ModMed
بواسطة Modernizing Medicine, Inc
ModMed typical implementation process:
Planning and Discovery: The process begins with a consultation phase where ModMed’s onboarding team assesses the practice’s workflows, existing systems, and data requirements to design a customized implementation plan focused on clinical efficiency and staff readiness.
Technical Integration: Data migration and integrations follow, where ModMed assists in transferring demographic, clinical, and billing data from legacy systems. This phase aligns APIs, labs, and third-party connections to ensure a seamless data flow into the ModMed platform.
Configuration and Customization: The system is configured to the practice’s specific specialty, workflows, and compliance requirements. This includes customizing templates, patient forms, billing codes, and user permissions.
Training and Education: Through Virtual Adoption Support & Training (VAST), ModMed provides live virtual sessions, role-based training, and access to the ModMed Communities knowledge base with video tutorials and practice simulations for all staff roles.
User Acceptance Testing: Before go-live, teams practice in a safe test environment to validate templates, document handling, and billing workflows—ensuring the system matches real-world operations.
Go-Live Deployment: The system is activated in the live environment with dedicated support. Practices can choose on-site or remote go-live assistance to manage transition smoothly and minimize downtime.
ModMed platform can be fully customized to fit the unique workflow, clinical, and administrative needs of different medical practices. Its architecture is designed around adaptive learning, configurable templates, and specialty-specific flexibility, allowing each organization to tailor the system’s features and interface to its operational requirements.
Specialty-Specific Customization: ModMed’s EHR platform (EMA®, gGastro®, gPM) offers built-in templates, protocols, and content libraries for over 11 medical specialties, including dermatology, orthopedics, ophthalmology, gastroenterology, and urology. Each module adapts terminology, diagnostic tools, and treatment pathways to the specialty’s needs.
Customizable Workflows: Practices can personalize exam flows, documentation steps, chart layouts, and appointment types to match how providers work. The workflow engine allows for drag‑and‑drop adjustments to streamline processes like patient intake, clinical note creation, and billing configurations.
Adaptive Learning Technology: The EMA® system learns from each provider’s usage—recognizing documentation habits, frequent diagnoses, and coding preferences—to optimize templates and predict charting actions over time, reducing manual edits and clicks.
Custom Clinical Templates: Users can create or modify clinical note templates, diagnoses lists, and SOAP note structures. The templates are designed to evolve dynamically, adapting to a clinician’s specific documentation approach.
Configurable Billing and Revenue Tools: Practices can tailor claim scrubbing rules, charge capture, billing workflows, and reporting dashboards. ModMed Pay includes customizable payment features such as autopay, text‑to‑pay, and automated reconciliation settings.
Patient Experience Customization: The APPatient™ app and Premium Patient Connect tools allow clinics to personalize portal branding, message templates, appointment reminders, and intake forms for their patient demographic.
Scalable by Practice Size: ModMed’s framework scales easily, from solo specialists to enterprise-level multi-location groups. Larger practices can configure enterprise features like permission-level controls, reporting dashboards, and multi-department setups.
APIs and Third‑Party Integrations: Through SynapSYS, ModMed provides an API that allows practices to connect custom apps, lab systems, CRMs, or hospital data exchanges. Integration support enables interoperability and data customization across the healthcare ecosystem.
Documentation and Data Flexibility: Providers may choose between hands-free AI documentation, touch-based note editing, or voice dictation and integrate those modes into personalized charting configurations.
ModMed offers a structured, role-based training and long-term support system designed to ensure successful platform adoption across all practice sizes and specialties. New users benefit from step-by-step onboarding led by certified educators, continuous access to e-learning resources, and dedicated customer support throughout all phases of implementation and use.
ModMed U (Online Learning Platform): A comprehensive, self-paced e-learning system featuring video tutorials, quizzes, and role-specific lesson plans that cover EHR use, practice management, and billing workflows. Administrators can track each staff member’s training progress through ModMed U.
Remote Instructor-Led Training: Practices with one to three providers receive remote, consultative sessions via GoToMeeting. These live sessions reinforce ModMed U content and focus on specialty workflows, documentation accuracy, and common troubleshooting techniques.
On-site Workshops: Larger practices (three or more providers) can opt for two-day, hands-on, classroom-style workshops. Trainers guide team members through real-world practice scenarios and assess readiness for the go-live phase using interactive exercises.
Virtual Adoption Support & Training (VAST): A virtual mentorship program that provides tailored onboarding sessions for multi-location or remote teams. VAST allows multiple users to train simultaneously and ensures flexible go-live scheduling across offices.
Focused Go-Live Support: Dedicated ModMed educators assist during and immediately after go-live, helping staff fine-tune workflows and perform data validation. This phase ensures stable day-to-day operations right after system launch.
