Hot Topics Blog

Feature your practice on Facebook

2009-12-22T10:28:00.001-05:00

Feature your practice on Facebook
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com

The newest forms of marketing and advertizing for your practice are here. If you are not yet using social media sites to market your practice, you may be at a disadvantage. Ophthalmologists and administrators alike have been using social media sites; such as, Facebook, LinkedIn and Twitter increasingly for personal use. Many have now branched out from personal profiles by creating profiles for their practices. While you may not reach everyone you want for your practice through just one platform, the more places you advertise and have practice information readily available, the more likely it is that it will end up in the hands of the patient.

There are advantages to using these social sites to promote your practice. Not only are these sites considered an interactive marketing tool but they also serve as a direct, real time, medium to communicate with patients. Telling your patients about your practice’s services via your Facebook page is a fast and free way to share ever-changing information. Posting your practice as a group on Facebook will give you more opportunities to appear in online searches and let you connect with patients in ways you can't via your practice's web site. Ultimately, you are encouraging visits to your own web site and making it easier for your practice to be found. This gives you increased exposure online with very little effort.

While there are many advantages to using social media sites, there are potential disadvantages as well. First off, your practice Facebook identity must be managed and monitored regularly. Frequent updates will keep information on your practice relevant and current. Additionally, poor comments or ratings could potentially hurt your practice’s reputation. Decide on a strategy early on as far as who will control and respond to any complaints or negative comments. Make sure you have a practice member dedicated to managing these types of situations to maintain a positive reputation. Furthermore it is important to be conscious of the marketing and advertising guidelines imposed by your state licensing boards along with HIPPA regulations as well. Follow these guidelines just as you would with any traditional forms of marketing.

Presenting your practice on Facebook functions to highlight services, put you in close contact with your patients and add to your practice’s market prescence both online and off

Unconventional Practices for Ophthalmic Job Seekers

2009-12-07T09:32:00.000-05:00

Unconventional Practices for Ophthalmic Job Seekers
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com

In these challenging times both employed ophthalmic professionals and those interested in positions in the industry are using unconventional practices to keep themselves current and essential. Both job seekers and employed professionals know, just as the practices’ ophthalmologists do, that it is important to continue to learn and grow. Now, along with solid education, experience, and proper certifications, professionals in ophthalmology are making a greater effort to add value to the practice and ultimately for themselves.

Ophthalmic professionals seeking a promotion or new position are pursuing unique skills. I have heard of job seekers working with a career coach to provide them with expert advice, guidance, and support. These coaches concentrate on helping the job seeker develop goals, plans, and action steps towards future employment. Additionally, there are those who enroll in intensive Spanish courses, hoping to broaden opportunities within the Hispanic marketplace. Employees who learn Spanish for business can help practices increase their: revenue, markets, patient base, customer service, and overall bottom line.

As more and more practices choose to add EMR, many ophthalmic professionals find that developing IT skills can add both to their own career advancement and marketability. Similarly, adept personnel are sharpening their soft skills. These soft skills are important in any profession or job role, and in this fast changing marketplace, can help you remain an asset.

There are plenty of examples like this and many ophthalmic professionals are choosing to remain prepared and relevant in today’s unpredictable economic cycle. Determine what areas you could improve upon, then sign up for a course, seminar or conference to help you do it.

High Demand for Optometrists in the Ophthalmology Practice

2009-11-18T14:16:00.000-05:00

High Demand for Optometrists in the Ophthalmology Practice
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com

The demand for optometrists (ODs) in the ophthalmology office is ever increasing. In his keynote address at a recent industry meeting Harvey V. Fineberg, MD, PhD, President of the Institute of Medicine, comically referred to ophthalmologists who cautioned him not to mention the “O” word. The “O” word meaning optometrists. In view of the current and future challenges in healthcare, he is advocating a more collaborative relationship between ophthalmologists and OD’s than ever before. Practice employment trends are reflecting this sentiment. Over the last 15 years the number of practices employing optometrists and/or embracing co-management has increased drastically. Whereas years ago only about 25% of ophthalmology practices employed optometrists, now about half of all ophthalmology organizations employ OD’s.

