10 Part Workflow Interview: Vishal Gandhi of ClinicSpectrum, Booth #1256 at HFMA

It’s not often I meet someone as or (more?) obsessed with healthcare workflow as I am. I believe I’ve met my match in Vishal Gandhi of ClinicSpectrum. I’ve not done one of my multi-question, in-the-weeds, workflow interviews in a while … it feels good to be back in the saddle. Enjoy!


(Image from Vishal’s excellent video interview with @TechGuy)

BTW You can visit ClinicSpectrum in Booth #1256 HFMA (Healthcare Financial Management Association) conference this week in .

  1. How did you come up with “Empowering Cost Effective Workflow”?
  2. Do you have any competitors? How do you think about them?
  3. What’s your workflow “philosophy”?
  4. What is a “Hybrid Workflow Model”?
  5. What’s your educational background? Industrial Engineering?
  6. What do you mean by “PROCESS dependent practice rather than a people dependent practice”?
  7. Is ClinicSpectrum turning into a Population Health Management/Care Coordination platform?
  8. Do you have a portfolio of workflow solutions?
  9. What is the single most important demo for folks to see at your HFMA Institute booth?
  10. Are your cost accounting systems up to value-based healthcare?
  11. Where in the world has been your favorite place to travel to?
  12. Thank you’s and leave taking… nice guy!

1. Let’s start with your tagline, “Empowering Cost Effective Workflow.” I’ve read that taglines should be simple, memorable, and functional. How did you come up with it?

Empowering cost effective workflow was derived out of our organizational experience with transforming solo and individual practices over the past several years. Industry trends and healthcare changes after President Obama came into office leant toward saving money for healthcare from healthcare. This would only be possible through avoiding duplication of care, auditable billing activities and enforcing billing automation, thus providing major savings due to solving pre-existing issues of improper billing, low utilization and risk management. This is where ClinicSpectrum’s tagline or positioning statement of, “Empowering Cost Effective Workflow,” was born.

2. Do you have any competitors? How do you think about them?

I’ve never considered competitors, because no organization does what we do for healthcare service organizations with both back-office support and powerful software automation. Other back office service companies focus on providing back office resources, while our approach is to reengineer or restructure workflow with use of their local team, our technology team and our back office resources. As part of empowering cost effective workflow, we created custom tools, technologies and designed an ideal workflow plan for solo practices and large clinics to leverage and significantly reduce operational costs via three ways:

  1. Increasing productivity through self-accountability and benchmark within existing staff
  2. Enabling automation on some of the manual tasks
  3. Outsourcing some of the secretarial functions to back office team
    members with a salary range from $6.5/Hour to $9.5/Hour compared to local team starting with $14/hour

3. I think that “workflow” has so many interesting aspects and is so relevant to so many relevant healthcare and health IT problems and solutions. What’s your workflow “philosophy”?

When money gets tight, or in some cases tighter, organizations need to do more work for less money. So ultimately it boils down to automation or cost effective labor. There is no other way to do more work for less money while you are expanding or growing. One of the single most important functions in operational planning is reducing variable expenses as you scale up.

Workflow was built into our success as an ONC-certified EHR / Enterprise Practice Management / Revenue Cycle and Practice Consulting company. However we were restricting that knowledge for clinics only. Some of the companies we are consulting in for the past 12 years are in the practice management and revenue cycle management market as well, and so we have been exposed to several technology platforms that give us this experience in workflow planning.

One of my friends who owns a billing company mentioned one time during a discussion in 2009: “It is very hard for billing companies or practice management companies to survive just based on their knowledge domain. We need a knowledgeable team, technology and people to expand and grow.”

I told him, I can provide you with technology and people. You should focus on finding new business and retain your knowledge team. Leave the rest to me. In the last 5 years, the company has grown from the ground to more than 100 accounts, generating significant revenue for the practices we serve.

Creating a workflow plan using the three elements I’ve mentioned is a hybrid workflow model – knowledgeable team, automated technology, and back-office staff - because in which, we are using their team, our team and technology. I call this a triangle and it is called hybrid because the onus of performance is passed onto each element in the plan. Technology must work as desired. Back office team members must produce and deliver tasks accurately and the knowledge team must continue to audit and supervise.

Our technology platforms (4 of them have patent pending) are derived out of this hybrid workflow plan only.

