Looking for ways to make life easier? Technology can lead the way

New products can save time and money, increase efficiency

When a health plan proposed a change in reimbursement for a particular drug, Barbara Metzer, administrator of Citrus Valley Urology in Glendora, CA, wanted to know how it would affect her practice’s bottom line.

She simply ran a report on her practice management software, and in a few minutes, she knew that the practice had 100 patients on the drug but only seven belonged to that particular health plan.

"Without the aid of my computer, this would have been very time-consuming. There are so many ways the new technology can help you manage your practice," Metzer says. For instance, you can track how many patients you saw on each plan, what you are getting in the way of reimbursement, and what you should get reimbursed for. To track this by hand is virtually impossible, she adds.

"Ultimately the objective of information technology is to support the organization’s objectives. This includes improving patient care, improving efficiency and effectiveness — and if you’re lucky, reducing costs," says John Spearly, vice president of Phoenix Health Systems, a health care information technology consulting and outsourcing firm in Washington, DC.

But if your practice isn’t on the cutting edge of technology, you aren’t alone.

"Health care, in general, is considered behind the times in terms of technology," asserts Julie Elmore Jones, MBA, MHA, consultant with Gates, Moore & Company, a health care management consulting and accounting firm in Atlanta.

However, physician practices are under pressure to computerize their operations to meet the demands of managed care companies and payers alike, she adds. "If physicians aren’t submitting claims electronically, the intermediaries want to know why."

Electronic submission of claims greatly improves your cash flow. Not only can you get payments more quickly, if you need to re-file, you can do so in seven to 10 days as opposed to 30 to 60 days with paper claims, Jones says.

At Citrus Valley Urology, all of the billing is handled electronically. "More and more carriers are insisting on it," Metzer says.

"Turnaround time used to be months. Now that we’re billing electronically, the turnaround time for payments is much improved. When you cut to the bottom line, it can be extremely beneficial," she adds.

Computerized patient records can save money and staff time by cutting down on transcription time and the time spent looking for charts, according to Jones. "The larger the practice, the bigger the expense involved in maintaining a paper system. Transcription is consistently one of the most expenses line items that physician practices have," she says.

Practices lose a lot of money chasing charts and often have to hire people just to pull charts and look for them when they are out.

Urology Associated of Southeastern North Carolina, based in Wilmington, developed an electronic medical records system five years ago, primarily to reduce the amount of time and energy required by the staff to chase down charts, says Richard Rutherford, CMPE, former administrator of the practice. Rutherford recently joined the American Urological Association in Baltimore as head of its practice management section.

The practice is now implementing a new, more comprehensive system, he says. (For details on how the system works, see related story, p. 75.)

Computerizing the patient records has saved staff time and helped the growing practice avoid hiring additional staff, particularly in the medical records department, Rutherford says.

The electronic medical records system, combined with the practice’s voice mail system, has also helped cut down on overtime pay for the nursing staff by making it easier for the nurses to return telephone calls between patient encounters. Now, instead of having to look for the charts, the nurses can access the records by computer when they have a few minutes and have all the information they need when they call back patients, he adds. (For more information, see story, p. 76.)

More than 95% of Gates, Moore & Company’s clients are transmitting at least some of their claims electronically, and a few have converted to systems that completely computerize their patient records and billing systems, Jones says.

"Just two or three years ago, I didn’t have any clients with computerized patient records. Now I can list a handful of clients who do have them, who have implemented them successfully, and who are very happy with them," she says.

The transition to computerized patient records can be painful because the staff has to adjust to the new system. "But once they’ve gone through that transition, the majority of clients say they would never go back to a paper system," she says.

At this point, practices are not solely computerized, Jones points out. "A lot of legislation has to occur before they can become truly paperless."

Metzer’s practice uses the computer to set all appointments. The software has time slots for each physician and asks for specific patient demographic information so the check-in will go more smoothly.

"Computers help our office improve customer service. During the first phone call, we gather data. That helps with the flow of scheduling. We see who comes in for shots and enter it there. We can see who needs what procedure and know how long it takes," Metzer says.

"Some physicians are faster than others and need shorter appointments. Some take more time," she says.

The daily procedures involving appointments are as follows:

• Staff run a list every day to find out who is coming in for an appointment.

• The computer runs a fee slip that is put in the chart.

• The physician checks off what he or she did.

• When the patient checks out, if he or she needs another appointment, it’s entered into the computer.

• The chart then goes to the billing person, who looks at it and evaluates it. The system gives the practice the ability to bill electronically every day.

The computer also prompts the staff to make reminder calls or send out cards when it’s time for a patient to come in for a checkup or diagnostic procedure. "I can’t say enough good things about how efficient this makes us," Metzer says.