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Do Practice Management Systems Keep Your Practice Legal?
When it comes to practice management systems, the “writing is on the wall” says Dr. Thomas Handler, analyst at Gartner. “Every doctor is headed in that direction and it will eventually become the standard of care,” he predicts.
In part, that prediction is already a reality, at least within the scheduling and billing components.
“The benefits in scheduling and billing are obvious in stream-lining processes, added efficiency, and better collections and cash flows,” says Bret Jones, analyst at Leerink Swann & Co.
Beyond front- and back-office work, few physicians are happily venturing further into technologies designed to aid their practice.
“That’s because scheduling and billing are pretty much standardized so it’s easy to do,” says Jones. “Electronic Medical Records (EMR), Electronic Practice Management (EPM), e-prescribing, those are slower on the uptake because they are more customized and rather labor intensive.”
But now that HIPPA concerns over electronic filing have been resolved and paper performance is an insurance industry mandate, doctors can find little ammo with which to fight acceptance, hence the scripting on painted sheetrock to which Dr. Handler referred.
Even so, doctors are chafing at having to fork out the money for systems they feel benefit everyone else but them. “They can’t help but think ‘Why am I paying for it when others benefit from it like the patient that gets cheaper meds and the hospitals that save on data entry costs?” they ask ‘what’s in it for me?” says Handler.
While the benefits to doctors are often unclear, there are a few major points in the plus column. “EMR can lower malpractice insurance costs for one thing,” says Handler. That can be a hefty and very pocketable savings.
“If done correctly, you won’t miss things you shouldn’t miss, errors should be reduced, and efficiency should increase,” said Handler.
There’s also the unintentional side effect of this automated thoroughness to consider. “Doctor’s normally document the things they do, not the things they don’t do,” explains Handler. “In contrast, when the systems’ defaults are used, the system can report billable activities were performed, that weren’t.”
For example, a doctor may examine the ailing body part and note the problem and then click the button for the default reporting of normal on other body parts. But the system, according to its own default system, will report these “normal” readings as “upon examination” rather than “as button pushed.” This can lead to higher automated billings in favor of the doctor but increase law suit potentials if a problem lurks where you did not examine but the system recorded that you did.
“This is an example of over-documentation that can lead to trouble by documenting areas were examined that weren’t but can also lead to you getting paid for things you haven’t done,” says Handler. “Either way, there’s no malintent on the doctor’s part, it’s just the side effect of a one-click reporting system.”
“Essentially, under-documenters are at risk as are over-documenters,” he adds “the trick is to use the systems correctly so that it doesn’t take too much time or too much money, and so your documentation is thorough and to your benefit in terms of efficiency, insurance compliance and legal protection.”