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The 5 IT Skillsets Every Physician Practice Manager Needs to Succeed in 2009 and Beyond

I wrote this article for the Physician Office Managers Association of America (POMAA) March/April 2009 Newletter.  If you don’t know POMAA, check out their website.

The Road to Success © Matt Trommer | Dreamstime.com

Each of us have areas of expertise based on our experience, our education and what we find interesting and fun.  IT knowledge and skills are no longer optional, however, and I suggest every medical practice manager learn as much as possible about the following five areas.  Your work life and the life of your practice may depend on it!

Skill 1: Email Etiquette and Management

Email can rule your work life if you don’t make good choices with your messages.  Managers need to know how to use the Rules Tool (Outlook) to automatically move messages into folders, and how to turn emails into Tasks and Appointments.  Work communication can succeed or fail if you don’t have the basics under your command.  Knowing how to archive your email will not only save you time when looking for important information, but will save you from the frustration of searching through hundreds of emails.  Here are the basics of email management:

  1. Most organizational experts recommend looking at your email twice a day, and turning off the setting that notifies you immediately when you have new email.  Email can be very addictive, and can suck your time away from projects and other work.
  2. Just like paper, try to only touch an email once.  Once you read the email, decide whether to delete it, answer/forward it and delete it, or do something else with it like dragging it to the task list or calendar.  Don’t get caught in the ugly cycle of reading it once, and going on to the next email without doing anything about it.  If you do that, you’ll end up with lots of emails that you have to read again…and maybe a third time.
  3. Never put anything critical (of a criticizing nature) in an email.  If you need to have that type of conversation with a colleague, pick up the phone.  A critique to an employee is best done in person, with a follow-up email for the file.
  4. Always check your outgoing email for tone.  The best tone for business email is professional. This means a greeting, a message, a “thank you” and footer with your full name, title, and contact information.  Some organizations are more formal, and some are less formal, but I would err on the side of being more professional.  You can always set your email signature to include the greeting and thank you and your name, so all you have to do is complete the middle.
  5. For emails that do need to be saved for reference, make subfolders under your Inbox to place reference email. Even better, copy the email to a Word document, and delete the email.
  6. Have high priority (your boss or bosses) and low priority (listservs, subscriptions) email automatically come into their own folders.  The low priority email can wait and the high priority email can be dealt with first.
  7. Group emails with jokes, homespun wisdom, clever tests and unbelievable pictures are a waste of your time.  If you need a break from work, go for a walk, but get rid of the group emails.  They take personal and server email space and can border on or be outright offensive, causing a problem if you don’t nip it in the bud.  Remember that email is legally discoverable.
  8. Be careful about answering emails off the top of your head, possibly when you’re angry, or rushed.  If you need to delay answering an email because of your mood, drag the email over to the task list and set the to-do for tomorrow.

Medical Nurse

Skill 2: Understanding Medical Office Software

Acronyms come and go, but the basic software that supports medical practices remains the same.  Practice Management Systems (PMS) typically include registration, scheduling, billing and reporting as one component.  Today’s systems are built around the billing function, with scheduling and registration supporting the ability to generate electronic claims and post payments back to the transactions.  Because billing is becoming more standardized, it is the reporting that can make or break a practice.

Electronic Medical Records (EMR) are sometimes referred to in a broader sense as EHR (Electronic Health Records) and range from the simplest of systems which act as a repository for the electronic chart to the most sophisticated systems which may include  digital imaging, e-prescribing, complex messaging, medication reconciliation, and test alerting, among others.  EMR and PMS can be totally integrated, or can interface with each other, populating the other uni-directionally or bi-directionally.  Those mangers with a deeper understanding of their own software systems will find it easier to implement pay for performance measures such as PQRI and e-prescribing, and will not have to rely on vendors to educate them.

PACS is Picture Archiving and Communication System and allows easy indexing and retrieval of images.  PACS exists primarily in radiology and surgical specialty offices, but as more hospitals extend EMR and PACS privileges to physician offices, managers will need to understand something about the technology.

Other systems that will interface to your system are transcription, outsourced billing systems, data warehouses, claims clearinghouse, electronic posting systems, and web services interfaces.  Get or make a graphic representation of your software and hardware system/network so you can talk knowledgeably about it and understand the effects of adding new servers, workstations or software modules.

