Click - there goes another paper-based practice

MGMA Connexion, Apr 2006 by Nelson, Rosemarie

Use IT tools to cut costs, increase efficiency and take a step toward EHR

Converting from a paper-based practice to one with a fully implemented electronic health record (EHR) doesn't have to be an all-or-nothing prospect. Phone systems, Web sites and various information technology (IT) tools allow you to become more electronically efficient without affecting physician practice patterns. Furthermore, these tools serve as stepping stones toward EHR implementation.

Whatever small steps you take now, ensure that the tools you choose:

* Are easy to use;

* Increase provider and staff productivity;

* Increase practice capacity;

* Provide easy, immediate and remote access to information;

* Reduce paperwork;

* Improve and accelerate communication;

* Reduce mistakes; and

* Improve quality of care.

Use technology to enhance communication with patients

Because the practice of medicine demands communication, focus conversions or new technology on areas that can enhance it. The Web is an obvious place to start, but your physicians may not share that perception.

Nevertheless, whether it's shopping, paying bills or searching for information on every imaginable topic, consumers expect to conduct myriad transactions online. Why should transactions with their physicians be any different? Aside from paying their medical bills at your practice Web site, allowing them to book appointments online is ideal. This can do more than increase patient satisfaction. Online registration reduces no-show rates, can guide patients to other services, and allows your staff to check patients' insurance coverage before appointments for the collection of co-pays and deductibles.

You can also use your Web site and/or phone system to provide patients' test results. Taking the latter idea, you assign a patient a personal identification number (PIN) at the encounter. After lab results arrive, a nurse or staff member leaves a recorded message about the results and links it to the PIN in a phone messaging system. The patient calls, enters his or her PIN and hears the message. The practice then follows up with the patient when needed. Similarly, patients can view interpretations of lab results online through a secure Web portal.

If nurses or staff members insist that they don't have time to record such messages, simply point out the time they already devote to pulling charts and explaining lab results when patients call the practice. The conversion makes the process much more efficient while freeing time for staff.

Electronic systems are great time-savers

In addition to getting lab results online or via an automated system, patients should be able to use your technology to renew prescriptions. Electronic prescribing (e-prescribing) offers patients and physicians many safety and cost benefits. Furthermore, e-prescribing can reduce the time devoted to a refill from 15 minutes to three minutes by replacing paperwork and phone calls with electronic documents and a fax machine.1

Office notes represent more piles of paper that your conversion process can eliminate. Using various programs and document management systems, create electronic templates that allow data entry for:

* Charts;

* Correspondence;

* Superbills;

* Prescription reissues;

* Lab results;

* Patient histories;

* Referring-physician information; and

* Patient-satisfaction surveys.

To help manage the forms, create password-protected folders for providers and patients in which you file the appropriate documents.

The conversion from paper to electronic documents still requires practices to back up and store records, but again, electronic processes offer many advantages over paper ones. First, check with your malpractice insurance carrier to ensure that you're not required to keep paper records - many allow you to destroy them as long as they can be reproduced. Copy the documents to an internal server and an external, portable hard drive that you store off site.

Let the world know you're a tech-savvy practice

When you complete your conversion, publicize it. Include your Web address on statements, appointment cards, brochures and advertisements. Use automated phone tools such as appointment reminders to announce new Web site features to patients.

The proliferation of services that consumers handle online or through automated systems trains them to expect more. Group practices cannot isolate themselves as an exception to this movement. As Charles Darwin said, "It's not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change."

notes

1. Erstad TL. Analyzing computer-based patient records: A review of the literature. J Healthc Inf Manag 2003; 17(4):54-55.

By Rosemarie Nelson, MS

about the author

Rosemarie Nelson, MS, MGMA Health Care Consulting Group principal, rosemarienelson@alum.syracuse.edu