1. Practice Management Systems 1 Steven D. Atwood, M.D., FACP satwood@pol.net satwood@pol.netwww.adultmedicine.com/presentations/practice-management-systems Leveraging Practice Management Systems for a More Efficient Practice

2. Practice Management Systems 2 Key Points for Today 1.What you need to know, not nice to know 2.What might separate the winners from the losers 3.Specific examples of how your PMS can actually help you do your job or help 1. 1.save time 2. 2. improve efficiency 3. 3.increase patient satisfaction 4. your bottom line 4.improve your bottom line

3. Practice Management Systems 3 Key Sections for the Physician 1.Scheduling / registration 2.Billing / accounting 3.Serving the patient 4.Which program 5.Where to get suggestions and specs

4. Practice Management Systems 4 Let’s Get To It Scheduling u Everyone Must Be Able to Schedule nurse when telling coag results nurse when telling coag results l doc when telling patient to drop in see schedule at every station and from home see schedule at every station and from home u 30 Second Rule– book appointment in seconds– l patient name, doc, reason, when, done l trim names selection to those that are relevant

5. Practice Management Systems 5 See Schedule Easy to Add or Change

6. Practice Management Systems 6 Know key data before the time is reserved

7. Practice Management Systems 7 How much time, which room Robust detail Bundled procedures

8. Practice Management Systems 8 Are You Behind? When Can You Get Back to the Hospital? u u Arrive u u Roomed u u Exit u u No Show Helps to track when patients Show the data by using symbol, color, highlights

9. 9Practice Management Systems e.g. 9am and you are behind You are seeing now Arrived X No Show Seen and left

10. Practice Management Systems 10 One Write, No Duplication u u Cut & Paste u u Drag & Drop u u Notes Everywhere e.g. individual claims, individual codes such as with prolonged detention

11. 11Practice Management Systems Cut and Paste or Drag and Drop to any spot that week or in future months

12. 12Practice Management Systems Notes, Notes, Notes Everywhere

13. Practice Management Systems 13 Archive the Inactive Data u u No scrolling through 30 people with similar names u u Index patients by doctor or site then use the list associated with this site etc.

14. 14Practice Management Systems Archive or leave out the data you don’t need >>leave out patients not seen in 10 years >>just your site’s patients--not entire system

15. Practice Management Systems 15 Billing u u Past we used numerous fee schedules generally a Medicare max allowed fee schedule and a fee schedule for the rest of your practice  Now generally all accounts assigned but everyone has a different payment schedule e.g. 1.6 x Medicare rate, no coverage for carve outs another is 0.8 x Medicare rates

16. Practice Management Systems 16 Billing u u Paid vs. Expected - your computer should show you the expected payment as you enter payments

17. Practice Management Systems 17 Billing u u Paid vs. expected--see as you enter

18. Practice Management Systems 18 Billing u u charge vs. paid for each insurance company

19. Practice Management Systems 19 QUERIES u u PMS is basically linked databases u u the setup is proprietary u u you are locked in u u when you buy it you might be married for life because you might not be able to get your data out if you switch to another program

20. Practice Management Systems 20 QUERIES u u Future Is Modular u u No All-in-One Program Separate Program or Module for Each Part e.g. EMR, Billing, Schedule, Ordering u u Now STANDARDS Provide the Connectivity Between Programs u u Not Locked In, so Programs Compete on Performance u u Best of Breed may be easier to determine u u Export every field will help all this

21. Practice Management Systems 21 QUERIES PMS Design Linked Databases

22. Practice Management Systems 22 QUERIES

23. Practice Management Systems 23 Off the Shelf Software vs. All-in-One Package u u Software doing majority of operations for a large corporation may have dozens of pull down menus and take 3 days of training before you can use e.g. IDX or similar software for large health systems

24. Practice Management Systems 24 Off The Shelf Software vs. All-In-One Package u u Separate Programs or Discrete Modules helps 1.) Training 2.) Security 3.) Upgrades 4.) Can Reduce Down Time u u Quicken $79 -- all bills and bank activity u u QuickPay $50 or QuickBooks $179 -- payroll u u HotFax -- can fax any file as if you were printing it

25. Practice Management Systems 25 SECURITY   User ID, Password   Station ID   Section Permission e.g. Hospitalize Senator, only treating staff have access to this patient’s tests e.g. charge and collection for the day not accessible by file room staff Too many programs give full access to everything after you log on

26. Print to File u u Best thing since sliced bread u u can use a claim clearinghouse & NO INTERFACE NEEDED u u e.g. Print a HCFA type claim then you can Print to File so you can save the printout and all it’s formatting Your clearinghouse can use this file and the print layout to transfer this information to their database NO INTERFACE NEEDED-- NO MORE TYPING

27. Practice Management Systems 27 Print to File

28. Practice Management Systems 28 Every letter and number is exactly where it would be on a claim Thus a computer can import the data Print to File

