[Practiceimp WAS Re: efficiency an d money

[Guest guest]

Lynn, , Annie,

OK this is going to be lengthy, please bear with me. The idea of

printing and mailing labs seems absolutely wacky (unless your

patients don't have internet access). These workflow issues are

EXACTLY how using the new secure updox email and the updox desktop

can do everything you have mentioned at a fraction of the time

without envelopes, postage, or papercuts! Here is a typical

scenario:

-The lab sends me a multi-page fax with multiple patient's labs- it

shows up in my email inbox. ***

-I open the email and UpDox asks me if I want to load the fax into

the " workspace " , I click yes

-I view small thumbnail views of the pages. I click on the first

one and a larger version of it shows up in the window below the

workspace. I can read all of the details of the lab and see who the

labs belong to.

-I click an icon to open up my patient list to select that patient's

name to assign that page to that patient

-Once the patient is assigned, I have the option of annotating the

lab form with either a typed message or a voice recording.

-When I am satisfied the lab is ready for the chart, I click a

little icon that opens a window that asks me what I want to do with

the file. With one checkbox, I designate that I want the file filed

in the patient chart in Amazing Charts, and I select under what

category heading. I click another checkbox that designates that I

want to E-mail the patient. (there are other options of what to do

with the document, but for this example I will stop there). I then

click a " done " button.

-At this point an Email editor pops up with the patient's email

address in the " to " field and the lab report with its annotation

saved as a PDF attachment. I can then write a personal email to the

patient, or select from a list of customizable template emails (just

like you can make templates in the letter writing screen of Amazing

Charts).

-My last step is clicking a small padlock icon on the email editor

screen to ensure that the Email and its attachments are encrypted

and can only be opened by my patient on his free home UpDox

program. I then click " send " , and whammo.....I'm done.

I can then close the email editor and return to my " workspace " where

the remaining pages of the multipage fax are waiting for me to view,

anotate, assign, file in AC, and email to the patient.

*** If you don't get labs faxed to you and you scan paper into the

computer, there is a simple function where you simply drag and drop

your scanned files from any file folder on your computer into

the " workspace "

>

>

>

>

>

> Hi Lynn,

>

> You have a lot of issues below, and it is late, so I am going pick

on

> the phone med thing just for the moment.

>

> When it comes to lab results, I mail each and every result to the

> patient, with an interpretive letter. With my emr, that is easy

to do,

> and MUCH faster than talking to people on the phone. Even when I

> customize the letter and add education items, it is still faster

than a

> phone call. If I think the findings require a discussion, then

that

> needs to be an office visit about 99% of the time, tho' there are

always

> exceptions. I like sending letters better than talking on the

phone for

> a couple reasons: Saving time is #1, but a close second is that

there is

> clear, accurate recording of what I told the patient; none of

this " You

> never told me I have diabetes, you just said my sugar was a little

high "

> stuff – it's right there in black and white (or 1s and 0's). Also

it

> avoids the " while I have you on the phone… " add-ons…And if labs are

> abnormal and some sort of follow up is needed soon, I hate to say

it,

> but I really try not to call those folks myself. A staff person

calling

> to say " Dr. Skaggs wants you to come over as soon as you can takes

under

> 5 minutes. If I call, it's " Why can't you just tell me on the

phone?

> If I need a surgery referral, can't you just do it and let me know

where

> to go and when? " I find it really hard to say " When you came

in for

> your " sprained ankle " I only charged you for a 99213, but if I now

have

> to get you some crutches, excuse you from work for a while, get a

> referral cleared thru your crappy insurance, find an orthopod who

takes

> your crappy insurance and set up the appointment….well, I need to

get

> you in here so I can get paid for all that stuff " Easier to just

have

> the college girls give an appointment…

>

>

>

> More later, bed now,

>

> Annie

>

>

>

> RE: [Practiceimp WAS Re:

efficiency and

>

> >money

> >Date: Tue, 10 Oct 2006 22:20:26 -0400

> >

> >Lynn, I am finding that I am providing free services to office

visits

> at

> >a rate of almost 10 to 1. Is that what you mean by admin time? For

> >every visit a patient makes I have to respond to two specialist

> >contacts, one radiology report, two lab reports, two formulary

and/or

> > " care management " issues, three phone calls from the patient, and

one

> >pharmacy phone call (not a formulary issue).

