Easing Compliance in Healthcare with Julie Sheppard

August 19, 2020

Julie Sheppard is a nurse, an attorney, and certified in Healthcare Compliance by the Compliance Certification Board. Married to a physician, her understanding of healthcare compliance issues grew from education, experience, and personal interest. With the increase in compliance challenges facing healthcare providers, Julie was inspired to create a practical, comprehensive healthcare compliance solution, and founded First Healthcare Compliance in 2012.

John Shegerian: This edition of the Impact! Podcast is brought to you by ERI. ERI has a mission to protect people, the planet and your privacy, and is the largest fully integrated IT and electronics asset disposition provider and cybersecurity-focused hardware destruction company in the United States, and maybe even the world. For more information on how ERI can help your business properly dispose of outdated electronic hardware devices, please visit eridirect.com

John: Welcome to another edition of the Impact! Podcast. I am John Shegerian and I am so honored to have with us today the founder and president of First Healthcare Compliance, Julie Sheppard. Welcome to the Impact! Podcast, Julie.

Julie Sheppard: Thank you, John. It is great to be here. And I appreciate you having me on today.

John: It is wonderful to have you on, and you do important, important work at First Healthcare Compliance. But before we get to the entrepreneurial side of Julie Sheppard, these are big backstory here. Can you share a little bit about your journey in bio leading up to the founding of First Healthcare Compliance?

Julie: Sure. It probably makes sense to start at Clemson University. That is where I went to school. I ended up there thinking that I was going to become a microbiologist, and I did not – spoiler alert – we all see that that did not happen. I met my husband. We were in freshman biology together. So, by the end of college, we were dating very seriously. I had switched my major to nursing, and he went to medical school at the Medical University of South Carolina. So we got to spend those years in Charleston, South Carolina, a really beautiful city. We were married. During that time, I worked as a nurse, and our first son was born in Charleston, about a month before we moved to Syracuse, New York for my husband’s residency.

So we were in Syracuse. Spent five great years there while he completed his Otolaryngology residency, and we ended up in Wilmington, Delaware and we still call Wilmington home today. In the meantime, two more sons were born in Syracuse, and fast forward to being in Delaware for a couple of years, younger son was about to start preschool. And so, I was kind of turning some attention back to doing something professional. Again, was not sure what I was going to do. I think I was looking over some materials about becoming a legal nurse consultant. And my husband who is incredibly supportive, looked at me, just like someone who has that surgical background, who has done four years of medical school and five years of residency. And he said, “Well if you are going to do that, just take LSAT and go to law school. I am sure you can do it. It is just a few years.”

John: Wow.

Julie: So that is how it started. I took the LSAT in June and applied online through local law school, federal law school in July, and by August I was starting law school. A lot of people thought that was crazy.

John: Wait, let us take a pause there. Wait a second, Julie, and you already had three children at this time?

Julie: I did, I did.

John: Going to law school, you are an L1 with three children, incredible. I love it. That is inspiring unto itself. That itself is just amazing.

Julie: Yes.

John: And what confidence your husband had in you to just say go all the way if you are going to do the little bit of legal stuff. Just go all the way, that is wonderful.

Julie: Exactly. I think everybody should have a supportive spouse like that.

John: Right.

Julie: So I did it, I had a great support system, went through law school. My kids are kind of with me through all of that which, I think, in the end was great for them to see.

John: Right.

Julie: And then it was a bit of time between law school, and then having this idea, but that kind of shows the perspective that I had, going into law school as a nurse and as a physician’s spouse. Looking back, it just seems natural that I ended up thinking about compliance and if you think about, back in 2011 feels so long ago now.

John: Right.

Julie: But, there were a lot of things changing and happening that really caught my attention as far as compliance in medical practices, because I was looking out for my husband and his partners and their administrators and their growing practice and thinking. “Wow. How are they going to do all of this? What is available to them?” And we have a lot of friends through positions and so I would speak with them, and try to get an idea of what they were thinking, or if they even knew what was expected of them and many times they did not, because there is so much expected of them in so many different areas. I know that you have a really strong understanding of cybersecurity and what is expected, but there are a gazillion other things that they have to think about…

John: Right.

Julie: …and act on at all times, and that is on top of it.

John: Right. What kind of doctor is your husband?

Julie: Ear, nose and throat. So I think I said otolaryngologists earlier, but most people know that as your nose and throat.

John: Got it. It was during this journey, and having great knowledge of your husband’s business and also your circle of friends as you say were doctors as well. You started seeing gaps or voids that could be filled or opportunities? What was it? How was it showing up or manifesting itself to you for you to say there is a business there?