The challenge for an administrator is to identify when it is appropriate to add a new optometrist and how they will balance the OD’s role in the practice to continue to provide high quality, high value care. Most ophthalmology practices find that by adding optometrists to their staffs they are offering a more complete vision-care package to their patients, which drives up profits in the process. Overall, successfully integrating optometrists into the practice can dramatically facilitate practice growth within, while providing a professionally stimulating and financially rewarding environment for both the ophthalmologist and optometrist.

Optimal MD-OD relationships are proving to be mutually advantageous to the doctors and practices involved, allowing for increased patient flow and higher revenues while maintaining a high level of patient care. The trend is advancing towards more and more ODs in ophthalmology practices and an increasing alliance between both professions.

Staffing for EMR

2009-11-02T15:29:00.001-05:00

Staffing for EMR
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com

Upon returning from a recent industry meeting, one of the most common topics of conversation and concern was the adoption of Electronic Medical Records (EMR). While there is much planning and forethought that goes into implementing EMR, once the decision is made concerns about staffing for this project must be confronted.

The first step is to outline what the practice goals are for this process of automation. Meet with your staff and make clear to them what post implementation goals are. Once you have your current staff on board, consider any personnel needs. Be sure not to underestimate your staffing needs, especially in the transitioning process. Despite what some practices might think, EMR does not necessarily enable a work force reduction, especially in the beginning.

A practice or ophthalmic institution has several options for delegation of work. The most straightforward approach would be to invest in your current employees. Once you have discussed the choice to initiate EMR, expand the duties of those staff that are enthusiastic about the change. If your staff is willing to absorb new responsibilities, those ancillary positions such as medical records staff can be gradually phased out over time.
Addition of permanent IT staff is not absolutely necessary and all depends upon the system you choose. Larger practices that choose locally hosted systems are more likely to need a permanent IT employee. Smaller practices that use online systems could be better served by hiring an IT consultant for the initial stages of implementation. Technology consultants come with different skill sets and it is important to have a checklist for your practice. Ask prospective consultants the right questions to determine how they will complete the work.
Taking on EMR can be both an exciting and challenging experience. There are several components that lay the foundation for a smooth transition with staffing and personnel being at the cornerstone. Take time to plan and prepare with every aspect of this investment and the efficiencies and revenue generated should pay off in dividends.

Scheduling and Patient Flow

2009-10-21T14:05:00.000-04:00

Scheduling and Patient Flow
Polly Neely, pollyd@msn.com

Patient flow and scheduling are vital to your practice. There are numerous methods to evaluate this. One is to take a day where no one in your practice has schedules for the following day. This means no charts are pulled ahead of time, no preparation is done ahead of time, and there is only anticipation no expectations.

You may surprise yourself to find that you stay on task all day, inclusive of a lunch break and ending at the correct time. When we are on ready to perform, we do just that, perform! While this cannot be standard practice, it can let you know if you have the staffing, equipment and process to achieve a successful on time day full of efficiencies and quality patient care. Not to mention happy employees that work a good 8 hour day for 8 hours pay and get lunch and leave without overtime.

Having a Practice Management Consultant

2009-10-16T19:00:00.001-04:00

Having a Practice Management Consultant
Polly Neely, pollyd@msn.com

There are times when you just need that verification that the action you are about to take it the correct one. It is times like these when two heads are better than one. Having access to an on-line practice management consultant could prove to be an economical and advantageous benefit to administrators, managers, employees and physicians.

A Note About Job Promotions

2009-10-05T10:25:00.000-04:00

A Note About Job Promotions
Polly Neely, pollyd@msn.com

Most job promotions stem from excellent performance. However, are they all good moves for both the employee and/or the practice? Just because someone is good at the job they are performing, doesn't necessarily mean they possess the qualities and abilities to perform effectively in management.