4. What is a “Hybrid Workflow Model” and why have you gone so far as to trademark it?!


Our Hybrid Workflow Model is a workflow plan that encompasses three factors:

  1. Workflow knowledge team (local)
  2. Technology suite
  3. Back office team

Using the above three elements, we deliver a defined process, deliverable tasks with a timeline for success and an audit. Each one of the elements has specific duties and continuous monitoring for achievement of those duties. The ultimate objective of the Hybrid Workflow Model is to create a COST EFFECTIVE, ACCURATE and CONSISTENT workflow.

Knowledge is too powerful to just reside with just one individual.

All of ClinicSpectrum’s knowledge is replicable on a FAST TRACK basis through organized video recordings, process manuals and rule engines. So when a company gets a big assignment, adding new team members is easy to do.

An existing customer recently relayed to us that they may need an additional 12 resources in the next 2 months. They wanted to know how we would scale up that quickly to meet their needs.

We work with our clients to institutionalize knowledge of their business so new team members can be brought up to speed within a short period of time. This is what we call process dependent workflow plan, rather than people dependent.

5. In your video interview, you sound like an industrial engineer. What’s your educational background?

I have a Bachelor’s in Electronics Engineering, so you are correct I am an engineer. My specialization in engineering is System Design. I also have earned a Masters in Business Administration. Additionally, I am a certified healthcare auditor, certified medical collector and I am pursuing a “CHMBE” by HBMA.

Additionally, I think it’s important to mention that we have filed four patents for some of our unique automation tools or products. One of my most favorite is PRODUCTIVITYSPECTRUM.

ProductivitySpectrum is all about increasing productivity within existing team. As mentioned earlier, there are only 3 ways to do more work for less money. Either increase productivity or introduce automation or find cost effective work force.

ProductivitySpectrum focuses on first aspect of increasing productivity. For someone with subject knowledge and reasonable intellect, loss of productivity is due to

  1. Loss of focus or distraction due to social media, computer and other things
  2. Healthy competition or we call it BENCHMARKING

Above product has 2 components, MONITORING would take screen capture of their activities; identify resource wise time spent and employee desk time. So if they are wasting idle time due to NON PRODUCTIVE activities on computers, it would be streamlined. BENCHMARK comparison allows dynamic benchmarking through employee’s own best performance days. It keeps reminding of his/her efficiency against his/her best days and creates an automatic daily reporting for supervisory position.
It comes with smartphone app to monitor any employees’ activities on the fly.

6. On one of the slides in one of your PowerPoint decks, I saw the phrase: “PROCESS dependent practice rather than a people dependent practice.” Do you diagram and flowchart workflows? Even scribbled on a napkin! I think this kind of artifact wonderful evidence of what think of as a “workflow worldview.”

Below is a visual of our 3-step presentation, which defines an ideal front desk workflow plan. It has a graphical view built into it.


(Cool graphic!)

7. I also saw this: “Every task/office function gets audited randomly across the practice” “-Patients who are non-compliant clinically -Reminders for tests/procedures” When I read this I start thinking — Population Health Management, Care Coordination, etc. — which are really hot topics these days. Is ClinicSpectrum essentially turning into a PHM company or care coordination platform? Plans? Ambitions? Do you have your eye on any specific technologies to help you realize your vision?

ClinicSpectrum is not essentially turning into a PHM or CC platform, instead we provide all technology and resources required to do PHM and CC.

Most EHRs have a built-in feature to do risk management or identify and cluster patients based on conditions, procedures and other demographic parameters including hospitalizations.

In order to do an effective PHM and CC, you need following items

  1. Technology or EHR product that defines risk management index or area of concern for high-risk patients.
  2. An automation engine that would remind patients’ for required visits, tests and lifestyle changes so that they can be kept out of emergencies and non-compliance.
  3. Team of professionals who can review clinical guidelines and call the patient, explain things they need to take care of, and bring them back as required to physicians’ offices for better risk management.

ClinicSpectrum aims to provide an automation engine (as we own a messaging platform called MessageSpectrum) and back office team members who are trained in various pay for performance programs, quality measures and risk management. We are currently providing support to several practices that are part of ACOs and PCMH programs.

8. I also notice you use the phrase “Workflow Solutions to Increase Profitability and Decrease Cost.” Do you have a portfolio of workflow solutions? What are they? How do they fit together? I notice more-and-more health IT vendors and service providers talking about “workflow solutions”. I think this is a natural and to-be-expect evolution. Now that we have some much clinical and healthcare financial data, we have to do something with it: workflow! But I’d love to hear you elaborate on whether you agree or not…

We are in business of either increasing revenue or reducing costs for billing companies, hospitals, healthcare IT companies, consulting organizations, multi-specialty groups and small physician’s clinics.

