Efficiency and effectiveness — taken together, these two words encapsulate the basic goals and benefits of physician office automation. Based on my experience as the office manager for a group practice, the right healthcare IT solution can also have a profound impact on employee morale.
Established in 1982 and located in Knoxville, Tenn., Farragut Family Practice (FFP) is a five-provider group with a total clinical and administrative staff of 16. A successful practice, FFP serves an average of 2,255 patients per month and is growing steadily at an average monthly rate of 20 new patients.
In 2004, we were struggling along with outdated, DOS-based practice management software. Working within an individual account required navigating across seven or eight separate screens. When a staff person was interrupted — as frequently happens in a busy medical office — he or she would have to start all over again from the first screen. Aggravating? Absolutely.
The system's appointment scheduling features were so cumbersome and system performance had become so slow that we had reverted to manual scheduling on paper forms. It took me from six to eight hours to run basic month-end financial reports. Detailed financial reports had to run overnight. I had no choice but to devote one weekend a month to financial reporting.
Adding to my frustration, the system had very limited reporting capabilities. Getting the data to examine practice issues — such as FFP's overhead costs by procedure compared to different payers' reimbursement rates — was a tedious manual process.
To make matters worse, an IT consultant warned FFP that a severe system crash, so severe that odds were that it would be fatal, could occur at any time. That worry weighed heavily on my mind day by day. Moreover, when I contacted the system vendor with a question or support issue, it was taking several days just to get my calls returned.
Thus, FFP was burdened with sluggish performance and inadequate functionality from an antiquated system teetering on the brink of collapse, and we could not get even basic support from the vendor. Clearly, the time had come to find a new practice management solution.
New and Improved
I spoke with managers of other local physician groups to get vendor and system recommendations. FFP evaluated four alternatives. Our main criteria for system selection included:
1) a robust, up-to-date technology platform;
2) ease of training;
3) ease of use;
4) customer service and support; and
5) initial and ongoing costs.
For FFP, MicroMD from Henry Schein Medical Systems was the best choice on each of our selection criteria, and it was 30 percent less expensive than the highest-cost software we reviewed.
A Windows-based, client/server system developed with SQL Anywhere, and we chose to deploy MicroMD on a Dell (Round Rock, Texas) server. Medical Software Associates, a Microsys value-added reseller, managed hardware configuration, software installation, data conversion and on-site training. Our installation date was March 23, 2005, and FFP went live on the new system in two days.
The new system has enabled us to improve the management of the essential operations of our practice. With our old system, FFP's accounts receivable had been running from 90 to more than 120 days. In less than a year on MicroMD, we achieved a reduction to less than 60 days and thereby improved the practice's cash flow. Collections during patient check-in also increased, averaging $350 to $500 more per day. Scheduling is more streamlined, and that has helped support the ongoing growth of the practice. Based on the costs of hardware and software, FFP secured a positive return-on-investment in 9 months.
In addition, custom and ad-hoc reporting has improved. When physicians or patients have questions, we can access the information we need to help them quickly, enabling FFP's staff to be more responsive. The financial reports that used to take six to eight hours to run now take less than 30 minutes.
The right practice management system improved the efficiency and effectiveness of our practice. In fact, FFP is now starting to plan to select and implement an electronic medical record (EMR) system, which we could never have even contemplated if we had not solved our practice management system problems. And, now that healthcare IT actually helps our staff get their work done, employee morale and job satisfaction have improved.
ABOUT THE AUTHOR: Darlene Limburg, CMPM, LPN, MX received her certificate for Certified Practice Management Aug. 2002 from DoctorsManagement, LLC in Knoxville, TN. She maintains a license for LPN from 1982-present and currently holds a limited X-Ray license from the state of Tennessee in Core/Chest and Extremities.