Julie: I would say, do you realize that this is required of you, you have to… For instance, you have to… We need a very simple example, you have to offer the Hep B vaccination to all of your employees and if they refused that you have to have them find a Hep B declination form. Sort of basic compliance.

John: Right.

Julie: But it was just kind of slipping through the cracks. You can imagine. It is a medical practice. This is a business and you want your doctor to be focused on the patient care aspect, and then the administrators have so many other things to deal with, to think about all of HIPAA, all of OSHA, all of the billing, coding, documenting portion of it. And then, of course, there is the whole HR piece that seems to integrate more and more and especially in a medical practice or any healthcare setting. There is a lot of extra training and i’s to dot and t’s to cross and such. So there is just a lot going on. They needed a way to streamline things and to tract thing.

John: Wow. So I am on your website now. For our listeners out there, Julie’s website is just chock-full of information and really easy to understand and get a lot of great information to get going on. It is www.1sthcc.com, first with a number one. 1sthcc.com. So it is simple. It has tons of resources on it, including just a very recent compliance manual on COVID-19, which we are going to get to in a little while. So what you are saying to me, Julie, and what I am understanding, but tell me if I am misinterpreting this at all. It is a blurring of the lines where you are filling gaps in HR, EH&S, HIPAA, and other regulatory compliance issues. There is a wide array of roles that you play in a medical setting, it sounds like that. First Healthcare Compliance fills gaps in all those areas.

Julie: Well, I think we are there to help the people who are playing all those roles, and sometimes it is one person wearing the hat of HR and wearing the hat of compliance along with three other things. So we are there to aid that individual or those individuals and by the way, you called it my website which is flattering, but it is not at all true. I do not do this by myself. I have a team of people who are just excellent and really are the reason for success. And you mentioned the COVID-19 ebook, I think you probably fill the pop-up.

John: Yes.

Julie: That was compiled entirely by Sheba Vine, who is also an Attorney. And she is our Vice President and General Counsel, and she just contributes a lot of really excellent content and educational material.

John: So now, you are a nurse, you are an attorney, you are a mom, you are a spouse of a doctor, talk about then. Okay. I think I have enough to make this a business. How did that happen? Where is the tipping point? And what was the first foot forward into that? And then how did it evolve since your launch?

Julie: So I am not sure about everybody else who has ever started a business, but I do not think anybody is ever completely sure, that they have enough…

John: You are right.

Julie: …to start a business. Right?

John: Right.

Julie: So I said, “It looks to me like this could be really helpful. I think this could be really helpful.” And I kept talking to people and a lot of credit goes to our clients and the physician who so willingly talk to me…

John: Right.

Julie: …leading up to the launch because they are really generous with all of their answers and helping me see exactly how they do things. We still meet as a team once a week, by the way.

John: That is great.

Julie: We look at the client requests, how they are actually using the system, and how we can enhance it and make it better? Because it is always changing.

John: Yes.

Julie: But I had a really strong hunch that putting this together, streamlining everything into one platform, so that they did not have to go to different experts and different vendors to achieve all these different elements of their compliance program, keeps it all in one place for them and makes it very easy to train their employees and to track that online because that is one big part of it. All the payers required a training log.

John: Right.

Julie: So that is one piece that everybody sees as very critical. It evolved over time. We started working just with physician practices here in Delaware and the Philadelphia area, and some of those folks, most of them I would say, are still with us today. So we are really so thankful to those practices who have had faith in us and been with us for so long.

John: Just for our listeners. What year was this that you officially launched First Healthcare Compliance?

Julie: It was in 2013.

John: 2013.

Julie: Building version 1 in 2012.

John: Right.

Julie: We had some guinea pigs, but then we officially launched and people started actually purchasing and buying our services in 2013.

John: Wonderful. So it started mostly in your local area at that time with people you know, and how has it evolved over the last seven years?

Julie: So it is just amazing and hard to believe, but we have clients all over the country including Alaska and Hawaii.

John: Wow.

Julie: And I think a lot of that success, it is obviously my team and the content that they produced. I know that you met and worked with Catherine Short, our Partnership Marketing Manager.

John: Right.

Julie: We do a lot. We just believe in content marketing and producing our content. So we are always offering. We have a blog every week that has an e-newsletter that goes along with that. We have compiled a lot of our materials and we create a digital monthly magazine now that is also free. And we have a webinar series and a YouTube channel. It is very robust, so that if you are looking for any particular topic about healthcare compliance, there is a good chance you could go to YouTube and end up on our YouTube channel. And that is just part of what we believe. It is our mission to serve as a trusted resource and to provide as much as we can to our prospects and our clients.

