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Computer Consult: Is your system in neutral when it should be in drive?


You may be failing to exploit all its features. You paid for it?use it!


Computer Consult

Is your system in neutral when it should be in drive?

You may be failing to exploit all its features. You paid for it—use it!

By Rosemarie Nelson

Imagine buying a car, but never using the cruise control or the air conditioning. You're not getting your money's worth, right?

Some doctors treat their computers the same wasteful way. For example, almost every practice uses a computer for scheduling appointments, but many operate as if they still relied on one solitary scheduling book at the receptionist's desk. In other words, they think that only one person—namely, a receptionist—should make appointments.

Before the computer, this notion made sense. You couldn't have four people scheduling patients in four different books—not without the risk of double or triple-booking. But computers transcend this little problem of physical location. You can run your scheduling book on a network of computers accessible to every staffer, which can solve some knotty problems. For instance, all too often, patients are instructed at the end of a visit to schedule a follow-up with the receptionist, but they forget to do so. That's bad for their health and your revenue. But with an exam room computer, a nurse could book that follow-up visit on the spot.

Decentralized scheduling can make your staff more productive, too. It enabled one practice I worked with to see 150 patients each afternoon with just three front-desk staffers. That's because they're freed from the responsibility of scheduling appointments for patients who telephone in. That's now the job of a scheduler at another workstation. The front-desk people make follow-up appointments only for patients already in the office. So these staffers have more time to manage the flow of patients from waiting room to exam room. And, not distracted by the telephone, they can actually smile when they're speaking with Mrs. Jones.

Your computer can also help you schedule annual preventive care visits more efficiently. Just query your billing system to identify patients whose office visits generated CPT codes for procedures such as Pap smears and prostate exams. Use your system to produce address labels for these individuals, and then mail postcard reminders one month before their next annual exam is due.

Electronic submission of third-party claims is another example of often-wasted computer firepower. E-billing is a standard feature of many practice management systems, but lots of doctors either ignore the capability or apply it only to major payers.

Their stumbling block? It takes time to set up an electronic claims account with carriers. However, this initial investment will pay for itself many times over with long-term productivity gains. The hours that staffers spend printing and processing paper claims are better spent hounding insurance companies about accounts receivable. By switching to e-billing and freeing staff for intensified collection efforts, that practice I worked with has reduced its median A/R from 75 days to 65.

Interested in electronic medical records? If you dictate chart notes, you have the makings of a simple EMR system under your nose. Presuming that your patient-encounter reports are transcribed in an electronic format, it's a breeze to organize them for future reference.

Here's how: Print the transcribed chart notes as usual to file in your paper chart. But save those electronic files on your PC, and start building a database. Label each document with the patient's name and the date of your service. Then file it in a document folder, one for each physician in the practice. Or save each doctor's folder as an icon on the computer desktop. Then connect a modem to that PC, if you haven't already. That way, either you, a triage nurse, or your partners can access chart notes from the hospital or any other place—any time of the day.

Ask your system vendor to visit your practice and recommend other ways to use your system more effectively. Or hold a staff meeting and review the tips in this article to jump-start everyone's thinking. Your employees probably have great ideas on how to improve operations; it's just a matter of asking them to speak up. Create an environment for thinking outside the box. That way, you'll get more oomph out of your computer box.

The author is a computer consultant in Syracuse, NY.


Rosemarie Nelson. Computer Consult: Is your system in neutral when it should be in drive?. Medical Economics 2001;7:156.

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