Management qualities should be evaluated prior to promoting. There are times when an employee can be satisfied staying in the same position if they know they command the respect and acknowledgement that their performace is above expectations and they are a valuable player in the team of success at your practice. Consider an increase in benefits and/or salary along with keeping present position to show an employee he or she is doing an excellent job and they are valued vs a managerial promotion.

Who Gets the Job?

2009-09-28T14:39:00.004-04:00

Please welcome our new guest blogger - Polly Neely. She may be reached at pollyd@msn.com.

Ever think why two people with equal qualifications interview for the same job and one gets a job the other goes home wondering what happened? When speaking to several recruiters they say it is most times their attitude. While one asks about the benefits and days off, the other asks about job advancement opportunities and if the business is open to suggestions from employees for improvement.

Yellow Page Advertising

2009-09-25T11:52:00.002-04:00

Yellow Page Advertising, Yvonne Martin, Business Management Now, ymartin@bmgnow.com

Yellow Pages advertising please, please review what you are spending on this medium. Take the time to make sure you are listed on all the online listings and make sure to call all the cell phone carriers to ensure you are listed. It is very simple to update a listing to the cell carriers. As we are looking for ways to contain our costs this is an easy one. I am a baby boomer, I cannot even tell you the last time I looked at a phone book to find a service or provider. I look online or use my cell to get the number if necessary. When phonebooks come to the house, they go into the recycling I keep only one book for an emergency.

New Ways to Train Your Staff

2009-09-18T10:45:00.002-04:00

Yvonne Martin, Business Management Group, ymartin@bmgnow.com

Take the time to measure and train your staff. Have some friends come through the practice or enlist a business person from one of your organizations to take an objective view of your practice as a patient. We will often cut corners and then it becomes a practice having “fresh eyes” go through and give you and objective opinion will help you stay on the path of good customer service. If you have staff members who are not measuring up, take the time for some retraining, perhaps corners were cut or you were just too busy at the time they were trained.

Ideas to Find New Patients

2009-09-14T14:10:00.005-04:00

Ideas to Find New Patients
Yvonne Martin, Business Management Group,ymartin@bmgnow.com

If you cataract numbers are down, look at doing some free informational seminars at senior housing in your area. Cataract patients are shopping physicians more than ever before. If you are doing a new procedure, using a new lens, make sure that the community knows about it. This includes primary care physicians in your area. They are often the forgotten source of new patients.

Staffing Issues

2009-08-30T15:53:00.002-04:00

Staffing issues
Yvonne Martin, CEO, Business Management Group
ymartin@bmgnow.com

Look at your community for help, with the job market tighter than ever, there is the opportunity for an internship program in your practice. Get together with local junior colleges, boys and girls clubs, High schools, Chamber of Commerce, and other organizations. Train volunteers to help with various jobs within the practice. It will help ready them for the job market and provide a much needed working reference and will help with the overload in your practice and who knows…you might find just the right person for a position in your practice.

Phone Management

2009-08-23T15:42:00.002-04:00

Yvonne Martin, CEO, Business Management Group. Contact: ymartin@bmgnow.com

Are your phones being put on service to get a head start to the day or over the lunch hour?

Consider a service from the phone company to measure the volume of calls per hour, per day. I recently suggested this to a practice that was having a problem building volume for some new physicians. When they looked at the number of calls coming in from 7:30-9:00am and 11:30-1:30pm and started having those calls manned instead of sent to service, they found the schedules filled up quickly.

When you know the volume of calls per hour you can schedule your staff accordingly. Perhaps a phone staffer can be doing some admin jobs when the volume is low or they can be going through some other training within the office.

Staff Involvement in Solutions

2009-08-19T11:15:00.006-04:00

Yvonne Martin, CEO, Business Management Group. Contact: ymartin@bmgnow.com

Staff involvement is critical to problem solving. Be creative with your inclusion of staff. One idea might be to have mini staff retreats -- these can be a half day or a full day -- and they can be once or twice a year. Involve the staff in putting together ideas for the agenda and developing solutions to problems. For example, if space is an issue at your practice, let staff be involved in the process of possible extended hours and/or weekend hours. (Whenever possible it is better to expand hours instead of space and if you can have a physician and staff buy in on this the process will be much easier.) Review forms, consents, flow, and other issues. Let the staff be part of the solution to the day to day problems. You will then find there will be ownership in the resolution.

