Manage My Practice

Newsletters, especially electronically delivered ones, can actually generate revenue for your practice in many different ways.  So here are a few ideas for improving your monthly medical practice income this summer by distributing a newsletter to your patients.

• Building rapport. A newsletter will keep your medical practice in front of your patients.  They will think of you first for healthcare, answers, and advice.  An electronic newsletter can establish your ability to communicate effectively using this newer communication device.  It is especially admirable to have an article written by one of your physicians each month speaking directly to patients in a candid bedside manner.  Your patients are more likely to refer you to one of their friends when they know, like and trust you.
• Selling products on the shelf. A newsletter can assist you with selling items you have sitting on your shelf right now such as dermatological creams, supplements, equipment, etc.  You may even want to announce flu shots or vaccines when they come available.
• Promoting services.  You may have services that some of your patients have not taken advantage of, or may not be aware exists at your practice.  By highlighting other services that you provide in addition to doctor visits, you could acquire new revenue from existing patients.
• Introducing new services. Many times you will want to introduce new products or services to your patients and an electronic newsletter can help you to get the word out quickly and effectively without added cost.  You can also announce specials and offers you may have for the month using this venue.  New providers and staff can be announced to patients this way too.
• Informing patients. Apprising your patients of the latest news, healthcare trends, and policies affecting your medical practice can be a benefit for both you and your patients.  You can provide assistance through your monthly updates to help them assimilate all the new information they are receiving from the media more easily.
• Building credibility. Your newsletter can build credibility for your practice and physician(s) by answering general questions, and by discussing diseases and symptoms related to conditions you treat commonly within your specialty.  This establishes your practice as the expert and go-to facility for patients’ healthcare needs.

There are many ways that an e-newsletter can provide benefit to your medical practice and generate additional revenue.  If you already have a newsletter in place, then make sure to utilize it to the fullest by sending regular and consistent monthly notices preferably at the same time each month.  Continue to add new patients to your newsletter list each week.  Provide fresh new content and updates to your newsletter regularly.

If you are just getting started and need ideas for a newsletter you can begin with a simple template such as this layout:
•    What’s New
•    Tips – Q & A
•    Medication Updates
•    Featured Article
•    Announcements/Specials

For more ideas and information on distributing an e-newsletter, visit my blog at Practice Manager Solutions.

Rebecca Morehead, CPCC
“Bringing new ideas to practice manager life.”
Contact me: Twitter Facebook Linked In

When Matthew Browning first described YNIO (Your Nurse Is On), I was really surprised to learn what his product was.  I don’t know what I expected, but it wasn’t the elegant solution to staffing he described.

Here’s the description from the YNIO website:

Your Nurse Is On^TM was developed in 2000 by a trained Family Nurse Practitioner in response to the inefficient relief staffing procedures found in healthcare today. With today’s challenging environment of cost savings and instant communications it became apparent that calling replacement staff one at a time was no longer an adequate solution.

With the improvements in internet telephony that occurred around 2005, we created a system that allows you to call any available nurse to fill your vacant shift. You now have the power to contact many nurses, in any order you choose, on whatever device they prefer. Since the nurses on our system make their availability known in advance, you will never disturb another unavailable nurse or waste your time calling them.

I could really relate to this solution! Who among us hasn’t spent hours on the phone filling staff slots, getting coverage for unexpected medical leaves, and trying to piece together coverage for routine vacations?

YNIO distills the product down to four easy steps:

1. Scheduler creates a request for staff.
2. YNIO contacts all available staff – instantly.
3. Staff receives the request and accepts or rejects the shift.
4. Scheduler is immediately notified.

And what are the proposed benefits to a facility using YNIO?

• Save time – system can call dozens of nurses simultaneously
• Save money – no more dollars wasted calling nurses who are unavailable
• Fill shift vacancies – expanded pool of available nurses
• Increased employee morale – decreased shift vacancies can decrease shift call outs, injuries and burnout
• Increased efficiency – leverage technology to save money, save time, quickly fill shift vacancies and save paperwork with our paperless billing and performance tracking systems.

