hail of bullets—or bulletins.

Based on the principle that one can never have too much knowledge—or too varied a spectrum of experience—Barrett has packed his impressive resume with a BS in Healthcare Management from Southern Illinois University (SIU), a Masters in Operations Management from the University of Arkansas, and a PhD in Healthcare Management from Capella University, plus 11 years in the U.S. Navy Healthcare System, five years as practice director at the MED, and more—including continuing service as a part-time adjunct faculty member for SIU and independent consultant for a variety of medical groups, health systems, and health services companies.

Barrett enlisted in the Navy at age 17 as a hospital corpsman, went through paramedic training and spent his first two years as medical support for a Marine recon unit and, from this beginning, focused and sculpted his career direction with an emphasis on learning as much as possible about how to make healthcare delivery more efficient and effective.

Drawn to Memphis by marriage, Barrett recently took on administrative duties for Southwind Medical Specialists and has wasted little time during his first four months on the job: Barrett ‘relaxed’ one weekend at home by building an Android app that allowed a patient’s phone to interface with Southwind’s website, receiving GPS directions to the office for their appointment. “I was just stubborn,” he shrugged dismissively.

How does your military experience—as primary care practice manager in Okinawa, Japan, for example—compare to the demands of parallel civilian responsibilities?   

One of the unique challenges there was the need to maintain operations in the base clinic—even though over a weekend, half your folks are gone somewhere. So basically you do it with less than half of the staff you normally have. In a lot of ways I look at deployment as turnover. We have turnover everywhere; we can just plan it a little better with the military. We know that somebody’s coming and somebody’s going in two years, and we know we’re going to get a replacement in.

The biggest difference is that in the military you have a single payer source: you learn the TRICARE manual, and you’ve got it down pretty well. Outside of the military system, you have hundreds of insurance payers that all have slightly different rules. And things vary within an insurance company based on each plan—so there are more requirements to keep up with.

You lead operational revisions implementing the Army’s patient-centered medical home model standards. How well did PCMHs work in the military?

A hundred different organizations are using the PCMH concept; the Dept. of Defense bought into this one because it was a national certification, not driven by any one insurance plan or interest group. Its basic function is to put the patient back in the center. The DOD system has a great opportunity for that because they have a very well-defined patient population and it doesn’t change greatly or very frequently. The first challenge in having a certified patient-centered medical home is to understand your patient population, meeting their needs, and offering availability, whether it’s through electronic portals, or through same-day access. In private practice that’s a lot more difficult to do. One of the challenges with the DOD system, however, was that the physicians seem to get deployed.

What are some of the worst situations you’ve had to troubleshoot?

Every organization is a little bit different regarding where its problems are; but usually, the greatest challenge I see is getting everyone on the same page, rowing the boat in the same direction, so to speak. Although there’s always some level of resistance, my solution is to treat the situation like evidence-based medicine: We have to show evidence that doing things a better way really can work to make life easier for the physicians and clinicians. Typically when I go into a new place, there are small issues I can address immediately to make some quick impacts. Some of those quick wins help you out with major changes that have to come down the road.

What are your goals—long and short-term—for Southwind?

Long term, the goal is to evaluate the services and identify areas for growth. Our short term goal is to select an EMR and get it operational.

It’s always a matter of finding which one is going to work best for your specific group. The system’s got to be strong enough to do what I want it to, and it’s got to be flexible enough not to completely change the doctors’ way of doing business, and it’s got to be easy enough that they’re going to want to do it—and then they’ve got to be able to afford it.

Right now, our implementation timeline is dictated by the stimulus funds that are available or forthcoming. Ideally, we want to have our selected EMR system operational by January 1, maximizing the available stimulus dollars.

Is specialized knowledge about EMRs becoming increasingly important for administrators?

You do have to know the basics of the language, and what to look for. Whether it’s a patient portal or a check-in kiosk, even if you’re buying your lab equipment—if you don’t know how to ask if it’s going to interface into your system, you can buy a piece of equipment that doesn’t work when you plug it in. The IT company or salesperson will answer anything that you want—or they’ll get you the answer—but you have to ask the right question.

A lot of exciting EMR information is going to come along in the next few years; a lot of the initiative with electronics is to help decrease some of the duplication of tests and ordering, so that if you see a cardiologist, a rheumatologist, and a primary care doctor, we’re not all doing the same test and just don’t know about it. That information needs to be shared so patients receive complete care, without being charged multiple times for the same test.

How is healthcare reform likely to impact revenues for your field of medicine?

It will be interesting, to say the least. One thing that we do expect is upgraded emphasis on preventive care. We’re already working on strategies to reach out to patients when it’s time for different preventive services to make sure we get them back in here—not only because of the stimulus, but because it’s good medicine to give you a flu shot before you get the flu.

In what accomplishment do you take the most pride?

What I’m most proud of is that I had to learn soccer, because my seven-year old son took soccer. When a kid wants to learn and likes the sport, Dad’s got to learn to like the sport. I’ve never played in my life, so I spent a lot of time watching YouTube video on how to play soccer—but I DID learn how to play!

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