Efficiency in the Ophthalmology Office

2009-08-10T11:35:00.003-04:00

We are going to change topics for a short time. Please welcome Guest Blogger Yvonne Martin, CEO of Business Management Group, Newbury Park, CA. Yvonne may be reached at ymartin@bmgnow.com or 805-375-6611.

From day to day our industry seems to be changing. I try to always concentrate on the opportunities and stay positive. It is easy to get caught up with the things not going right -- but I try to focus on how to improve them and not tear them down.

I wanted to say a little bit about time efficiency. We speak so much about cost savings and time something we all need a little more of these days. Most practices are bombarded with sales calls. It helps not to have all of these calls transferred throughout the day to the person doing your practice marketing. Instead, make a list of the callers and give the list to the employee to call back if they are interested. If you have a vendor who calls every week (or more often) tell them that they will be called back if there is interest in their service or product.

EHR Bridge Technologies – Clinical Messaging

2009-07-23T15:48:00.000-04:00

EHR Bridge Technologies – Clinical Messaging

Emily L. Graham, RHIA, CCS-PA
ASCRS/ASOA Associate Director, Regulatory Affairs

Bridge technologies are use to fill gaps where EHR components are missing and may support cross-enterprise connectivity. One of the most common bridge technologies used to connect physician offices with hospitals, aside from systems used to order diagnostic tests and retrieve results, are clinical messaging systems. Clinical messaging systems “provide connectivity between a hospital and the offices of its medical staff members” according to Margaret K. Amtayakul, MBA, RHIA, author of Electronic Health Records: A Practical Guide for Professionals and Organizations, Third Edition. She further defines clinical messaging as the secure transmission of clinical information between organizations and across the continuum of care. Physicians can bridge technologies like clinical messaging to communicate not only with hospitals, but with other providers, patients, payers, and other health care organizations. Regional Health Information Organizations (RHIOs) also employ these technologies.

Source: Electronic Health Records: A Practical Guide for Professionals and Organizations, Third Edition, by Margaret K. Amatayakul, MBA, RHIA

Data Exchange Standards

2009-07-16T13:30:00.000-04:00

Data Exchange Standards
Emily L. Graham, RHIA, CCS-PASCRS/ASOA Associate Director, Regulatory Affairs

Databases collect and store data in an organized way, and almost all health care organizations have multiple databases. But, in order for these databases to relate, data exchange standards and vocabulary standards must be used. Data exchange standards are also referred to as message format standards or interoperability standards. According to the text, Health Information Management Technology: An Applied Approach, edited by Merida Johns, PhD, RHIA, data exchange standards are critical to ensuring that when data is being exchanged, it is being done correctly and reliably.

In the US, data exchange standards are developed by groups such as Health Level Seven (HL7), Digital Imaging and Communications in Medicine (DICOM), American National Standards Institute (ANSI), ASTM (formerly known as the American Society for Testing and Materials), and the National Council for Prescription Drug Programs (NCPDP).

Source: Health Information Management Technology: An Applied Approach, Second Edition, edited by Merida Johns, PhD, RHIA.

Regional Health Information Organizations (RHIOs)

2009-07-10T09:08:00.000-04:00

Regional Health Information Organizations (RHIOs)
Emily L. Graham, RHIA, CCS-P
ASCRS/ASOA Associate Director, Regulatory Affairs

The exchange of health information often begins at the local level through community-based efforts. According to Margaret K. Amatayakul in Electronic Health Records, A Practical Guide for Professionals and Organizations, “RHIOs are generally conceived to be regional or local/entities/groups of healthcare stakeholders, such as physicians, hospitals, insurers, patients, and community members, that oversee and support the exchange of electronic information at the local level to support care.”

RHIOs, also referred to as Health Information Exchanges (HIEs) take many shapes and forms depending on the community in which they are in. Some are very small and focus on a limited area in a city or town, or they can be encompass an entire state or region.

