Have we Outgrown our Technology?

January 8th, 2018 Posted by Healthcare Revenue 0 thoughts on “Have we Outgrown our Technology?”

We get this question a lot from provider groups in the middle of a growth phase. Often, they are already using systems for billing and electronic medical record (EMR), and they are not sure what processes could be improved, and if there is a business case to improve them.

Over the years, we’ve identified a number of clear indicators that it’s time to invest in technology. This can be in the form of implementing a pre-existing Software-as-a-Service (SaaS), implementing a platform solution, or developing a custom software solution. We’ll elaborate in an upcoming post on which of the 3 solutions is the right fit for you, but for now let’s focus on the “smell test” of determining if there is a need. Some are oblivious, while others are more subtle.

1. Mountains of Paper

If your processes involve a lot of data collection via paper, and then workflows on that paper, it’s time to look at a solution to reduce the volume. This is very common with practices where the provider is seeing the patient without access to a computer or tablet.

  • Errors – Any paper-based data collection is prone to errors and omissions.
  • Redundant Data Entry – Some or all of the data collected will need to be digitized.
  • High Cycle Times – Your process only moves as fast as paper.
  • Labor Intensive Reporting – If your work orders are on paper, someone has to manually count them every time you want to know how many are open.
  • Lack of Visibility – Until the information gets into the system, it might as well not exist, which means management is always a day behind in a real-time world.
  • HIPAA Risk – access control can be a real problem if your records are stored in a paper format.  Rarely do you have an “access log” of employees looking up records in a file cabinet.

2. Field Employees Stuck at Desks

A company pays field employees, such as nurses doing home health care, to be in the field. If they’re wasting time trudging back to a computer to do double bookkeeping, they’re wasting double money.

  • Errors – Working after the fact from memory or handwritten notes inevitably leads to bad data.
  • Morale – If they came to work for you in the field, they’re probably happier and more productive there than riding a desk.

3. Email is your electronic Order System…Wait, What?

One thing we actually like about paper is that at least you know there’s one copy of Order #89348. When everything is ‘electronic’ but sitting on a File Share you have all the problems of paper and even more problems with version control. We see a lot of organizations that have grown up using email to move documents around and rely on convention to know where the right versions are. This works alright for a small team where everybody is on the same page and knows the conventions perfectly, but it doesn’t scale, doesn’t support automatic business logic, and doesn’t support real-time data analysis.

4. Administrators Don’t Have Real-time Access to Key Performance Indicators

If a department head can’t see the RVUs being produced or the office manager can’t easily see how much of next week is booked up then we have a problem.

5. Siloed Software Systems

Using an EMR for tracking patient records? Great! Have an awesome online appointment request form? Fantastic! Using an accounting system that most CFOs would drool over? Awesome! Are they connected? If not…

  • See Paper List Above – You are now subject to some or all of the issues with paper-based processes.
  • Conflicting Data – Does the data in your systems match? Oh, you need three days to reconcile? It’s okay, we’ll wait, but will your competition?
  • Morale – Nobody enjoys spending 10 hours per month turning timecards from your Operations system into identical invoices in your accounting system.

Note: Use of MS Access databases tend to result in very siloed systems. When you have a small workforce these databases are invaluable but as the business grows, the Access databases tend to grow very poorly with it.

6. Cost and Revenue Grow at the Same Rate

If a practice has a goal to double revenue, it is reasonable to expect approximately a double in the amount of cost of providers to create that revenue.  In addition, in an organization where the processes are manual, also expect to have to double overhead/support labor.  It’s this latter cost that can be contained via better technology.

We hope this gives you some things to think about. If there’s anything we can do to help, don’t hesitate to reach us here!

Purchasing an Existing Healthcare Facility: Things to Know Before You Commit

November 14th, 2017 Posted by Healthcare Facilities 0 thoughts on “Purchasing an Existing Healthcare Facility: Things to Know Before You Commit”

For healthcare services providers, buying an existing facility might be an easy way to expand services and increase market presence, but there are a number of critical questions you should ask before committing to such a purchase. With today’s constantly changing healthcare regulations, some of the biggest issues often encountered when acquiring an existing facility are related to licensing. Under certain conditions, these can end up being deal breakers.

The best way to avoid getting too far into the purchase process before discovering one of these deal breakers is to have a knowledgeable design professional perform a facility evaluation. Although a prepurchase inspection is typically done as a part of the due diligence process when assessing any potential real estate purchase, those types of inspections are not geared toward regulation compliance or suitability issues, they’re generally just an evaluation of the building envelope and infrastructure. When it comes to medical facilities, not only do you need to know the physical condition of the building and its mechanical, electrical, and plumbing systems, but you also need to know whether it can support your mission. That is, can it be used in the way you intend to use it? And if not, can it be modified to meet your needs? If it can, how much will it cost and how long will it take? These are a few of the questions that can help you quickly determine whether or not to pursue the purchase.

Let’s say you’re contemplating the purchase of an Ambulatory Surgical Center that has been unoccupied for some period of time. The facility appears to be in relatively good condition and it certainly meets your needs for expanding your outpatient surgical capacity. You intend to occupy the facility as is, and aside from a fresh coat of paint on the interior walls, you anticipate that it will require little to no work prior to move-in. After all, it was used as an ASC for many years and your plans are to use it the same way. You decide to move forward with the purchase. Later, while preparing to occupy the facility you learn that the change in ownership has triggered a full healthcare facility compliance review by the state. As it turns out, the facility was originally designed and built under regulations that have since been updated. In order to comply with the new requirements you’ll need to undertake a costly renovation to increase some room sizes and replace some of the HVAC equipment. You’ll also need to provide some additional spaces that weren’t required under the old regulations, and these spaces cannot be accommodated within the existing building’s footprint. The only option for providing them is to add on to the building. When you update your pro forma to include these unexpected construction costs along with the delay they’ll cause in occupying the building, the feasibility of the purchase becomes questionable.