This sounds like a needed solution for practices, nursing homes, hospitals, and home health agencies.  I am also fascinated by the creative process of innovation and delivery to the market and asked Matt a few questions about the development of his product.

MARY PAT: Matt, what does it take (emotionally, financially and otherwise) to conceive an idea and bring it to the market?

MATT: I believe it begins with a personality that is inclined to analyze situations and procedures with an eye toward improvement. “How can we make this, or do this, better than we are today?” As this behavior becomes internalized and part of our daily routine, we begin to generate ideas, “maybe this could work” type of thoughts that can result in some solid ideas, proposals and hypotheses. This stage of innovative thought is rather common and many people have an idea that could “change the world,” however an idea at this stage is often lacking a “vision” of how it can interact with our current realities, change existing processes, improve outcomes, save time and reduce expenses. The basic business infrastructure, legal processes, finances and team that are very important considerations to bring an idea from conception to market are often not understood, at this point of the innovation cycle, by the inventor and are definite challenges. These challenges may be the reason that many potential innovations are never brought to market.

So, besides an idea, and a ‘vision’ of how it fits into the world, flexibility, determination and persistence may be the most required traits for the innovator. The key to this game is teamwork, assemble the highest quality team you can, rely on experts for knowledge outside of your personal domain and remember that the objective is bringing the product or process to the world to make it a better, safer, more enjoyable place for as many people as possible. Success is often a direct result of service to others and bringing your innovation to the world can be a great service.

On the emotional and financial fronts, expect the endeavor to take twice as long as you expect and to cost twice as much as you expect. Having an awesome team and a supportive social network are invaluable to the eventual success. I am fortunate to have a very supportive family that believes in me and our innovation and they have been very tolerant of the extraordinary amount of hours and obligations that are part and parcel of this innovator’s life. To summarize, I believe a good idea can become a vision that with a very dedicated individual can become a team working toward the release of an innovation commercially. Hard work, perseverance, flexibility, ability to learn and the ability to delegate are all requisite as well.

MARY PAT: What’s been your lowest moment to date in bringing your product to market and what has been your highest?

MATT: My personal and corporate nadir occurred, ironically, during one of the best events of my life, the birth of my son, Arthur. Our product, YourNurseIsOn.com, was struggling through the “proof of concept” phase, after nearly a year in development and design, when my wife had an unexpected, emergent delivery of our son. We were traveling in Florida on a doctor-approved combination business and family trip, when our son decided he was coming into the world, nine weeks early. Aside from a very difficult and dangerous birth experience, we were over 1500 miles from our home in New Haven, CT. Our company was being run from my laptop and mobile phone and I was juggling a fully packed calendar of business obligations all while running from ICU to NICU, for 5 weeks. It was two months before I was able to safely return my family to our home in New Haven. In addition the amazing amounts of time needed for both my wife, Phoebe, and my son, I still needed to meet with potential customers, conduct regular tech meetings, solicit further investment and continue to work on intellectual property issues, technological challenges and personnel needs.

We had invested our life’s savings to get to this point and now, with this amazing, yet traumatic family event, we began to question many of the decisions that had brought us to this place and time. Out of time, out of money and out of my home, it was easy to think how much ‘better’ it would be if I ‘just’ worked as a Family Nurse Practitioner as I was trained to do and could bring home a regular ol’ paycheck for ‘only’ 40 hours. Those questions never last for long, the ‘vision,’ never sleeps, it never relents and it can become all-encompassing and turn us into 4am to 11 pm machines but, occasionally, even entrepreneurs are human

Conversely, our highest point to date has been our attendence at HIMSS 2010 this March. We were selected to present at the Healthcare IT Venture Fair and after an exciting presentation we were no longer unknowns to the major players in the healthcare arena. When big names like Intel, Blue Cross, GE, McKesson, Blank Rome and the United States of America take note of your product and want to engage in investment, customer and business development discussions, you begin to realize that the power of the innovation is becoming recognized. The time since HIMSS10 has been a constant blur of inquiries, customer demos, partner requests, commercialization deals, amazing pilot discussions, customer implementations and, of course, investors.