29. Practice Management Systems 29 Print to File

30. Practice Management Systems 30 Print To File u u Select printer then click print to file option u u Go to DOS prompt (in Windows>Accessories) u u Enter the command PRINT and file name e.g. u u Then strike enter and your file prints thus you can save anything you want to print

31. Practice Management Systems 31 Print to File printer must be connected by LPT-1

32. Practice Management Systems 32 Physician in Back Office u u Need a full registration sheet or face sheet u u insurance type may dictate where to go for tests u u insurance type may dictate which hospital to use u u insurance type may only cover certain meds u u may need DOB u u may need SSN u u may need phone numbers for patient u u may need phone numbers for insurance company

33. Physician in Back Office u u must be able to tag individual data u u progress notes u u claims to send u u schedule spots to reserve u u rooms or equipment to reserve u then as a batch you can print fax reserve reformat Same as hold down Control then left click to select desired data in Windows

34. Practice Management Systems 34 FAX u u If you can print it you should also be able to fax it

35. 35Practice Management Systems Send to fax machine rather than printer

36. Practice Management Systems 36 u u prescriptions goal is to order the right med quickly u u formulary u u which med, which dose vs. Voice Mail at Pharmacy Orders FAX a Script-- how do you sign if digital signature not OK

37. Practice Management Systems 37 Forms u u Scan the form u u Insert the file on a page as a background u u Overlay text boxes where the data goes u u Bookmark each box (control+F9) u u Jump box to box / bookmark to bookmark (F11)

38. 38Practice Management Systems Any word processor & hopefully your PMS can prepare and store any form Start box 1 F11 to jump to next field bookmarks

39. Practice Management Systems 39 Physician in Back Office u u Email at every work station

40. Practice Management Systems 40 What’s Out There u u How Many Different Programs u u List of Vendors u u Cost u u Features Selecting Your Practice Management System

41. Practice Management Systems 41 PMS Vendors 1. 1.Medical Manager 2. 2.Millbrook 3. 3.IDX 4. 4.NextGen 5. 5.CompuMedic There are over 110 programs perhaps ½ have ASP (web based) option 1.Lytec 2.Medware 3.Medisoft 4.E-MD 5.FoxMed e.g. Larger Systems Smaller Offices

42. Practice Management Systems 42 PMS Vendors List on Internet at www.HIPAA.org/ pmsdirectory www.HealthCareInformatics.com/ issues/2002/10_02/spotlight.pdf about 110 listed www.aafp.org/ PreBuilt/fpnet_techguide.pdf 9 rated

43. Practice Management Systems 43 PMS Purchase or Lease Prices Varies by options—wide range Buy and own, then elective updates Yearly lease and required yearly updates Monthly lease per provider or per station

44. Practice Management Systems 44 PMS Purchase or Lease Prices u u $ 200Medisoft u u $ 600-2000 MedWare, Lytec u u $ 7,000 NextGen & per provider u u $15,000+ IDX, Medical Manager Varies widely and changes - many options - must contact vendor perhaps

45. Where to Go for Information 1. 1.www.acponline.org/PMC/practice.htm 2. 2.www.ComputingForClinicians.com by ACP Fellow 3. 3.www.aafp.org/practicemgt.xml user comments 4. 4.www.ctsguides.com/medical.asp buy reviews 5.www.HealthComputing.com/KLAS 5.www.HealthComputing.com/KLAS buy reviews 6. 6.www.MGMA.com members only 7. 7.www.KnowledgeStorm.com needs free registration 8. 8.www.CivicResearchInstitute.com/mi5.html

46. Practice Management Systems 46 SUMMARY on Leveraging Your Practice Management System to Save You Time, Improve Efficiency, and Improve Your Practice 1. Everyone Working with Patients can Schedule and Has Access to Registration Data u uJust seconds to reserve an appointment u uNeed to know the health plan and contact numbers u uRegistration data effects your medications and tests u uOld unused data to archives u uMS Office type features—cut/paste, drag/drop, tag

47. Practice Management Systems 47 SUMMARY on Leveraging Your Practice Management System to Save You Time, Improve Efficiency, and Improve Your Practice 2. Can really use the ability to easily export or query almost every field in the PMS u u List of who is on a medication with a new alert u u List and # of patients on a HMO 3. Need ability to track expected payments for each insurance company as the payment comes in

48. Practice Management Systems 48 SUMMARY on Leveraging Your Practice Management System to Save You Time, Improve Efficiency, and Improve Your Practice 4. Need ability to easily find, complete, and fax paper – u u e.g. Referral form–who, what, where, when, why 5. Inexpensive programs like Quicken can easily manage key functions– Maybe everything in one program is not a good idea 6. Every work station needs office e-mail

49. Practice Management Systems 49 Questions

50. Practice Management Systems 50 Steven D. Atwood, M.D., FACP satwood@pol.net satwood@pol.netwww.adultmedicine.com/presentations/practice-management-systems Leveraging Practice Management Systems for a More Efficient Practice