Manage Demand Online

Physician Associates manages its patient flow better than most. The multispecialty practice doesn't have extra staff or faster physicians. Its secret: an interactive Web site for patients.

Denny Buhring, chief operating officer for the Longwood, Fla., practice, says, "Patients love the access our Web site (www.paof.com) provides for messaging, appointments, prescription refills, and even paying their bills." 

And his staff and physicians love that the site helps get them home on time at the end of the day and keeps the chaos under control.

Most practices still handle patient demands mainly through the phone. Scheduling, refills, triage - all make the phone ring. The constant ringing drives everyone nuts and keeps staff from focusing on patients in the office. And patients forced to wait on hold or sit around waiting for a call back aren't happy either. Why do it that way?

Your patients are online, and they want more from your practice via the Web. According to a Harris Interactive survey of patients in 2004, 70 percent of patients want more than "electronic business cards." They want access to clinical test results, automated appointments, and electronic prescription refills. 

That's not just the younger set. According to Pew Internet and American Life Project survey results published in March 2004, 66 percent of wired seniors had looked for health information online by the end of 2003, and 47 percent of online seniors had purchased something on the Internet by the end of 2003. That doesn't even count the baby boomers, slightly younger than retirees, who are vastly more attached to the online world.

A Web portal that allows patients to contact the office will increase patient satisfaction. Patients can use the Web at any time of day or night for so many of the same tasks that tied them up on the telephone. Your practice staff can manage those incoming Internet communications more effectively than the interruptions created by the unplanned incoming phone call.

A stepping-stone approach to implementing technology can speed up communications, reduce chart pulls, and allow you to see more patients more efficiently. And you don't need an expensive, incomprehensible Web designer to make it happen.

An application service provider (ASP) can get you up fast. Often, the ASP will easily integrate components to your existing Web site so that you can take advantage of the features you need most, like secure, HIPAA-compliant interactions such as delivering lab results, appointment reminders, and prescription renewals. Get online and take a look at some of the products and services in the marketplace. A sampling for your review:

• CareCatalyst (www.kryptiq.com)
• Medfusion (www.medfusion.net)
• RelayHealth (www.relayhealth.com)

Boost clinical flow

Academy Allergy, Asthma & Sinus, P.C., in Fisher, Ind., is making patient triage easier - and safer - than the usual flow of phone messages. According to physician owner David Patterson, the practice is using an add-on to its EMR from Cerner to facilitate secure physician-to-patient e-mail. Unlike most phone messages, the e-mail is automatically stored to the patient's EMR.

Patients can also have electronic access to their problem and medication lists and can enter their own medical history online. The data goes right into the EMR, saving a lot of time after the patient's first visit. "We've learned that patients are more thorough and histories are more accurate when completed electronically, which benefits the patient care process for the practice and the patient," Patterson says.

Even without an EMR, you can use the Web to obtain patient histories and streamline the intake process. For example, check out www.medicalhistory.com for an interactive tool called Instant Medical History. The software "interviews" the patient and produces an intake document for your encounter with that patient. If your patient doesn't have Web access, you can install a kiosk in your reception area for your patients' convenience. Alternatively, with the installation of a secure wireless network, which can be reasonably inexpensive, and tablet PCs, patients can sit in any chair in your reception area and complete their histories online instead of on a clipboard.

Using the Web to automate the prescription reissue process is another time saver for your office. Most applications allow physicians to work in wired or wireless environments using a wide variety of devices, from a desktop PC at the nurse station to a PDA or smart phone. Via the Internet you can prescribe, check for drug interactions, access medication histories, review drug reference information, and transmit prescriptions directly to a pharmacy. Approximately a third of all prescriptions result in a callback from the pharmacy, and e-prescribing eliminates those callbacks. How many hours each week can you save in your practice by not pulling charts and handling those calls? Learn more about these services by checking a few of the vendors' Web sites:

• PocketScript (www.zixcorp.com)
• Rcopia (www.drfirst.com)
• RxWriter (www.micro4.com)
• TouchScript (www.allscripts.com)

Smooth check-in

Make the patient registration and check-in process more efficient with patient registration forms on the Web. An easy first step? Simply provide your patient enrollment and medical-social-family history forms as downloadable documents on your site. 

Reading Pediatrics in Reading, Pa., invites patients on its Web site (www.readingpediatrics.com) to complete the forms and mail or bring them to the office. That means patients are greeted and roomed efficiently; you won't find yourself with idle time because a patient is still in the reception area completing his registration or history form. Web-based registrations also reduce no-shows. When patients register online they have a greater sense of commitment. It's as if the act of filling out the form generates a relationship.

With patient registration information in hand in advance of the patient's appointment, your staff can verify insurance enrollment and even determine eligibility and coverage for specific procedures online. You can save as much as three to five minutes per enrollment and double that for authorization/referral information using online resources instead of the phone. Let's say you have 30 patients for insurance verifications each day and, by using the Web, you recover 90 minutes each day. Imagine what your staff could accomplish with that additional time. Ask your claims clearinghouse provider about its Web services or try these services:

• EDI Healthcare (www.edihealthcare.com)
• Proxy Claim Web (www.proxymed.com)
• WebMD EDI Services (www.webmd.com or www.envoy.com)

Educate patients

Access to clinical information for the patient is a winning technology for all. You'll save money by eliminating the purchase of patient education materials or the expense of copying handouts. Your practice will have less paper lying around or displayed in wall racks. Your patients will have confidence in the online educational resource because you've recommended it.

"I like to swivel my 17-inch monitor during patient visits to click on our Web site and navigate to the patient education link I'm recommending," says Patterson, explaining how he encourages use of the education on his site.

Some other ideas?

Dr. Kristen Kratzert's practice in Syracuse, N.Y., Women's Wellness Place, offers patients the convenience of purchasing natural supplements via the practice Web site (www.kratzertmd.com). 

Even if you are not offering supplements or other products for sale, you can provide your patients with the convenience of online bill payments. Suburban Psychiatric Associates in Amherst, N.Y., provides an easy method for their patients via www.suburbanpsych.org. 

Even if you build a fantastic site, you can't expect patients to find it on their own. Market your site to your patients so they become familiar with the services you provide via the Web. Put your Web address on patient statements, appointment cards, educational brochures, encounter slips, and any printed material that reaches the patient's hand. Include your Web address on any advertising, including the Yellow Pages. Change your answering machine message to prompt patients to go online to your Web site and change the message frequently to announce new features that will pull patients to your site.

You'll see greater efficiency and patient satisfaction for not too much cost - and often even cut your operations costs.

Rosemarie Nelson last wrote about EMR ranking systems in the March issue. She can be reached at editor@physicianspractice.com. Resources and vendors mentioned in this article were selected as examples by the author, not by Physicians Practice staff.

This article originally appeared in the May 2005 issue of Physicians Practice.