Practices should consider learning about existing RHIOs and HIEs, or efforts to develop them in their area, to ensure their specialized needs are being considered.

Best of Fit or Best of Breed? The Choice is Yours

2009-06-30T14:02:00.000-04:00

Best of Fit or Best of Breed? The Choice is Yours
Emily L. Graham, RHIA, CCS-P
ASCRS/ASOA Associate Director, Regulatory Affairs

Most practices will need to make a decision about whether to use multiple vendors or a single vendor for all of their health information technology (HIT) system needs. For example, some vendors have products in their suite for e-prescribing and electronic health records (EHR), where other vendors might offer only an EHR product or e-prescribing product.

According to Margaret K. Amatayakul, author of Electronic Health Records: A Practical Guide for Professionals and Organizations, "[b]est of fit, or single source, is a scenario in which the products in one vendor's suite of products are integrated or fit well together and it is difficult to introduce other vendors' products. Best of breed is a situation where the best products are selected from various vendors. Unless best-of-breed products are open source, meaning the source code is readily available, is technology neutral, and does not restrict use of another software, it can be difficult to get them to communicate with one another."

There are several case studies available on the internet that discuss how different healthcare organizations decided between best of fit or best of breed.

Hybrid Health Records

2009-06-24T12:54:00.000-04:00

Hybrid Health Records
Emily L. Graham, RHIA, CCS-P, ASCRS/ASOA Associate Director, Regulatory Affairs

We are all clear about the definition of an electronic health records (EHR), but sometimes where hear about hybrid health records? According to the American Health Information Management Association’s (AHIMA) e-HIM Workgroup, a hybrid health record is a system with function components that include both paper and electronic documents and use both manual and electronic processes. Oftentimes, health care organizations will move toward full EHR use through a phased approach where both paper and electronic records are being used. For example, a practice may have all its lab, radiology, and other diagnostic test results in an electronic record, but progress notes are still hand-written. Another practice may scan all paper documents related to the medical record and catalogue them within the EHR system while also maintaining a paper chart. Both of these examples could be considered a hybrid health record.

Data Definitions

2009-06-17T08:36:00.003-04:00

Data Definitions

Emily L. Graham, RHIA, CCS-P, ASCRS/ASOA Associate Director, Regulatory Affairs

Data are defined as the dates, numbers, images, symbols, letters, and words that represent basic facts and observations about people, processes, measurements, and conditions. A data element is an individual fact or measurement that is the smallest unique subset of a database. The word “data” is often used in conjunction with other words like accuracy, granularity, etc. These additional data-terms are defined below.

· Data accuracy is the extent to which data are free of identifiable errors.

· Data availability is the extent to which data are accessible whenever and wherever they are needed.

· Data comprehensiveness is the extent to which health care data re complete.

· Data consistency is the extent to which healthcare data are reliable.

· Data currency is the extent to which data are up-to-date.

· Data granularity is the level of detail at which the attributes and values of healthcare data are described

· Data integrity is the extent to which healthcare data are complete, accurate, consistent, and timely. It is also a security principle that keeps information from being modified or otherwise corrupted either maliciously or accidentally.Data precision is the extent to which data has the values they are expected to have.

· Data relevancy is the extent to which healthcare-related data re useful for the purpose for which they were collected.

Confidentiality, Privacy, and Security: Taking the Confusion Out of Commonly Misused Terms

2009-06-15T13:22:00.002-04:00

Confidentiality, Privacy, and Security: Taking the Confusion Out of Commonly Misused Terms
Emily L. Graham, RHIA, CCS-P, ASCRS/ASOA Associate Director, Regulatory Affairs

In discussions about health information technology (HIT) and electronic health records (EHR), the terms confidentiality, privacy and security are often misused. An excerpt from Health Information Management Technology, An Applied Approach by Merida L. Johns, PhD, RHIA, provides a clear explanation:

…[I]n the healthcare context, privacy is usually understood to mean the right of individuals to limit access to information about their person…[c]onfidentiality…refers to the expectation that information shared by an individual with a healthcare provider during the course of care will be used only for its intended purpose…Security can be defined as the protection measures and tools for safeguarding information and information systems.