So how did a facility purchase that seemed so promising at first go so far off track? Unfortunately, situations similar to this aren’t that uncommon. But, had a facility evaluation been performed prior to proceeding with the purchase, you would have been aware of the challenges involved and the additional costs associated with them. That information would have certainly been of value when you were negotiating the purchase. Because healthcare facilities are some of the most highly regulated building types that exist, and the complex codes and regulations they must comply with are continually changing, it’s difficult to know whether a facility, once it changes hands, can be used in its current configuration or if major revisions will be necessary.

Putting a healthcare property back into commerce can be complicated. Before you make a purchase offer you should always include having a facility assessment performed as part of your decision support process.

These are typically provided by healthcare architects and can usually be combined with a traditional prepurchase building inspection. While the inspection will focus on the condition of the various existing building elements, like the exterior skin, roof system, and mechanical/electrical/plumbing systems, the assessment will address the building’s planned use, even if that use will remain the same. One advantage to having a healthcare architect perform the evaluation is that they’re not only experts in the codes and regulations that apply specifically to healthcare facilities, they’re also well versed when it comes to local zoning requirements, which can be critical when developing options for a potential building expansion or renovation. Zoning requirements can limit building expansion opportunities because of floor area ratios and setback requirements, or because the expansion will reduce the number of parking spaces below a required minimum. These are some of the things your architect will assess and provide guidance on. Should it be necessary to do even minor work to the building, you’ll want to have some idea about the costs and the schedule for completing the work. Your healthcare architect can provide budget and schedule assistance, and can help give you a more complete picture of the overall financial and time investments you should anticipate.

How Can Social Media Help Your Hospital?

November 14th, 2017 Posted by Healthcare Revenue 0 thoughts on “How Can Social Media Help Your Hospital?”

Social media is making a big impact in the healthcare field, but when it comes to hospitals, there’s no one-size-fits-all approach. The techniques that work in other industries don’t always translate to the medical field. Here are some tips on how you can make social media work for your hospital.

  1. Be mindful of interacting with customers. – It’s important for all of the healthcare professionals in your network to understand what is and isn’t okay when it comes to speaking with patients over social media. A social media policy that will protect patients’ privacy and create guidelines can help employees understand whether it’s appropriate to friend, follow or otherwise communicate with patients outside of work.
  2. Monitor feedback closely. – In today’s world of instant feedback, it’s easier than ever to gauge public perception of your brand. When it comes to a hospital, it’s crucial to maintain an honest and dependable image to attract potential patients. Social media monitoring can help you understand how your hospital is being viewed and how your organization is being placed in the conversations of your patients.
  3. Create engaging content. – More people than ever are turning to social media for medical advice. This is an unprecedented opportunity to build goodwill for your brand within the community. Even for the medical community, compelling content is king– use of hashtags, pictures, videos, and infographics –  will capture the attention of your audience and make a long-lasting impression.

9 Vulnerabilities Medical Practices Create Themselves

September 13th, 2017 Posted by Healthcare Revenue 0 thoughts on “9 Vulnerabilities Medical Practices Create Themselves”

Unfortunately, many medical practices proverbially-speaking, shoot themselves in the foot, and create vulnerabilities themselves, which open them up to potential cyber-attacks and HIPAA violations.

Fortunately, most of these vulnerabilities can be prevented with small changes in mindset, culture, and processes.

9 Vulnerabilities Medical Practices Create Themselves

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HIPAA 101

September 1st, 2017 Posted by Healthcare Compliance 0 thoughts on “HIPAA 101”

HIPAA dates back to 1996 and stands for the Health Insurance Portability and Accountability Act. At first HIPAA’s regulations were vague and with little to no enforcement. That changed in 2009 with HITECH Act (Health Information Technology for Economic and Clinical Health), which was part of the 2009 American Recovery and Reinvestment Act. This act charged the Office of Civil Rights (OCR) to enforce HIPAA’s policies with a minimum penalty of $50,000 and the law even states that “a medical entity’s reasonable lack of knowledge of a violation…is no longer accepted.” In 2013, HIPAA’s reach extended to companies working with medical entities, known as Business Associates (BAs).

Who Does HIPAA Regulate?

Any business that creates, stores, edits, or transfers Protected Health Information (PHI) must comply with HIPAA regulations. HIPAA defines PHI as:

  • Is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse.
  • Relates to the past, present, or future physical or mental health or condition of any individual, or the past, present, or future payment for the provision of health care to an individual.

ePHI is the electronic version of PHI, known as Electronic Protected Health Information.

HIPAA breaks businesses into two categories:

  • Covered Entities (CEs)includes health plans, clearinghouses, and providers (doctors, clinics, psychologists, dentists, chiropractors, nursing and hospice homes, and pharmacies).
  • Business Associates (BAs)any company that comes into contact with PHI, including an IT firm, shredding company, document storage company, attorney, accountants, collection agencies, EMR (Electronic Medical Record) companies, data centers, transcriptionists, and many more.

HIPAA also requires all CEs to have a BA Agreement (called a BAA for short) with each Business Associate they work with directly.
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