ATLANTA – During an education session Wednesday at HIMSS10, Gregory Oliver, DO, primary physician at Oliver Family Healthcare, shared his insight into how to implement a fully functional EMR in a solo practice and raise profits by 25 percent annually through efficiency and the laddering of technologies.
Physicians need to embrace a collaboration of “White Coat” (those who ask “What’s best for the patient?") and “Dark Suit” (those who ask “What’s best for my practice?”) paradigms of thinking, according to Oliver. “If organizations are not profitable, then they won’t be able to help patients,” he said. “It is critical to become efficient and profitable.”
According to Oliver, an efficient EMR is an engine that creates revenue opportunities as data can be accessed 24 hours by software automatically and reviewed for quality care issues and opportunities for billing encounters.
Citing many challenges of escalating costs, declining reimbursements, consumer demands and the pressure to remain clinically and technologically up to date, Oliver said that the EMR should be a centerpiece for an organization’s enhanced profile with strategic planning to “plan, do, review.”
Physician’s ownership mentality of the EMR is required for a successful implementation and learning the power of the EMR and partner technologies will create greater rewards for the practice and doctors, according to Oliver.
“We want to take care of patients, but it will be profitable if it’s efficient,” he said.
Making the EMR the centerpiece, Oliver said many initiatives could assist a practice gain revenues, including:
Schedule Management and Visit Expansion: An organization can establish independent visit parameters for each clinician and establish appointment times for ancillaries in office visits. “Manage who comes in at what time and track no-shows,” he suggested.
Enhanced Intra-office Communication: Messaging between the staff is "essential," he said. One inexpensive solution is that his staff uses handheld walkie talkies, while only high level clinicians can speak over the system through which the nursing staff is connected. The clinician can ask for supplies and a nurse will provide that for them "in 30 seconds to a minute which reduces time in the facility," Oliver stated.
Correct coding: Correcting coding can have an organization find revenues from undercoding practices.
Test results reporting efficiency: Lab tests are sent overnight at Oliver’s practice with a single test review site in the EMR.
Preventable Care and Visits Outreach: An automatic search of the EMR system for preventive and disease management protocols. Also, having the ability for patients to cancel appointments electronically along with the automation of phone calls and confirmation of appointments helps filli open appointment slots quickly.
Dispensing Medication: An on-premises medication dispensary where a clinician can order prescriptions in the exam room and patients pick up the prescription at the front desk can help gain revenues. “Patients love getting medications in the doctor’s office,” said Oliver.
E-Script Efficiency: Scripts sent to a state pharmacy from exam room can result in high patient satisfaction with no wait time at the pharmacy.
Patient Follow-up Reminders and Tracking: Automatically sending reminders to staff about patient needs or desires can help track patient visits.
Vendor Interfaces-Lab, Hospital, Ancillary Equipment: Bi-directional interfacing with labs and pulling electronic data from local hospital networks could help get more referrals.
Patient’s Technological Perception: A patient could think that facilities with modern technologies provide better care. “In a time where patients will pay more out of pocket for primary care services, the office that provides the best care will have more ‘good patients’ [meaning ones that pay their bills],” Oliver said.
Oliver also noted that his practice immediately saved $39,000 in transcription costs going live on an EMR system. An additional $60,000 was saved in employees costs. Two employees left because they “didn’t want to learn computers and we didn’t need to replace them as a result of the EMR,” he said.
“The longer you use the EMR and partner technologies, the better you get at them so greater efficiencies are achieved,” concluded Oliver.