Just as the development of the automobile made the horse-drawn carriage a rare sight, personal computers (PCs) will make paper patient charts, referrals, reports, prescriptions, claims, and payments obsolete for medical practices in the electronic age. Once a technological innovation reaches a high enough level of consumer usage, rapid innovations and changes occur in the way products and services are purchased and delivered.
By 2007, experts believe that PCs will be found in more than 90 percent of American homes, with some homes having multiple PCs. Most of these computers will be linked to the Internet and will be routinely used for information, education, communication and trade. As such, the way patients choose and interact with their health care providers will quickly change.
Obviously, everyone will be connected. Your patients will be computer literate, search the Internet for information, and communicate with your practice electronically. Payers also will be connected to you electronically, as will your colleagues and other health care providers.
Recognizing this, your office will need to stay abreast of information system developments and obtain the necessary upgrades and revisions to your information system. Why? Speed, accuracy and cost. Claims processing, billing, collections, contract analysis, benchmark analysis, financial projections, and business communications will all be computerized. In some successful practices, they already are.
Diagnostic systems, medical records, patient protocols and outcome analyses also will be digitally connected. Your referrals will be electronically processed, mediated by “smart systems” and approved or disapproved without human intervention.
Less Than Obvious Impacts
The idea behind the Internet is to make accessible–to anyone with a PC and a browser–massive amounts of information, at low cost, quickly. Soon, your patients will expect your practice to maintain a Web site that is “good enough” for them to bookmark for easy and frequent use.
Patients will routinely search the Internet for qualitative and convenient information about your ability to treat their diseases or conditions. In essence, they will become “experts” in the diagnosis and treatment options available to them. They will make provider decisions based on Internet information. More important, they will expect the point of doctor-patient contact to migrate from the medical practice office to their home PC.
Sounds like futuristic “technojunk?” Consider how consumers now buy software, books, cars, and even homes online. They can read book reviews and passages, learn the cost of a car to the dealer, and scan virtual “homes for sale” catalogs, all while sitting at their home or business computer. Imagine how these people will approach health care services.
Patients will expect your practice Web site to inform and educate them, and provide interactive services, such as online appointment scheduling and questionnaire (i.e. patient history, satisfaction surveys, etc.) completion from their home computers.
They will monitor their health status and view their treatment progress electronically. Often, they will attempt to diagnose themselves and determine which providers to see. They will need you to help them distinguish science from fad. More important, they will need you to guide them as they attempt to triage themselves.
Just as the telephone and television expanded the volume of information and increased the speed at which information is available, the PC and Internet will merge interactivity and telecommunications with remarkable information management capacity. This will result in “virtual” house calls, with the doctor on one end of the computer connection and the patient on the other.
Planning for the New Millennium
Your medical praccctice can be one of the ones that benefit from the dawning of the electronic age of health care, if you understand the possibilities before you and the expectations of your patients, and use that understanding to your advantage. What needs to be done?
First, make optimal use of your information systems (IS), which can and should be much more than just a billing system. Successfully computerize functions such as patient scheduling, practice accounting, medical records, and more. Increased speed and accuracy alone will pay for your IS.
Second, with the computer performing more mundane repetitive tasks, you and your staff can focus time and energy on more important and interesting matters, such as patient care, managed care strategies and practice development.
Last, reorganize your personnel and work allocation to take advantage of computerization. You will need fewer people to accomplish certain tasks, but only by adjusting your organizational structure can you achieve the full benefit of efficiencies your IS is capable of providing. There will be less differentiation between “front office” and “back office” duties, which, in turn, will result in quicker response.
Remember that your patients–to some extent now, and to a greater extent in the future–are going to expect you to make optimal use of the technology available. Consider the following applications of computer technology.
World Wide Web
The Internet is becoming the primary reference tool for patients to learn about their diseases/conditions, possible treatment methods, and provider options. Your patients are more readily going online and will use their Internet skills to learn about their health.
To provide the most meaningful care to your patients, you must help them separate the useful online information from the misleading, inaccurate and inappropriate. Know what they are “learning” online by reviewing the pertinent Web sites.
Incorporate the Internet into your patient education programs, first by encouraging your patients to visit your Web site (to learn how to use the Internet to market your practice, see Practice Management.). Include your universal resource locator (URL) or “Web address” on all your practice literature, brochures and stationery.
Patients visiting your Web site will want to learn about your educational background, the procedures you perform, the services you offer, review your practice philosophy, and learn about which health plans you participate in and which insurance carriers you accept. Send them special alerts via e-mail.
Moreover, use your Web site to direct patients, as needed, to other appropriate providers, particularly according to their health plan policies. Provide information about the help they need (that you do not provide), and where they can get it.
Your patients will expect to be able to access your schedule and request an appointment time, which your staff will either verify or decline. Before the patient visits, your practice also will be able to obtain all necessary preliminary information (i.e. insurance forms, patient records, etc).
Clearly, communicating electronically is convenient for your patients, and is a cost-efficient, broad-reaching vehicle for you too.
Practice Management
Get the most from your information system. Use your IS to generate reports and expenses, utilization rates, patient demographics, and other indicators of practice business success. You will spend less time trying to get paid, and more time analyzing how your practice is operating. More immediate service and more efficient operations will surely benefit your practice.
Connect your computer with those of other physicians with whom you routinely do business. Use your IS for referrals, consultation reports, treatment plans and similar matters. By making ssuuch coordination efforts, your patients’ health care will improve.
Explore the use of electronic messaging. You can reach a large audience clearly, quickly and cheaply with e-mail. Compared with hard copy messaging, e-mail is quicker and easier, reaches its destination faster, and incurs no postage or service charges.
Telemedicine and Virtual House Calls
Telemedicine extends computerization from communication to telemetry. Equipment already exists to obtain a patient’s vital signs and other readings at home, using a variety of digital devices. Plug the appropriate monitors into the patient’s PC, connect his or her PC with yours, and the data flows into the electronic medical record without staff involvement or expense. Moreover, automatically generated, electronically backed-up files need a fraction of the storage space paper files do.
Virtual house calls, telemedicine and computerized communication will initially benefit some patients with chronic conditions requiring continual monitoring (i.e. diabetes, asthma, and epilepsy). Your practice will be able to monitor these conditions when the patient is at home or even asleep. More important, patients will be able to discuss matters with you electronically.
Most medical practices will re-examine their personnel requirements. Most will need more medical technicians and triage nurses to help people who need information and less “administrative” help. At some point, most physicians will find it difficult to personally manage the practice and will hire practice administrators with business training and experience to assume executive (not just administrative) responsibilities.
Practices also will need information specialists, who combine their technical skills with a strong understanding of practice applications/operations. Some physicians will also earn a second degree, probably in business administration or law. Some will become computer specialists and IS experts.
This article was originally published in the spring 1999 issue of the Forecast Newsletter, published by the Health Care Group®, a nationwide health care consulting group in Plymouth Meeting, Pennsylvania.