Becoming more productive is almost a lifestyle for some people.

With everyone running around trying to get more done in less time, the allure of increased efficiency drives a lot of the decision making of professionals, providers and patients alike. One area that is easy to overlook however is learning to use all of the capabilities of the tools you already have. Take software for instance: maximizing efficiency means making sure you (and your employees) are getting the most bang for your practice’s buck out of the software packages they purchase. Learn to really use the stuff you have before you request your next upgrade quote.

The other day a friend of mine asked me a question in a tone of voice that gave the impression the subject had been a persistent pain in her neck.

“Is there a way to get a to get Word to recognize that I type “anyhting” by accident every time I mean to type “anything”? I must do it twenty times a day, and having to stop and correct it is really slowing me down”

 

Say what you will about the Microsoft Office products that are commonly found in business settings – they don’t lack in features. In this case my friend had a feeling that Microsoft had something like its Autocorrect feature for your own “personal typos”.  Autocorrect is the handy feature that will turn common typos-  “teh” instead of “the” etc… – into what Microsoft assumes is what you meant to say. Autocorrect-like software is also found on most cellphones’ text messaging programs, sometimes to humorous results when the cellphone makes bad assumptions for you! But can you add your own entries to Autocorrect so that your own “anyhting”s can be taken care of instantly without effort? Yes you can!

The AutoCorrect list is global across the Office programs that support this feature, which means that when you add or delete a word from the list in one Microsoft Office program, the other Office programs are also affected.

Create or Change AutoCorrect entries in Microsoft Office 2010

1. Click the File tab and then, under Help, click Options.
2. If you are using Outlook 2010, click Mail and then click Spelling and AutoCorrect…For all other programs, go to step 3.
3. Click Proofing.
4. Click AutoCorrect Options.
5. On the AutoCorrect tab, make sure the Replace text as you type check box is selected.
6. In the Replace box, type a word or phrase that you often mistype or misspell — for example, type usualy.
7. In the With box, type the correct spelling of the word — for example, type usually.
8. Click Add.
9. Click OK.

Create or Change AutoCorrect entries in Microsoft Office 2007

In Outlook

1. On the Tools menu, click Options.
2. Click the Mail Format tab, and then click Editor Options.
3. Click Proofing, and then click AutoCorrect Options.
4. On the AutoCorrect tab, make sure the Replace text as you type check box is selected.
5. In the Replace box, type a word or phrase that you often mistype or misspell — for example, type usualy.
6. In the With box, type the correct spelling of the word — for example, type usually.
7. Click Add.

In Word

1. Optionally, if you want to add a formatted text entry, open the document that contains the text that is formatted the way that you want, and select that text.
2. Click the Microsoft Office Button, and then click Word Options at the bottom of the window.
3. Click Proofing.
4. Click AutoCorrect Options.
5. On the AutoCorrect tab, make sure the Replace text as you type check box is selected.
6. In the Replace box, type a word or phrase that you often mistype or misspell — for example, type usualy.
7. In the With box, type the correct spelling of the word — for example, type usually.
8. Click Add.

Create or Change AutoCorrect entries in Microsoft Office 2003

In Outlook

In Word

 

An excellent article on EHRs and CCHIT was pointed out to me recently and I thought I’d pass it along to my readers.  To answer the question “What is CCHIT?”, the site SoftwareAdvice says this:

CCHIT is a private, non-profit organization formed to certify EHRs against a minimum set of requirements for functionality, interoperability and security. It was founded in 2004 by three industry associations ( HIMSS, AHIMA and the Alliance (no longer in operation.))  It was subsequently funded further by the California Healthcare Foundation and a group of payers (e.g. United HealthGroup), providers (e.g. HCA) and software vendors (e.g. McKesson). In 2005, CCHIT was granted a $2.7 million contract by the Department of Health and Human Services (HHS) to support its mission. A number of other medical associations have since supported CCHIT. Despite the HHS contract, CCHIT is not an extension of the federal government.

