Rosemarie Nelson
Rosemarie Nelson is a medical practice consultant.
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Latest articles
Physician voices
Incoming telephone calls should be a good thing in a medical practice, right? Requests for appointments from new patients and established patients are the lifeblood of the practice. But for many practices, the phones are an overwhelming burden for everyone,…
Incoming telephone calls should be a good thing in a medical practice, right? Requests for appointments from new patients and established patients are the lifeblood of the practice. But for many practices, the phones are an overwhelming burden for everyone, from the receptionist and nurse to the provider with an inbox full of patient messages to sort through.
In general, approximately 25% of incoming calls to a medical practice are repeat …
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Increase patient and provider satisfaction by reducing phone messages
Patient voices
Much is being made of the meaningful use requirement to use secure online messaging to communicate with patients about relevant health information. The new Stage 2 measure requires that more than 5% of unique patients seen by the eligible professional…
Much is being made of the meaningful use requirement to use secure online messaging to communicate with patients about relevant health information. The new Stage 2 measure requires that more than 5% of unique patients seen by the eligible professional during the reporting period were sent a secure message using the electronic messaging function of certified EHR technology.
But to meet that goal, we have to get our patient population engaged …
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How to improve patient engagement
Physician voices
The calendar says it's time to think about the holiday shopping season, and planning for ICD-10. Oct. 1, 2014 is the date for submitting ICD-10 diagnosis codes. What's your plan for the transition from ICD-9 to ICD-10? The breadth of…
The calendar says it’s time to think about the holiday shopping season, and planning for ICD-10. Oct. 1, 2014 is the date for submitting ICD-10 diagnosis codes. What’s your plan for the transition from ICD-9 to ICD-10?
The breadth of changes will have an impact your entire office. It’s obvious that your billing staff and coding staff will need training, but have you considered your other staff — those who schedule surgeries or …
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What’s your plan for the transition to ICD-10?
Health technology
Eligible physicians are dropping out of the HITECH incentive program. Why? Often, it's because a practice implements an EHR and then tries to mimic all their old paper processes and workflows. That can get them through the vendor's initial implementation,…
Eligible physicians are dropping out of the HITECH incentive program. Why? Often, it’s because a practice implements an EHR and then tries to mimic all their old paper processes and workflows.
That can get them through the vendor’s initial implementation, but it is not sustainable for the long term.
Workflows and operational processes must be modified to optimize the new tool. Technology changes what is feasible, and to adapt, we need to …
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7 golden rules to optimize EHR implementation
Physician voices
Your front office staff are the face of your practice -- an expression of your practice's philosophy, attitude, and values. So it should be a top priority to hire and retain top-quality people to fill such roles as receptionists, phone…
Your front office staff are the face of your practice — an expression of your practice’s philosophy, attitude, and values. So it should be a top priority to hire and retain top-quality people to fill such roles as receptionists, phone operators, medical secretaries, and transcriptionists.
But it can be a challenge to keep these people and keep their morale high because these positions often include high levels of stress for low …
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Finding and keeping great front office staff
Health technology
What is the measure of successful technology adoption? Is it never having to hunt for a missing chart? Is it a reduction in specific operating cost line items? Is it about access to clinical information when you need it and…
What is the measure of successful technology adoption? Is it never having to hunt for a missing chart? Is it a reduction in specific operating cost line items? Is it about access to clinical information when you need it and where you need it?
Technology implementation has a significant effect on profitability. The Medical Group Management Association Cost Survey Report beginning with 2010 data shows that total medical revenue after operating …
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10 mistakes practices make in implementing information technology
Physician voices
Why do you need a population health management (PHM) IT system? In our last column we discussed the fact that reimbursement tied to outcomes will demand a greater level of patient management. Greater, perhaps, than your EHR can deliver. The…
Why do you need a population health management (PHM) IT system? In our last column we discussed the fact that reimbursement tied to outcomes will demand a greater level of patient management. Greater, perhaps, than your EHR can deliver. The early focus of new pay-for-performance and bundled payment systems is on preventive care for top chronic illnesses.
The 15 most expensive health conditions account for 44% of total …
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Why you need a population health management IT system
Health technology
Office-based medical practice is changing fast. The government is providing incentives to those practices that use electronic prescribing and electronic records systems and will soon penalize those that don't. Health reform will shortly deliver many newly insured patients to your…
Office-based medical practice is changing fast. The government is providing incentives to those practices that use electronic prescribing and electronic records systems and will soon penalize those that don’t. Health reform will shortly deliver many newly insured patients to your office. A host of new patient care models aimed at making healthcare more team-based are emerging. Reimbursement tied to outcomes will demand a greater level of patient management and engagement …
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Your EHR needs a population health management system
Health technology
Should physicians use a consultant to help choose a practice management system or EHR for their practice? According to recent Medical Group Management Association surveys more than 50% of physicians used the services of a healthcare consultant or firm at…
Should physicians use a consultant to help choose a practice management system or EHR for their practice? According to recent Medical Group Management Association surveys more than 50% of physicians used the services of a healthcare consultant or firm at least once in the previous 3 years.
But did they have to? Was it a smart move?
The answer: It depends
Not every practice needs a consultant’s assistance when replacing and choosing …
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When should physicians hire an IT consultant?
Health technology
You're using an EHR. You're e-prescribing. You've eliminated pulling the old paper chart (most of the time!). That's good. But how about those orders? Are you still writing on the bottom of your fee slip or encounter ticket that you…
You’re using an EHR. You’re e-prescribing. You’ve eliminated pulling the old paper chart (most of the time!). That’s good.
But how about those orders?
Are you still writing on the bottom of your fee slip or encounter ticket that you want the patient to be scheduled for a test or with another physician? That’s not good.
Get the order in your EHR.
