Time and profits are precious commodities at medical practices, but EHRs and the new standard of accountability can jeopardize both.
Our company provides an online practice management program as part of our billing services. In 2011, a global consulting firm acquired the third-party company that hosted and managed the program we used. During the transition, the product and customer support began underperforming.
When the 5010 electronic submission format was implemented in early 2012, it only exacerbated the problems that we were already experiencing. In order to remain consistent with our company’s brand and quality of service, we found another practice management and billing program. This one included an EHR.
The program we acquired was about six years old, and although some of the modules were still in development, it initially appeared to be very forward thinking, efficient, and user friendly. However, when we started using the program it became clear that we had overestimated it. The old one took two clicks to print a statement, the new one took four. Submitting a corrected claim now took six steps instead of two, and scheduling an appointment took six clicks instead of four. With the exception of charge entry, every function was twice as complicated in the new system.
Unfortunately this wasn’t a new problem for us. In the past, at the request of our clients, we had tried other all-in-one practice management and EHR products, all with the same outcome - they were labor intensive and unintuitive.
This is not very surprising. By design, per meaningful use criterion, EHR programs track and document every action taken by clinicians and administrative personnel. Just as clinicians are required to document every interaction with a patient, along with justifications for services rendered and time spent, administrative staff is required to document and justify every change in a claim or patient’s insurance plan, etc. It helps us avoid mistakes, with each step serving as a gate to the proceeding step.
While this degree of documentation and accountability is the correct way to operate a medical practice, it takes a significant amount of time and effort to maintain. A few extra key strokes or clicks here and there may not seem like a big deal, but when added up over time, and compounded by an unintuitive design, hours of productivity can be lost - which is exactly what happened to us when we switched to the new system.
There are typically three areas that directly affect a company’s bottom line: materials, staff, and technology. Technology is particularly important, and time consuming technology can have a large impact on your company.
For example, assume your physician assistant must see at least 30 patients a week to bring in enough revenue to cover the cost of his salary and contribute to profits. The additional time that he must spend entering information into your EHR will cut into the number of patients he can see or the time he can spend with each patient, which will subsequently off-set your financials or customer service.
And if your administrative staff, with their limited amount of time, has to choose between submitting claims or following up on unpaid claims, and picks submissions, you will lose revenue from unresolved denials or discrepancies.
Time and profits are a precious commodity among private medical practices, and most simply do not have the resources to provide the same level of care and competency as they did pre-EHR and the new standard of accountability.
So, where do we go from here? As much as any big data analyst or programmer would hate to admit it, a program is only as good as its user. If you can develop a level of accountability within the human component of your policies and procedures, you can opt for an easier, faster technical component.
Luckily for us, our old system responded to its disapproving customers and eliminated its shortcomings, allowing us to return to business as usual with a system that was efficient for our specific needs.
If you are having trouble picking a system that will not reduce your productivity, I would suggest doing a trial period with a small sampling of clients and/or patients in order to determine if the new program is effective.