Computer Savvy Daniel Sroga | Dreamstime.com

Skill 3: Using Technology to Stay Current in Your Field

Magazines, newspapers and even television news is losing favor as people find the latest and most in-depth news on the Internet.  For physician office managers, news and important information is available through websites, newsletters, newsfeeds, webinars, podcasts, listservs and blogs. How does a manager sift through all these options and stay current with the demand of running a day-to-day practice?

One of the most important ways to consolidate this information is to subscribe to a feedreader or email from websites you like and have the news come to you (called “push technology”), instead of you checking the website every few days or whenever you remember (aka “pull technology”). These are the programs that will eventually do away with most, if not all, of your magazine subscriptions.  You know that guilty pile of professional magazines that you have in your office or at home that you have scanned but still plan to read in-depth?  Gone!

Most websites offer email or RSS options to their users.  An email option asks you to enter your email address and will email you when new information is available, typically offering the full content inside the email itself.  This is ideal for anyone who has these emails automatically placed into an email subfolder to read later.

RSS stand for Really Simple Syndication and is a way to push the content of many sites into a feedreader, which is an organizer of website feeds.  There are many feedreaders available at no cost and adding a new website feed to your personal feedreader is as simple as clicking on the orange RSS icon on the website page and identifying the feedreader you use.  The nice thing about using RSS is that you can group sites into categories you decide upon, it is easy to add new sites and drop sites that you find a waste of your time, and you do not clog up your email program with lots of emails.

Webinars and podcasts are another way to stay current. Many webinars are free and allow you to dip your toe into the pool of knowledge on a particular topic.  Webinars with a fee attached are usually longer and more in-depth, and can replace the traditional go-to conference which has become a budget breaker for many practices.

eBooks are quickly becoming the way to get just the information you want when you want it.  Most eBooks are reasonably priced (some are free) and can be stored or printed.

Patient Emailing His DoctorSkill 4: Online Patient Interactions and Web 2.0 Applications

Patient interactivity via practice websites is growing exponentially.  Many practices are using web functionality to communicate with their patients via secure messaging.  This allows bi-directional communication such as:

1.      Request an appointment (patient) or appointment reminders (practice)

2.      Send statements;  patients pay online with a credit card (practice & patient)

3.      Inform patients of test results (practice)

4.      Create personal health records (patient)

5.      Request a prescription refill (patient)

6.      Virtual office visits (practice & patient)

7.      Complete registration via fillable .pdf forms and download to practice management system (practice & patient)

8.      Request medical records; send an electronic copy of same (practice & patient)

9.      Complete a history of present illness prior to the on-site visit (patient)

10.  Ask & answer questions for the doctor, nurse, or staff (patient & practice)

If you’re not looking into ways to communicate with your patients electronically, start now.  Web 2.0 is now more typically referred to as social networking, social media or new media. What started out as a way for friends to communicate with each other is now an amazing, ever-expanding ability to connect/market to businesses, patients and referrers.  Very few medical practices are using social media, but they should, because it is the way of the future, and in many cases, very affordable.

Knowledge Management & Retention ©Dmitriy Shironosov/Dreamstime.com

Skill 5: Knowledge Management and Retention

Most medical offices try hard to document processes such as “How To Make An Appointment For Dr. Jones,” but find it difficult to keep up with documenting changes to those written protocols.  Documentation is crucial for operations in that it supports job performance and consistency, and is a basis for training new employees.  The traditional documentation method for most practices is use of Word documents, which can create an immediate usability logjam.  Due to cost, Microsoft Office is not installed on many workstations, and many office employees are not trained to use Word, so the onus for original creation of and changing of protocols falls to one person.  Changes in healthcare are happening so quickly that it is not reasonable for one person to be able to update all documentation, unless they are dedicated to it on a full-time basis.

Better and more affordable solutions are becoming available.  Speech recognition and office wikis are two possibilities for documenting office processes.  Speech recognition (you may already be using it for your transcription) is a very affordable solution, but it does take time to train the program to recognize your voice.  If you are not used to dictating, it may also be a learning curve, but it is one that will pay dividends down the road.  Doctors can use it to help you by dictating their preferences, such as appointments, patient intake, room set-up, procedure set-up, patient phone protocol and after-hours call contact protocol.