MARY PAT: Is this a product that can be affordably scaled for any customer, or do you anticipate the ROI being on target for a specific type/size of customer?

MATT: Our product, YourNurseIsOn.com, is a Software as a Service (SaaS) product that helps allocate the right healthcare staff, where they are needed, when they are needed there, by instant, 2-way text, phone and/or email communications. We are a Software as a Service (SaaS) platform that allows for quick and easy adoption, keeps customer costs low and removes their maintenance responsibilities.

We offer a number of value propositions for the customers including faster speed of fulfillment, decreased nurse vacancy, reduced overtime spending, increased patient-provider contact hours, improved patient outcomes, license management, call order adherence, expanded communications capabilities and amazing compliance reporting performance. Flexible scheduling, with all the extra communications needed, has become a best practice for healthcare workforce recruitment and retention. YourNurseIsOn.com makes these communications effortless. For organizations that rely on communicating with a distributed workforce, to operate around the clock, our solution is quickly becoming indispensable.

The ROI metrics are being compiled presently and should prove to be favorable for any size organization. We expect the return on investment period to be very brief as we can provide over 8 hours of phone calling in under 30 minutes and provide the 2-way text and email channels for improved efficiencies. Our soon to be announced pilot with a nationally recognized health provider network will soundly demonstrate our scalability for any sized facility, organization or governmental body.

MARY PAT: Where do you want YNIO to be in 5 years?

MATT: YourNurseIsOn.com is focused on excellent customer experience, and service, for every single client that engages our services, and we will continue with that focus relentlessly as we continue to grow and scale our platform. YourNurseIsOn.com is well poised to become the de-facto communications method for healthcare organizations that need to contact and confirm their specialized, distributed workforces on demand. The ability to easily reach specific individuals, that are qualified and available for a specific function, in a quick and easy manner on any device of their choosing will only become more important given the coming increases in healthcare demand and simultaneous scarcity of all healthcare providers. YourNurseIson.com has the ability to efficiently deliver caregivers where they are needed, not only in institutional settings, but in the communities where the majority of care is being delivered. YNIO, with its international patent -pending status will be the communications ‘glue’ that holds it all together.

MARY PAT: Many people are predicting that NPs and other mid-level providers will be the future of primary care if physician shortages play out as expected.  What do you think?

MATT: Personally, as a nurse practitioner, I feel that this is all too often the focus of discussions about the future of healthcare and is, just as often the beginning of contentious debate that ends in a turf war between doctors and other providers. I do not believe that either of us are the future of healthcare. I believe that we cannot possibly train sufficient numbers of providers to care for the onslaught of demand that is quickly approaching. The future of primary care will lie in the hands of the individual, their families and their communities. This will be supported by tele-medicine, bio-sensors and smart homes to begin and eventually lead to caregiver robots and software algorithms diagnosing and treating your ailments:

• A wristwatch, scale and shoes that track your fitness regimen, downloaded nightly into your Personal Health Record and gently recommending tomorrow’s diet or workout schedule.
• Personal reminder software to gently prod you to take your medicine, engage in physical activity or to remember a wellness event or medical appointment.
• Accentuated reality software to help make informed dietary, activity or purchase selections based on wellness scales, provider recommendations or personal preferences.
• The ability to export this information to your Electronic Health Record to share with your providers, specialists or family
• A smart home with a bed that signals that Grandma woke up later than usual after a restless night, a chemical sensor toilet that signals she may be a bit dehydrated, a pill bottle that alerts when she hasn’t opened it- these types of events triggering personal reminders, check-in requests to a neighbor, visit requests to family, or send an alert to her community caregivers, etc. If no one is able to check on her status, emergency services could be automatically notified.

