Posted by CEP America on Tue, Mar 16, 2010 @ 06:20 PM
By Michael Harrington, CEO, MedAmerica
As the healthcare reform debate continues, the overall complexity of our country's healthcare system seems almost overwhelming. Many healthcare organizations, physician groups, administrators and physicians are frustrated and unsettled by the pending sea change in how the government will fund and support our myriad healthcare programs.
Navigating the healthcare maze is challenging enough. But with total healthcare spending predicted to reach a staggering 20% of the entire US economy by 2017, and with per person healthcare expenditures looking to double during the same period, physicians and medical professionals will be hard pressed to spend quality time with their patients - adding to increased concerns about healthcare quality and safety.
That's why I firmly believe that the importance of a qualified, third party practice management organization has never been greater. To illustrate my point, I've identified the top 5 benefits a practice management organization can offer to health administrators and physician groups:
- Deep understanding of your business - The strength of a practice management organization is that you are working with a team of experienced professionals who understand the healthcare industry. You'll work with people who truly know and understand your business, and will treat you like a partner.
- Efficient and cost effective - Because a group offers comprehensive management specialties under one roof, you'll be able to take advantage of an array of management solutions without having to shop around to several consultants or smaller firms. This "one-stop shopping" approach increases overall efficiency and cost effectiveness.
- Collaboration - Collaboration ensures open lines of communication and a healthy sharing of ideas that lead to high-performance solutions that work for your practice. A practice management organization should be completely in sync with your unique needs.
- Technology - The benefits of a larger practice management organization include Information Technology services that are right for your needs, vs. a cookie cutter approach that may not serve your best interests. Looking toward the future, technology will be playing an ever greater role in maintaining a successful practice.
- Financials - having access to a full scope of financial, billing, reporting, benefits administration, etc. enhances the profitability of your practice. The best practice management firms offer these capabilities and take the burden off of you and your practice to keep up with ever-changing State or Federal mandates.
The bottom line is the healthcare industry isn't going to get any less complicated. The right healthcare practice management organization can really make a difference in running a successful practice. And as I like to say, it allows doctors to do what they do best - practice medicine!
Have any opinions on practice management groups? I'd love to hear them!
Posted by Guest Blogger on Tue, Dec 15, 2009 @ 01:45 PM
By Dan Culhane, M.D.
As published in a recently published story, Texas state health officials are discussing the merits of changing a requirement that Texas emergency rooms have a physician on-site at all times, as long as a physician can get to the hospital within 30 minutes.
According to the story, the proposed change would ease financial strain on small specialty hospitals. These facilities are required to have emergency rooms, yet they have very low emergency room traffic.
On the face of it, the proposed change makes financial sense. Why should a hospital with very few ER patients have to pay for on site ER physicians 24/7?
But opponents say the proposal would create risks for patients coming to emergency rooms with the need to see a doctor immediately. What's more, there's the fear that hospitals trying to avoid costs would eliminate on-site ER docs to avoid uninsured patients - and instead specialize in high-dollar/high-profit surgical procedures.
My view on the proposal is that the status quo requires all hospitals to provide emergency services, and thus spreads out uninsured and underinsured patients. In the absence of a system that provides health care for a higher percentage of Americans, I'm in favor of spreading the care for the uninsured around.
This issue might be less contentious if we provided adequate coverage for more of our citizens. If everyone had quality coverage that provided for emergency care I suspect this would be much less of an issue.
I look forward to your comments.
Posted by Guest Blogger on Fri, Dec 04, 2009 @ 04:58 PM
By Christy Palombo, RN
Seems like every day there's a new challenge concerning H1N1. For those of us in emergency medicine, it's important to take note. Is the hysteria starting? Are ER's about to be hit by an onslaught? Are people listening to us and staying home if they're ill?
On Thursday, an article published in the Washington Post stated that people may be able to spread swine flu even after their symptoms have subsided.
This comes from a recent study of Air Force cadets who came down with the flu this summer. It was found that a large number of the cadets were still "shedding" the virus more than 24 hours after their fever and other symptoms had disappeared. You can read the full report here: American Journal of Preventive Medicine
These findings bring into question whether people are listening to what we've been telling them, most importantly, staying home if they have flu-like symptoms (such as fever, sore throat, cough, etc.) instead of going to work or school and spreading the virus to others. If transmission is still possible after symptoms have gone, it could be bad news if individuals are returning to work or school too soon.
Because of swine flu vaccine production delays, the government has backed off initial estimates that as many as 120 million vaccine doses would be available by mid-October. As of last week, only 11 million doses had been shipped to health departments, doctor's offices and other providers across the country, according to the CDC.
All of which means, unless current behavior patterns change, there will be a lot of sick people heading for their local ER. My view is that medical professionals and the media need to get the word out to individuals and employers that staying home if you feel sick is the best medicine. It's clear that there will always be those who try to power through whatever illness they have, but it's also clear that the H1N1 pandemic is not business as usual. Behaviors need to be modified, and we need to make sure that message is getting out to the public. That's what I'm attempting to do here.