Private wikis are another good bargain in the marketplace, as many are available at no cost, and may be installed and managed on the web.  Wikis need at least one person to function as editor. Since you can have your entire staff work on documentation, the staff becomes very invested in the process of keeping the wiki fresh and up-to-date.

There are other free or low-cost project management web programs that can also be used to track changes and remind staff to document changes later.  The one area that is most important for tracking changes and managing knowledge in the practice is in billing.  Many practices are held hostage by their billers as their knowledge is so specific and proprietary that the manager feels s/he could not recoup it if they left.  No practice should be vulnerable based on knowledge any single employee has, including the manager.

I am very interested in technology that creates value in medical office practices.  If you are using something new and different in your practice, please email me and let me know.  Also, if you have any questions about the ideas I discuss in this article, I am glad to answer them: marypatwhaley@gmail.com.

Posted in: A Career in Practice Management, Electronic Medical Records, Learn This: Technology Answers

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Monday Special: New Ideas for Office Gift Exchanges and Alltop.com

If wading through endless sites on the internet looking for the good stuff wears you out, here is a great site that lists quality sites in categories.  Alltop.com is a natural followup to the post I published earlier this week about RSS (Really Simple Syndication) or as I like to think of it “Read Stuff Simply.”

Alltop describes itself this way:

You can think of an Alltop site as a “digital magazine rack” of the Internet. To be clear, Alltop sites are starting points””they are not destinations per se. The bottom line is that we are trying to enhance your online reading by both displaying stories from the sites that you’re already visiting and helping you discover sites that you didn’t know existed. In other words, our goal is the “cessation of Internet stagnation” by providing “aggregation without aggravation.” 

I really like the idea of a digital magazine rack because I don’t subscribe to magazines anymore (although I do read People when I’m at the “beauty parlor” – yep, my dirty little secret!)  I really dislike paying to receive advertisements, which is what I think magazines and television are.

Here is a short, entertaining video on how Alltop works.

Just for fun, I added an Alltop section on the right-hand sidebar on this site.  I chose “Leadership,” so the most recent five posts on Alltop under the topic of leadership will now display on my site.

I found an interesting site today by browsing through Alltop.  I found Management Craft: Discussions About State of the Art Management by Lisa Haneberg.  Her article “Ideas for the Holidays” offers a variation on an idea I’ve been toying with for my practice – the idea of having a holiday exchange of a different kind.  Instead of buying and exchanging gifts, I thought about having an exchange of useful, but no longer needed items.  Often, traditional gift exchanges turn out to be disappointing or not everyone wants to participate.  Lisa’s articles talks about a book exchange – what a great idea!  Have everyone bring in a book or books they have at home and no longer want/need and let everyone exchange during the holiday party.  You could theme the exchange to kitchen items, jewelry, art, almost anything!  It could even be holiday decorations that you no longer want, or no longer fit in the house that someone else would be thrilled to get.  Another alternative is having each person exchange a service – it could be cooking, babysitting, sewing, lessons on home computing, photography, lawn service, anything – in one-hour increments!  Instead of a blind exchange, staffers could “shop” at the party for a service they need and give one hour and take one hour.

Anyone else have any interesting holiday party or exchange ideas to share?

Posted in: Day-to-Day Operations, Learn This: Technology Answers

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Monday Special Part One: RSS – What is That Orange Box I See Everywhere on the Web?

 

 

 

 

 

 

 

Readers: how are you coping with the onslaught of information?  Emails, news stories, professional reading, listservs, blogs – it goes on and on. Here’s one technology you should take advantage of to ease the information load, whether you use it for your own knowledge, use it for your practice website to update patients, or use it to see what updates your competitors are making to their websites.  Abraham has written a great guide to RSS, what it is and how to get started using it.  If you have follow-up questions for him, please leave a comment by clicking at the end of this article.

RSS – Making the Web Work for You

In the past year, I have radically changed the way I surf my favorite web sites.  For my writing, information, and entertainment, I check for updates and new info on over 200 websites a day.  I like to stay informed, and that’s what it takes. Of course, I don’t read every word of every page – I could never get that done!  I skim, I browse, and most importantly, I get the web to do the work for me.

