Upgrading your office technology can give you a host of ailments, both real and imagined. First, there’s the headache associated with researching and selecting a system that’s right for your practice. Then there’s the whiplash that occurs at the thought of keeping up with the daunting pace of that technology—its configuration and interminable upgrades. Lastly, there’s the churning of the stomach that happens once everything is in place, as you mull over whether you made the right decision. Of course, the decision to embrace practice management technology is one that you must make at some point. The DOS-based billing and reporting systems and penciled-in appointment books of old are no longer sufficient to handle the needs of even small practices. The inefficiencies and costs of maintaining an antiquated system are ones no practice—regardless of size—can afford for long. Hal Ornstein, DPM, recently upgraded the DOS-based system at his New Jersey practice. “I should’ve gotten rid of it years ago,” admits Dr. Ornstein. “If I had wanted to do a production report for the week, it took one to two hours to print and I couldn’t view it on the screen. From a tracking standpoint, it was absolutely terrible. “Now with the crunch of managed care and such, it’s critical that we run our numbers and see the cost per patient, as well as what our volume is. For example, if you’re going to accept a managed care contract, you need to know what it costs per patient to be seen in your practice and what kind of contract you need.” What New Software Can Bring To Your Practice Indeed, the many practice management applications provide doctors a host of valuable features and options unheard of as recently as a few years ago. No two systems are exactly alike, so you need to select the system that best suits your practice. Some features to consider include the following: • Enterprise-wide access to patient records. You and your assistants working on multiple terminals can access records simultaneously. • Scheduling. Patients can schedule appointments over the Internet. • Automated e-mail and referrals. Patients e-mailing questions can get an immediate automated response. Similarly, referral letters can be generated, based on selections made in patient records. • Online prescriptions. You can generate scripts on a terminal and have them added to the patient’s record. • Billing features. You and your staff can expedite online billing in accordance with your practice’s needs, as well as all pertinent regulations. Such features create greater efficiencies in a podiatry practice, which is a positive aspect on many levels, particularly when considering the sheer volume of patients you must see on any given day. Why It’s Critical To Overcome Fears Of New Technology Still, Raymond Posa, the founder of R. Francis Associates, a Belmar, N.J.-based medical consultancy, encounters some DPMs who resist the pull of using new tools. “There are two essential classes of doctors out there,” points out Posa. “The ones who are really into (using technology) are very easy to guide, to show how certain features and applications will make them more efficient. The ones that don’t care for technology are more of a challenge. I show them what it will do for their bottom line, how it will make their staff more efficient, relieving the stress on the staff and making them more productive employees. They see the benefit in that.” He also shows them how they are compelled by federal regulations to take greater care with their records, care that new office technology can expedite. “One of the primary requirements of HIPAA is that patient records must be protected,” notes Posa. “You need to know if one of your employees is snooping around looking at things he or she shouldn’t be looking at. At a minimum, a practice management system must log each user, track where they go and be able to print a log of that information. That feature is what separates a lot of the packages out there—many of them are just basic billing programs. Those are just not going to be sufficient.” Addressing Cost Concerns While cost is certainly an important factor in selecting a system, going for the lowest-priced option can actually prove exceedingly costly in the long run. “You get some systems that are really inexpensive, (systems) that you can’t grow with,” points out Dr. Ornstein. “That’s what people do. They don’t look at where they’re going to be in two, three or four years. Does the system handle medical records? Does it handle multiple sites well? Can it handle my growth? They were the primary questions we considered.” However, more expensive isn’t always better. “Generally, a decent package will run in the $3,000 to $12,000 range, depending on how many users you have,” explains Posa. “If you (try to) get off cheap now, you’ll pay for it down the road. Sometimes, paying for it later on is more expensive, because you wind up re-doing a lot of work and there’s extra effort involved. “I’ve seen one practice spend a quarter of a million dollars, which is absolutely ridiculous,” Posa continues. “Others will run $60,000 or $80,000. On the other hand, there are some systems that are inexpensive but very basic—essentially, they’re accounting programs that don’t have a lot of extra enhanced features.” Dr. Ornstein gives an example. “A cardinal mistake would be if a podiatrist is just starting a practice and he wants to save money, so he buys a $1,000 program. Before he knows it, three years go by and his practice is booming and he has outgrown his cheap software. So then he has to go through all the trouble and hassle of converting his existing records to this new program. It’s a nightmare. It’s not the most efficient way of doing things. In the overall scheme of things, your software is one of your best practice management tools and one of your best investments in your practice.” Overcoming The Hurdle Of Integrating Old Patient Records Dr. Ornstein’s example illustrates another issue DPMs face when switching to new technology—the integration of their existing records with their new system. Such a transition can be tricky, especially if your old system is not compatible with the new one. “A lot of doctors now still use the DOS version of (a popular billing system) that was a dead-end product,” says Posa. “Even when this company that made the product got bought out and upgraded to Windows, the system itself wasn’t upgradable. You couldn’t just import your old stuff into the new system. You had to go through all sorts of machinations to get it to work. “The problem with medical practice software is that transitioning from one to another can be a horrendous experience. Then you have to run both systems for several months to let everything clear out of the old package. It requires a lot of effort and a commitment from the practice that it is for the best.” How To Help Your Staff Make The Transition Another key part of any such technology change is how a practice helps its people handle the transition. Dealing with such a change can make the transferring of electronic records look easy. “There’s almost always a natural resistance to change,” explains Posa. “The people you’re dealing with in an office tend to be clerical types and not technology types. When you throw them something like this, there’s a lot of pressure they feel, because of the high volume of data they have to process—appointments, records, billing and the like. When they don’t understand the tools they’re supposed to use to do their jobs, it’s very frustrating.” “I’ve heard stories of practices losing top staff people when they change their software,” points out Dr. Ornstein. “Right now, there is such frustration in my office. We communicate well with our staff and prepare them, but it’s still an issue. “For example,” he continues, “I didn’t realize that one of my main staff people didn’t know what a mouse is. Not only did she not know the new software, she also didn’t know how to use Microsoft Windows. Once you convert over to something like this, you need to make sure they know the basics, such as beginning Windows skills.” Posa advises a little extra hand holding might be in order. “The key to making a smooth transition is a lot of patience. You also need to talk to the people so they understand you,” adds Posa. “You don’t want to throw a bunch of technical babble at them and blow them away. They’re not looking to be impressed. They’re looking to learn.” One way of easing staff through the learning process is to “deputize” one or more of the more proficient staffers, making them on-site super users who can help answer minor technical questions and, if needed, train less proficient staff on a continuing basis. Posa has used this tactic to great effect, saying having one contact person cuts down on calls to him and gives the staff a higher comfort level in dealing with their peers. Final Words Ultimately, Dr. Ornstein says, everyone benefits from the enhanced efficiencies and time and cost savings that solid practice management software makes possible. In other words, it’s worth doing and worth doing right. “It’s a big investment of money and time,” he concludes. “Everything you do, do right. Your best investment is in yourself and your practice.” Mr. Smith is a freelance writer who lives in Cleona, Pa.