Technical Services Representative

 

Technical Services Representative
Reports to:
VP R&D

Location: Madison, WI

Job Summary:

National Decision Support Company (NDSC) is currently seeking an individual to join our technical services team and provide excellent support in solving our customers’ technical challenges. This includes working with NDSC customers during sales, implementation and post-live phases. This team will work together with the implementation and R&D team in all aspects to achieve customer success.

The successful candidate will need to demonstrate a willingness and ability to work in a fluid, close-knit team environment, where tasks could be outside of the core function. This position will provide the successful candidate with personal development opportunities in a rapidly growing company with disruptive technology.

Principal Responsibilities:

  • Work hand-in-hand with customers addressing technical challenges
  • Be the primary customer contact for NDSC customers post live
  • Own customer upgrades and help roll out product enhancements to customers
  • Work with customers to improve product workflow and resolve technical issues
  • Work with internal team and customers to understand product goals and help overcome technical challenges
  • Initiate development tasks to achieve customer satisfaction
  • Identify areas of improvement and assist in creating and implementing solutions

Minimum Qualifications:

  • 2+ years’ experience in technical / services position, healthcare experience preferred
  • Bachelor’s degree or greater in a technical or science related discipline 

 

About Us:

National Decision Support Company is a rapidly growing healthcare IT software company who is passionate about making healthcare smarter.  Our solutions help providers make educated decisions that improve patient care and evaluate cost effectiveness.  We have a start-up atmosphere and a youthful mentality but the market demand and stability that exceeds our age.  Our customers include some of the most prestigious hospitals in the country and are currently expanding into Europe.

 

Technical Services Team Leader

Technical Services Team Leader


Reports to:
VP R&D

Location: Madison, WI

Job Summary:

National Decision Support Company (NDSC) is currently seeking an individual to grow and manage the technical services team and provide excellent support in solving our customers’ technical challenges.

Core function of this position is to lead and grow a technical services team that helps our customers achieve success. This includes working with NDSC customers during sales, implementation and post-live phases. This team will work together with the implementation and R&D team in all aspects to achieve customer success.

The successful candidate will need to demonstrate a willingness and ability to work in a fluid, close-knit team environment, where tasks could be outside of the core function. This position will provide the successful candidate with personal development opportunities in a rapidly growing company with disruptive technology.

Principal Responsibilities:

  • Leadership and Management
    • Guide team efforts towards successful implementation and post-live projects
    • Provide technical leadership to team members
    • Work with internal team and customers to understand product goals and help overcome technical challenges
    • Initiate development tasks to achieve customer satisfaction
    • Identify areas of improvement and assist in creating and implementing solutions
    • Participate in management meetings and take responsibility for technical customer initiatives and other assigned action items
    • Manage workload across team members
    • Contribute to product vision
  • Technical Services
    • Work hand-in-hand with customers addressing technical challenges
    • Own support tools to track and aid NDSC customers
    • Be the primary customer contact for NDSC customers post live
    • Own customer upgrades and help roll out product enhancements to customers
    • Work with customers to improve product workflow and resolve technical issues

Minimum Qualifications:

  • 3+ years’ experience in technical / services position, healthcare experience preferred
  • Prior experience in a management / leadership position
  • Bachelor’s degree or greater in a technical or science related discipline

About Us:
National Decision Support Company is a rapidly growing healthcare IT software company who is passionate about making healthcare smarter.  Our solutions help providers make educated decisions that improve patient care and evaluate cost effectiveness.  We have a start-up atmosphere and a youthful mentality but the market demand and stability that exceeds our age.  Our customers include some of the most prestigious hospitals in the country and are currently expanding into Europe.

 

Software Engineer in Test

Job Title:  Software Engineer in Test

Reports to:  Director of R&D

Location:  Madison, WI or Remote – Telecommute

Job Summary:

Early stage Healthcare IT Company specializing in delivery of Clinical Decision Support content to healthcare organizations and health plans.  Seeking new team member who can fulfill the quality related responsibilities of a cross-functional, agile software development team.