Post-Go-Live Optimization Training: After implementation, additional live virtual training helps users refine advanced features, increase efficiency, and optimize workflows. The focus is on automation, ancillary staff optimization, and reporting capabilities.
ModMed Communities Knowledge Base: A 24/7 online support hub featuring quick reference guides, training manuals, knowledge articles, and video demos. It also includes an employee onboarding section for training new hires after the go-live period.
ModMed employs a robust, multilayered security framework to protect sensitive healthcare data, ensuring full compliance with HIPAA, HITECH, and ONC certification standards. Its security architecture incorporates administrative, technical, and physical safeguards, with continuous auditing and governance protocols across all cloud-hosted systems.
HIPAA and Business Associate Compliance: ModMed signs a Business Associate Agreement (BAA) with clients and operates as a verified HIPAA-compliant vendor. It implements all three fundamental HIPAA safeguards—administrative, physical, and technical—to secure patient data and meet breach notification requirements under the Security Rule.
Cloud-Based Security and Encryption: The platform uses AES-256 encryption for data at rest and TLS 1.2+ encryption for data in transit across its Amazon Web Services (AWS)-based cloud infrastructure. This ensures that all ePHI (electronic Protected Health Information) is encrypted end-to-end, preventing unauthorized interception or tampering.
Multifactor Authentication (MFA): Built-in MFA and role-based access control (RBAC) mechanisms are core components of ModMed’s defense model. These ensure that only verified users can access critical systems and sensitive information. MFA is available in all EMA® and gGastro® solutions and has become a recommended best practice for cybersecurity insurance eligibility.
AI Governance and Ethical Data Handling: ModMed enforces enterprise-level AI governance policies to ensure its AI models—such as ModMed Scribe—operate under strict privacy and fairness controls. AI systems undergo bias audits, dataset validation, and continuous monitoring under the 2024 ONC certification framework for Predictive Decision Support Interventions (PDSIs).
Data Access and Audit Trails: Every event related to data access, updates, or deletions is logged via real-time audit trails. Administrators can trace all user actions, making it easy to detect anomalies, prevent insider misuse, and meet regulatory compliance for audits.
Regular Penetration Testing and Risk Assessments: ModMed conducts recurring third-party security audits and penetration tests to identify and address potential vulnerabilities. Annual risk analyses and remediation plans maintain compliance with the ONC’s §170.315(b)(11) standards for certified EHR technology.
Redundancy and Disaster Recovery: The platform leverages geographically distributed data centers, redundant backups, and a disaster recovery plan that ensures less than a 24-hour restoration time in the event of a system failure. All backups are encrypted and stored within U.S.-based facilities.
Least Privilege Controls and User Permissions: ModMed applies a least-privilege principle, ensuring that users only access the specific modules and records required for their role. Access rights can be customized for physicians, billing, and administrative staff independently.
Intrusion Detection and Threat Monitoring: Advanced intrusion detection and anomaly monitoring systems continuously analyze data traffic patterns for irregular activity. Security operations teams are notified automatically when potential threats are detected.
Privacy Policy and User Data Governance: ModMed’s privacy framework transparently outlines how personal and clinical data are collected, stored, and processed, with explicit limitations on third-party sharing. All data use adheres to the “minimum necessary” principle under HIPAA.
ModMed follows a structured and continuous release management cycle to ensure its EHR, practice management, and analytics systems remain compliant, secure, and functionally current. Updates include security patches, regulatory adjustments, new AI features, and specialty enhancements. The process is designed to minimize disruption while maintaining ONC certification and HIPAA security standards.
Update Frequency: ModMed products—such as EMA and gGastro—typically receive monthly maintenance releases and quarterly feature updates, along with major version upgrades once per year.
Automated Cloud Delivery: Because ModMed is hosted in a secure cloud environment, all updates are deployed automatically without local installation, ensuring zero downtime for users during deployment windows.
Regulatory Synchronization: Coding, billing, and compliance modules are updated in sync with annual CMS and AMA coding changes—including CPT, HCPCS, and ICD-10 updates (CPT in January, ICD-10 in October, and HCPCS quarterly).
ONC Real World Testing: Each certified ModMed product undergoes annual “Real World Testing” as required by the ONC 2015 Edition certification rules. This process verifies interoperability, security, and continued compliance with federal standards. Test results and implementation metrics are published yearly in ModMed’s Real World Testing reports.
Staged Rollout Process: Updates are first deployed in sandbox and pilot environments, where ModMed technical teams and select client practices validate functionality and stability before general release.
Client Notification and Training: Customers are notified in advance through in-app announcements, email bulletins, and the ModMed Community Portal. Training videos, release notes, and webinars accompany each major update to guide users through new capabilities.
