What is your practice’s smallest problem? WHAT IS YOUR BIGGEST PROBLEM? .
What is your practice’s smallest problem?
WHAT IS YOUR BIGGEST PROBLEM?.
Outsmarting the GeeksHow medical managers can optimize time, money, and tech!
Camille A. WilliamsAdministrator, ENT ASSOCIATES OF SOUTH ATLANTA;HEALTH & TECHNOLOGY RESEARCHER & EDITOR;
CERTIFIED NEUTRAL/ MEDIATOR, USA
What is "Outsmarting a Geek?"
Simple phrase for knowing enough NOT to get taken advantage of
AND
To get your best options on all transactions.
PURPOSE OF THIS PRESENTATION
Prepare the medical manager to take advantage of technology without high price tags and/or frustration.
To provide thorough understanding of technology options for everyday use.
To answer questions about new technologies and their value to the medical practice.
MY MOTTO
CHEAP IS CHIC
It doesn't matter if you're a one-doctor shop or 100 physicians strong, there are affordable, scalable solutions for almost any aspect of your practice. Fortune 5 - 500 companies use these solutions to cut their expenses.
Why shouldn't you?
AREAS OF IMPROVEMENT
Personnel
Telecommunications
Patient Interaction
Office Hardware
Staff Training
Accounting
Administrative Tasks
Practice Income
Myth vs. Truth
Common myths regarding technology, medicine, and the digital age
Myth #1
Only an IT (Information Technology) professional can work on, maintain, or fix a computer system.
Truth #1
Computers, like Virginia Slims (TM), have come a very long way baby! Most computers can be successfully maintained by someone with a two-page manual.
Myth #2
The more I pay for the computer or system in question, the better the quality system I'll get.
Truth #2
Not necessarily. In technology, the rate of positive change is about 90 days. For example, wait 3 - 6 months after Christmas and the fully-loaded TV or computer you want can be found at a 30-60% discount. Patience, even a little patience, is a virtue.
Myth #3
All the salespeople and practice magazines say that without new technology my practice will fall behind the times, so I should buy whatever is on the market.
Truth #3
Put down the order form...The truth is that technology is a tool. Matched well to your needs and talents, it's an effective tool. Poorly matched, it's a hassle.
Example of Truth #3
Grandma's Computer:
A very nice clothes stand. Too much computer!
POP QUIZ!What is Cloud Computing?
Answer:
It's Internet-based computing, where Shared Resources, software, and information are provided to computers On Demand, like electricity.
Defogging Cloud Computing
You are already using Cloud Computing in your everyday life if you do any of the following:
1. Use a search engine. Google anything lately?
2. Check email online.
3. Buy a website name online.
4. Shop on eBay, Target.com
5. Enjoy a little Farmville or online Poker
How can a manager use this?
Example #1
Traditional Word Processing: Office buys Microsoft Office for all computers. Each computer has a license, but two are included per disc. Each disc of 2 licenses is $300. 7 computers = 3 licenses needed3 licenses x $300 = $900
Using The Cloud Alternative:
Online Document Management & Calendar from Google. Linked to email account, includes word processing, spreadsheets, presentations. Accessible anywhere with internet access. No license, no maintenance.
$50 per user per year for Enterprise Solution, otherwise...
FREE
How is Money Generated if it's Free?
The good old-fashioned way: Advertising!
Think of Cloud Computing as Free Television: ABC, NBC, CBS
Traditional Computers and Networks, by comparison, are Digital Cable.
What about Security?
Security in Cloud Computing
First, you should know....security is a concern whether your information is stored on a disk, in a chart, or on your email account.
Passwords matter!
The Cloud…
Compared with a "Legacy" system
Less Equipment to replace
Nothing to “walk out of the door”
Track access of each user
Restrict access for each user
Multiple backups in multiple regions of data, information
What Camille Did...
Briging Cloud Computing into a Small-to-Medium size medical practice
Simplicity is the Ultimate Sophistication
~LEONARDO DA VINCI
First, I decided to stop purchasing...
What if you never bought another computer license...ever again?
What if you never paid for another Software Update? Or, better, never waited through another Software Update?
=
Practice Priorities
Budget
Electronic Health Record
Improve/Increase Services for Patients
Communications
Security
BUDGET Target Big Ticket,
Recurring Expenses: Staff, Telephone, Clerical Supplies
First Target: Telephone
Our average 2008 Telephone & Data bill was $2000 per month, for two offices.
$24,000 per year.
Downsides: Could not transfer calls between offices, no caller ID, manual forwarding to answering service, no way to track call volume (relevant to the staff expense)
Went "into the Cloud"
Chose a new Telephone Service Provider After careful research, chose two Enterprise Voice-Over-Internet-Protocol (VOIP) providers to trial.WHAT IS VOIP?
Phone service over the internet
VOIP on a Budget
Auto-Attendant
Advanced Voicemail
Custom Messages
Online System Management
Flexible Routing
Custom music on hold
Detailed call reports
Conferencing
Caller ID Call Waiting Call Forwarding Find Me/Follow Me Call Transfer Voicemail sound files
New Monthly Telephone Bill?