> >

> >

> > " I am checking my Admin time: patient time ratio and it is

HORRIFIC!

> >something

> >like 40 hours of admin to 20 patient hours. I have got to FIX

THIS!

> >I'm

> >going to break down my times even more to see where it's leaking

out

> to.

> >I

> >really want to get to a sustainable work load over the next year,

or I

> >will

> >be BERSERK! I'll keep you guys posted. Thanks again for all the

> >support

> >and it was lovely to see you all in the flesh.

> >

> >Lynn "

> >

> >In a " big office " where MAs do a lot of this stuff they don't

probably

> >realize how much time it eats up, but if you do it all

yourself....I

> >have randomly reviewed charts in the past to look at this

question. In

> >the past week and a half I have started leaving all charts open

until

> >the end of the day... for every patient I actually see during a

day

> >there are 9 - 10 more open at the end of the day, for who I have

had to

> >do SOMETHING, but for whom I am paid nothing...What can we do

about

> >this?

> >Annie

> >

> >

> >

>

[Guest guest]

Dear -I do agree that mail is wacky and will be cutting back on it someday - but when I started up about 1/2 my 1000 patients did not use email effectively, SO it was not safe for me to use that method of communication. Stamps and envelopes cost me about $50.00 a month, so it's not make or break thing for me. As I see it, the process of converting to email involves at a minimum: surveying a group of current patients accurately to verify what percentage has good email access, clarifying with each patient at the time I give them a lab slip how they want to be contacted and keeping track of that until I'm comfortable just using email always. Anyone starting a new practice can create that expectation with their patients as they enroll, which will be much easier. Now, I type the letter in AC, print it, and my receptionist generates an envelope, so it's pretty fast. Lynn, , Annie,OK this is going to be lengthy, please bear with me. The idea of printing and mailing labs seems absolutely wacky (unless your patients don't have internet access). These workflow issues are EXACTLY how using the new secure updox email and the updox desktop can do everything you have mentioned at a fraction of the time without envelopes, postage, or papercuts! Here is a typical scenario:-The lab sends me a multi-page fax with multiple patient's labs- it shows up in my email inbox. *** -I open the email and UpDox asks me if I want to load the fax into the "workspace", I click yes-I view small thumbnail views of the pages. I click on the first one and a larger version of it shows up in the window below the workspace. I can read all of the details of the lab and see who the labs belong to.-I click an icon to open up my patient list to select that patient's name to assign that page to that patient-Once the patient is assigned, I have the option of annotating the lab form with either a typed message or a voice recording.-When I am satisfied the lab is ready for the chart, I click a little icon that opens a window that asks me what I want to do with the file. With one checkbox, I designate that I want the file filed in the patient chart in Amazing Charts, and I select under what category heading. I click another checkbox that designates that I want to E-mail the patient. (there are other options of what to do with the document, but for this example I will stop there). I then click a "done" button.-At this point an Email editor pops up with the patient's email address in the "to" field and the lab report with its annotation saved as a PDF attachment. I can then write a personal email to the patient, or select from a list of customizable template emails (just like you can make templates in the letter writing screen of Amazing Charts). -My last step is clicking a small padlock icon on the email editor screen to ensure that the Email and its attachments are encrypted and can only be opened by my patient on his free home UpDox program. I then click "send", and whammo.....I'm done.I can then close the email editor and return to my "workspace" where the remaining pages of the multipage fax are waiting for me to view, anotate, assign, file in AC, and email to the patient.