FROM ISSUE 4 OF VOLUME 3 / 2010
by Jeff Mongelli
Whether or not you choose to pursue the ARRA Stimulus dollars for your practice, the new technology it introduces will have a significant impact on the practice of medicine. Broadly speaking, one of the thrusts of ARRA is increased communications. More specifically, systems are being developed and implemented that allow for the seamless flow of data across multiple platforms and between physicians and their patients. You may choose not to pursue stimulus dollars, but you can benefit from some of these technologies. Let’s consider the patient/physician communication.
A recent analysis of 10 years of studies tracked by Medline indicates a high correlation between physician/patient communication and improved patient care. While that result alone will motivate many physicians to adopt new technologies, time and cost constraints will keep others on the fence. But if we look at the mechanics of a typical workflow, it reveals opportunities for business development, increased patient retention, and improved office efficiencies. Let’s look at a specific example. A patient is referred to your practice by a gP for evaluation and treatment. But your office doesn’t receive a call, fax, or letter, instead a secure email is sent to your office with an encrypted link to the patient’s information. With a couple of clicks by your front desk clerk, the patient data is imported into your PM/EMR system. With another click, the patient is emailed an encrypted link where they can review the information you have, including their insurance information, and then complete your designated clinical forms, including medical history and current list of medications being taken (under the new law you are required and responsible for maintaining a complete list of their medications), etc. Once completed, the patient can select an available appointment time, make their co-pay where appropriate, and then submit that information to your practice. Your front desk clerk sees the data come in, clicks to confirm eligibility, a service provided by your clearinghouse, and confirms the scheduled appointment. No phone calls, no delays, no missed co-pays, no data entry errors, the list goes on. For patients that are not technical or prefer not to use the computer at their home, this same information can be gathered electronically from your waiting room using a variety of form factors ranging from kiosks to iPads or Phreeshias proprietary tablets. This capability exists now. Products like Medfusion, PogoMD, Phreeshia, and others offer variations of this technology. Much like early generation EMR’s, these systems will improve as their adoption propagates. But the benefits don’t end there.
Extending this technology post encounter, you’ll be able to quickly share select data, like lab and pathology results and images with your patient, along with your comments and instructions for them. This functionality meets one of the stimulus requirements, but it also keeps your patient more engaged in their care. Patients can also view their bill online, see what insurance has covered, and what their remaining balance is. Of course, they then have the option to pay the balance electronically. Again, all of this access to information translates into fewer patient calls to your office, reduced statement costs, and more. certain systems even offer the ability to record the patients’ receipt and opening of the information, along with the amount of time they spent reviewing it. This increased level of accountability will reduce your liability and remove the ambiguity over exactly what instructions were provided.
Another benefit of these patient communication portals will be your immediate access through any web enabled device to patient records. Another example could be an evening call while you’re out to dinner from the hospital regarding a patient you recently treated that has presented to the ER for excessive bleeding. The attending physician relays patient delivered information that doesn’t seem to correlate with your recollection, so from your smart phone you access the patient record and identify the specific information, medications prescribed, procedure performed, etc. so the treating physician has a more accurate and complete history to evaluate the patient with. Once again, these types of remote access utilities are currently available from leading EMRs and patient communication portals.
This trend towards increased communication of information will continue for the next several years. We anticipate EMR systems to evolve away from their current “documentation centric” orientations and more towards “communication centric” models. In other words, as the input of patient data, progress notes, procedure notes, etc. becomes more and more standardized and homogeneous, what will differentiate future EMRs will be the ease and flexibility in which you are able to disseminate and collect that information from external sources.
One added dimension these types of systems offer is the ability to be a marketing engine for your practice. Some systems offer custom automated reminders. Do you have patients that inquired about, or were scheduled for repetitive treatments and they haven’t followed up? A good portal will automatically track and message the patient for you. Integrate a system like this with a search engine marketing effort, and you’ll have an automated and very sophisticated marketing presence that will increase revenue for your practice. Do you send newsletters to your patients? What if you could tailor the content of your newsletters specifically for a patient’s diagnosis or interest? This type of personalized dialogue is possible with these enhanced communication tools, and that will keep your patients thinking about you while conveying your interest in and awareness of their conditions.
The bottom line is while the carrot of the stimulus may not be enough to motivate you to change how you are currently practicing, the advent of these emerging technologies will alter the trajectory of the practice of medicine. For elective oriented practices, they open windows of opportunities to increase volume and improve patient loyalty. Our advice has been consistent on this subject. Ignore the stimulus at your own peril. Rather than argue the merits or otherwise of the changing rules, learn how to win in the face of this change. We believe improved communications will ultimately yield tremendous benefits to those that choose to embrace the technology Jeff Mongelli is the CEO of Acentec, Inc., a leading provider of ambulatory healthcare information systems and a full suite of complimentary technology products to the medical community. He can be reached at 1-949-474-7774.
Read on the VEIN Directory: http://www.veindirectory.org/magazine/article/integrating_emrs_into_a_communication_centric_practice