LEVERAGING YOUR EMR and PMS TECHNOLOGY: Making It Worth the Investment By Sue Hertlein Sr. Consultant The Coker Group CME Activity Planning Committee Name Title/Institution Disclosures Roger Brown, PhD Director, House of Delegates Office None James A. DeNuccio, MBA Director, Organized Medical Staff, None Group Practice & Senior Physician Services Cynthia Penkala, CMM Senior Policy Analyst, Practice None Management Cneter Kay Stanley, CMPE Associate Partner, The Coker Group Employed by company that publishes AMA Practice Management Publications Raymond Helm Director, Group Practice Market None Segment Leigh Adams Marketing Manager, AMA Business None Products & Services Carrie Waller Manager, Special Groups None Alice Reed Program Administrator, Office of None Group Practice & Senior Physician Services Faculty Sue Hertlein Senior Consultant, The Coker Group Employed by company that publishes AMA Practice Management Publications
AGENDA & OBJECTIVES • EMR Optimization : � Identify the essential business & clinical functions required to realize the efficiencies of an EMR system. • PMS Optimization : � Identify important business elements that improve efficiencies in a PMS system. • ROI Measurements � Construct and use a return-on-investment (ROI) tool in your practice. • Leadership Roles: � Analyze the roles of physicians and administration in these processes.
You’ve installed your new, robust EMR…… Now what??? . . . Take 2 and call YOUR Doctor!??!! 1. You did your due diligence in selecting the ‘right’ software. 2. You hired an IT specialist to purchase, configure and install the hardware. 3. You listened to your vendor as they guided you through the implementation plan and schedule. 4. You provided training to all staff. 5. You built your templates. 6. You began using your new system(s).
. . . . . however, you just don’t feel like you have full optimization in your practice. EMR OPTIMIZATION EMR OPTIMIZATION EMR OPTIMIZATION • Are all physicians automated? • All PA’s and NP’s automated?
EMR OPTIMIZATION • Could be losing “benefits” of $12,000-$25,000 per month per provider EMR OPTIMIZATION • Printing the schedule to paper? • Still pulling old charts? • Still creating a chart or other paper documents? EMR OPTIMIZATION • Collecting vitals manually or digitally? • Who documents chief complaint? • . . . . History? ROS?
EMR OPTIMIZATION • Fully utilizing templates for Exam, Assessment & Treatment Plan? • (Caution: Be aware of the “cloning” macros in EMR’s.) • Customizing templates on the fly? EMR OPTIMIZATION • Created custom templates by chief complaint to include your treatment protocols? EMR OPTIMIZATION • Still dictating? • Still printing scripts to paper?
EMR OPTIMIZATION • Educate patients to call their pharmacy for Rx refills - - not your office. EMR OPTIMIZATION • Interfaced with Quest, Labcorp or hospital for bidirectional transmissions? EMR OPTIMIZATION • All staff utilizing messaging? • Entering all patient calls into system? Incoming and replies?
EMR OPTIMIZATION • Utilizing E&M coder? • Ensure you audit the codes! EMR OPTIMIZATION • If applicable, set-up health maintenance reminders. EMR OPTIMIZATION • Utilizing patient education? • Using customizable letters for PCPs, specialists, patients?
EMR OPTIMIZATION TIPS • If multiple physicians, get together to share ‘tricks’ and/or shortcuts • Develop and utilize ‘super users’ EMR OPTIMIZATION TIPS • Offer ongoing training (web-based or onsite by vendor, internal, etc.) PMS OPTIMIZATION PMS OPTIMIZATION
PMS OPTIMIZATION • Using customizable instructions for front desk/scheduler? • Customized visit types and modifying as needed? PMS OPTIMIZATION • Scheduling all resources in system? • Utilizing online eligibility verification? PMS OPTIMIZATION • Are you transmitting your charges from EMR to PM for autocoding? ���������� ���������� 99214 81000
PMS OPTIMIZATION • Processing charges daily? • Transmitting electronically? PMS OPTIMIZATION • Utilizing ERA? PMS OPTIMIZATION TIPS • Take digital pictures of patients • Utilize the standard reports
PMS OPTIMIZATION TIPS • If a good fit for your practice, think about using an automated call messaging system RETURN ON INVESTMENT
SHOW ME THE MONEY!!! ROI • How do you measure ROI? • Is it all about money… what about quality? ROI • What about employee satisfaction?
ROI INTANGIBLE RESULTS • Improved patient care • More accurate coding • Faster replies to patient inquiries • Quality of patient records • Improved employee job satisfaction ROI “HARD” DOLLARS � Transcription costs � Chart costs � Paper costs � Storage space rental ( re- purposed ) ROI “SOFT” DOLLARS � Salary savings to create, pull, file & search for charts � Increased billed charges � Decrease in A/R � Reduction in staff additions, due to repurposing office staff
ROI CASE STUDIES ACTUAL ROI #1 MEASUREMENT DOLLARS PERCENTAGE CHANGE Decreased Total Aged -$100,255 -22.3% A/R Decreased Insurance $19,531 -42.6% Aged 90+Days Reduce d Transcription $58,415 -50.6% Costs Increased Billed $514,800 15.8% Charges ACTUAL ROI #2 MEASUREMENT DOLLARS PERCENTAGE CHANGE Decreased Total Aged -$152,430 -14.7% A/R Decreased Insurance $35,230 -22.4% Aged 90+Days Reduce d Transcription $27,600 -45.3% Costs Increased Billed $624,000 7.3% Charges
ROI ROI Calculator LEADERSHIP’s ROLES • Physicians • Adminstration LEADERSHIP’s ROLES PHYSICIANS • Openly support Practice’s decision regarding an EMR • Embrace change - be open • Be flexible • Fully implement and utilize the EMR
LEADERSHIP’s ROLES PHYSICIANS (con’t) • If issues with application, talk with physician champion privately; constructively voice your concerns. Offer suggestions. • Listen to the clinicians and their opinions • When needed, ask for assistance (coaching, training, etc.) • Work together to share shortcuts, etc. LEADERSHIP’s ROLES ADMINISTRATION • Openly support Practice’s decision to purchase new PMS and/or EMR • Embrace change - be open • Be flexible • Listen to the staff performing the tasks regarding the system application LEADERSHIP’s ROLES ADMINISTRATION (con’t) • Identify ‘super users’ for PMS and EMR and utilize them in training new hires, cross training, coaching and re-training. • Celebrate successes
AMA Resources • AMA Practice Management Center offers free resources for AMA members: www.ama-assn.org/go/pmc • AMA Bookstore offers practice management publications at a discounted member price: www.amabookstore.com Thank You! Thank You! Sue Hertlein The Coker Group shertlein@cokergroup.com 678-832-0423
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