*** If you don't get labs faxed to you and you scan paper into the computer, there is a simple function where you simply drag and drop your scanned files from any file folder on your computer into the "workspace"> > > > > > Hi Lynn,> > You have a lot of issues below, and it is late, so I am going pick on> the phone med thing just for the moment.> > When it comes to lab results, I mail each and every result to the> patient, with an interpretive letter. With my emr, that is easy to do,> and MUCH faster than talking to people on the phone. Even when I> customize the letter and add education items, it is still faster than a> phone call. If I think the findings require a discussion, then that> needs to be an office visit about 99% of the time, tho' there are always> exceptions. I like sending letters better than talking on the phone for> a couple reasons: Saving time is #1, but a close second is that there is> clear, accurate recording of what I told the patient; none of this "You> never told me I have diabetes, you just said my sugar was a little high"> stuff – it's right there in black and white (or 1s and 0's). Also it> avoids the "while I have you on the phone…" add-ons…And if labs are> abnormal and some sort of follow up is needed soon, I hate to say it,> but I really try not to call those folks myself. A staff person calling> to say "Dr. Skaggs wants you to come over as soon as you can takes under> 5 minutes. If I call, it's "Why can't you just tell me on the phone?> If I need a surgery referral, can't you just do it and let me know where> to go and when?" I find it really hard to say "When you came in for> your "sprained ankle" I only charged you for a 99213, but if I now have> to get you some crutches, excuse you from work for a while, get a> referral cleared thru your crappy insurance, find an orthopod who takes> your crappy insurance and set up the appointment….well, I need to get> you in here so I can get paid for all that stuff" Easier to just have> the college girls give an appointment…> > > > More later, bed now,> > Annie> > > > RE: [Practiceimp WAS Re: efficiency and> > >money> >Date: Tue, 10 Oct 2006 22:20:26 -0400> >> >Lynn, I am finding that I am providing free services to office visits> at> >a rate of almost 10 to 1. Is that what you mean by admin time? For> >every visit a patient makes I have to respond to two specialist> >contacts, one radiology report, two lab reports, two formulary and/or> >"care management" issues, three phone calls from the patient, and one> >pharmacy phone call (not a formulary issue).> >> >> >"I am checking my Admin time: patient time ratio and it is HORRIFIC!> >something> >like 40 hours of admin to 20 patient hours. I have got to FIX THIS!> >I'm> >going to break down my times even more to see where it's leaking out> to.> >I> >really want to get to a sustainable work load over the next year, or I> >will> >be BERSERK! I'll keep you guys posted. Thanks again for all the> >support> >and it was lovely to see you all in the flesh.> >> >Lynn"> >> >In a "big office" where MAs do a lot of this stuff they don't probably> >realize how much time it eats up, but if you do it all yourself....I> >have randomly reviewed charts in the past to look at this question. In> >the past week and a half I have started leaving all charts open until> >the end of the day... for every patient I actually see during a day> >there are 9 - 10 more open at the end of the day, for who I have had to> >do SOMETHING, but for whom I am paid nothing...What can we do about> >this?> >Annie> >> >> >>

