The Paperless Medical Office?

26/11/08 14:45 Filed in: Practice=20 Management

Going = paperless is a=20 hot issue in medical practice management today. It sounds like a great = idea with=20 lots of benefits and no downsides. But is this true? There are = significant=20 benefits and savings in going paperless (as far as is currently = possible) but=20 there are critical issues that need to addressed which may completely = reverse=20 any expected cost savings.

What can be=20 paperless?
Currently, it = is not=20 possible to be completely paperless in medical practice. Most areas of = practice=20 can be relatively paper-free but still involve paper as the medium of=20 communication between the practice and other practitioners, hospitals, = labs or=20 funding bodies. Probably paper-light is a better term and covers the = following=20 areas:

billing & receipting including = Medicare=20 Online
letter management
clinical notes
appointment & procedure = booking
prescribing
test ordering
incoming documentation from = referrers and=20 other sources

The Benefits
Typically, when a doctor says they are = going=20 paperless, they mean that all incoming documents are going to be scanned = into=20 their practice management system. No more filing cabinets!
To my = mind, the=20 benefits are the following:

the ability to access your = documents from=20 anywhere. This can be accomplished in a number of ways such as via the = web or=20 by synchronising the files to your laptop. This is THE reason for = going=20 paperless I think. It offers the potential for having your clinical=20 information with you at the moment you need to make a decision.
data security. Destruction of your = rooms=20 with your filing cabinets is a disaster. Appropriate off-site backup = of your=20 paperless office means you haven=E2=80=99t lost anything.
submitting accounts electronically = can offer=20 quicker turnarounds and savings. Medicare Online bulk bills are = usually paid=20 within 36 hours. Postage is unnecessary for these accounts.
communicating with colleagues and = patients=20 using email and SMS. Note that patient information is confidential and = must=20 not be sent unencrypted.
clinical documents are now = legible.
no more filing cabinets. Filing = cabinets=20 take up space that costs money and filing files takes up staff time.=20

Numerically, = there aren=E2=80=99t a=20 lot of benefits in going paperless and it is difficult to put a dollar = value on=20 the one I think is the most important ie having your data wherever you = go. The=20 cost of the filing cabinets is obviously going to vary with your actual = floor=20 costs.

The=20 Costs
Whilst the benefits = of going=20 paperless can be somewhat intangible, the costs are definitely not and = are=20 commonly grossly underestimated by doctors contemplating this option. = Going=20 paperless is a major endeavour.
The costs are:

equipment-related = costs

- modern computers have enough = horsepower to=20 manage electronic documents but you may need to upgrade your hard = disk=20 storage as scanned documents and photos can eat up storage=20 space.

- - expect to replace computers = every three=20 years maximum

- document scanner. You should = budget around=20 $1500 for one of these. Do not think that your current flatbed = scanner will=20 suffice - it won=E2=80=99t.
- backup devices and=20 software

- - you need to budget for devices = to=20 support at least two rotating backups as well as software that = allows you=20 to schedule automatic backups
- - offsite storage of a backup is = essential=20 in the paperless environment

- high-speed internet connection = is=20 essential for the remote backup service

staff-related = costs

- you have to learn to = type
- get good staff that are = IT-aware.=20
- training. Filing cabinets have a = user=20 manual that is less than one page long and require minimal training = for new=20 users. A paperless environment requires staff that are tech-savvy = which=20 basically means that they have been adequately trained in the whole = of the=20 office=E2=80=99s IT. This means, for example, that all staff members = can recover the=20 system from a fatal crash. If your system goes down for any reason, = your=20 practice stops.

security costs

- regulatory bodies place higher = demands on=20 the electronic storage of documents than they do on paper storage. = We have=20 mentioned the issue of adequate backups above
- physical security. Not only does = the=20 access to your rooms need to be secure, the access to your computer = needs to=20 be secure as well. If you are running a single user system, the = computer=20 should be secured by a physical security system. Servers should be = locked in=20 a cupboard with adequate ventilation.

support costs

- the better trained your staff = are, the=20 lower your support costs. A paperless system is much more complex = than a=20 conventional system and is less fault-tolerant. You are going to = need IT=20 support from a reputable person or firm. Make sure you contact us = for=20 recommended people.
- typically, IT support runs = around $120 -=20 $150 per hour. Consider a support contract for both the software and = hardware.

practice management=20 limitations

- Medicare Online offers the = tantalising=20 benefit of quick turnaround of payments. However, this is only true = if you=20 accept the rebate fee or have a strict policy of getting paid in = full at the=20 time of consultation.
- the glue that will tie your = practice into=20 the wider health care network is not in place yet. There is no way = for=20 transmitting your path requests and prescriptions electronically to = labs or=20 pharmacies. The main benefit is that they are now=20 legible.

Conclusion
A paperless practice can be a great idea. = However, the=20 cost-benefit equation needs to be done for each practice because the = costs can=20 very rapidly get out of control.

SmartRooms

Practice=20 Management

=C2=A9 2008 Doctorware (Aust) Pty Ltd Contact=20 Us