Before you buy a Practice Management IT system, read this to understand how to better evaluate them.
Practice management and record keeping systems are often billed as having the ability to save costs in your practice with better efficiency, prevent malpractice suits with better record keeping, eliminate all those ugly file cabinets, and bring order to all those messy paper files. But most of the time they are abandoned within months of implementation, wasting both cash, employee and doctor time, which adds even more costs in lost revenues and underserved patients. It’s not that these systems will never work. It is because they are poorly architected. In this article, I’ll tell you what to look for, what to avoid, and what to run away from.
The biggest problem that there is invariably a wide gap between IT programmers and the mortals that use their applications. In Practice Management Systems, this gap is closed tightly. So how can you tell and what should you look for in a Practice Management IT system?
The most important thing is that the program its programmers be fully aware of the business model of a medical practice. Many such application programmers come from a world where revenues come from product sales made by low wage workers. So the programs align to tracking for quality or accounting purposes. The revenue source in a medical practice is its most highly paid workers: the doctors! This is a very big difference.
The fundamental principle of practice management is optimizing doctor time so that every minute possible is generating revenue. Doctors only have so much time, so revenues are a function of how much time they have and how long it takes to see a patient. This is where many of these systems fail because they don’t take into account the work flow in a patient visit.
When a patient signs-in at a medical office, the typical work flow is that the patient’s file is pulled and both are taken to an examination room to wait for the doctor. The doctor maximizes revenue by moving from room-to-room diagnosing and prescribing as fast as possible. If an in-office treatment is needed the doctor quickly exits to see another patient and a nurse comes in to prep the patient. The most important part of this work flow is when the doctor has the face-to-face with the patient. The doctor asks questions, takes notes, examines the file, etc. Now you add a computer into the examination room and doctor productivity immediately falls.
Here is a case study that shows why: This practitioner’s office saw an addition of almost 10 minutes of computer-related overhead for each patient consultation. As a result, the loss in fees was greater than the IT investment. The problem started placement of the monitor and keyboard in the exam room. Because it forced the doctor to face the screen and key information in, it interfered with the social interaction between doctor and patient. As a result, the doctor continued to take notes and then would enter the data after the exam was over. The patient had to wait for the prescription, so everyone was frustrated in addition to the revenue loss. There was triple prescription entry because the doctor wrote it in the notes, typed it into the machine, and hand wrote the prescription. Worse, when the patient came back for a recheck, there was a lag time to bring up what was a text file.
Ideally, a record management system should improve practitioner efficiency not detract from it. So the interface should be to a digital notepad, similar to that used by Federal Express or UPS delivery personnel, but architected specifically practitioners and customizable by the doctor. The doctor should be able to preload a list of favorite drugs, then simply check boxes for the prescription, have the prescription automatically printed for signature, with all the data stored for future reference in a truly relational database. Here are some use examples that should be implemented: As the doctor walks to the room, he or she can click on the room number and it brings all that patients records, with current and last prescribed drugs. Should the patient have a problem with a prescription, the doctor should be able to click on the drug in the list and pull up notes and data summaries that span all patients along with links to relevant outside sites. This should also allow manufacturer’s and regulatory agency updates to be sent directly to the notepad. This should all happen with a seamless interface that does not change the doctor/patient relationship, while increasing doctor productivity, knowledge, and patient safety.
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