Improving Practice Efficiency Through Emerging Technologies

By Andrew Smith
Published: Tuesday, Feb 03, 2015
Owen Dahl

Owen Dahl

The New Year offers little hope of breakthrough software improvements for medical practices, but experts say oncologists can still make 2015 a time of breakthrough productivity gains.

Most practices can get far more from existing tools and personnel—if they take the time to systematically analyze their workflow, eliminate obviously counterproductive practices, and experiment with potential improvements.

“There is no magic bullet. Substantial improvement takes real effort, but it’s worth it,” said Owen Dahl, a consultant with Medical Group Management Association. “Small improvements add up. Many offices can increase overall efficiency by 10% or more. That’s like adding 2 free workers to a staff of 20,” Dahl said.

Many practices, for example, can save time by making better use of online portals that allow patients to view test results and communicate with doctors, nurses, and staff.

The basic technology arrived a decade ago amid predictions it would delight patients and practices alike. Patients would get an easier way to pay bills, manage appointments, view test results, and request refills. Practices would get a system that streamlined (and eventually automated) those time-consuming tasks and eliminated the need to call patients about upcoming appointments.

Only a few studies published to date measure such claims against reality, but such studies generally find that patient portals actually deliver much of what they promise.

A much-cited paper published a decade ago in the Journal of General Internal Medicine compared 6 primary practices that bought early portal software with 9 that did not. It found that offices with portals typically dealt with 13.7% fewer patient contacts than offices with no portals (P = .025).

Portal technology has improved since then and people feel more comfortable communicating online. Newer reports from individual practices seem to reflect these trends. They typically suggest that robust portals and aggressive efforts to get patients using those portals can decrease practice call volume by 30% or more.

Using Portals

Yet many oncologists have yet to roll out portals with the sort of functionality that truly reduces (or eliminates) the time staff members must spend on a wide variety of activities. Their ‘portals’ are little more than glorified e-mail systems that let patients view some records online.

Many other practices pay vendors for portals but fail to notify patients about their availability. Federal records indicate that a solid majority of medical offices now offer some sort of portal, but a 2014 survey by the consultancy Technology Advice found that less than half of all patients realized that their doctors provided such a service.

Patients obviously cannot serve themselves when practices fail to give them the necessary tools or to make them aware of those tools, but offices that want to maximize self-service must do more than buy and advertise good portals. Case studies suggest that enrollment drives are the key to portal use. “Practices that sign patients up and walk them through the portal while they’re actually in the office can often get enrollment rates over 50%,” said Elizabeth Woodcock, a consultant who has written several books about managing medical practices.

“But practices should not push enrollment at all until they offer a quality portal that gives patients an easy way to do a number of things. Most people will only test your portal once, so it’s counterproductive to send them to the sort of placeholder portal that has little functionality.”

Improving Productivity

Other communication technologies can also boost worker productivity.

Most oncologists already have software that sends prescriptions directly to pharmacies and retrieves laboratory results directly from testing companies, but published research and case studies alike suggest that all practices should push themselves to use such programs whenever possible.

Some might object that electronic prescriptions take longer to write than paper prescriptions—and although some published studies disagree, others support this intuition—but research that also measures follow-up calls from pharmacies concludes the software saves time.

Indeed, a Medicare study from 2005 estimated that pharmacies call doctors with questions on 30% of all written prescriptions. Good software, on the other hand, makes it pretty hard to write an ambiguous prescription.

Seamless communication between medical offices and pharmacies has stoked demand for seamless communication between electronic health records (EHRs) among various medical offices. The ability to share patient records (with patient consent, of course) would obviously save all practices a tremendous amount of drudgework, and it will come—some day.


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