John: Now, in terms of… Explain your client base now. Is it medical offices like your husband’s office? Is it hospitals? Is it urgent care, or all of the above?

Julie: So we have a very strong base in the physician practice market.

John: Okay.

Julie: Because that is where we started. The reason the business came into being, we were looking out for practices, but quickly began to evolve, and we built platforms that are specifically for long-term care, or for hospital systems, or billing and management companies in the day. That happened almost immediately. We were working with physician practices, where people kind of found us through our website, and our blog, and our webinars and such. And billing company owners would call me up and just say, “Hey. Can you build this for me, for my billing company because we need this?”

John: Right.

Julie: And so that is what we did. We have been interned worked with a couple of billing companies and created a platform for them, and then they like to see that their clients, the physician practices, or sometimes an ambulatory care clinic or something like that, physical therapist, dentist, we have a lot of different types of healthcare facilities using our system. We have not really taken the time to go out and market to each one of them separately, but the thing about federal rules and regulations as they apply to everybody.

John: Right.

John: Our system is really helpful.

John: Got it.

Julie: And then the resources we offer. So within our platform, within our cloud-based comprehensive compliance management tool, we have sample documents and all kinds of sample policies and procedures and things like that. They are really helpful.

John: For our listeners who just joined us, we have Julie Sheppard on with us. She is the founder and president of the First Healthcare Compliance. You could find her great company at www.1sthcc.com. Julie, when you were sitting at the kitchen table with your husband, I am sure with your boys at some time, and other friends, other doctor friends that were part of your social circle and friendship circle. Your original vision of First Healthcare Compliance compared to where you are now, how is that journey been? Because my experience is it is never a straight line from 2013 to 2020, and it goes exactly the plan, there is zigs, there is zags, there is ups, there is downs, and there is new pockets of opportunity. Like you said things are ever-changing. How did the original plan apply to where you are today?

Julie: Wow. If someone really held through, the whole idea of providing something streamlined to physician practices was there at the beginning, and it is definitely at the core of what we do now. But I think it is hard for anybody to anticipate or to have anticipated the evolution that has occurred since then. So back in 2011, 2012, and there are a lot more solo practitioners, a lot more independent physician practices, we are seeing more and more. Everybody consolidate, will be acquired by a larger system and some of that was happening before COVID-19. And I think so many other things that have been accelerated due to this crisis. I think that independent practice is definitely facing more and more challenges. So, we are seeing a lot of bigger practices now.

John: Got it. That makes a lot of sense. When in the journey in the last seven years did you turn to your husband one night and say, “Is it going to work?” This actually is because, as you said when you put the first foot in front of the others, no entrepreneur that is a hundred percent sure. Because that is impossible. Otherwise, everyone will be doing this if there was no risk in and everything was just with certainty. It is never certainty when you are out on the high wire as an entrepreneur. So when did you actually say, “Okay, we got something here.”

Julie: Wow. Yes, I think it was pretty early on.

John: Good, that is good.

Julie: I am so very optimistic. The thing that I look for proof may not be somebody else would see as proof. Before we ever reach any kind of financial sure sign that the business is thriving, for me it was seeing people who are real users of the system actually say, “This is what I have been looking for. This is what I need. Wow. I cannot live without this.” So for me as soon as I saw those signs and it was very early on, we did not have to do a lot of marketing. People found us because the content we produced. That gave me and my team, I think, a lot of a lot of reason to keep going.

John: So now, it is 2020, and you had initial goals when you started the business to succeed. Everyone first wants their businesses to succeed. No one knows truly how big it is going to be or small. But everyone takes pride when whatever they have started. It is like another child. That is birthing another child, planning, giving birth, and then trying to help the baby to grow. What were your goals when you started compared to your goals today as you look forward to post-COVID? God willing. This tragic period gets behind us and science wins, and vaccinations come out and it is like the third grade. It is not the super ball. Not one vaccination wins. It is almost like the third grade where there are fifteen winners, or at least ten and we get the world as vaccinated as possible, and we get beyond this. What does your business look like going forward with your visions? And your goals now compared to 2013 when you had other goals?

Julie: Well, I do not know that the goals have dramatically changed. I mean, I feel really lucky that I am here talking to you in 2020 and the business is what it is. So you start and part of what makes it reeling I guess is not knowing whether or not it will succeed.

John: Right.

Julie: But it has and we are still here, and we are still viable. And our goal, our overarching priority as a company is to serve as a trusted resource and to help create confidence among compliance professionals around the country, and that is what we are doing. That is what we aim to do every day.

