Why Seoul Medical Group Is Planning Widespread Deployment of Elation EHR

Asian-American-focused independent practice association Seoul Medical Group (SMG) has quietly grown to serve more than 100,000 patients through a network of over 5,000 primary care physicians and specialists across seven U.S. markets. Healthcare Innovation recently spoke with Myong Lee, CEO of Advanced Medical Management Inc., on behalf of SMG, and EHR vendor Elation Health’s CEO Kyna Fong about their plans to deploy Elation’s EHR across the SMG network. 

Myong Lee is the son of first-generation immigrants from South Korea. The co-founder of Clever Care, he has assisted companies such as agilon health and Clover Health with building and scaling their businesses.

Kyna Fong co-founded Elation Health in 2010. She is a Robert Wood Johnson Foundation Scholar in Health Policy at UC Berkeley and UCSF. Fong hold an M.S. in computer science from Harvard University and a Ph.D. in economics from Stanford University.

Healthcare Innovation: Myong, could you first tell us about Advanced Medical Management and its relationship with Seoul Medical Group? 

Lee: Advanced Medical Management is a management services organization and a sister company of Seoul Medical Group. I'm responsible for running the MSO, but I work very closely with the primary care physicians within SMG.

HCI: When I saw the announcement about this partnership, I realized that I had never heard of SMG, which I think is surprising given its size. 

Lee: I get that a lot. I think some of it has to do with the fact that they're really focused on the Medicare Advantage population. Secondly, the primary focus is on the Asian senior population. We're currently located in California, Hawaii, the State of Washington, Georgia, New York, and New Jersey. It is under the radar, but it's actually one of the largest IPAs in the country. I came on board last June, and really a big focus has been on implementing technology and data analytics to support value-based care.

HCI: You previously started a company called Clever Care. Could you briefly describe that, and is there some continuity between that company and this one? 

Lee: I was the co-founder and CEO of Clever Care Health Plan, which is an Asian-focused Medicare Advantage plan based in Southern California. Seoul Medical Group was actually one of the first IPAs that I contracted with. So one way or another, I have partnered with SMG for years now.

HCI: Is SMG an accountable care organization unto itself?

Lee: We actually have an ACO partner, but what we are is a full-risk IPA. The end goal is to be at full financial risk for the member. Our PCPs in some parts of the country are taking delegation. They're doing parts of what the insurance company would normally do. We're actually doing back office admin work, because we're getting paid a capitation directly from the insurance company.

HCI: What drew you to working with Elation? 

Lee: As I look at where the investments have to be made, Elation was a no-brainer for us. It just makes the PCPs’ lives easier. Value-based care is constantly changing the requirements. So if we could take away this crazy administrative burden by partnering with Elation, we can actually focus in on what's really important to patient care, as well as what CMS is looking for. That’s massive for us.

HCI: Kyna, Elation has received lots of positive feedback, including winning a Best in KLAS award. Could you share your story about the founding of the company?

Fong: I started the company with my brother. I was a tenure track professor at Stanford in health economics, and my brother was a management consultant doing health IT strategy and implementation work, mostly for large health systems. 

But we ended up in healthcare mostly because of our experience as teenagers, when our dad, who's a primary care doc, moved us down to the U.S. from Canada. My brother Conan and I helped with the practice. We helped him buy a practice, build it from scratch, negotiate with insurance companies. Fast forward a bunch of years, and we were trying to convince our dad to put some sort of technology into his practice. He generally refused and thought it was going to make his life worse and make patient care worse. We eventually convinced him to let us look, but when we looked at what was available we were super disappointed. Being the inquisitive, curious people we are, we built something instead. And it's been continually live ever since. The second deployment was in our family friend’s office. And the rest is history.

I think the big differentiator for Elation has very much been our clinical-first philosophy — putting the patient/physician relationship first and foremost. And I think that's just massively differentiating in a space that's dominated by billing-oriented EHRs.

It is why a partnership with SMG, which is trying to help independents be successful in value-based care, is such a powerful and exciting partnership, because a clinical-first focus is so highly aligned with success in value-based care and helping enable the right thing to happen at the right time, with technology as a way to simplify what it takes to be successful and do the right thing.

HCI: Myong, in the current state, before this announcement with Elation, are SMG’s provider organizations using a wide variety of EHRs?

Lee: It’s everything from paper to a dozen-plus different platforms.

HCI: Would it be make your life easier if you can get them all on the same platform? Is that a goal?

Lee: Yes, it would be. We know how doctors are. It takes a lot of time, right? But people are really excited. Kyna and her team have been presenting and working with the PCPs. A lot of EHRs are really focused more on fee for service and our entire business is really on value-based care. 

In value-based care, everything that primary care physician does with a patient has to be documented, and then it has to be submitted back to the MSO. Then we submit that data to the insurance company, who ultimately sends it back to CMS. We're in so many different value-based care arrangements, and every single one requires, ultimately, the same data set. But imagine if you have to do this on paper or you have to go into all these different portals, it's just so inefficient. That’s the friction. So the more PCPs that we’re able to get on the platform, it's just easier for everyone.

HCI: Do you have a goal for a certain percentage of them to switch over in the next few years?

Lee: I want to get close to 100%. I realize that’s a very hard target, especially with the older physicians. But when you specifically look at the younger physicians, that's where it has to be 100% and quite frankly, we're getting great feedback, and that's where we're getting a lot of uptake, because they're very comfortable with technology.

HCI: Kyna, do you have a lot of experience with transitioning these practices off their old EHR and onto Elation? And is it painful sometimes, or do you have a process that makes it easier?

Fong: Every single day we get physicians comfortable and successfully on-boarded to our technology. We show them the value and speak about how this enriches their relationships and their success with SMG.

From a transition perspective, it's a big part of what we've been focused on as a company, almost from the get-go. There are a lot of ways you can streamline it, and especially as data has become more structured, consistent and interoperable. All the various requirements that each certified EHR goes through does make the transition easier than it used to be. And the nice thing about working with Elation is that because so much of our focus has been on the user experience and the ease of use, it doesn't have an enormous training burden that other systems might.