Continuous Monitoring: Post-release, ModMed’s DevOps and Compliance teams monitor performance telemetry, error logs, and client-reported issues to ensure smooth stability across newly updated environments.
ModMed’s data ownership and portability policies—defined across its Privacy Policy and Terms and Conditions for EMA gGastro and related platforms—establish that client practices maintain primary control over their patient data, while ModMed acts as a data processor and custodian. These policies align with HIPAA, GDPR, and various U.S. state data privacy laws to guarantee transparency, data access, and lawful portability.
Data Ownership: Under ModMed’s agreements, the medical practice retains full ownership of all patient health data, practice data, and imported records entered or generated within ModMed’s systems. ModMed does not claim proprietary rights over client or patient data. However, the company exclusively owns its software, frameworks, source code, and derived anonymized datasets (used for analytical benchmarking or system improvement). Practices can export or retrieve their original data at any time through authorized interfaces or reports.
Custodian Role and Data Handling: ModMed operates as a Business Associate under HIPAA, meaning it processes data solely to facilitate EHR, billing, and analytics services. The company complies with minimum necessary data use principles, ensuring that ModMed staff only access data required to support or maintain the client’s account.
Right of Access and Portability: Clients and, where applicable, individual patients can request data exports in structured, machine-readable formats (commonly CSV, XML, or HL7). This allows seamless transfer to other EHRs or health systems. Data portability requests are processed under applicable frameworks like GDPR Article 20 and corresponding U.S. laws (CCPA, CPRA, CPA, etc.). ModMed verifies requesters’ identities before completing any export or deletion.
Data Retention and Deletion: Upon contract termination, ModMed maintains customer data for a defined retention period—typically up to 60 days—to allow full extraction. After this window, data is securely deleted or irreversibly anonymized in compliance with NIST 800-88 and HIPAA retention standards. Clients may request written confirmation of data destruction.
Derived and De-identified Data Use: ModMed reserves limited rights to use de-identified or aggregated datasets for research, analytics, and product improvement, provided such data cannot identify specific practices or patients. This is consistent with HIPAA’s de-identification rules (§164.514(b)(2)).
Portability Mechanisms: Data portability is supported through the platform’s API framework (SynapSYS) and export tools, enabling secure data migration to other applications or EHR environments. ModMed guarantees interoperability with FHIR and HL7 standards, ensuring compliance with ONC interoperability mandates.
ModMed offers flexible scalability terms that allow healthcare organizations to expand or contract their software usage as their operational needs evolve. The platform’s architecture, pricing structure, and contractual framework are all designed to support dynamic scaling while maintaining cost efficiency, system performance, and compliance continuity.
Scalable Cloud Architecture: ModMed’s EMA and gGastro systems are cloud-based, enabling practices to add or remove providers, locations, and modules without the need for hardware investments or full reinstallation. This design supports both vertical growth (adding users or specializations) and horizontal expansion across new facilities.
Add-on and Upgrade Flexibility: Clients can upgrade or add-on software features, users, or service bundles at any time through billing adjustments or change orders. Expansions to services such as analytics, telehealth, or revenue cycle management (RCM) are activated seamlessly on existing accounts.
Downgrade and Contract Adjustment: Practices scaling down can adjust the scope of services—such as reducing provider licenses or removing auxiliary modules (e.g., RCM or patient engagement tools)—by submitting a Change Order Request. Upon approval, ModMed may rebalance fees according to usage, with terms negotiated in good faith to ensure fair adjustments.
Statement of Work Flexibility: ModMed’s contracts include change-order provisions under its Statement of Work (SOW) model. When clients request scope changes, the company evaluates the request, updates service levels, and modifies pricing or timelines as mutually agreed.
Data Migration and Support for Growth: For practices expanding or merging, ModMed provides data conversion and migration services, allowing newly acquired or additional sites to integrate their records without disrupting the existing setup. ModMed staff assist in unifying workflows and analytics during expansion phases.
Elastic Licensing Model: Subscription plans scale according to provider count, location, and specialty type. Licensing can be increased or decreased at renewal or mid-term by coordinating with ModMed’s account managers. Practices pay only for the enabled users or modules they actively use.
Billing Adjustments for Scaling: When clients upgrade mid-cycle, billing is typically prorated to reflect new features or provider counts. For downgrades, adjustments take effect at the next billing cycle, ensuring consistency in subscription management.
ModMed’s contract renewal and cancellation policies are outlined in its Standard Terms and Conditions agreements (covering EMA®, gGastro®, gPM, and RCM services). These terms govern automatic renewals, pricing adjustments, termination requirements, and post-termination data provisions. The agreements are designed to maintain compliance, prevent service disruption, and ensure financial clarity for healthcare practices.
