HIStalk Interviews Tim Elliott, CEO, Access

Tim Elliott is CEO of Access of Sulphur Springs, TX.

Tell me about yourself and the company.

We started the company about 15 years ago based on some needs that a customer had. It was with another one of our companies at that time. It grew into what it is today. We deal with enterprise forms management.

I grew up in a family that was in the multifunctional hardware business. The need for forms came out of that.

What’s going on with electronic forms in healthcare?

It has changed a lot. When we first started, everyone needed the ability to get rid of pre-printed forms. So we first started, it was all about output of forms — current forms, forms with barcodes, and that sort of thing. That’s been the legacy piece that we’ve been dealing with for probably the last 10 or 12 years.

About five years ago, we bought another company called Formatta out of Virginia and it changed what we’re able to do. So many of our customers were wanting to go completely paperless. Everything we do now is dealing with paperless, web-based forms.

What are some creative things customers have done outside their core EHR functionality?

We’re gap fillers. A facility buys Epic, Cerner, Siemens or Meditech. Every facility has most of the same needs, but they all have different workflows and processes. The big EMRs are good at addressing all the big stuff. We go in and help deal with the little stuff.

Some systems don’t have great procurement systems. We have the ability to have automated purchasing systems, where you’re signing off on POs and requisitions. We have a customer in Kansas City who runs a lot of their HR — their customer-facing or their employee-facing stuff — directly off our solutions. They’re using some pretty big EMRs and some pretty big HR systems.

Every customer does something a little bit different. Our customers have driven some interesting solutions that we never thought of. A lot of things that we market came from our customers. They didn’t necessarily come from our minds.

That’s really what’s fun about what we do. We go into every healthcare facility with some specific things we know that are issues, but we get a lot of, “Wow, that’s really neat, but wouldn’t it be cool if we could do this?” or, “We’ve been trying to solve this problem for five years and this might do that.” We began discussions around that and the light bulb goes off. They start seeing how something like this could fix some of those things. We fix it electronically instead of with paper or additional processes.

We’ve worked over the three to four years on integration. It’s one thing to have a paperless front end, but what happens to the data? What happens to the forms at the end? We’ve gotten really good at the integration — where do these things reside, where do they go, where do they attach, what records do they go into?

When you’re talking to CIOs, what seems to be worrying them most these days?

Cost. Dollars. Most of them have spent so much on investing in IT solutions or trying to get some of the money coming in. It’s not as much about the solutions that fulfill the daily needs, but how can we get by and how can we get everything in place in order to meet the regulations? 

The people who are working out in the departments are aware of that and that’s important to them as well. But they’re really concerned with, how do I keep this from being a three-day process? How can we make this a one-day process or a one-hour process?

Someone pays many millions for Epic, Cerner, Siemens, Meditech or whatever it may be. About two to three years down the road, they start addressing some of those things. They all think it’s going to be paperless and everything’s going to be great with the world and it’s going to solve all their problems. Then the paper starts seeping through the concrete a little bit to the top. They’re starting to see those gaps and we’re able to address those.

Once your system is installed, do super users create the applications or does IT have to do it?

It depends on the facility. Usually we’ll go in and implement based on a need. They have a particular need or problem they’re trying to fix. We’ll go in and help and implement around that. Our professional services people will help them solve that. But then we’ll train a super user on how to replicate that, or how to fix the problem. 

We have different types of customers. We have some that have incredible admins that are doing an incredible job of understanding what it does. We’ll call them in three months and they will have fixed four other things that we weren’t even aware of when we first started with their work flows. Then we have some users that need our help and we push them a little bit here and there. Then we have some that just say, come in every six months, look what we’ve got, find our gaps, and help us fill those. But most of our clients do a lot of it themselves.

Are you using newer technologies such as web-based forms and smartphone form entry?

We’re doing a lot. In the last year and a half, we’ve done a lot of development on the app side where we can use iPads and iPhones. It’s a question of which is the best platform to do certain things on. How do you do it on the iPad screen or a Surface screen or an iPhone screen or a Samsung Galaxy screen? All those are different. How can you make that experience right for all of them? That’s what we’ve worked on the last two years. 

We’re getting there and we have customers using it now. We have a couple of international customers that are going to do some incredible stuff with it with the iPad. Patient-facing forms, patient-facing stuff on the web or on an iPad or a Surface there in the facility.

As a gap filler, do you worry that other companies will widen their reach and step on your turf?

They do. We’re partners with a couple of EMR vendors. Their goal is to try to fill all the needs of their clients. The reality is that, at the beginning, they can’t. As they build a new version, they push that out to their clients. Those clients see holes and they ask for those to be filled. They can’t fill all those immediately. I takes four, five, or six years before they can meet all of those. That’s where we fill those gaps until their vendors can fill those. By that time, there’s other gaps that we fill.

We’ve been doing that for 15 years. We don’t try to take the place of their EMR. All we try to do is fill those gaps until they can be served by that vendor. We’re usually finding other things around it. Once our customers install our solutions, they keep them there a long time. It’s just not always the same solution at the end that it was at the beginning.

Where do you take the company from here?

We’re looking at a lot of interesting things. We’ve had more change in our customer base in the last two years than we’ve had in the last 15 and that’s good. We’re focusing on is the integration part, integration directly inside of some of the EMRs. With a lot of our web-based solutions, we’ve found some really nice niches. I’m sure that everyone will hear more about this in the next year or two. But really doing some neat things around trying to make the experience better not only for the patients in the facility, but also all the team members inside of the facility, giving them an ability to do things easier, faster, better, and paperless.
What you’re going to see from us in the next year or two is a lot of integration directly with the EMRs, a lot of integration with the data back into multiple places so that it can be analyzed, used, played with, understood, all those things. That’s where our focus has been the last two years and what you’re going to see from us the next two.

Do you have any final thoughts?

Access is a development company. We do a lot of fun things, but our favorite thing is listening to what our customers are saying and filling those gaps they have. They’re the ones that make us better. This healthcare thing that we’re all in is really about users and customers and what they want. We’ve been very, very blessed to be able to have team members on our side who listen well and develop around that. We’re excited to see what the next two or three years have for us.