| The increasing reliability of the Internet technology | | | | results are critical for successful implementation: |
| and standardization of systems interfaces have | | | | 1. Communication |
| recently enabled comprehensive "best-of-breed" | | | | 2. Expectations management |
| configurations of modern EMR software and billing | | | | 3. Consensus building and conflict resolution |
| service, made available to physicians under the | | | | 4. Delegation |
| "pay-as-you-go" business model. | | | | 5. Attention to detail |
| Software-as-a-Service (SaaS) model allows | | | | 6. Verification of delivery |
| physicians to confirm the benefits of technology | | | | Track. Schedule regular (weekly) implementation |
| solutions first and pay later. While such solutions | | | | review meetings with practice manager to |
| deliver multiple risk management and operations | | | | 1. Ascertain progress is made according to the |
| control benefits, they also require disciplined | | | | plan or |
| implementation processes. | | | | 2. Modify the plan. |
| Since SaaS model eliminates traditional systems | | | | Schedule. Without specific action items including |
| management headaches, the transition to | | | | specific owners and delivery dates, implementation |
| best-of-breed configuration of outsourced billing | | | | will drag on and exceed allocated costs. Consider |
| and SaaS EMR requires focus on people and | | | | using a process tracking system, e.g., TrackLogix. |
| processes: | | | | Pay special attention to |
| 1. Communicate, communicate, and communicate. | | | | 1. Payer enrollments: Fill out required paperwork. |
| The likelihood for implementation success is | | | | Check for clerical errors. |
| directly proportional to staff involvement. Review | | | | 2. SOAP note customization: Review current |
| current workflow, understand expected changes, | | | | notes. Consult every doctor in the practice when |
| and make sure everybody in the practice agrees | | | | designing the new templates. |
| with them, including practice manager, doctors, | | | | 3. Custom reporting: Address any unique practice |
| and office personnel. To avoid errors and conflicts | | | | needs. |
| in the future, leave nobody behind using the old | | | | 4. Legacy systems and data: Review interfaces. |
| workflow. Document specific | | | | Contact vendors. Prioritize record upload. |
| 2. Steps required to schedule an appointment, | | | | 5. Testing: Design test plan for specific transition |
| register patient's arrival, find out outstanding | | | | and integration items. Schedule dates. |
| balance, bring the patient to the exam room, find | | | | 6. Going live: Find low-volume days to reduce |
| previous diagnostics, treatment and financial plans, | | | | damage from unexpected errors. |
| gather vital signs, medication and allergy lists. | | | | 7. Personnel training: Focus on the new process. |
| 3. Tasks required to get paid in full and in time. | | | | Test newly acquired system skills. |
| Include coding, claim submission, denial review, | | | | Train Gradually. Allocate enough time to train |
| appeals, follow up with payers and patients, | | | | everybody on both the new processes and |
| secondary submissions, and review of accounts | | | | technology. Do not try to jam everything your |
| receivable. | | | | system can do in a single training session. Expect |
| 4. Individuals performing those tasks, locations, | | | | multiple training sessions, adjusting to participants' |
| and task durations. | | | | learning pace. Ease in, use the "onion peel" |
| Manage Expectations. Laurence J. Peter observed | | | | approach, training personnel only the features |
| in The Peter Principle: "If you don't know where | | | | required for the new processes and specific |
| you are going, you will probably end up | | | | scheduled items on hand: |
| somewhere else." Document specific changes in | | | | 1. Basic Scheduler and Superbill. Learn to schedule |
| the new work flow. Identify specific steps in the | | | | patient appointments, enter demographics for the |
| new workflow that require fewer or less qualified | | | | new patient, and test patient eligibility and balance |
| resources. Quantify expected benefits in terms of | | | | on line. Enter charges for patient visit. |
| saved resources, added revenue, and personnel | | | | 2. Workbench and Problem Tracking. Identify |
| savings. Schedule specific timelines for meeting | | | | denied claims. Respond to billing operations |
| specific financial benchmarks. | | | | requests for information, review denied claims, |
| Control the Fear of Change. Do not force the | | | | update claim data. |
| new system on the old work flow. Had the old | | | | 3. EMR. Update SOAP notes. Test drug interaction. |
| processes met new business requirements, you | | | | Refer to other doctors and review referral |
| wouldn't be looking for better solutions. Carefully | | | | reports. |
| design the new work flow leveraging the new | | | | 4. Basic Accountability Reports. Track charges, |
| solutions together with work flow participants, | | | | payments, and billing quality (percent of A/R |
| including the practice manager and every doctor. | | | | beyond 120 days). Generate a summary of |
| Prioritize. Do not try to implement an entirely new | | | | accounts-receivable by payer or a breakdown of |
| process including all new features at once. Soften | | | | revenue by physician for a given month or |
| the transition shock by using a gradual approach, | | | | cumulative to date. Review end-of-day report of |
| minimizing the amount of changes but maintaining | | | | patient visits, new patients, patient visit average, |
| a steady and sufficiently frequent pace of such | | | | missed appointments, accounts receivable. |
| small changes to complete the transition on time. | | | | 5. Advanced EMR. Modify SOAP note templates. |
| Avoid scheduling migration to a new system | | | | Modify alert generation rules. |
| coincidental with the practice move to a new | | | | 6. Patient Relationship Management. Create and |
| physical location. | | | | track payment plans. Manage patient compliance. |
| Lead. Without a manager for entire transition | | | | 7. Advanced Reporting and Performance Analysis. |
| process, members of the transition team will find | | | | Track payment variations by CPT codes and |
| other priorities and will not take responsibility for | | | | payers. Identify the worst payer for the best |
| delivery. While technical background or prior | | | | revenue-producing CPT code. Analyze your audit |
| familiarity with EMR are helpful, the following | | | | risk exposure. Identify under-coded or over-coded |
| leadership skills and a commitment to accomplish | | | | claims. |