As a Software Engineer in Test you will be a key member of the R&D team who will be actively developing automated tests against our entire stack with individuals who are smart, and love what they do.  Serious candidates will be passionate about creating great software in a team-oriented, agile environment and able to demonstrate the ability to own and manage testing responsibilities of our products, working with both engineering and product teams.

This position will provide the successful candidate with personal development opportunities in a rapidly growing company with disruptive technology.

Principal Responsibilities:

  • Build and maintain automated test projects.
  • Create test cases, test plans, and specifications as well as creating or acquiring test data sets.
  • Actively participate as a member of an agile development team and help the team deliver the highest quality products.
  • Work closely with engineers, product owners, and sales staff to create comprehensive feature requests, test plans, as well as contribute to internal and client documentation.
  • Develop standard testing and quality practices.
  • Drive the creation and maintenance of regression tests.
  • Increase functional test coverage by both expanding existing coverage, as well as creating new test suites.

Minimum Qualifications:

  • Two years of experience in testing web services and web applications.
  • Ability to think critically and understand complex systems.
  • Quick learner with high attention to detail.
  • Ability to perform root cause analysis and help triage issues.
  • Strong interpersonal, problem-solving, and documentation skills.
  • Passionate team member eager to collaborate to create great software.

Nice to have Qualifications:

  • Experience in the medical IT field.
  • Experience understanding relational data models, and writing SQL against relational databases
  • Knowledge of QA best practices and testing methodologies.

Full Stack Engineer

Reports to:  Director of R&D

Location:  Madison, WI or Remote – Telecommute

Job Summary:

Early stage Healthcare IT Company specializing in delivery of Clinical Decision Support content to healthcare organizations and health plans.  Seeking new team member who can do full stack development on a cross-functional, agile software development team.

As an Engineer you will be a key member of the R&D team who will be actively developing across our entire stack with individuals who are smart, and love what they do.  Serious candidates will be passionate about creating great software in a team-oriented, agile environment and able to demonstrate the ability to create innovative solutions.

This position will provide the successful candidate with personal development opportunities in a rapidly growing company with disruptive technology.

Principal Responsibilities:

  • Design and build software using .NET technologies in AWS
  • Actively participate as a member of an agile development team helping deliver the highest quality products.
  • Play a significant role in designing and shaping the architecture of our code base.
  • Work closely with fellow engineers and product owners to help create high quality software.
  • Create and execute problem solving strategies.

Qualifications:

  • Experience preferred with .NET, ASP.MVC, C#, Entity Framework (EF), SQL, AWS, web based development, and service oriented architecture (SOA).
  • Comfortable with agile and Extreme Programming (XP) practices.
  • Quick learner with high attention to detail, adaptable to change.
  • Excellent time management and prioritization skills.
  • Collaborative personality with a solid work ethic and initiative, requiring minimal direction.
  • Passionate team member who is eager build great software.

Education and Experience:

  • Bachelor’s degree in Computer Science or related field, or equivalent combination of experience and education.
  • Experience in the medical field is a plus.
  • Senior candidates – 3 to 8 years of software development experience.
  • Junior candidates – 0-3 years of software development experience.

We’re hiring – Project Manager

Company: National Decision Support Company (http://www.acrselect.org/)
Job Title: Implementation – Project Manager

Reports To: Director of Implementation

Location: Remote – Telecommute (No travel required) preferred location in IL, MN or WI

Job Summary:

National Decision Support Company is an early stage healthcare IT company specializing in the delivery of Clinical Decision Support content to health care organizations, radiology practices and health plans. We are seeking an individual to join the implementation team to manage project delivery to customers. You will work with customers to help install our software and ensure their on-going success. The successful candidate will need to demonstrate a willingness and ability to work in a fluid, close-knit team environment, where tasks could be outside of the core function. This position will provide the successful candidate with personal development opportunities in a rapidly growing company with disruptive technology.