John: What is… Obviously, it is so exciting and I can hear the pride in you and the I know how humble you are, but to succeed in anything. It is very hard, entrepreneurship, whether they some sort of stat out there and I do not even have the stat in front of me, but there is something like ninety percent of all new ventures fail. Some ridiculous number, so the risk level is high no matter how talented people are and entrepreneurs are or no matter how hard they work. What do you enjoy the most about your work? But also, give me the flip side. Talk a little bit about what is also some of the, what do you least enjoy as well?

Julie: All right. Well, that is a lot of questions that blew up, a lot to talk about. I think I really enjoy learning and enjoy working with people. I mean, both my team, and then you know all of our clients and all the other experts we get to work with. I think people in general and healthcare are just really tough resilient people. I think that is playing out right now with COVID-19. I mean, I know it is tough to be working on the front lines. I cannot imagine being a nurse in a hospital right now and working with the COVID population. So I think it is just nice to be surrounded by smart, strong people who have an optimistic outlook. I also am lucky because I like to learn and I get to learn something new almost everyday. So, compliance, like we were saying your business, ERI.

John: Yes.

Julie: Gives you a window into the cybersecurity piece of it and that is huge

John: Right.

Julie: That is one little piece of… [crosstalk]

John: Right.

Julie: I get to try to learn. I cannot learn everything, but when it comes to HIPAA, or the whole billing-including piece or right now, there is so much, and it is really been shining a light on the importance of infection control and patient safety and all the OSHA standards. So we get to meet people from a business perspective, or legal perspective, or healthcare clinical perspective. I think that is really lucky. How many people get to engage with so many different types of professionals in one job.

John: Experts, really, smart people.

Julie: Yes.

John: And it is not even what you dislike the most. It is just what is the hardest part of what you do? It does not have to be a dislike, but it just what is like the “hmm”?

Julie: Well, I mean, I think it is… I find this role right because I was a nurse and then I went to law school.

John: Right.

Julie: I did not even really practice as a lawyer. So I think I jumped into something because I got excited about the business idea, but I do not really have a business or leadership background. And so there have been some times I really not done the right thing or I kind of messed up when it comes to hiring or leading.

John: We all do. It is hard.

Julie: It is hard, yeah.

John: It is hard. Leadership is ever-changing as well. I think, one type of leader successfully ran companies in the 70s and 80s and even early 2000s, and I think leadership is evolved now to a much more, how do we say it, a macro perspective almost of both, leading by example, kindness, empathy, respect. There is a lot more that goes into leadership than just the ability to hire and fire people and make a good speech or make a good presentation. I think it is the human condition has evolved and I think leaders had to evolve with it or not succeed, frankly.

Julie: I think that is so true.

John: So what is next? Something gets you out of bed in the morning, so what is next? What is the next goal that you set or hurdle that you have created in your mind, even if it is not on paper to get you out of bed and says, “Okay. We have got x amount of clients today and by 2025, we are going to have 5x or 10x or 3x.” What is your… How do you gauge constantly push yourself? Because obviously, Julie, and I know you are disarming in your humbleness, but I mean someone who has taken that. First of all, there is no easy being married to someone who is a high-achieving, really smart person. That itself. Marriage is an evolving process and to be married to a doctor or a lawyer or someone else. So A, marriage you got three great kids that are now evolving to adulthood, etc. But you are a nurse, you are a lawyer, you are a high. If someone is seen as an A+ person, you are A+++. What are the goals? How do you… People find different ways to motivate themselves. How do you stay motivated to continue to create goals for yourself to achieve?

Julie: I mean, I am very motivated. I do not know that I have to try to create goals for myself.

John: Okay.

Julie: Since it started, I just think about it all the time to the point that my husband and my kids will make fun of me. “Here we go again. Every conversation leads back to First Healthcare Compliance with you, Mom.”

John: But Julie, I take that as a strength. I do not know. My kids say the same thing to me and my wife cuts me off and she is the CEO of our company and she says enough talk about this. I mean, she just herself wants a break so, but they say, I mean when you really listen to a podcast or read a book or read passages by any of the great ones and there is a bunch of them, but we will call it gates. We will call it bezels, the musk, just for some reason folks out there. They are obsessed with their business. They are obsessed with their what they have created so that… And I am not sure if I am using the right word obsessed but that is what that is on their mind. They wake up, they go to bed, that is what is on their mind. That is a strength. I take that as a strength. I think that is wonderful.

Julie: Yes, I mean, I think if you enjoy what you do and you are really motivated to see it through and I am. Whenever I committed start of business, I wanted to see through and see it succeed. And so it takes up a lot of my mind space.

John: Yes.

