Clinical practice in the 21st century is sure to pose some tough challenges. Gone forever is the practice of unlimited care for any reason with relatively meager accountability. The delivery of health-care services will largely be predetermined by the contractual language of the third-party payor and the manner of interaction with the treating physician.
As a result, the responsibility placed on you as an attending DC will grow exponentially. Not only will you have to refocus on your primary task, the proper treatment of the patient based on today’s standard-of-care protocols; but an additional layer of concern will be required, which will seriously affect how all health-care providers function. Clinical documentation is becoming more important than ever.
The comfort zone of a professional practice depends on many factors. Clinical success is of paramount importance, but another extremely important consideration is reimbursement for the services performed. It is painfully obvious that the economic side of a professional practice is vital. Today’s demands for reimbursement have created multiple layers of complexity. Simple submission of a HCFA 1500 form will no longer be adequate. Your clinical records, as well as progress, daily notes or SOAPs, will be mandated as a prerequisite to financial reimbursement.
You may be wondering how an already overloaded and economically stretched chiropractor will be capable of responding. Fortunately a solution exists, but it will require a studious and clinically disciplined attitude: Documentation, documentation, documentation! Notes, SOAPS, histories and outcomes all must be accurate and impeccable. The domino effect is: How can you efficiently implement this in your office setting.
Paper, manila folders and handwritten notes will become memorabilia of the past. Only by the incorporation of intuitive, computerized office software can this be efficiently accomplished. Computerized patient records (CPR) will become the normal standard in the health-care delivery system. While this change may require an attitude or paradigm shift for many, the potential benefits abound.
Once medical records are in a digital format, all the efficiencies of workflow can be achieved. You can send, transmit, fax, e-mail or print all or any part of the record upon demand. No longer must the you keep onsite all the necessary paper records. You can quickly and easily access any data needed for proper reimbursement. Workers’ compensation, personal injury protection coverage, major medical, PPO, HMO, managed care or a cash practice can all be intuitively integrated by proper software design.
The economic advantages gained by electronic data transmission/electronic claims submission are significant. The savings to an office may amount to thousands of dollars over a 12-month period. Of special note, today’s multi-disciplinary practices demand a complete software solution to coordinate all providers; especially with the oversight that these practices necessarily attract.
In choosing practice management software, you need to consider not only the billing and accounting capabilities, but also how well the clinical management of the program will be integrated. The practice management software for the 21st century will demand complete computerized integration of all office functions: namely, clinical, clerical, records, data, statistics and reporting. Fragmented, disassociated, non-integrated programs will be inefficient and basically non-functional.
The evolution of all software and computerization will be in a “humancentric model.” The software will duplicate the office workflow, and in essence, function as we humans perform. This capability will allow for ease of integration between you, your staff and your computer system. It is thus obvious that the first half of the equation, Documentation = Reimbursement is frustratingly valid. The benefits to computerized record-keeping are not limited to simply increasing office efficiency. Computerization will also help decrease the inefficient use of your time, allowing you to direct your energies to that which you do best, namely treating patients. The added value will be profound.
You will be able to monitor instantly all clinical aspects of patient care and then integrate any necessary changes. Instant access to the vast clinical information available worldwide will necessarily improve outcomes. The future research data that will become available to the chiropractic profession will directly impact our professional growth and acceptance by the mainstream. Patient care will improve, overhead costs will decline, and financial benefits will accrue.
Perhaps the most undervalued effect of integrated practice management software will be the clinical benefits derived by patients. The instant availability of clinical data coupled with the ease of transmission will greatly enhance the interactions of multiple disciplines. The portability of patient files will be conveniently maximized. The improvement of record-keeping, added to the clinical data collected, will significantly reduce the doctor’s risk of malpractice. It is well-known that inadequate records are responsible for the majority of lawsuit losses. Your defensibility will be directly proportional to your recording, tracking patients’ compliance, attendance and outcomes.
The doctors who embrace technology will be better informed, serve their patients better and be clinically more efficient. No longer can doctors remain static. You must either progress or assume the consequences. Thus the final part of the equation D=R=MD (Documentation=Reimbursement=Malpractice Defense) will logically flow.
The technologies now being developed and improved will contribute to making our offices comfortable and will help return the pleasure of practice once again. The increase in CPU speed and power are directly beneficial to health-care providers. This technology will allow for improved consumer-friendly functionality such as voice technology. The time is near for full voice integration between the computer and its human partner.
The recent release of a new technology from the world of Microsoft, namely Pocket PC, will deliver significant benefit to the hand-held computer systems. The benefits to the professional world will be incredible. The advantages of powerful mobile computerization will render much of the past as obsolete.
As these hardware developments increase, the practice management software must keep pace and incorporate these improvements. The end result is a victory for both you and your patients.
Think of the possibilities that lie before us: “Good morning HAL, please help me with the diagnosis.” This type of technology, envisioned in Stanley Kubrick’s “2001: A Space Odyssey,” is no longer such an impossible dream.
