Management

As I wrote in previous posts, the technical side  of the electronic medical records (EMR) implementation process, namely which EMR system to use, is probably the least critical component.

The most important things are ultimately related to the people side or what is known as ‘change management’. For EMR, this boils down to the implementation plan (which we discussed earlier) and the training plan.

The EMR training plan can be broken down into three steps:

1) Identify current skill levels. Many of your employees are probably recent high school graduates and (more…)

We’ve all heard the proverb, “He who fails to plan, plans to fail.”

This is certainly the case in the majority of failed electronic medical records (EMR) implementations, and usually the physicians/ administrators/ owners (circle your choice) bear the responsibility. Since this may well be the most difficult (and expensive) project your medical practice will undertake, it literally pays to have a good plan in place.

Implementation of an EMR system is truly a formidable task and the logistics can be overwhelming. We realized that we would need an integrated plan that would tie together both the technical side of the project with training in order to maximize efficiency, making the best time and use of our staff and contracted help.

So we worked with a project manager to break our EMR implementation project down into major processes and then (more…)

Perhaps one of the most challenging aspects of implementing an electronic medical records system (EMR) is managing its effect on the staff.

According to a study by executive search firm Korn/Ferry International, one of the most common mistakes that executives make when joining a company or making changes is failing to properly read the existing corporate or office culture. An example would be a control-oriented manager coming into a company with a collaborative culture, leading to tension and resistance.

In this column, I’ll explain how to adapt the existing office culture to facilitate the staff’s acceptance of a switch from paper records to EMR.

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I’ve been asked to respond to the question: what would you do if a staff member came to work with a tattoo or tongue ring? Well, this happened to us a while back, so we developed a policy statement which is now incorporated into our employee handbook.

Basically, it covers jewelry and personal appearance. It states that staff may only wear a certain number
of earrings, necklaces, rings and bracelets. It also says that there shall be no jewelry that is visible to a patient which involves a piercing of any kind, which would include a tongue ring. For someone with a visible tattoo, they are told that (more…)

I recently read a book entitled Corporate Agility (Grantham et al, 2007 AMACOM). And although initially I thought it was just applicable to large corporations, I realized that in fact it could be very useful for the typical medical practice. It describes a process known as collaborative strategic management (CSM). This is a strategic approach to management that incorporates three main areas: human resources (HR), information technology (IT) and corporate real estate (CRT).

The main principle of CSM is that, although these three areas may seem completely distinct, they need to be thought of as interdependent. Most of us are familiar with the terms HR and IT, but what does corporate real estate mean?

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Getting staff on board may be the most challenging part of technology change, but change management principles can help counter resistance.Electronic medical records systems are designed to make practice management easier. By automating, streamlining, and centralizing many of the dozens of administrative tasks staff members must attend to on a daily basis, an EMR system can significantly enhance your staff’s efficiency, freeing them up to focus their efforts on more critical matters.

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Before you let an employee go, ask yourself these important questions: Why is my employee not working up to standard? What can I do to help him? Ever ask yourself those questions? Well, if you’d like to know the answers – read on. You see, it all boils down to asking 3 simple questions, and depending on the answers, you’ll know what to do.

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Why is the cost of healthcare going up when doctors’ reimbursement keeps going down?If doctors are getting paid less and less by managed care insurance companies, why is the cost of healthcare rising exponentially in the country? Just look at the stock returns of these same insurance companies. And while physicians on average have seen about a 95% decrease in reimbursement in the last ten years, compare this to the compensation of the CEOs of these companies: $358 million for one CEO of a health insurance company.

If you add the total compensation of the top ten insurance company CEOs, this equals 1/900 of the total healthcare expenditure of the United States. In other words, 1/900 of all the money spent on healthcare in the US goes to ten people.

Is it too late to reverse the physician shortage?

According to an article in HealthLeaders Magazine concerns about a future shortage of doctors may be too late. Peter Fine, CEO of Banner Health in Phoenix, says the shortage is already here.

Several factors are to blame:

- One third of practicing physicians is over the age of 55
- U.S. Medical Schools have not provided for the loss of 33 percent of the physician workforce - by the year 2020, the nation may be short anywhere from 24,000 to 200,000 physicians
- Studies show that younger physicians coming out of training do not want to put in 80-hour work weeks required by certain specialties - it may take two younger doctors to equal one current doctor
- Aging baby-boomers are poised to increase the number of people over 62 from 46 million to 83 million - and older Americans tend to utilize health care services more

To combat shortages in specific areas such as Family Practice, Gastroenterology, and Urology, some managed care systems are having their hospitals recruit and hire physicians as employees, with enticing packages. Despite promises of newly constructed medical facilities to beautiful beaches within a short drive, many doctors coming out of training aren’t biting.

Ultimately, however, the United States may be forced to do what other industrialized countries such as Great Britain are having to do: import physicians from abroad, such as Asia or the Middle East.

If you were wondering how to keep track of people…If an organization has a significant number of employees, it can often be a challenge to keep track of where they all are. Some software systems can help regulate workflow in a medical practice by tracking the work of individual employees, but these require some type of manual input on some level.

In case you were wondering if you could implant RFID (radio frequency identification devices) in human beings, some states are already beginning to legislate the matter. California, as is often the case, is at the leading edge in technology-related legal standards. A bill recently signed by Gov. Arnold Schwarzenegger prevents employers from forcing employees to have RFID chips installed as a condition of employment or in return for payment.

And while it doesn’t address the issue of voluntary RFID implantation, it has placed a moratorium on the use of these chips in children for the next three years, presumably until more research on safety and security risks can be adequately addressed.

So, for now, medical practices will have to continue to rely on yelling down hallways or paging people overhead to account for live bodies.