Instead of taking the time to write on paper, keep your hand …
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Getting your orders online reduces risk in the practice
Health technology
Vendors talk about partnering with medical practices all the time – especially in the information technology (IT) world of electronic health records (EHRs) and practice management systems. But, ask any physician about their IT solution and most will express dissatisfaction,…
Vendors talk about partnering with medical practices all the time – especially in the information technology (IT) world of electronic health records (EHRs) and practice management systems. But, ask any physician about their IT solution and most will express dissatisfaction, unhappiness, or harsh complaints.
The reason? For the most part, medical groups are not trained effectively for integrating IT into their work flow.
Ask EHR vendors about their approach to training and …
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Make IT vendors your partner for a smooth EMR transition
Health technology
The latest numbers from the CDC's National Center for Health Statistics affirm that a majority of small practices do not have an EHR. Why is that? One big reason is because small practices don't have the management or technical infrastructure…
The latest numbers from the CDC’s National Center for Health Statistics affirm that a majority of small practices do not have an EHR. Why is that?
One big reason is because small practices don’t have the management or technical infrastructure available to prepare for and handle the biggest challenges facing medical practices today.
What are those challenges and what’s that got to do with EHR implementation? According to the Medical …
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Don’t ever believe EHR uptake is slow only because it costs too much
Health technology
Which electronic health record system should I select? Among physicians and managers in small-group practices today, there is no more common question. But lately, another vexing question has emerged: Whether to install EHR software on servers in your office, or…
Which electronic health record system should I select?
Among physicians and managers in small-group practices today, there is no more common question.
But lately, another vexing question has emerged: Whether to install EHR software on servers in your office, or subscribe to an Internet-based system maintained in “the cloud.”
What Is “the cloud”?
When EHR vendors began offering their products via the cloud, many physicians were puzzled. Some think that the cloud is simply …
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Should you consider an EHR in the cloud?
Health technology
Technology adoption is iterative. Here are some suggestions that can help you adopt and morph EHR techniques and processes to fit into your own practice's workflow. When it comes right down to it, some are basic learning techniques that can…
Technology adoption is iterative. Here are some suggestions that can help you adopt and morph EHR techniques and processes to fit into your own practice’s workflow.
When it comes right down to it, some are basic learning techniques that can apply to any new situation in the office.
And remember, everyone has something to learn.
Don’t get stuck in your own routine, if a physician finds a work-around that improves a system function …
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Tips for a seamless EHR transition
Physician voices
Billing is way more than billing. In a typical medical practice, more than 300 insurance cards cross the front desk every month. The variety of plans and coverage along with the complexities of coding and the difference among payers requires…
Billing is way more than billing.
In a typical medical practice, more than 300 insurance cards cross the front desk every month. The variety of plans and coverage along with the complexities of coding and the difference among payers requires expertise and technology to effectively manage accounts receivable, regardless of practice size.
There are two basics required to manage your billing and accounts receivable — a practice management system and a clearinghouse.
The …
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Efficient billing in your medical practice
Physician voices
Do you cringe when you hear the phrase "office meeting"? Some medical practices meet too frequently and some seldom meet, but others have it just right – routine meetings with preparation, an agenda, and follow-up. Your practice can get it…
Do you cringe when you hear the phrase “office meeting”? Some medical practices meet too frequently and some seldom meet, but others have it just right – routine meetings with preparation, an agenda, and follow-up. Your practice can get it right, too.
And make no mistake, meetings are important. Medical practices, regardless of size, have a variety of positions that are not interchangeable, but do interact throughout the day.
To make …
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Planning effective office meetings for your medical practice
Physician voices
Your staff members are your most important (and costliest) resource. Have you invested in them? Do they know what is expected of them? Have you asked them if they have what they need to do their jobs? Optimizing staff performance…
Your staff members are your most important (and costliest) resource. Have you invested in them? Do they know what is expected of them? Have you asked them if they have what they need to do their jobs?
Optimizing staff performance is a process. It starts with a plan, not the formal performance review.
You can’t do a successful performance evaluation without establishing accurate standards against which the employee’s performance can be …
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How to review the performance of your office staff
Health policy
Doctors who do not successfully e-prescribe 10 times for Medicare patients in the first six months of 2011 using claims-based reporting may be hit with a 1% penalty on their Medicare Part B payments for covered professional services in 2012.…
Doctors who do not successfully e-prescribe 10 times for Medicare patients in the first six months of 2011 using claims-based reporting may be hit with a 1% penalty on their Medicare Part B payments for covered professional services in 2012.
The penalty will increase to 1.5% in 2013 for those who don’t e-prescribe for 25 Medicare patients during 2011.
Not yet e-prescribing?
Maybe your …
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E-prescribe now, or risk a Medicare penalty
Physician voices
It's easy to get caught in the surf on the Web. But plug these URLs into your browser and explore some simple tools that can help not only keep your practice above water but help it ride high. www.digitalassent.com Digital…
It’s easy to get caught in the surf on the Web. But plug these URLs into your browser and explore some simple tools that can help not only keep your practice above water but help it ride high.
www.digitalassent.com
Digital Assent automates the patient intake process with a PatientPad instead of the clipboard and an online tool for advance registration. It does integrate with EMR systems, but it provides another strong operational …
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9 websites that savvy medical practices use
Health technology
I had a déjà vu experience recently when I visited a medical practice that was like so many others I've been to before. This practice just wasn't getting their investment back from their EHR. The practice had been live on…
I had a déjà vu experience recently when I visited a medical practice that was like so many others I’ve been to before.
This practice just wasn’t getting their investment back from their EHR.
The practice had been live on the EHR for about five months and was functioning effectively without pulling charts for patient visits. The clinical staff was comfortable with the …
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Why the return on investment in an EHR is poor
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