Primary responsibilities include:

§ Establish and maintain strong relationships with customers
§ Work with customers to develop and manage their implementation plan and timeline
§ Customize product configuration/set up to meet the needs of the customer
§ Identify and resolve issues that arise throughout the implementation
§ Work closely with other areas including product development and sales to ensure customer needs are met
§ Work with the implementation team to continue to improve implementation tools and process
Minimum Qualifications:

§ Bachelor’s degree or greater
§ A history of academic and professional success
§ Strong project management skills
§ Strong customer service skills and background
§ Excellent verbal, written, interpersonal and presentation skills
§ Detail oriented
Preferred Qualifications:

§ 2+ years of project management experience; with demonstrated ability to manage complex, multidisciplinary projects
§ 2+ years of healthcare IT experience
§ Proficiency with Microsoft Excel

Trickle-Down Economics of Medical Imaging

Trickle-Down Economics of Medical Imaging

Saurabh Jha, MBBS, MRCS

February 05, 2015

Medical Imaging and the Price of Corn

After the Napoleonic wars, the price of corn in England became unaffordable. The landowners were blamed for the high price, which some believed was a result of the unreasonably high rents for farm land. Economist David Ricardo disagreed.

According to Ricardo, detractors had the directionality wrong. It was the scarcity of corn (the high demand relative to its supply) that induced demand for the most fertile land. That is, the rent did not increase the price of corn. The demand for corn raised the rent. Rent was a derived demand.

Directionality is important. Getting directionality wrong means crediting the rooster for sunrise and blaming umbrellas for thunderstorms. It also means that focusing on medical imaging will not touch healthcare costs if factors more upstream are at play.

Medical imaging is a derived demand. The demand for healthcare induces demand for imaging. Demand is assured by the unmoored extent to which we go for marginal increases in survival.

The Demand for Imaging in Stroke

The treatment of ischemic stroke using thrombolytics and intra-arterial therapy (IAT) is instructive on how imaging can be induced. Lytics improve outcomes but must be administered relatively rapidly after onset of symptoms. IAT, which is treatment at the site of arterial blockage, allows the clock to tick for a bit longer and has recently been shown to be beneficial.

In the MR CLEAN[1] study, patients with acute ischemic stroke with radiographically proven occlusion in the proximal anterior circulation were randomly assigned to IAT or usual care. IAT included local thrombolysis, mechanical break up of thrombus, or stent placement. In both treatment and control groups, most patients also received thrombolysis with alteplase (Activase®).

The results published in the New England Journal of Medicine [1] showed that patients who received IAT within 6 hours of stroke onset had a clinically significant increase in functional independence at 3 months without higher mortality.

Counting the CTs and CT Angiograms

However, patients don’t walk into the emergency department saying, “Good evening, doctor, I have an occlusion in the proximal internal carotid artery. Can we get moving, please?” Sometimes they have classic signs and symptoms of stroke in the distribution of the target artery. Often they have more vague signs and symptoms that could be due to other causes.

Thrombolytics aren’t candy that you distribute willy-nilly. They have serious side effects such as bleeding in the brain. They can worsen the neurologic deficit. They can kill, even when used correctly.

Patients first need a CT of the head—not to pick up early stroke; that’s a clinical diagnosis. A CT is done to make sure that the stroke is not caused by a bleed. Hemorrhagic strokes are less common than ischemic strokes but common enough to warrant routine use of CT for this distinction.

The other reason for CT is to ensure that if the stroke is indeed ischemic, there is not so much brain edema that thrombolysis will lead to bleeding. The risk for bleeding in an ischemic stroke increases in edematous brains.