Telephone: $300 per month for two offices
Data: $400Total: $700 per month or $8400 per year
One-time investment in telephones: $1600 New annual total for service after phone purchase:
$8400
$24,000 - $8400
=
$14,000saved in 2009 on Telephone & Data,
more features, more control
Thin Clients & Simple Servers
1 – regular PC = $1200
7 Thin Clients for the two offices = $1400
Splurged on new monitors @ $100 apiece = $500
1200+1400+500 =
Total Cost: $3100 to update computers in two offices, used by 7-10 peopleBy comparison, we could have spent $8400 + software
Savings: $5300
Control over each terminal use
Control over websites
Documents
Communication
Software License: 1
No more wondering what websites the staff visit. I can look at each user's log of activity and limit access as I see fit.
No expensive Firewalls, or software.
Why is it important to control use?
It’s super easy to download a virus that can – and will – infect every single computer
Anyone using email can open an attachment or have one open automatically if the virus is programmed to do so
Bad Examples: One employee used to stream sermons from her church to listen to at work. That activity crashed our system with a Trojan Horse virus.
I once overheard an employee brag that she still kept tabs on her old office by having all emails sent to her account – first! She was locked out of our system before the ink on that pink slip cooled!
Cut the charge by 75% on our PM Software, which we paid for by license = $1500 savings in one year
Finally, after a 6 year search...
With prices ranging from $50,000 per license
To $650 per month + a “$2000 set-up fee”, per physician
My practice has converted to EMR...
FOR FREEwell, okay, I bought
the doctor a tablet computer
The Beauty of the Cloud
No Installation, we just log on from any computer
ePrescribe - with the Medicare incentive
Fully Functional in Five Minutes
Secure
Intuitive
No Training Expenses (all videos on YouTube!)
Oh yeah, and we are eligible for Federal Funds...
CRITERIA
1. Affordable - I can give an educated guess to the costs of most EMRs and they are grossly overpriced
2. Easy-to-Use - If it's harder than email, it's a disaster for me and my doc. If I require 40+ hours of training, the product is not EASY or well-planned. 40 hours of training = $6000!!!
3. Web-based - I am not buying and maintaining equipment.
4. Customizable - I'm picky, so is my doctor. Over the years of evaluation we've gotten very specific.
Added Bonus: No smarmy salesperson who knows less about EMR technology than I do and just wants to make numbers!
SecuritySecure
Bank-level encryptionBackups, redundancy, biometrics, disaster recovery Fortune 500 security for the small officeService Level Agreement (SLA) guarantees uptimeYou maintain ownership of your data
Traditional vendors Cannot guarantee security at any level with onsite installations
Protocols, uptime/SLA, redundancy, audits (practice’s responsibility)
About Practice Fusion EMR
Who is Practice Fusion?Founded in 2005Largest and fastest growing EHR community
Over 40,000 users in all 50 states400% community growth in 2009
Backed by salesforce.com and the original funders of Apple
Premier EHR for offices under 20 practitioners
EHR Incentives
Economic stimulus incentives - $44,000 Practice Fusion guarantees HHS certification Providers can qualify for $44,000+ for using an EHR system Only Practice Fusion enables you to pocket the stimulus
funds Learn more about the stimulus plan on PracticeFusion.com
“You guys are truly an example of progress and forward thinking for the second decade of the 21st century and web 2.0 in medicine. Keep up the great work!“ – Dr. Pina
SUNSHINE AMIDST THE CLOUDS
The HHS vision for health IT can’t be achieved with client-server installation. The purpose of Washington’s $19 billion investment is to make health data portable and interoperable. Immunization registries, Personal Health Record systems, research for public health, emergency-access health data, patient driven mobile health devices – all this is powered by web-based EHR platforms where health data is no longer locked in silos.
Other Cloud Uses
"Information Workers"
*Hired an RN in Indiana to get surgery pre-authorizations*Hired team in another country for live phone reception *Regularly hire online for contract review & document creation (at fraction of the cost)
FINANCIAL MANAGEMENT
Create practice budgets
Analyze debt/ plan repay
ROI of Purchases
Break-Even Analysis
Revenue Projections
Calculating Expenses
Weekly Bookkeeping
Increasing practice income
Payroll – Save 60% or More
Old Payroll service charges:
*Minimum $150 per month Additional charges for filings Additional charges for bonuses Annual charge: $1800
New payroll company? $55.00 a month, no extra feesAnnual Charge: $660 Added bonus: web-based time clock to calculate payroll
Savings: Over $1100 per year, with more options & control
Resources for Research & Change
EHRbloggers.com - EMR
VOIPReview.com - Telephone
Dinkytown.com - Finance
Paycyle.com - Payroll
Weebly.com – Fee Websites
Lifehacker.com –Useful ideas
eLance.com - Freelancers
THANK YOU!I'll take questions if there are any...