Reference: Health Information Management Technology, An Applied Approach by Merida L. Johns, PhD, RHIA

Decision Support Systems

2009-06-11T09:44:00.001-04:00

Decision Support Systems
Emily L. Graham, RHIA, CCS-P, ASCRS/ASOA Associate Director, Regulatory Affairs

LaTour and Eicenwald-Maki, in their text, Health Information Management Concepts, Principles and Practice, describe decision support systems as interactive computer systems that intent to help decision makers use data and models to identify and solve problems and make decisions. In the clinical setting, these systems are known as clinical decision support systems (CDSS) and assist physicians and other healthcare providers in applying new information to patient care through the analysis of patient-specific medical/clinical variables. CDSS can be as simple as providing alerts, reminders and access to medical literature.

HIT Standards: What are they and who develops them?

2009-06-05T14:57:00.003-04:00

HIT Standards: What are they and who develops them?
Emily L. Graham, RHIA, CCS-P, ASCRS/ASOA Associate Director, Regulatory Affairs

An excerpt from Margaret K. Amatayakul in her text, Electronic Health Records, A Practical Guide for Professionals and Organizations, Third Edition, explains that

Within healthcare, standard protocols that support communication between
applications are often referred to as messaging standards, also called
interoperability standards or data exchange standards. Messaging standards
provide the tools to map proprietary formats to one another and more easily
accomplish the exchange of data. Some of the standards development organizations
(SDOs) also are incorporating semantic interoperability into their standards.
This means they are making accommodations for embedding standard vocabularies as well as standard syntax in their messages.

However, because the standard protocols developed to date have often had a lot of optionality, full interoperability has not always been possible. When this occurs, or when a vendor does not use a standard protocol in its application development, an
interface must be written to achieve interoperability between the two
applications….[i]nterfaces can be costly to develop and depend on cooperation
from the often-competing vendors of both applications that are attempting to
exchange data.

HL7 is one of several American National Standards Institute (ANSI)-accredited SDOs operating in the healthcare arena. Most SDOs produce standards (sometimes called specifications or protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance (claims processing) transactions. HL7s domain is clinical and administrative data. HL7 is not only the name of the SDO, but also the standard it has produced. The HL7 standard consists of rules for transmitting demographic data, orders, and patient observations, such as lab results and H&P exam findings, in addition to rules for appointment scheduling, referrals, problem list maintenance, and care plans. HL7 continues to be revised and new versions are released so it can remain relevant in the digital age.

The National Committee on Vital and Health Statistics (NCVHS) has recommended HL7 as the core standard. More information about HL7 can be found at http://www.hl7.org/.

References:
Health Level Seven, http://www.hl7.org/
Electronic Health Records, A Guide for Professionals and Organizations, Third Edition by Margaret K. Amatayakul, MBA, RHIA, FHIMSS

Interoperability: What Does It Mean?

2009-06-04T08:02:00.002-04:00

Interoperability: What Does It Mean?
Emily L. Graham, RHIA, CCS-P, ASCRS/ASOA Associate Director, Regulatory Affairs

As explained by Margret K. Amatayakul in Electronic Health Records, A Practical Guide for Professionals and Organizations, Third Edition, basic interoperability is the ability of software and hardware on different machines from different vendors to share data. However, interoperability has been further defined in healthcare by the Office of the National Coordinator(ONC), Connecting for Health, and others to mean:

· The ability to exchange patient health information among disparate clinicians and other authorized entities in real time and under stringent security , privacy and other protections (ONC 2005b)

· The ability of different information technology systems and software applications to communicate, to exchange data accurately, effectively, and consistently, and to use the information that has been exchanged (NAHIT 2005)

· The ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities (HIMSS 2005)

· At the application level, interoperability means the capacity of a connected, authenticated use to access, transmit and/or receive/exchange usable information with other uses (Connecting for Health 2005)