Our technology products such as

  • “InvoiceSpectrum,”
  • “CredentialingSpectrum,”
  • “AutoCollectSpectrum,”
  • “ProductivitySpectrum,” and,
  • “MessageSpectrum”

provide some of the most essential technology pieces to design and implement a workflow plan for increasing productivity and decreasing costs. To add to that, soon we will also launch HumanResourceSpectrum , EligibilitySpectrum and WorkFlowSpectrum.

As deductibles become a perennial issue, our EligibilitySpectrum product along with our eligibility verification services will enable complete front end eligibility checking for hospitals, clinics and any other healthcare facility.

WorkFlowSpectrum is a web-based document management and work allocation and management platform so organizations, including clinics, don’t have to use Dropbox or any other cloud-based service. This offering is more dynamic and target driven.

If someone retains your services on a monthly retainer basis, with our InvoiceSpectrum product, you can automate your entire invoicing cycle. It applies to billing companies, consulting companies or any healthcare service management company.

Now, if you need a team to provide consistent and persistent AR follow-up for clients with outstanding payments, our team can help. So together, with InvoiceSpectrum and back office AR follow-up, we can automate any healthcare company’s accounting or invoicing department.

These are just a few examples of how combining software products, in conjunction with our back office services, automate a department with reduced costs.

CredentialingSpectrum has been a major attraction for several larger groups. As defined by one of our existing customers, it is one of the most comprehensive products for credentialing and contract management.

9. You’re going to be at the Healthcare Financial Management Association conference (HFMA National institute) in in Las Vegas. When attendees visit Booth #870 (I looked it up), what is the single most important thing for them to see? A demo? Of what? Something else? Also, what great list of speakers! I know you’ll be in your booth a lot, but who are you excited to hear and why?

  • AutoCollectSpectrum to manage and automate patient balance collection
  • CredentialingSpectrum to manage entire credentialing activity
  • EligibilitySpectrum to manage front end eligibility, while most insurance plans today have high deductibles.

And, of course, providing additional information on our back office services and Hybrid Workflow Model implementation.

I am sure that there are a number of speakers that I would l like to hear. Most of all I will be interested in any topic that shows an innovative way for practices to collect patient balances. While we hear so much about patient engagement on the clinical side for quality of care, it is critical that we do not overlook engaging with the patient on the financial side. I welcome being sent suggestions for talks to attend that address this.

10. Believe it or not, I was a pre-med Accountancy major (University of Illinois, Champaign-Urbana). I’m checking the ClinicSpectrum blog and I see lots of cost and financial accounting material (plus credentialing, patient education, and other good stuff). As healthcare moves from maximizing volume-based reimbursement towards value and cost improvement strategies, where do you see medical practice management systems evolving? Will managers ever get anywhere close to knowing the “true cost” of a specific procedure or patient encounter (say, door-to-door). Are your current systems up to it?

Yes in fact we are building a cost matrix in our enterprise practice management system currently that would do 2 things:

  • Allow to add all fixed costs: rent, utilities, malpractice and any other
  • Allow to insert monthly variable costs: salary, supplies, outsourced services, etc.

Even though the industry relies on an RVU based model, it is not accurate. Our system will create a procedure performance based on six months of trending data and derive, by procedure, reimbursements by payer or plan.

Our cost matrix will pick up all fixed and variable expenses and divide it among total number of patients and total number of procedures by visit code.

This will allow them to scale up or scale down depending upon this cost to revenue matrix, and also allow them to plan for both breakeven and revenue targets for new providers.

11. To round it out – where in the world has been your favorite place to travel to?

I cannot say that I have a favorite place, but rather that I like to travel to as many places as possible. I am going to Barcelona, Spain on July 17th. This will be my 9th country that I have traveled to. I am also a passionate photographer, so you can imagine, I would love to travel to one new country every year and capture beautiful images.

12. PHEW! Those questions were really in the workflow and processes weeds! I thank you so much for your patient consideration and answering of these relatively technical questions (which are, nonetheless, so important to the financial health of your medical practice customers!).

I thank you very much as well for spending so much time and being so thoughtful and thorough. I All of your questions were meaningful and relevant to current challenges in healthcare, and I enjoyed answering each one.

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