Julie: And enough of my time. But I do really enjoy having time to do other things, too. So I am not someone who works 24/7. I do enjoy time with my husband and our boys and we have had a lot of togetherness with COVID.

John: Right. A couple of things. I want to go into a couple of other things. First of all, I do not want to not mention. You also have two other books besides what is on your website in terms of your COVID-19 manual. You also have two books on Amazon, “HIPAA Privacy and Security” and “First Healthcare Compliance: The Fundamentals”. They are available on Amazon, correct?

Julie: Correct.

John: Good.

Julie: So, yes the COVID-19 ebook that you mentioned is a downloadable and we created those periodically and we try to do that at least a few times a year, and obviously, we needed to create one with all the changes occurring around COVID. The other two books are available on Amazon. You can also get to them from our website. We have a shopping cart with some online modules. So the fundamental corresponds to a four-hour course that we have created that covers the fundamentals, so HIPAA, OSHA, Federal Fraud Waste and Abuse, and some of the employment law. So that is really a great course for someone who is entering the profession or things that they would like to. Maybe take a pivot into Health Care Compliance or even just somebody out there trying to earn CEU because if you are certified through HCCA like I am, you have to have forty CEUs every two years to renew. It sounds like a lot, but there is always a lot to learn and to catch up on. Our course is a great way to get a few of those. And then the HIPAA Privacy and Security book is obviously just something that we find people asked about a lot. We do a couple of live events each year. Well, lately, they have been online like everything else. But we enjoyed before COVID-19 having live events at the Delaware Law Schools in collaboration with Delaware Law School in their graduate programs in compliance. And we have one that is solely on HIPAA in the fall, and I believe you are going to be a speaker at that event in November, John.

John: Right. Thank you. And I appreciate the invitation, and thank you. Your husband and the doctors that you are friends with and that are your cabinet of advisors, have they all been leveraging this telehealth trend now due to COVID-19? And is that becoming a bigger trend that is here to stay? And does that create new opportunities for your business?

Julie: So yes, I think. I will start at the beginning of your question. Almost all of the physicians I know or that we work with leverage telehealth in some way during the pandemic and most of them are continuing on in some way to varying degrees and I think it is all speculation. It is all we can really do right now. Kind of points to the fact that this just accelerated, the movement toward telehealth and it is here to stay. I guess it remains to be seen at what level, but I personally think it is here to stay. I think we are going to see a lot of permanent changes, not just in medicine, but the world in general.

John: Interesting. Make sense, I mean they say the teleworking from people working from home now is here to stay even if it is not at the levels that we are today. It is going to be it is still at some increased level compared to pre-COVID. So it makes sense that telehealth is also here to stay at some baseline that I guess is yet to be seen what it will be.

Julie: Right. Yes, and I guess you ask does that increase our business and really, and we have not seen big swings with our business either way, because we already provide an online service. As I said, we were based in Wilmington, Delaware. We work with people all over the United States and that is because we already provided online training, and we work with people full free and online and that is our business model anyway. So it has still been pretty much business as usual for us except, we have been busier, creating all the content to help people with all the changes that have come about.

John: Right. We have a lot of entrepreneurs out there or aspiring entrepreneurs that listen to the Impact! Podcast, any advice in the rearview mirror now that you could share with young and aspiring entrepreneurs that want to be the next Julie Sheppard?

Julie: Well, I can try to give advice, but I think everybody has their own paths. Every business is unique.

John: Right.

Julie: If you have a great idea and you are committed to it, do not listen to the naysayers, and just try to get past your fear of failure. Everybody has it. I am convinced that everybody has some fear of failure or some a little bit of doubt. You have to have that back there somewhere, but just get rid of that and keep going because sometimes it does not work out. Sometimes you will not have success. You know, with every step of the way, you are going to run into some obstacles that just stop you a little bit. But you have to be willing to just work through those or work around them.

John: Right. I think that is great advice getting over your fear of failure and just do not listen to the naysayers. Those are two great pieces of advice because there are always naysayers out there. There are always naysayers.

Julie: Yeah. Right.

John: Julie, I just want to say thank you again for all that you do. Thank you for spending time with us today. For our listeners again to for that want to find Julie Sheppard’s great company, First Healthcare Compliance, they could go to www.1sthcc.com. And they can find her, they can find her books, all the resources, massive amount of resources. I am on your website. The number of videos and information and now, you have the downloadable ebook on COVID-19. There is just so much there. I really would like you to go there. If you need her kind of help that her firm offers. Julie Sheppard, thank you for your time today. You have been more than generous with us. You are making a great impact and making the world a better place, and I thank you again for joining us and look forward to having you back on the Impact! Podcast.

Julie: Thank you so much, John.