For IAT, we need to know who has a treatable lesion. Signs and symptoms don’t tell us with certainty who has a culprit lesion in the proximal internal carotid arteries, and neither does standard CT of the head. Patients need CT angiogram not only to identify those who have a treatable blockage but also to find out who doesn’t have a treatable lesion. We can’t tell this without doing a CT angiogram.

Obviously, this means that more patients will get a CT angiogram than are eligible for IAT. Many more will get a CT angiogram than will actually benefit from IAT. (Not everyone deemed to benefit from IAT will actually benefit.)

Okay, so CT of the head is done in all, and CT angiograms are done in many. Is it time to check out with the radiology cashier? No. We are far from done with imaging.

Imaging for Complication Monitoring

After thrombolysis, patients will have another CT of the head to make sure that the clot buster did not cause a bleed. They will be managed in the neuro-intensive care unit (ICU). The level of care will be higher. The sensitivity to mild variation in objective ICU parameters will be intense. Surveillance CTs of the head will be frequent.

There is a plausible risk for bleeding elsewhere after thrombolysis, such as in the abdomen. How do we know whether the patient has bled? Signs and symptoms aren’t reliable. Remember, these patients have neurologic deficits, which bar some from verbalizing clearly.

A fall in hemoglobin and hematocrit could herald a bleed, even if more often than not these indices fall because of the fluid status. Patients in whom these indices have dropped may need a CT of the abdomen to look for bleeding. The cheaper noncontrast CT will suffice in most but not all patients. Some may have active bleeding warranting interventional radiology, which requires a CT angiogram for diagnosis.

IAT involves a puncture of the femoral artery and then navigation of a catheter through the aorta, which is not without complications such as seroma, which may resolve spontaneously. Less commonly, patients might develop a false aneurysm of the femoral artery or an arteriovenous fistula. Patients need an ultrasound and/or CT or MR angiogram of the femoral arteries when there is suspicion of dangerous complications.

The aorta and carotid arteries are tricky territories to navigate. The surgeon might tear the arterial wall. The tear might propagate. These patients need a CT angiogram of the chest and neck. The surgeon might feel that he or she was a bit too enthusiastic breaking up the clot and fear that the artery has been torn. These patients will get a CT angiogram as well. Better safe than sorry.

Broken thrombus could embolize and infarct new areas of the brain, causing new neurologic deficits. In those instances, an MRI of the brain, a CT angiogram of the head, or, more likely, both may be ordered. Of note, in the treatment arm of the MR CLEAN trial, new strokes were reported in 13 of 233 participants.

We are not yet done with imaging.

The CT dye load and natural variation may elevate the creatinine, prompting an ultrasound of the kidneys to exclude a postobstructive, and treatable, renal impairment. Patients will receive countless chest and abdominal x-rays when support lines are inserted and manipulated, in accordance with principles of safety.

A few CTs of the chest may be ordered because a radiologist could not “exclude pneumonia with absolute certainty” in someone with left partial lung collapse, which everyone in the hospital has, particularly when an intern puts in the clinical information, “new fever, exclude pneumonia, kindly.”

Cost and Quality Considerations

Stroke doesn’t sleep at night, and neither do its costs. Radiology departments must be staffed to provide timely access and reports. CT angiograms are complex studies. Trained radiologists, and perhaps expert 3D technologists, must be available 24/7. The window for IAT is 6 hours from stroke onset—the urgency at 5 hours, 30 minutes will be intense.

The medical imaging consequent to applying thrombolysis and/or IAT for stroke in practice is substantial. Any other industry would proudly showcase this exemplar of trickle-down economics. However, patients don’t pay large marginal costs for small marginal benefit. The costs are diffused. But costs are costs. Healthcare is neither a free market nor a market that is free.

How should payers reimburse the derived demand for imaging? They can say: “Stroke team, here is how many quality-adjusted life years (QALYs) the population gained. Thanks for your contribution, radiologists. Here is your share. Yes, I know it isn’t a lot, and your efforts were enormous, but you must admit, the net QALYs are a bit modest.”