Couple these technologies with instant, 2-way, verifiable communications systems, and these networks will provide the bulk of care in the near future. There simply are not enough resources to provide care any other way. I hope to see NPs continue to expand their roles, earn autonomy and continue to provide excellent care to millions of people. NPs, MDs, therapists, etc. are all going to be in short supply and high demand. All of these professionals are important to the healthcare delivery team and will have to be allocated with, supported by and communicated to with advanced technologies to expand their practice reach, improve their collective effectiveness, begin to decrease costs, and continually improve outcomes.

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It was a real pleasure talking with Matt and getting to know more about YNIO and more about him (the geek in me enjoyed the geek in him!)  I truly appreciate how open he was in the interview. Thanks, Matt!

The YNIO (Your Nurse Is On) website is here. Matt recently guest posted on HealthcareIT Today which can be found here. You can connect with Matt here:

Email
Twitter
LinkedIn

There’s nothing I can say but close your door for 16 minutes and 59 seconds and watch this.

mhealth is short for “Mobile Health” and is medical and public health practice supported by mobile devices, like MP3 players and smartphones. Here’s a link for more info on smartphones, medical applications and other fun stuff from Epocrates.

The last conference I went to might be the last conference I ever go to.  I do like some parts of conferences, but not all, or even most. Medical manager conferences do not seem to have changed since I first started going to them in the late 80′s.  Big sessions with big names. Little sessions with little names. The Exhibit Hall. Parties. Get-togethers. Late nights and early mornings.

I usually expect to accomplish two things during the conference.

One is to pick up some little pearl of wisdom from a random conversation that goes like this:

THEM: Blah blah blah blah.
ME: Hey, what did you just say?
THEM: Blah blah blah blah.
ME: You do that? At your practice? And it works?
THEM: Blah.
ME: How do you do that?
THEM: Blah blah blah blah yadda yadda yadda.
ME: I’ve gotta try it – thanks so much! Hey can I get your card and call you if I get stuck?
THEM: Blah yadda yadda.
ME: Yeah, great to meet you too!

The second is the brain time I get during a totally boring session when I can think without interruption about a problem I’m trying to solve.  I can reflect, scribble notes and no one cares. The phone is not ringing, there’s not a line at my door, there’s not a to-do list to do in my to-do book.  One thing I can never get enough of is time to think.  Work is full, almost every minute, with noise and interruptions and lots of people needing something.  What I need, what we all need, is more time to think.  If you never have time to think, or plan, or process, there is no managing going on.

Here is what my dream conference would look like:

1. Speakers on big screens – What is the value of having a big name speaker come personally to a conference?  Have them speak virtually.  Save a lot of money for us and save a lot of time for them.  Come to think of it, what do the big names actually contribute to the conference?  I’m not sure.
2. Infomercials – Why not have the exhibitors do infomercials at breaks in the programs? Anyone can make a video explaining their product. The videos could be available on the conference YouTube Channel for anyone who misses the infomercials and wants to flip through them.
3. No exhibit hall – I’ve heard so many vendors say they won’t have the budget soon to attend conferences.  How do vendors raise the money to attend conferences, give out goodies and door prizes and sponsor parties? By raising their product price, of course.  When I hear people say “We couldn’t have a conference without the exhibit hall,” I think “I bet we could have a better conference without the exhibit hall.”  No exhibit hall means a lot more time to meet with people I really want to see. No exhibit hall means I don’t have to carry home a bunch of literature I don’t want. No exhibit hall means I don’t have to feel guilty about finding the fastest way from the front of the hall to the coffee stand/food/bar.
4. Breakouts on demand – I’d like to go to smaller breakout sessions when I want to fit them into my schedule.  If I get into a great discussion with someone, I don’t want to drop it to run to a session, I want to go with the flow.  Breakouts could be constantly running on screens in dedicated rooms, or I could get them on my laptop whenever I was ready for them.
5. The Unconference - there are several versions of the Unconference, but the version I’ve been exposed to is one where a huge block of time at a conference was completely unprogrammed.  It was the second day of a two-day conference and all throughout the first day, attendees wrote things they wanted to talk about on Post-it notes and stuck them on a big blank wall.  The conference organizers were responsible for combining like ideas, assigning a time and a room and finding a facilitator for the topic.  I came to a conference with a need and my need was met!  Conferences, especially large ones, by necessity must choose topics and book speakers far in advance.  With as fluid as healthcare now is, conferences need to match the fluidity of healthcare to be pertinent.
6. Networking, networking, networking – What can’t I get ANY other place? A conversation with my peers.  People with different experiences, different perspectives and different ideas.  That’s the best thing I can bring home from a conference.