[Guest guest]

Dear -I do agree that mail is wacky and will be cutting back on it someday - but when I started up about 1/2 my 1000 patients did not use email effectively, SO it was not safe for me to use that method of communication. Stamps and envelopes cost me about $50.00 a month, so it's not make or break thing for me. As I see it, the process of converting to email involves at a minimum: surveying a group of current patients accurately to verify what percentage has good email access, clarifying with each patient at the time I give them a lab slip how they want to be contacted and keeping track of that until I'm comfortable just using email always. Anyone starting a new practice can create that expectation with their patients as they enroll, which will be much easier. Now, I type the letter in AC, print it, and my receptionist generates an envelope, so it's pretty fast. Lynn, , Annie,OK this is going to be lengthy, please bear with me. The idea of printing and mailing labs seems absolutely wacky (unless your patients don't have internet access). These workflow issues are EXACTLY how using the new secure updox email and the updox desktop can do everything you have mentioned at a fraction of the time without envelopes, postage, or papercuts! Here is a typical scenario:-The lab sends me a multi-page fax with multiple patient's labs- it shows up in my email inbox. *** -I open the email and UpDox asks me if I want to load the fax into the "workspace", I click yes-I view small thumbnail views of the pages. I click on the first one and a larger version of it shows up in the window below the workspace. I can read all of the details of the lab and see who the labs belong to.-I click an icon to open up my patient list to select that patient's name to assign that page to that patient-Once the patient is assigned, I have the option of annotating the lab form with either a typed message or a voice recording.-When I am satisfied the lab is ready for the chart, I click a little icon that opens a window that asks me what I want to do with the file. With one checkbox, I designate that I want the file filed in the patient chart in Amazing Charts, and I select under what category heading. I click another checkbox that designates that I want to E-mail the patient. (there are other options of what to do with the document, but for this example I will stop there). I then click a "done" button.-At this point an Email editor pops up with the patient's email address in the "to" field and the lab report with its annotation saved as a PDF attachment. I can then write a personal email to the patient, or select from a list of customizable template emails (just like you can make templates in the letter writing screen of Amazing Charts). -My last step is clicking a small padlock icon on the email editor screen to ensure that the Email and its attachments are encrypted and can only be opened by my patient on his free home UpDox program. I then click "send", and whammo.....I'm done.I can then close the email editor and return to my "workspace" where the remaining pages of the multipage fax are waiting for me to view, anotate, assign, file in AC, and email to the patient.*** If you don't get labs faxed to you and you scan paper into the computer, there is a simple function where you simply drag and drop your scanned files from any file folder on your computer into the "workspace"> > > > > > Hi Lynn,> > You have a lot of issues below, and it is late, so I am going pick on> the phone med thing just for the moment.> > When it comes to lab results, I mail each and every result to the> patient, with an interpretive letter. With my emr, that is easy to do,> and MUCH faster than talking to people on the phone. Even when I> customize the letter and add education items, it is still faster than a> phone call. If I think the findings require a discussion, then that> needs to be an office visit about 99% of the time, tho' there are always> exceptions. I like sending letters better than talking on the phone for> a couple reasons: Saving time is #1, but a close second is that there is> clear, accurate recording of what I told the patient; none of this "You> never told me I have diabetes, you just said my sugar was a little high"> stuff – it's right there in black and white (or 1s and 0's). Also it> avoids the "while I have you on the phone…" add-ons…And if labs are> abnormal and some sort of follow up is needed soon, I hate to say it,> but I really try not to call those folks myself. A staff person calling> to say "Dr. Skaggs wants you to come over as soon as you can takes under> 5 minutes. If I call, it's "Why can't you just tell me on the phone?> If I need a surgery referral, can't you just do it and let me know where> to go and when?" I find it really hard to say "When you came in for> your "sprained ankle" I only charged you for a 99213, but if I now have> to get you some crutches, excuse you from work for a while, get a> referral cleared thru your crappy insurance, find an orthopod who takes> your crappy insurance and set up the appointment….well, I need to get> you in here so I can get paid for all that stuff" Easier to just have> the college girls give an appointment…> > > > More later, bed now,> > Annie> > > > RE: [Practiceimp WAS Re: efficiency and> > >money> >Date: Tue, 10 Oct 2006 22:20:26 -0400> >> >Lynn, I am finding that I am providing free services to office visits> at> >a rate of almost 10 to 1. Is that what you mean by admin time? For> >every visit a patient makes I have to respond to two specialist> >contacts, one radiology report, two lab reports, two formulary and/or> >"care management" issues, three phone calls from the patient, and one> >pharmacy phone call (not a formulary issue).> >> >> >"I am checking my Admin time: patient time ratio and it is HORRIFIC!> >something> >like 40 hours of admin to 20 patient hours. I have got to FIX THIS!> >I'm> >going to break down my times even more to see where it's leaking out> to.> >I> >really want to get to a sustainable work load over the next year, or I> >will> >be BERSERK! I'll keep you guys posted. Thanks again for all the> >support> >and it was lovely to see you all in the flesh.> >> >Lynn"> >> >In a "big office" where MAs do a lot of this stuff they don't probably> >realize how much time it eats up, but if you do it all yourself....I> >have randomly reviewed charts in the past to look at this question. In> >the past week and a half I have started leaving all charts open until> >the end of the day... for every patient I actually see during a day> >there are 9 - 10 more open at the end of the day, for who I have had to> >do SOMETHING, but for whom I am paid nothing...What can we do about> >this?> >Annie> >> >> >>