Technology: Learn to Love Your Nerd

Jay Simmons is responsible for the world - at least within the confines of Memphis Gastroenterology Group’s IT needs.

A five-year veteran at the 11-physician practice (which comprises a clinic, endoscopy center, and surgery suite), IT manager Simmons single-handedly runs a lean, mean technical machine, chock full of redundancies and fail-safes. And he takes pride in his work. “My name’s on it,” he says.

Simmons’ duties encompass keeping all of Memphis Gastro’s technical tools up and running, including the phones, practice management system, EMR, and both the on- and off-site data centers. He’s also responsible for hardware and software needs assessments, maintenance, upgrades, backups, disaster recovery protocols, and training. “If someone doesn’t know how to use a mouse, you just show them,” he says. “And if the VPN is malfunctioning, you fix that too.”

Someone like this, you want to keep happy.

Still, the relationship goes both ways, and you do have choices. Should you address your IT needs in-house, or would outsourcing work better for you? Whatever you decide, here are some ways to develop a strong, mutually beneficial connection between your practice and your favorite IT nerd.

A sound investment

These days, with even toasters housing microchips, the question is not if you need IT support. You might be pretty tech-savvy yourself - what practice management consultant Rosemarie Nelson calls a “physician enthusiast.” And maybe you really do know how to fiddle with your wireless router to make it work. But do you truly have the vision, time, and IT skills necessary to streamline all your technologies so the practice’s data and capabilities are available to the right staff, at the right place, at the right time?

This was exactly the problem at Memphis Gastro, says Simmons. “When I first started here, we had just a Unix system with the green screens that crashed on a regular basis,” he recalls. Also, the fax server was not working properly, and the staff needed training for its Microsoft products. Simmons addressed those problems first.

Having someone with broad-spectrum IT knowledge on staff can save you big bucks. For example, Simmons proved invaluable when the group went paperless. The practice administrator had already spent two years researching a replacement for the group’s antiquated practice management system and procuring an EMR. Simmons agreed with her choice, but after scrutinizing the proposed purchase agreement, he was aghast at the price tag. By eliminating many “bells and whistles they didn’t need,” he says, he “trimmed almost $500,000” off the purchase price. “That helped prove my worth right off the bat.”

Simmons also renegotiated the practice’s copier contract to lower its maintenance costs, and he re-outfitted the office with a new phone system. The initial asking price: $100,000. “We got it for $50,000,” says Simmons. “I worked it hard. I put in a lot of hours.”

A skilled in-house technical perspective can also help you avoid future headaches. Gateway Medical Associates, a multispecialty practice in Exton, Pa., went live with its integrated EMR and practice management system about a year and a half ago. Because the 28-provider practice already had a satisfactory practice management system, prevailing opinion in the office was to purchase just an EMR and “simply” interface it with the existing practice management software.

But Gateway Medical’s director of information services, Vince Carrigan, disagreed. Well aware of the yawning gap between “should interface” and “will interface” due to the current lack of an industry standard for exchanging patient data, Carrigan espoused a common vendor for the two software applications, even though it meant spending more money to replace something the practice already had. “I felt strongly about having an EMR and practice management system with the same company, because a version upgrade could happen at either end, and finger pointing could start,” he explains.

The practice’s CEO, Jim Rodgers, listened: “[Vince] convinced us, and because of his input we decided to spend the money.” They’ve never regretted their decision.

High-tech matchmaking

Everyone outside of the IT profession has a certain amateur technology skill level, from the plugged-in enthusiast pining for the newest gadget as soon as it’s released, to the techno-phobic curmudgeon who eschews most technologies as new-fangled frippery.

The people who work in your practice fall all along this spectrum. Considering that fact, the busy nature of a medical office, and the ever-increasing pressure to adopt paperless habits, the IT professional you need and want will have to know how to serve your practice competently and diplomatically, despite these challenges. But how do you find such a gem?

One solution is to create your own. Gateway Medical puts a high value on Carrigan because he’s become exactly what they need. He was a serendipitous find. Carrigan’s mother worked in Gateway’s billing office for a decade. Her son started taking care of the practice’s IT needs on a part-time basis a few years back while he was still in college. “We knew Vince, and we knew his work ethic,” says Rodgers. Carrigan’s degree in finance, his MBA, and his impending MS in information systems give him a well-rounded skill set to meet Gateway’s complex IT needs.