What does your dream conference look like?

With huge growth in 2009, social media is not just a passing trend used by online marketers; it’s a real, effective method of communicating ideas, sharing information and connecting with people across all age and socioeconomic groups. Healthcare, while slower to adopt the social media wave than other industries, is coming to realize the potential social media tools provide to develop connections with patients, potential patients, along with other physicians and healthcare leaders around the world.

What are some of the driving forces behind this explosion in popularity? One reason is that as consumers, we’re no longer trusting of advertising and we don’t want to be marketed to, we want to be engaged, build a relationship, make the company earn our trust and hear our friends or family’s review of their experiences. In fact, studies show that today, only 14% of people trust advertising, whereas 78% of people trust recommendations and referrals. Companies are using social media outlets to build relationships, trust and encourage recommendations and referrals from their engaged consumer base.  As practice, hospital and physician growth are so strongly correlated to patient referral and recommendation volumes, it is only natural healthcare organizations look to social media outlets to continue to foster patient relationships and increase referral volumes.

As of February 2010, where is the healthcare industry in its adoption of this social media explosion? Larger organizations and health systems are utilizing the power to connect, share and engage their patients.  While, on average, smaller private physician groups and individual physician offices are still slightly hesitant and dipping their toes in the social media pool cautiously.  One can understand why healthcare professionals do need to take a more strategic approach to interacting and engaging patients online with potential HIPAA privacy issues and other challenges looming. However, with a carefully crafted social media strategy, many health organizations are realizing the benefits of becoming more accessible in their marketing and reaching out to inform, educate and build trust with patients.  According to Ed Bennett (edbennet.org) hospitals are currently at a 53% adoption rate, with 336 Facebook pages, 430 Twitter Accounts, 254 YouTube Channels and 70 blogs. In total, 557 health systems are reported to be participating in some capacity with social media, with the term “social media” encapsulating many forms and tools, including Facebook, Twitter, YouTube, blogs, LinkedIn, Flickr, and a number of patient forums.

How are healthcare organizations using these tools effectively? Let’s focus on the top three tools currently adopted and being utilized in the healthcare social media sector.

Facebook: Physician practices and health systems alike are using Facebook as a dynamic, community-based website.  It has become a place where physicians and leaders can post timely, organic or professional videos to educate patients and also connect on a more personal level.  As a valuable resource for health information sharing, many organizations are taking the embarrassment out of sensitive subject matter and addressing specific medical problems, questions and issues for patients. Also, introductions to staff members and tours of the facilities are assisting organizations with connecting with their patients outside the four walls of their office and building rapport before patients even arrive for their appointment. Practices are also encouraging patients to participate and engage on their site through discussions and contests.  Private practitioners are more likely to start their social media strategy with just a Facebook Fan Page, while larger health systems and hospitals are embracing other social media tools in combination with Facebook in their initial strategy.

Twitter: Twitter is being adopted quickly by the larger health systems as a way to share information, publicize events like health screenings, fairs and clinics and also connect with other health organizations.  I like to think of it as a public relations channel for these hospital and health systems.  What’s great is that in short, 140 character or less “tweets”, these organizations are sharing a wealth of information to their patients and those patients are finding ways to access this health information and the system like never before.  Overall the smaller, private practitioners are not as quick to adopt Twitter as they are a practice website or even Facebook, but many are starting to realize the benefits of utilizing this community as a way to share their expertise and knowledge, along with driving traffic to their websites.

