"Welcome to our company blog. Within these blog posts, we hope to share our insights on clinical quality management, the patient-centered medical home, chronic disease management in primary care, evidence-based medicine, and the use of technology in ambulatory care settings."

- David Morin, CEO and Donald Nease Jr., MD, Chief Medical Officer

Data is data, right? Facts and figures presented in some manner. More data is always better than less? Larger reports must always tell you more? Many a job has been justified on generating data. There are many to which generating data is the end-goal. Each of us is drowning in data. And much of it really doesn't help you do what you do better. Shouldn't that be the point of getting data? Actionable data is data that you can do something with. It answers not just "what" but "why". An example: your clinical system generates a report that says your compliance rate with a guideline for measuring A1C levels every six months for diabetics is 50%. That tells you, for half your diabetic patients, you are meeting the goals of the guideline. Cool! Now, you want to get that compliance rate to 60%. What do you do? All the report tells you is that 50% are in compliance. You have no idea what's going on with the other 50%, you don't even know who they are. Good luck getting your compliance rate higher. Here comes the need for actionable data! The data you need to get your compliance rate higher includes: 1. A list of the patients not in compliance. Yep, this certainly is where you'd start, but this alone doesn't tell you why they are not in compliance. And, it needs to be all the patients not in compliance, even those you haven't seen in years. 2. Details as to why they are not complaint (like: have never been seen, have a lab req but never completed it, refused to do it, have not been asked to do it). Cool. Now we know what to do for each patient. How do we take action to move forward? 3. Contact information for each of these patients. Use this info for telephone calls, custom letters, emails, text messages, smoke signals, whatever it takes to reach these non-compliant patients and move them to compliance (Note: Cielo Clinic can generate letters and create call lists but cannot yet generate smoke signals). And, because you know the exact reason each patient is not in compliance, you can have directed communication with them to get to their exact needs. 4. Details on the actions you take. Track the fact you made calls, sent letters, got more lab reqs out, etc… So, as you continue to work with these patients, you know exactly what you've done to be smarter about it next time around. Got actionable data? Dave Morin CEO Cielo MedSolutions

Admit it. We’ve all done it: purchased software licenses, whether for our workplace or for our own use, only to find, a year or two down the road, that we really never used it. If there was a user manual or disc, it ended up sitting on the shelf collecting dust –- earning this entire category of promising-at-first-but-never-used software packages the dreaded but apt moniker “shelfware.” Although Cielo MedSolutions (www.cielomedsolutions.com) is relatively young, I’ve personally been in the software business longer than the kid who runs Facebook has been alive – whoa… now that’s weird – and I’ve not only seen lots of shelfware, but, to my dismay, quite a few shelfware VENDORS. It’s sad, but there are entire companies out there (and so, so many that have come and gone) who don’t particularly care what happens to the customer after she or he cuts the check and takes delivery of the software. When you purchase Cielo products, you get so much more than just software (or, in our case, SaaS, software-as-a-service). You get a long-term relationship with a world-class healthcare IT partner. We are committed to understanding your healthcare information technology challenges. We are committed to staying on top of the myriad information-related challenges confronting the world of clinical care -- whether they be new clinical guidelines, new quality reporting initiatives, pay-for-performance or other reimbursement-related reporting challenges, or public scorecarding -- and to partner with our healthcare provider customers by delivering SaaS solutions that genuinely help them to simplify and make sense of it all. We are committed to delivering Saas offerings to our provider customers that fit their clinical workflow, are easy to learn and use, and actually help them practice quality medicine. We are committed to delivering Saas offerings to our provider customers that have a rapid financial payback and a high return-on-investment (ROI) -- something even your CFO or CPA can love! We are committed to delivering hands-on user orientation and training, first-rate service, professional post-sales support and frequent software updates. And, it goes without saying: We are committed to delivering ultra-reliant, HIPAA-compliant data-hosting and network delivery. So, which sounds more appealing: shelfware, or a long-term partnership? Jim Price Chairman & Cofounder Cielo MedSolutions