Rodgers appreciates Carrigan’s intimate knowledge of his group’s operations: “He’s a very marketable person, and we’ve had to be very competitive with things like salary. … He’s one of our highest paid employees at this point, other than the physicians - and well worth it. If I had to go out and hire somebody, they aren’t going to know the nuances of the organization and the personalities; Vince does know.”

Another answer to your IT needs is to hire right. This is a challenge in any industry, but in the IT world, job requirements shift as quickly as the latest technologies. And within the medical world, new tech tools are entering the marketplace at breakneck speed. “IT is not at the bottom of the company any longer, just banging out zeroes and ones,” says Simmons. “Before, it didn’t matter if [your IT person] understood the flow of the front desk. It’s not that way anymore.”

Your IT person should possess at least a working knowledge of EMRs and practice management systems. “If I don’t understand how that button will flow and how it integrates with the rest of the clinic, I could really mess things up,” says Simmons, who dedicated hours to understanding the practice’s work flow when he first came on board.

Also, because IT has become much more mainstream, it’s critical that your techie also knows how to communicate, says Simmons. “You can always find someone who can do the IT side, but you also need someone who can articulate it.”

This means using accurate but layman-friendly terms, making eye contact, using humor appropriately, and knowing when and how to push an issue for the good of the practice. Simmons remembers one time when he was schooling all of his practice’s physicians on Dragon Naturally Speaking, a speech-to-text translator. One physician was proving to be a particular challenge, and Simmons had to schedule training sessions for him four or five times. Simmons finally told him, “‘Hey, Monday you’re going live.’ … He did, and it went fine.”

Should you outsource?

Having your own “IT nerd” on staff can certainly be a boon to your practice. But you may find that outsourcing - which allows you to choose from a wide variety of service offerings and maintenance plans - works just as well or even better for your business.

It certainly works for Walker Urgent and Family Care in Little River, S.C. Two years ago, the solo practice decided to automate, which naturally ramped up its IT needs. Too small for it to be financially feasible to bring an IT person on staff, but wanting the guidance of technical experts, the practice decided to outsource its IT needs. It chose a company called Computer Zone, which offers Medisoft practice management software, SpringCharts EMR, and automated billing and backup services.

Since then, they’ve experienced virtually no downtime. “One of the big positives is we don’t lose our charts anymore,” says Shenell Hamilton, office manager.

Walker Urgent and Family Care also avails itself of Computer Zone’s auto-posting service, which has greatly sped up insurance payment posting to its bank account. “We used to wait 30 to 120 days; now it’s about 14 days,” says Hamilton. She appreciates the peace of mind she now has knowing that a group of experts is there to support her practice’s IT needs: “Now we can spend time seeing patients and offering better services.”

Surely, such assurance is one major benefit of outsourcing. “A clinic is so entwined with its daily activities, they don’t want to be bothered,” explains Computer Zone co-owner Sandy Huggins. The company offers its services on either a per-call or maintenance contract basis. “After they buy the product, we have nothing left to give but support,” says Huggins. “We tell our clients that there’s nothing they can break that we can’t fix.”

Outsourced IT help is available in all sizes. McKesson, for instance, offers a broad range of IT services. It emphasizes connectivity, revenue cycle outsourcing, coding, driving claims, managing contracts, implementing EMRs, and providing practice management support. That may sound rather intimidating to a small practice, but Tom Leonard, senior vice president and general manager of McKesson’s Ambulatory Solutions Group, says that every client, regardless of size, has a “single point of contact” with whom to build a strong relationship.

So whether you prefer to employ an in-house IT specialist or pay for the support an outsourced IT services company can provide, the key is to choose a solution that best fits the specific financial and operational needs of your practice. Don’t rush when deciding. Choose carefully, and build a solid relationship with your IT experts based on open communication and trust. “Finding IT people is not difficult,” says Simmons. However, “Finding IT people who fit your organization takes time and effort.”

Shirley Grace is a senior writer for Physicians Practice. She can be reached at sgrace@physicianspractice.com.

This article originally appeared in the March 2008 issue of Physicians Practice.