YouTube: Healthcare organizations are using YouTube like their own, private television station that can be shared with millions of viewers across the world.  Again, more popular amongst the larger health organizations, videos of procedures, interviews with clinicians, tours of new facilities and patient testimonials are being posted in a searchable, user-friendly manner to continue to enhance brand awareness, build trust and gain patient loyalty.  This social media tool can be used much like Facebook, easing patient fears and answering tough or embarrassing questions. It can also give patients a visual insight into the facility so they know what to expect before arriving at an appointment or for a procedure.  It can act as an online referral source, highlighting patients that have had outstanding experiences and are recommending that organization to over a billion of their closest friends and family online. YouTube is the second largest search engine and healthcare professionals are quickly utilizing its power to share and connect with patients.

The fact of the matter is that for all industries, including healthcare, social media is both a curse and a blessing. Patients, who are now consumers with choices, can post content and interact freely with their physicians and their hospitals, sharing both outstanding experiences and negative experiences.  Many health professionals are worried about their vulnerability, but social media is real life, online.  As 2010 progresses, you’ll be seeing more and more attention placed on social media by healthcare professionals and by the end of the year, it will be a necessity for organizations to be participating and engaging online, or be left out.

I’ve been thinking about the medical office of the future.  How would you design a building today that is meant to take you into the future?  Here are my thoughts.

One of the hallmarks of a well-designed office, today or tomorrow, is flexibility.  You want as much functionality as you can possibly get out of each space and use each space for as many purposes as possible.

For instance, a large room with lots of voice and data jacks or wireless and electrical outlets might be used for:

1. Physician meetings, staff meetings or parties
2. Group patient visits
3. In-house health fair
4. Staff or patient training
5. Public meetings
6. War room for disaster management or ad hoc project (medical record scanning prior to an EMR go-live)
7. Conversion to workstations for a merger with another group
8. Place to do group sports or college physicals, flu shot clinics, DOT physicals

I see reception and waiting areas getting smaller as patients have less time and are less willing to wait.  Patients may not have to wait at all if you are sending them a text message or Twitter when the doctor is ready to see them.  Some practices will not have waiting areas as patients will be escorted directly into exam rooms where the entire visit, from soup to nuts, will take place.  Instead of going to the lab, the lab might go to the patient – see a phlebotomy application on a handheld device here.

Registration may be replaced by check-in kiosks that totally automate the process, including a vitals booth which takes the patient’s weight, blood pressure, oxygen levels and temperature.  Patients and their demographic and insurance information may be identified by fingerprints or iris scans. You may have a receptionist avatar greeting patients.  Here’s a cool video that shows a virtual administrative assistant (the first 2 minutes of the video.)

Fixtures are movable – storage cabinets are on wheels and not permanently attached to walls.  Any room can be an exam room, a treatment room, a test room, a procedure room, simply by moving the cabinet with the needed items and the machines, which will be handheld.  See an example here.

Providers’ phones are their everything.  Their mail, patient records, test results, journals, phone calls, and their family pictures are on their phone, so no need for an “office.”

As always, non revenue-producing space is minimized and revenue-producing space is maximized.

The need for storage of paper (records, forms, etc.) is minimized because everything is digitized and stored on the cloud.  The need for staff workstations is minimized because many staff work for the practice from home.

Medical records are not viewed on computer screens, they are projected onto walls in any room, at any time.  See the TED Talk on the Sixth Sense technology here.

Many patients are seen at home or in the nursing home, with the provider in the office using telemedicine technology or virtual office visits.

Medication samples will not be given at the physician office – they will be distributed at the pharmacy.  All medications will be samples (no cost) until it is established that it is the effective medication for that patient’s problem.

Here’s a neat video from Microsoft about healthcare of the future.  It will get your mind racing about the possibilities.

Microsoft Health – Future Vision from Microsoft Feed on Vimeo.

It’s frightening and exciting – might there be no need at all for brick and mortar physician offices?  I think it’s very likely.

What are your ideas about the medical office of the future?