That is if the absurdly but rationally high amount of medical imaging as a result of thrombolysis/IAT for stroke were reimbursed in a bundled payment for stroke. This is fine, but is it fair that the average returns on imaging are diminished because of increasing complexity of treatment and diminishing returns on QALYs, factors over which radiologists have little control?

Or should radiologists say to payers, “You want to improve survival in stroke patients using aggressive, expensive, and dangerous therapy. Here is an estimation of the costs of the imaging. Now put your money where your coverage is.”?

Regardless of the payment method, whether bundled pay for outcomes such as QALYs or itemized fee for service, it should be apparent that thrombolysis and IAT for stroke will substantially increase use of imaging. But imaging should not be blamed for increasing costs; that credit should be given to science and humanity for the high costs of stroke treatment.

When clot busting for stroke becomes practice du jour, the population will no longer resemble the trials. The MR CLEAN study was conducted in The Netherlands. This is the United States. Patients will be older and sicker; they will incur more complications, induce more imaging, and derive even less treatment benefit, statistically speaking. Any bundled payment determined by outcomes will become smaller with more and more activity in the bundle. The math of such a payment scheme can’t last for too long.

References

  1. Berkhemer OA, Fransen PS, Beumer D, et al; MR CLEAN Investigators. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015;372:11-20. Abstract

Account Executive

 

Company: National Decision Support Company

Job Title: Account Executive

Reports to: TBD

Location: Remote – Telecommute

Job Summary:

Early stage Healthcare IT Company specializing in delivery of clinical decision support content to healthcare organizations and health plans. Seeking individual to support and execute defined sales and business development targets.

Core functions of this position includes lead and demand generation, opportunity management and sales process execution.

The successful candidate will demonstrate a willingness and ability to work in a fluid, close-knit team environment, where tasks will often be outside of the regular job description.

Principal Responsibilities:

Lead and demand generation:

  • Conduct ongoing customer needs analysis, research of customer requirements through first party resources
  • Personal outreach to identified targets
  • Follow up on leads, leveraging marketing materials
  • Ensure contact details of key buying influencers are captured and entered into Salesforce
  • Initiate qualification process of leads and convert to opportunities

Opportunity management:

  • Maintain Salesforce, develop and streamline reports/analysis
  • Complete and maintain accurate sales forecasts in Salesforce, develop and streamline reports/ analysis for sales management
  • Develop quotations/ proposals in cooperation with sales management based on identified sales strategy and information collected from customer or partners as assigned
  • Track open opportunities, manage tasks during sales cycle
  • Ensure appropriate engagement of NDSC resources with clients, including assistance in maintaining sales demo calendar

Sales process execution:

  • Assist in completing sales projects including proposals and marketing

company services

  • Manage assigned deals
  • Assume project manager role in late stage of sales cycle, in support of executive team, for coordination to close
  • Cross functional liaison between client and the NDSC team

Minimum Qualifications:

  • College/University degree or equivalent experience
  • A history of academic and professional success
  • Proven ability to develop and maintain effective internal and external business relationships with various levels of management and non-management
  • Detail oriented with excellent verbal, written and interpersonal skills
  • Willingness to learn
  • Ability to work in cross functional capacity

Preferred Qualifications

  • 2+ years of insides sales experience, preferably in the health care industry
  • 2+ years of healthcare IT experience
  • Proven track record of achieving sales quotas
  • CRM experience, Salesforce specific experience a plus

Implementation – Project Manager

Implementation – Project Manager

Posted on May 23, 2014 by acrselect

Company: National Decision Support Company (http://www.acrselect.org/)

Job Title: Implementation – Project Manager

Reports To: Director of Implementation

Location: Remote – Telecommute (No travel required) preferred location in IL, MN or WI

Job Summary:

National Decision Support Company is an early stage healthcare IT company specializing in the delivery of Clinical Decision Support content to health care organizations, radiology practices and health plans. We are seeking an individual to join the implementation team to manage project delivery to customers. You will work with customers to help install our software and ensure their on-going success. The successful candidate will need to demonstrate a willingness and ability to work in a fluid, close-knit team environment, where tasks could be outside of the core function. This position will provide the successful candidate with personal development opportunities in a rapidly growing company with disruptive technology.