As of March 2009, Eighty-some ambulatory EHRs received certification against the 2006 CCHIT criteria, sixteen EHRs received certification against the more rigorous 2007 criteria and twenty have achieved CCHIT certification for the 2008 Ambulatory EHR criteria. We estimate this equates to roughly 30% of all ambulatory EHRs being certified, while additional EHR vendors are currently pursuing certification for their systems.

In the article, SoftwareAdvice’s founder and owner, Don Fornes, also goes on to answer the questions:

• What are the benefits of CCHIT?
• Why does CCHIT generate some controversy?
• Why doesn’t every vendor just get certified?
• What are the criteria used by CCHIT to certify EHRs?
• What important criteria does CCHIT not evaluate?
• Does CCHIT evaluate specialty EHRs or templates for specialists?
• Will CCHIT result in higher prices for EHRs?
• Will a CCHIT-certified EHR improve my practice’s income?
• Do I need a CCHIT-approved EHR to participate in my local HIE?

and ends with conclusions, recommendations and five key takeaways for helping you determine your path with EHRs and CCHIT.

Because I had never come across the SoftwareAdvice site before, I spoke with Houston Neal from Software Advice to understand what the site is and how it works.  Houston told me that the company has been helping healthcare entities choose practice management and electronic medical records software for almost 2 years and that the goal of the service is to help physicians develop a short list of vendors specific to their specialty and software needs.  There is no charge to the physician, but the software companies pay a referral fee to Software Advice.  Not all software vendors are represented on the site, but the company is working to get all vendors on board, and their representatives may discuss non-participating vendors if the needs of the physician warrant it.  Although I’ve not tried their service, it seems like a win/win situation if practices can get free software vendor recommendations based on a needs analysis.  I’d be interested in knowing if anyone out there has used SoftwareAdvice and what your feedback is.

By the way, in case you’re wondering, Houston confirmed for me that the way to pronounce “CCHIT” is either “SEA-CHIT” or :C.C.H.I.T.”  Thought you’d like to know!

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.

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.

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.

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.

Skill 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.

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.

Have you ever discovered a new software shortcut you can use that improves your efficiency?  Or someone is working with you and shows you a faster way to do something?  What a great moment and a great feeling of success that is – it’s almost like winning a prize!

Sometimes I’ll be working with Excel and just KNOW there’s an easier way to do something, but don’t have the time, the energy, or the patience to find out what it is.  Not that going to Help is that hard or time-consuming, but it’s a mindset that I will find out some other time how to do it faster.  That “other time” never comes.

We’re getting ready to have Brown Bag Training classes (30 minutes, during lunch, staff bring their lunch, not mandatory) at my practice to bring staff up to speed on some basics.  I’m sure we’ll give them some great tips, and I’m sure we’ll learn a lot too.  The point is to get everyone together and build our group knowledge by sharing what everyone knows.

In preparing our handouts for the classes, we’ll use the great article by David Pogue, a tech writer for the NY Times.  The article has 1228 comments full of tips from readers!  Here a few to whet your appetite:

You can enlarge the text on almost any Web page. In Windows, press Ctrl and the plus or minus keys (for bigger or smaller fonts); on the Mac, it’s the Command key and plus or minus.

Instead of the painstaking task of highlighting a whole document or web page with the mouse cursor, hit Control + A to select all.

You can tap the Space bar to scroll down on a Web page one screenful. Add the Shift key to scroll back up.

If you are having a problem in Windows and need to ask somebody for advice, try this: in Windows, use the Print-Screen button on your keyboard to take a picture of what’s on your computer screen. You can then paste that (CTRL-V) into a Microsoft Word document. Double click on it in Word and you will get options to crop it and resize it. Then email it.  Showing somebody the problem you are having is a lot easier than trying to describe it.

What’s your favorite tip or trick?