I heard something this morning on National Public Radio (NPR) that really got me excited – a very short snippet from Tim Brown about a project he’d like to work on – his vision of the electronic medical record of the future.  I think it’s worth 3 minutes of your time to listen to how his team has been working on health care problems, the key to the creative answers, how to get buy-in and what he would really love to to get his hands around.

Listen here.

I invited readers of MMP, colleagues on LinkedIn, and Tweeps (friends on Twitter) to comment on my post “101 ideas for Increasing Revenue and Decreasing Expenses.” I’ve listed their ideas below and hope you’ll chime in on the comments with even more ideas!  Thanks to everyone for contributing.

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David Kirkup

Partner at B2B CFO® – Experienced CFO for Rent. Fast, Effective, Affordable.

Consider adding a part-time CFO to the mix. Many medical offices have very weak financial capability or understanding. Assistance can range from better financial reports, capital expenditure analysis, budgeting and exit plans.

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Bobby Jones

Eastern Region Sales Manager – Billing Tree

1) Build a relationship with the patient before he/she leaves the practice.
2) Make sure they know you are expecting payment on the portion they owe, and when you are expecting that payment.
3) Let them know what your process is for collecting, and when they will go to an outside agency.
4) Enable a web site to take payments 24 hours a day.
5) Set up an IVR system to take phone payments after hours.
6) Communicate your available payment acceptance methods in writing, on the phone and every time you speak with your patients.
7) Send the invoice or statement when you intend to send it.
Re-inforce the payment acceptance methods on the first and any subsequent invoices.
9) Adopt a plan for following up with any patients that don’t pay after 10 days.
10) Get email addresses from all of your patients and their permission to contact them in that manner.

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Sukrit Tripathy

Sr. Product/Process Trainer and EDI Implementation Consultant

One suggestion would be to integrate the revenue cycle mangement function with your clearinghouse {for electronic billing} with integrated solutions like Coding database and Updates, Industry Broadcast, Performance and Audit reports for Claim Edits, Transmission and Rejects. Also, better training resources for billing staff actively into the practice management system.

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Barbara Rotter

Consultant at Pacific Women’s Medical Group

I would add effective cash management (even if interest rates are so low).

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Michael Glass

Medical and Business Consultant at Transworld Systems

Utilize a Flat Fee Collections Agency for Non-responsive Patient Pay concerns.

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Randall Shulkin

Principal Consultant – Culbert Healthcare Solutions

- Do you collect co-payments on the way in rather than on the way out?
- Does your PM/Scheduling system show the patient co-payment and outstanding patient balance in the appointment screen? If not, then can you download a listing for your front desk staff?

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Denise Price Thomas

DPT Healthcare Consulting & Training

I’d like to add “acknowledge the patient with eye contact” and offer “polished customer service” and they will WANT to return = return on your $ $

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Stacy Mays

Managing Partner, Dynamic Grape Companies

One other thought… don’t be afraid to try new technology. For example, one of my clients has developed a kiosk that allows patients to take their own weight and bp and electronically feeds the data into their EMR. The whole set up costs about $3500 and can save a ton of staff time. Tele-health in general should also be considered.

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Angela Short

VP at Operations

If you select a reasonably priced EMR and you implement enhancements then you more than save on staff cost. Keep in mind that my practice rolled out the EMR five years ago, so we have had time to get it right. Here are some of the savings/revenue opportunities:1. We utilize our electronic technology to send text messages and emails to our patients to remind them of their appointments. This function alone saves my practice one FTE. Not only do we save with staff time we improve patient satisfaction, as our Blackberry users loves the email or text that they can directly add to their calendars. The revenue enhancement to this function, we decrease no shows and lag time in our physician’s schedules.

2. The robust reporting within the EMR allows the organization to assemble important quality measures that we use in contract negotiations. Without the EMR this would be a labor intensive task.

3. We are able to push a secure message to our patients regarding their pathology results saving staff time on the telephone and increasing patient satisfaction by eliminating a visit just to obtain a normal result.

