Book Excerpt

Editor's note: Optometric Management is proud to introduce the first in our occasional series of book excerpts that provide sound
advice for excellence in practice management.

TITLE: How to Select and Implement the Right Computer Solution for Your Ophthalmic Practice AUTHORS: Susan and David Jones PUBLISHED BY: Medical Business Publishing Tel: 765-482-7964

CHAPTER 1: THE COMPUTER USERS

Who will use the system?

The reason you implement a computer system is so people can use it to make the practice run more smoothly and efficiently. Who will be using the computer system in your practice--the doctors, the technicians, the billers, the appointment schedulers or everyone? The people who will be using the system or viewing reports from the system need to have input into the decision-making process of selecting a system. Getting the staff on board and involved is very important. They will need to buy into the system that is selected in order to make the implementation a success.

The key people

Managers and physicians definitely need to have input into the system chosen. The office manager and/or administrator need to have input for practice management systems. Any physician who will use a medical records system needs to have input. The goal in implementing a new system is to improve how your practice works. Who best to help select the proper system but the people who will use it daily? Computer systems offer so many functions and have such a big impact on the way people do their jobs that it only makes sense to include the people the system will impact in the selection process. If they are left out, they can make the implementation fail. In one installation with which I was involved, the office manager was left out of the selection process. She was told which system the doctor had selected when he had been at a meeting. She made the installation process a nightmare by nit-picking and resisting every recommendation the trainers made because she hadn't been included in the selection process. So make sure you give your key people some say.

Get staff input

If the staff is too large to include everyone in the demonstrations of systems, at least be sure that everyone has input. Ask all staff members to write down the important features they need in a system. Incorporate these in the list of features you are seeking. It is better to try to get people involved before the system is selected than after. Most people like to feel they have control and input in their work. Staff who don't feel included can sabotage a computer system. However, once people have had their input and the best system is chosen, not every need will have been met. No system will do everything the staff can dream up, but the administrator, managers or doctors need to tell everyone why this system was chosen and then inform them they all need to do their best to make the implementation successful.

Change

Installing a computer system is always an upheaval for the staff since it changes so much of what they do everyday. Because installing a new system involves so much change and because people can only handle so much change at one time, do not schedule the installation at a time when many other things are changing. For example if you are building a new office, don't install a new system at the same time you move in. Install it either several months before or after the move.

If you are planning to install both a practice management system and an electronic medical records system (EMR), don't try to install them both at the same time. Get the practice management system up and running first. Implement the EMR system a few months later. The one exception to this is if you are opening a new practice and want to begin using both systems from the beginning. In this situation implementing both can work. A new practice usually does not have the volume of patients that an established practice has so the staff should have the time to make both systems work.

CHAPTER 2: NECESSARY FEATURES

Analyze needs and patient flow

First, analyze your needs and patient flow. This is time-consuming, but this is the only way to know what your practice needs. Doing this is likely to give your practice a system that performs the functions your staff requires.

Just as a doctor talks with and examines a patient to figure out what type of problem he has, you, a staff member, or a consultant must analyze the requirements of your practice to figure out what functions you'll want in a computer system. Certainly there are some findings the doctor can discover without talking to the patient. The doctor knows a patient's pressure should be within a certain range and will provide treatments to help it get there. You know you will need the practice management system to register patients, so you'll make sure the computer system includes a patient registration module. The doctor discovers from discussing the patient's eating habits that he eats mainly hamburgers and French fries, so the doctor strongly suggests that he cut down on the fatty foods and eat more fruits and vegetables. After discussing some of the activities the front desk staff performs, you realize that the computer system needs to be able to allow tracking of multiple authorization numbers, so you make sure the computer system allows the users to do that quickly and efficiently.

Create a required and desired features list

Your practice does many things that other practices do, but no two practices do everything the same. Take the information the staff members have given you as their input into the selection process from Chapter 1. Organize it by subject the way modules of software are often divided so that it can be used in the next chapter. Examples of headings for practice management systems are patient registration, billing and reports. Examples of headings for electronic medical records systems are findings, drawings and interfaces with automated instruments. Following are suggested headings for practice management systems and electronic medical records:

Practice Management System Subject Headings

Appointment Scheduling
Patient Recalls
Patient Registration
Tracking Patients through Office Visits
Billing
Statements
Insurance Filing
Mail Merge
Reports
Marketing
Codes
Accounts Payable
Time Clock
Payroll
Inventory
Spectacle Orders
Other Optical
General Ledger
Security

Electronic Medical Records System Subject Headings

Following Patients
Knowledge Base
Entering the Exam Data
Drawings
Drug Interactions and Dosages
Interfaces with Automated
Instruments and Laboratories
Specific Numeric Data
Interfaces with Practice
Management Systems
Determining CPT and Diagnosis Codes
Generated Documents and Reports
Security

Then use the organized information to dig deeper to make sure you have listed your important requirements. Some of the items on your list may be desired but not absolute necessities. List desired features as well as required features.

Your present system

If you are replacing your computer system, review that system and note what you and your staff like and dislike. Realize that just because your present system includes a certain feature that you like, the new system may not have that feature at all. So don't take for granted that newer systems will contain all of the features of your present system. For instance identifying the insurance company with the payment may be something your present system does that a new system may not. If certain features are important, they need to be included in your required and desired features list and discussed with the computer salesperson during the demonstration.

After working on your list, set it aside for a day or two. Then review it again to see if anything new comes to mind. Allow key personnel to review and revise it as well.