I was asked the other day about the impact EHR's will have on provider productivity. Not in terms of improvement, but the loss of skill set. The rationale was that EHR's "spoon feed" information. Therefore, providers will lose some of their analytical skill sets. Was this just an excuse not to use an EHR, or maybe just the comments of a technophobe? I guess I am just one of the guys waiting for the Star Trek system...just speak to the...
I recently visited my brother's plastic products manufacturing plant. Nothing like a nice linear product process to revamp images of Dr. Deming, Toyota and Six Sigma. They all kind of blur together after awhile and your left with the core belief about quality, resources and process deviations; All data driven of course. I see why it is such an easy thing to look at these processes and imagine the application to the service industry. We have process inputs and outputs, defects, deviations,...
When budgets get tight the first reaction is to cut as much as you can from your project budget. One of the first things to go is your external resources. Vendor added resources, external consultants and additional module effort aimed at proving "value added" to the organization. IT projects are tricky enough, without adding to your own stress level. Balancing daily customer support requirements while implementing a new solution requires additional resources. No doubt about it. So why...
The payer mix has certainly shifted within the last year. We are seeing a rapid increase in Self-Pay/Patient Responsibility. We are also seeing an increase in collections and write-offs for patients with large dollar balances. These patients have incurred a large amount of debt and risk bankruptcy, not by bad choices, but by unexpected illness.
Should a case be made to provide a bail-out to them? Or are they small enough to be allowed to fail?
Take stock of what you have. As in any survival situation, you start by analyzing what tools you have available to make it through the next few months. You can check strengths and weaknesses, find out what systems are reaching its life cycle replacement, and what partnering opportunities exists to develop and SLA or an ASP solution. What makes sense to do yourself and what needs to be farmed out?
Realize that you can not continue the Status Quo. Thinking that you...
I am often asked to evaluate organizations that have different clinical systems, financial systems, practice management and charge entry. These run the full range of top healthcare vendors. The question is normally the same: Should we be on the same platform across the enterprise or select from the best of each?
I think that vendors like to seize on clients that do not have their full product offering. Vendors like to make them think that they are not fully exploiting their...
We have all been bombarded by the news on the economy for months now. So now I am seeing a new healthcare trend. Let’s keep our projected revenue targets low because we know we are not going to have a good year. Are we really saying, “We did everything we could do to improve our workflow and therefore there is no room for improvement?”
I often conduct Revenue Cycle Assessments and uncover gaps between what the policy says and what is really going on. Taking it...
Maybe I am just a "glass half full" person. Maybe I am just tired of all the bad business news on CNN. Either way, I thought I would put together a list of things we can be thankful for this (Healthcare IT) Thanksgiving season. Please feel free to add to the list:
We are not in the middle of implementing ICD-10
Starke IV: "The Sequel-New and Improved," has not been published
You are not spending the Thanksgiving weekend re-writing all your HL7...
Have you ever worked
on a project that is already predefined with set timelines and live date, even
before you start the scope process? It reminds me of a Shotgun wedding.
All the attendees are there because this event was forced
upon them.
The father of the bride is there to make sure all goes
according to his plan, and can “fire” anyone who disagrees..
5. Indigent care, write offs and grants will be severely
limited. “Charity care”, community clinics and community hospitals will need to become
leaner and more efficient as they compete with other hospitals now accessible by
their patient base. Translates to improved Electronic Health Records, improved
front end processes and streamlined reimbursement processes for these
organizations.
4. Most reimbursement levels will follow Universal coverage rules.
But there may also be...
Patient portals have long been accepted as opportunities for
physicians to interact with patients, solve communication issues by providing a
secure conduit for clinicians and even allowing patients to pay their bills
on-line. The later is used as the ROI for purchasing such systems. But it falls
short of collecting medications, clinical history, glucometer results and other
personal clinical monitoring systems. So what about all these separate Personal
Health Records PHR’s? Microsoft,...
It was the perfect convergence in time; we got through the
expenses of Y2K only to take on HIPAA requirements and then we had the Stark
changes. Combine this with lower hardware costs and you have a perfect
opportunity for all the late adopters to jump on the EHR train, or at least
that’s what everyone thought. There just isn’t a big push to install EHR’s
across the industry. It is almost like the industry is waiting for a product to
come along and offer a...
If you read the Third Wave by Alvin Toffler it predicted in
the 1980’s that we would all have computers in our homes and people would be
working from home with full connectivity to their offices. When I first read it
I could not imagine the painful process of using a modem to do business all
day. Yet now we have internet companies investing in fiber optic home connectivity.
My last EMR project was classified as a “pilot” EMR for 3-4 physician offices. As I sat through the initial brief of the scope I wondered at what point will EMR’s not be considered a pilot project? Given the market penetration, the massive amount of testimonials, and the physician acceptance, wouldn’t you think we are ready to confidently undertake this type of project? I get the impression that the term...
I was on the way home from a doctor's visit and I drove past at least five banks. Having just experienced the typical paper shuffle and misplaced medical records during my doctor's visit, I had to wonder; What would it be like to have a bank do business the same way we do in healthcare? I mean really think about the ramifications. You would always have to go to the same branch because they would be the only one with your file. You would hope they did not misplace your file when you needed...
Pete Rivera
Pete Rivera’s blog reviews and discusses Electronic Health
Records and Practice Management systems. His blog will provide a forum to
discuss factors that are affecting adoption across the industry, implementation
challenges inherit with these systems and how organizations have been able to
overcome some of these challenges. This blog will provide business office,
information technology and clinical professionals an opportunity to comment on
the good, the bad and the ugly side of EHRs and PM systems. Rivera is a senior
healthcare consultant with Hayes Management Consulting with over 25 years of
clinical and IT experience. He is a retired Naval Medical Service Corps Officer
and a certified Project Management Professional.
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Pete Rivera