Jump on the bandwagon

MGMA Connexion, Sep 2005 by McElroy, Michael G

Automation and technology resources for small medical groups

Physicians' desire to reduce medical errors, improve quality of care and run their practices more efficiently has combined with the decreasing cost of automation to create an environment that supports technology in small group practices. In general, automation saves physicians about one hour per day with a payback apparent in two years.1

Automate - or pay the price

The Health Insurance Portability and Accountability Act (HIPAA) has standardized dataset codes for claim billing. Since July 6, 2004, medical practices that do not submit electronic claims in the HIPAA format to Medicare face a 13-day reimbursement delay.2 Clinics that have automated their billing can efficiently process payer documentation.

The cost of technology has posed a barrier for smaller practices, discouraging purchase of electronic medical record (EMR) systems and other kinds of labor-saving automation. However, as costs continue to decrease and capabilities improve, small groups have a number of cost-effective options.

Application service providers

Application service providers (ASPs) can automate many medical practice functions, such as claims processing, payment posting, payroll, collections, accounts receivable analysis and monthly reports on practice performance. ASPs locate servers outside the facility and take care of maintenance, upgrades and technical support. The ASP model requires low upfront costs and little to no computer staff. ASPs can reduce a practice's upfront costs and contain payroll expenses.3 ASP charges are typically 4 percent to 12 percent of collected revenues; many vendors also offer a payback over several months.4

Even though a practice rents the technology infrastructure from an ASP vendor, the group owns the data.

Internet access

The Internet provides a mechanism for sharing information conveniently for patients and caregivers alike, with minimal access barriers. If a practice uses the Internet to conduct business - especially with the ASP model - it should have broadband Internet access for speed, security and reliability.

Some medical group practices have their own Web sites that describe services, staff, location, hours of operation and other information. They may offer patients links to health topics, support groups and physician information. Others allow patients to obtain lab results, refill prescriptions, make appointments and send e-mail to providers.

Electronic medical records

Electronic access and storage of medical records is the wave of the future, yet at the end of 2003 only about 5 percent of doctors' offices had EMR.5 A recent study showed that smaller practices can see a positive return on investment (ROI) from EMR if physicians are committed to the system.6

To ensure that physicians use EMR, many practices provide incentives. In addition, to get the most from an EMR, maximize electronic data exchange and deal with technical and process issues upfront.

Handheld devices and wireless access

Most types of applications that run on a server can be displayed on a point-of-service device - a computer located where health care is being delivered. Such devices - handheld personal digital assistants (PDAs) and tablet personal computers - are portable. Software often can be customized affordably through partnerships with local colleges, technical schools or computer special-interest groups.

Physicians can use PDAs and tablet computers to obtain patient data and outside resources, record charges, record referral information and consultations, and communicate with other physicians and staff. The technology's main barriers are lack of an appropriate wireless infrastructure and the costs to implement one.

To afford handheld technology, small medical groups can use an ASP model, renting hardware and/or software. Other options include leasing, sharing technology with other clinics, outside funding through grants or partnering with vendors by beta-testing their products. Some vendors will combine the hardware price into their fees. Others give PDAs (which cost $250-$450) to physicians for free and recoup the cost through monthly fees, or base their fees on the number of transactions or the number of physicians using the service.

Small groups can be tech-savvy, too

Computer technology is becoming affordable, allowing smaller groups to improve operational efficiency, reduce patient errors and readily obtain current medical information.

Small medical practices need to perform due diligence and strategic planning now to ready themselves for technology advances.

notes

1. Ihealthreports. Achieving tangible IT benefits in small physician practices, First Consulting Group. Sept. 2002.

2. Centers for Medicare & Medicaid Services. Modification of CMS' Medicare contingency plan for HIPAA Implementation. Effective July 1, 2004, www.cms.hhs.gov/medlearn/matters/mmarticles/2004/MM2981.pdf.>3. Ihealthreports. Clinical decision support for the independent physician practice. Prepared by First Consulting Group, Oct. 2002