I welcome your thoughts and ideas on the topic - please ensure that your voice is heard!
Posted by Guest Blogger on Thu, Dec 03, 2009 @ 05:08 PM
By Nancy Burghart-Hall
With the ever-increasing demands put upon this nation's emergency departments, the challenge of implementing information technology has never been greater. And the challenges will continue to grow if the H1N1 pandemic comes to pass.
During "normal times", IT is touted to enable an ED's administrative and managerial systems to function more efficiently. In addition, software vendors tell us how clinical applications can lead to systems that more quickly capture patients' data into an electronic medical record - including the diagnosis coding, medications, and discharge summary. However, practical experience is showing us different, and the administrative overhead added to the workload by information technology often times slows down a productive ED.
Taken a step further, what will happen during extraordinary circumstances like a natural disaster or the predicted H1N1 pandemic - both of which create an onslaught of new patients?
Will our information technologies prove themselves as useful tools to help keep emergency rooms from being overwhelmed, or will our systems be even more disruptive and clog the ED during times of stress? Will your ED be able to effectively manage a pandemic using your current IT infrastructure?
The answer is "probably not". In which case, I have a couple of suggestions that are not necessarily "high tech" but have been shown to be helpful in expediting the online documentation and EDIS systems process.
Scribe programs:
A scribe is "a physician collaborator who fulfills the primary secretarial and non-medical functions of the busy emergency physician." Scribe programs have been shown to benefit ED doctors and their patients tremendously, expediting the ED process by as much as 30%-40%. During times of high stress, having a scribe program in place can be beneficial. For a thorough overview of how scribe programs work, visit: http://bit.ly/30wWLi
Voice Activation:
Medical records serve many crucial purposes. Besides a description of the clinical scenario and therapy, they serve to justify care to insurance companies and managed care organizations. It's important to note that hospitals and physicians are paid not by what they do for the patient, but how well what they do is documented. Voice Activation can support the documentation process, creating a higher quality chart.
So during a pandemic, how can an emergency physician quickly generate a comprehensive, accurate and legible medical record? Both Scribes and Voice Activation are tools to help you do this.
Is your ED's IT infrastructure up to the task? I'd love to hear your thoughts and learn about the systems you have in place. I'm also happy to share more information - just ask!
Posted by Guest Blogger on Wed, Dec 02, 2009 @ 01:40 PM
By Wesley A. Curry, M.D.
It's always of interest to read about large studies on the performance of emergency rooms that see over 120 million patients a year, and serve as the nation's health care safety net. The recent survey report from Press Ganey 2009 Emergency Department Pulse Report: Patient Perspectives on American Health Care helps to spotlight a major concern every person has -"will I or my loved one be seen by a health care provider and treatment started in a timely manner?" The report focuses on "average wait times" but in my opinion, averages don't tell the whole story, since there is a significant disparity between emergency rooms across the nation.
Why do we dwell on the average and not the best performances and worst performance by emergency rooms across the nation? I think the public would want to know, and the news media could better serve the public by pointing out the good and the bad performers.
I agree with the conclusions of the survey, that patient satisfaction is related to the length of time patients wait to be seen in the emergency room. The CDC reported average emergency room wait times of 55 minutes in 2006. We can only presume that wait times have increased since then for 2007 and 2008. So if the average wait time to see a provider in the ER dropped only 15 minutes from that, patients across the country would save more than 30 million hours of waiting, pain, and suffering.
If the time to provider (TTP) and turn around times (TAT) for admitted and discharge patients were required reporting for emergency rooms, consumers could more easily judge which emergency room is providing timely service. These operational metrics are excellent indicators of efficiency and quality, and we know strong performance in these areas also drive market share and revenue, something every hospital is concerned about today.
For example, in our large emergency physician practice partnership - with 3 million patients in 65 hospitals across seven states - we have seen a drop of 14 minutes in the time to provider. This is 14 minutes off a time to provider which was already 15 minutes below the average wait time of 55 minutes according to the results reported in a 2006 survey by the Centers for Disease Control (CDC). This is an indicator of improved efficiencies which have greatly increased patient satisfaction.
We can no longer blame uninsured patients and lack of reimbursement for long wait times. Nor can we keep blaming the nurses or the emergency physicians and lack of staffing. What is in short supply is effective physician, nurse, and administration leadership to address emergency room overcrowding issues.
We know that using the same emergency physicians and nurses - but changing the emergency room management and patient flow systems - can transform a poorly performing emergency room into a high performing one. And it can be done without significant capital expenditures. So let's have those who have achieved exceptional performance metrics speak up and challenge the media to get the real stories out about what's working well, not just what's the "average". Patients can then make an informed choice and will vote with their feet and choose the ER that makes them wait less. And we will all be the better for it.