I never type in any of the sites’ addresses or click on a saved bookmark in my web browser.  In fact, I don’t even have to check if anything is new.  Any time one of my favorite websites adds an update, they notify me automatically, and I can read it, or ignore it and move on.  There is a huge volume of potentially valuable information on the Internet, but the savvy consumer has to be able to parse, filter, and mine this info for things that can actually benefit them.  I use a simple, free, and easy to use technology to do all of this – and I’m going to teach you to do the same.

The secret is called “RSS”, and these three letters can dramatically change how you use the web.  RSS stands for “Really Simple Syndication”, and like so many of our new technologies, it’s a powerful tool that’s harder to understand than it is to start using.  Once people start using RSS, they love it, but have a tough time telling other people what exactly it is. So here’s my best crack at it:

RSS software (or a RSS web application) is a technology that will notify you every time one of your favorite websites has an update, and will automatically deliver the update to you.

Since the website tells me what’s new every 15 minutes, I can very quickly get a grasp on what I do and don’t want, and don’t spend nearly as much time reading things I don’t care about.

 

What do I need?

 

You need a way to read RSS feeds.  There are several options with pros and cons, but they all work on the same principle, and they will all save you time, and make you better informed.

One of the simplest ways to use RSS is to just read the updates in your web browser.  In Firefox 3, when you click on a link to an RSS feed, you are given the option to subscribe to the feed using “Live Bookmarks”, and if you accept, a folder with the name of the RSS feed will go on your “Bookmark Toolbar”.  When you click this folder, a menu drops down displaying recent updates for the feed.  Microsoft Internet Explorer as has a similar system, where you pull open a separate sidebar to look at the feeds you subscribed to.  For users who simply have a few feeds they want to keep track of, these are great ways to start using RSS as soon as you finish reading ManageMyPractice.com.

For users wanting a more customizable and in-depth experience, you might want to try one of several web-based RSS services.  One of the biggest and most popular is Google Reader. Google has a lot of practice in making things easy to use and understand on the web, and they do a good job with reading RSS feeds too.  It’s all web-based, so you read your feeds on the Google Reader website, and as long as you can remember your password, you can read them on any computer with an Internet connection.  Also, on the homepage for new Google Reader accounts, they have a great YouTube video about the service, and what it can do.

 

What feeds should I read?

 

You can read whatever you like! See Part Two of this Monday Special for some feeds Mary Pat reads.  I like to group my feeds into categories, and read groups of them all at once!  I have a category for local news, with happenings and goings on around my city in it.  Another folder has national news from the New York Times and Washington Post. Another is for sports feeds, with ESPN, Sports Illustrated, and other sources for info. Another is just interesting feeds that often have thought-provoking stories and pictures…you get the idea.  If there’s a website about a topic, chances are great that there are RSS feeds about it as well.  Most web pages that have RSS feeds will say so somewhere on the site.  Also, newer web browsers will have features to tell you automatically if a web page offers an RSS feed.  In Firefox 3 for example, a little orange RSS icon shows up in the address bar when a feed is detected, and clicking on it will give you options to subscribe.  And in FeedDemon, you can just type in a site’s address, and it will give you a list of feeds the site offers.

It is becoming increasingly rare for almost any website or blog to not have an RSS feed, so if you read it, you can probably read its feed instead.

Get out there!

This should give you a great start to reading RSS feeds from your favorite website, and more quickly and efficiently digesting the daily Internet flood of info.  And remember, if you’re having a hard time explaining to your friends and family what this powerful technology can do, you know where to send them!

 

To Recap:

 

  1. Information can be overwhelming.
  2. RSS (Really Simple Syndication) is a way to aggregate or gather the sites you care about and have them “push” their updates to you, instead of you having to go pull the information from them.
  3. Download news reader software.  See some suggestions above.
  4. Start looking for the orange RSS box on websites, click on the box, adding the site to your reader.
  5. Don’t let your RSS feeds overwhelm you; delete feeds that don’t consistently meet your information and relevance criteria.
  6. Let us know what feeds you find that you rate as high-quality.

Posted in: Learn This: Technology Answers

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