Automatic Renewal: ModMed contracts typically auto-renew at the end of each subscription term—monthly or annually—unless either party provides written notice of non-renewal within the required timeframe. The renewal takes effect immediately following the contract’s expiration, continuing under the same pricing or fee structure unless updated per notice.
Renewal Notification Period: ModMed requires at least 30 days’ written notice before the end of any contract period to opt out of automatic renewal or modify terms. Clients who fail to provide notice are automatically extended for the next renewal term.
Fee Adjustments: ModMed reserves the right to revise service fees or discounts between renewal periods. Any price adjustment becomes effective at the start of the next renewal term after providing 30-day written notice to clients.
Term Options: Some ModMed agreements include month-to-month renewals after initial annual terms, giving clients flexibility in engagement length following their first contract cycle.
Add-On Amendments: Practices can expand usage (e.g., additional provider licenses or modules) via an Add-On Addendum, with corresponding fees agreed before activation. However, reducing the number of users within a term is generally restricted until renewal.
Notice to Terminate: To terminate an agreement, the client must provide 30–60 days’ written notice, depending on product type. Termination becomes effective at the end of the current term unless otherwise negotiated.
Early Termination Fees: Clients canceling before the end of a contract term remain liable for all outstanding payments for the duration of that term. Modernizing Medicine does not typically issue refunds for prepaid fees or partially unused subscriptions.
Service Suspension: If payments become overdue for more than 30 days, ModMed may suspend system access until balances are paid in full. The practice remains financially responsible during suspension periods.
Refund Eligibility: Refunds are strictly limited. Clients may only receive a pro-rata refund in rare cases where ModMed fails to deliver services due to system discontinuation or contractual withdrawal, as explicitly stated in some specialty-specific agreements.
Data Export Rights: Upon termination, clients are entitled to request data exports of patient and financial records in structured, machine-readable formats (e.g., CSV or HL7). Requests must be made before account deactivation.
ModMed software complies with a comprehensive set of legal, regulatory, and industry standards designed to meet the highest levels of healthcare data protection, interoperability, and ethical technology use. Its certifications and governance align with HIPAA, HITECH, and ONC Health IT Certification requirements, ensuring confidence for practices that handle patient data and participate in federal reporting programs.
HIPAA and HITECH Compliance: ModMed’s entire suite of cloud-based EHR, practice management, and billing tools is fully compliant with the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH). As a “Business Associate” under HIPAA, ModMed maintains strict administrative, technical, and physical safeguards over all protected health information (PHI), supported by signed Business Associate Agreements (BAAs) with all clients.
21st Century Cures Act Compliance: ModMed adheres to the ONC’s Cures Act Final Rule, including mandates related to information blocking prevention, interoperability, and patient access requirements. The company maintains API-based data exchange capabilities through FHIR (Fast Healthcare Interoperability Resources) to ensure compliance with the Cures Act provisions and guarantees clients full access to patient data across certified systems.
ONC Health IT Certification (2025 Edition): ModMed’s EMA® and gGastro® platforms are officially certified by the Office of the National Coordinator for Health IT (ONC). Certifications include testing for §170.315 criteria such as computerized provider order entry, clinical decision support, automated quality measure calculation, and audit logging. These certifications prove ModMed’s compliance with federal EHR technology standards necessary for participation in MIPS, Promoting Interoperability, and other Medicare programs.
MIPS and CMS Program Alignment: ModMed’s EHR systems fully support MIPS Value Pathways (MVPs), quality improvement reporting, and PQRS replacements under the Centers for Medicare & Medicaid Services (CMS) guidelines. The system includes built-in compliance modules for CPT, ICD-10, and HCPCS codes, which are automatically updated each year.
AI Governance and Fairness Standards: ModMed’s Artificial Intelligence systems (like ModMed Scribe) are managed according to ONC’s §170.315(b)(11) “Predictive Decision Support Intervention (PDSI)** conditions of certification. The company conducts bias detection audits, fairness assessments, and dataset validation to ensure compliance with federal AI governance rules.
Cybersecurity and Risk Management Frameworks: ModMed’s risk management policies align with NIST SP 800-53, ISO/IEC 27001, and HITECH security practices. This includes continuous audit logging, encryption (AES-256/TLS 1.2+), multifactor authentication, and annual third-party penetration testing to maintain ONC Condition of Certification for security.
OCR and OIG Compliance Readiness: The company integrates U.S. Office of Inspector General (OIG) billing compliance policies and Office for Civil Rights (OCR) data protection standards to ensure its clients meet regulatory obligations during audits or federal investigations.