Primary responsibilities include:

  • Establish and maintain strong relationships with customers
  • Work with customers to develop and manage their implementation plan and timeline
  • Customize product configuration/set up to meet the needs of the customer
  • Identify and resolve issues that arise throughout the implementation
  • Work closely with other areas including product development and sales to ensure customer needs are met
  • Work with the implementation team to continue to improve implementation tools and process

Minimum Qualifications:

  • Bachelor’s degree or greater
  • A history of academic and professional success
  • Strong project management skills
  • Strong customer service skills and background
  • Excellent verbal, written, interpersonal and presentation skills
  • Detail oriented

Preferred Qualifications:

  • 2+ years of project management experience; with demonstrated ability to manage complex, multidisciplinary projects
  • 2+ years of healthcare IT experience
  • Proficiency with Microsoft Excel

 

EHR Clinical Decision Support Functions Linked to Better Care Quality | Blue Horseshoe Blogger

EHR Clinical Decision Support Functions Linked to Better Care Quality

Article

EHR Clinical Decision Support Functions Linked to Better Care Quality

California Healthline, iHealthBeat, Monday, November 3, 2014

Meaningful use standards that require clinical decision support functions could significantly improve quality of care, according to a study published in the American Journal of Managed CareHealth IT Analytics reports.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

Details of Study

For the study, researchers analyzed data from the 2006 to 2009 National Ambulatory and National Hospital Ambulatory Medical Care surveys on adult primary care visits to practices that met the requirement for Stage 1 of the meaningful use program. These practices had EHR systems with at least one of five CDS functions:

  • Electronic problem lists;
  • Lab result reports;
  • Notifications for out-of-range labs;
  • Reminders for preventive care; or
  • Warnings for drug interactions.

The researchers then divided the visits into three categories:

  • Visits to practices with all CDS functions enabled;
  • Visits to practices with at least one CDS function disabled; and
  • Visits to practices with at least one missing CDS function (Bresnick,Health IT Analytics, 10/31).

Please click below to continue reading…

Findings

The study found that 86% of patients who visited primary care clinics with all five types of CDS functions had controlled blood pressure, compared with 82% of patients who visited clinics with at least one missing function and 83% of patients who visited clinics that had disabled at least one function.

Further, researchers found that:

  • CDS functions were associated with blood pressure control and fewer visits for adverse drug events;
  • CDS functions were associated with better performance on indicators of quality of care and clinical decision support functions related to such quality measures (Mishuris et al., AJMC, 10/28); and
  • Decisions to disable CDS functions were associated with reduced quality of care improvements (Health IT Analytics, 10/31).

However, the researchers said they were unable to determine an association between disabling particular CDS functions and cancer screening, health education or influenza vaccinations because of limited data (AJMC, 10/28).

Implications

The researchers said, “Overall, meaningful use standards that include [CDS functions] appear to have a significant positive effect on some national quality-of-care indicators and health outcomes.”

They added, “It will be important to evaluate the evolving impact of meaningful use as the stages continue to be more widely implemented and better integrated with care processes; we anticipate further gains in healthcare quality indicators and outcomes as a result” (Health IT Analytics, 10/31).

Source: iHealthBeat, Monday, November 3, 2014

CDS functions within the EHR have shown the ability to improve the quality and safety of patient care. I personally feel that these functions serve as a safety net for providers and can help catch potential errors before they are made.

What are your thoughts on CDS functions, and do you feel it is appropriate for practices to have the option of disabling any of the CDS functions available?

Thanks for reading and please share your thoughts!

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