As you know if you've spoken with us or spent much time browsing our website, we're big on the fact that Cielo Clinic contains a coded, all-problem registry. Here's a brief description of why that is so important. Your registry is only as good as its accuracy. Many registries are built off of billing data. Not a bad place to start you may say. Just take all those people with asthma or depression codes and dump 'em in! Not so fast... Billing data sits at one end of a long process that begins with a clinician thinking, "This patient is wheezing, but I don't have enough yet to make an asthma diagnosis." So the clinician either writes down "wheezing" which gets changed to a billable diagnosis of asthma, or they realize from the start that wheezing won't get paid for and they just write asthma. When that billing data gets dumped into the registry, the patient with wheezing is now part of the asthma registry, and becomes part of the reporting for which one is responsible. Whoops! If you have a system that allows you to accurately represent with a coded problem what that clinician is thinking, "wheezing" doesn't become "asthma", and your quality improvement efforts are focused with precision on the patients that truly have asthma. Cielo Clinic contains a rich set of clinical terminology that was built by having primary care physicians record problems using words that make sense to them. These terms are coded, and mapped to a classification system that allows accurate aggregation of the problems into disease categories for quality management. If your quality management system can't do this, you'll spin your wheels focusing on patients that don't have the diseases you're trying to impact. If you build it they will come - Field of Dreams OK, maybe it's a bit corny, but that's our reason for having an "all-problem" registry. Clinicians build it by recording the problems they are working with every day. Not just on a select set of patients, but all patients. A lot of work? Not if you are getting something in return. What Cielo Clinic gives you in return is an accurate problem list on every patient, using terms you understand, not up-coded to meet billing standards. Additionally, Cielo Clinic gives you back reminders based on those problems and the ability to "on-the-fly" respond when new guidelines emerge for conditions. Because you've been accurately recording the problems, you have already built the registry for any given clinical disease category. You're building it, because those new guidelines will come! Don Nease, MD Chief Medical Officer Cielo MedSolutions

If you’ve been around us at Cielo MedSolutions (www.cielomedsolutions.com), you’ve probably heard us on more than one occasion belabor the pronunciation of our company name (“see EL oh”) –- which is a bit Americanized from the more proper Spanish pronunciation. But what you may not have heard is the meaning behind our name, which is kind of cool. In Spanish, “cielo” translates to mean both sky and heaven. It’s from the Latin root of the same spelling and meaning. So in French (another Latin language), sky is “ciel,” and based on this we better understand the derivation of the word “ceiling” in English. Well gee, thanks, Dr. Linguist, you may be thinking, what’s the point? When Dave Morin (http://www.cielomedsolutions.com/about-leadership.asp) and I launched the business in 2005, we wanted a company name that was evocative of dramatic improvement in the field of healthcare. We were looking for a name that suggested a positive, upward-trending future. We felt that “Cielo” evoked that feeling beautifully, while the accompanying “MedSolutions” connotes that our company is in the business of actually solving real-world problems –- and substantively helping healthcare providers by delivering useful solutions to today's challenges in clinical quality management. We hope Cielo's simple sunburst logo ties it all together. Jim Price Chairman & Cofounder Cielo MedSolutions

When we launched Cielo MedSolutions (www.cielomedsolutions.com) in ’05, we took a long, hard look at the healthcare IT space and realized the following: 1. that the country’s 360,000 primary care physicians were suffering… they were underpaid and overworked; 2. that commercial electronic medical record (EMR) or electronic health record (EHR) software wasn’t the entire answer for making those primary care clinicians’ lives better, partly because this software tended to be designed around the needs and the workflow of hospitals and inpatient medical care (as opposed to ambulatory care), and partly because it tended to record billing data (as opposed to clinical data) in the patient record; and, 3. that existing commercial software tended to be so expensive that the return-on-investment just wasn’t there for primary care providers. As we scoured the market at the time, we were fortunate to find some existing web-based software –- an example of what we’ve come to call a “clinical quality management” application –- developed by leading clinical researchers at the University of Michigan’s Medical School by the Family Medicine Professors Don Nease, Mike Klinkman and Lee Green. They’d developed and already proven out this software, with the help of NIH grant funding, and were already field-deploying it to manage over 140,000 patient encounters per year in their geographically-dispersed clinics. What we liked about what we saw with the UM software was that it was built around the needs –- and around the workflow –- of primary care clinicians, and actually helped each physician do a better job of keeping track of the myriad details associated with chronic disease management for her or his thousands of patients, both on the day of a patient visit as well as by facilitating proactive patient outreach. So, to make a long story long... we ended up exclusively licensing this technology from the University of Michigan (http://cielomedsolutions.com/news-pr-cms-march2006.asp). But -- and we think this is much more important in the final analysis -- we've ended up forming deep personal and professional friendships with the key medical researchers involved. Today, we have the privilege of calling Dr. Don Nease our Chief Medical Officer at Cielo, and Drs. Klinkman and Green both energetically serve on our Medical Advisory Board where they continue to challenge our thinking and provide thought leadership (http://cielomedsolutions.com/about-advisory.asp). On the application software side of things, we've rapidly evolved and augmented the technology we licensed from UM, and the result today is known as Cielo Clinic, a commercial SaaS (software-as-a-service) application for clinical quality management in ambulatory care settings. Jim Price Chairman & Cofounder Cielo MedSolutions