4. No more chasing charts for a phone message. My call center takes ALL clinical messages. This is attached to the patient’s electronic chart and routed to either a nurse to respond or a physician. This process greatly reduces staff time, decreases the time it takes to respond to the patient’s issue and provides a legal record of the telephone call which is often missed in a paper environment.

5. We receive a discount on our mal-practice insurance because in an electronic environment it is guarantee that your notes are legible.

6. The formulary function built into most EMR’s provides the physician will a real time snapshot if a prescription that he/she is about to write is covered by the patient’s health plan and provides alternatives if available.

I have just highlighted only a couple examples of the administrative benefits. There are many more. It is tough to imagine going back to a paper chart.

I have done the math and we could cover our current EMR with the incentives offered through the government initiative.

I will comment that physicians need to be trained on how to use the EMR. You can lose site of the patient and focus the entire visit on the computer versus the patient, however, we teach our physicians that the patient first and then chart completion. We conduct patient satisfaction surveys and I rarely receive a complaint regarding the physician’s time at the computer. I do however, receive praises from patients regarding the ePrescribe as it decreases their wait times when the arrive at the pharmacy, the prescription is ready.

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Okay Readers, it’s your turn – what’s your secret weapon for increasing revenue or decreasing expenses?

Mary Pat

I have been a fan of Chris Brogan’s for quite awhile now.  He is a superstar on the social media landscape and I almost got to meet him once when I lived in Seattle (sigh.)  Today I came across his post  “5 Things That Small Businesses Should Do Now.”  Many medical practices are small businesses (privately owned and operated, with 100 employees or less), but may have not considered any of these options.

Here are Chris’s suggestions and my commentary:

• Start a blog – I can’t think of any simpler website technology to start and master, and there are cheap and free platforms readily available. Why a blog? Because they’re easy to create, because they’re easy to update, because they encourage repeat visits, and because you can use them in many flexible ways.

My comment: Most practices have websites and it is easy to add a blog to a website.   Some administrators and/or physicians would gladly take on a blog, and if not, there are some great writing professionals who can create and write a blog for you.  Professional bloggers get to know your practice and your patient demographic and create a voice for your practice that uniquely fits you.  A blog extends and enhances your relationship with existing and future patients. It’s all about the communication.

• Start listening – People are talking about you. Find out where they are and who they are.

My comment: It has been hard for physicians to come to terms with the fact that patients are publicly rating them. In some cases, physicians are requiring consumers to sign gag orders before becoming patients.  The truth is, patients will not be stifled and physicians need to monitor the bandwaves for commentary about them and take it seriously.

• Try Twitter OR Facebook – Let’s not rush things. Facebook has many more users, but it’s a bit harder to find customers, prospects, partners and colleagues. Twitter is easier to use and faster to connect with people, but there are far fewer users on there today. I’ll let you choose. If you go with Facebook, make a personal account under your own name, and then start a fan page for your business.

My comment: Does this seem too far out? It’s not! At the very least, practices should be learning about the technology and preparing for the time when they will need to jump in.  Businesses (who want customers) can no longer hold themselves aloof. You need to be part of the conversation, or at least know where/what the conversation is.

• Get the word out – If you’re going to spend time building these social sites, let’s presume that you want more people to contact you and interact with you through them. Print business cards with the company name, and/or the request for people to join your fan page or follow you on Twitter.

My comment: Your website and your social sites should be on everything you print that patients take home or receive from you, and can also be communicated to patients via automated communication: appointment reminders, messages on hold, emails, and electronic newsletters.

• Try moving the needle – now lets really get crazy. See if you can fill the place up with social-media minded folks. Okay, this won’t work for every business, but don’t be too quick to count out the idea. Let’s try inviting them to a store-only special event, or let’s give them a discount code. You know, the stuff you already know how to do. Any difference in the results? See if you can do some kind of really special one-day-only push, and what that brings to you.

My comment: This won’t work for every medical practice but it’s ideal for practices with elective services – plastic/cosmetic surgery, allergy, complementary & alternative medicine, sports performance, vision correction, cosmetic dental services, infertility treatment, etc.