This is the first in a (most likely very short) series of articles about lack of efficiency at various locations I frequent. The purpose is not to put them down but to apply those same ideas to our own businesses and lives. It’s far easier to be a critic then to put this into practice, but well, one’s got to start somewhere.

My doctor has a solo family medicine practice with 2 or 3 assistants that serve various roles. I’ve always enjoyed his company and the kindness of his staff, and have been going there since maybe 2000. But the practice hasn’t utilized much technology, and I believe it’s to the detriment of both the patients and the staff. Here I’m going to look into how that relates both to their productivity and customer service. (I don’t think productivity should ever be an end in itself–it should facilitate more customers, higher revenue customers, better customer experience–something more than just working quickly.)

These are the issues I intend to comment on and explain how they could improve their practice or efficiency. While the lacking may be obvious, hopefully my solutions will be interesting.

1. They “kind of” have email, but not really
2. They don’t use or accept faxes
3. They have a voicemail greeting but don’t allow one to record a message
4. They can mail referrals if I provide a self-addressed, stamped envelope (circa 1995), otherwise I have to pick them up

At first glance you’re probably thinking one of two things: they’re extremely backward or they have very successfully limited their inputs. Their reasoning is probably a combination of convenience, lack of technical comfort, and resistance to change when “the system works.” But here’s where they’re missing out:

1. By limiting their correspondence to phone or in-person, they have to solve every problem right when it arrives
2. Their back and forth with providers and patients takes longer as the other party is often not available by phone (every missed correspondence is a waste of time)
3. They accumulate loads of paper, which must be filed–an activity that is time consuming and becomes expensive (space ain’t cheap around here)
4. They have busy times and less busy times, but correspondence related activities cannot be time-shifted to the less busy times
5. When there are emergencies it becomes time-intensive, expensive, and sometimes confusing to get information to providers, patients, or insurance
6. The more manual the processes, the more difficult it is to train replacements; technology could reduce the required knowledge of the job and make staff replacement or use of temporaries less of an issue
7. If one of the goals of the doctor were to either grow the practice or reduce his labor costs (his assistants’ time), technology could help with that

Here’s where a patient could benefit from successful implementation of these technologies:

1. Easier appointment scheduling and question answering when time-shifting is allowed; i.e., email and voicemail enable leaving a message and getting a response when it’s convenient for either party
2. Faster treatment and referrals with faxes or PDF’ing/emailing
3. Clearer understanding of steps to follow when they’re printed as opposed to being required to take notes (* this relates to medical advice via electronic means, and may have a whole can of worms related to it, but I’m going to skip that topic for now–needless to say there are pros, cons, and technologies that can help)
4. They’d feel comfortable by using the means of communication that they already use most often

Some general practices that the office could follow to improve their use of these technologies and prevent abuse:

1. Restrict all email to administrative-patient correspondence rather than substantive medical issues (to mitigate liability issues), or otherwise make clear the email and fax policies
2. Subscribe to a voicemail transcribing service (I use gotvoice.com) so that voicemails could be reviewed more easily and, when necessary, delivered directly to the doctor. This would also help to restrict inputs to email. (Voicemails could then be added to a patient’s file, as well)
3. Subscribe to a fax-to-email service to prevent additional paper and restrict inputs to email (I use Kall8, but that likely wouldn’t work for them)
4. Use a compliance archiving service like Enterprise Vault (via a hosted provider–I use NTTA) to ensure that this data is backed up and accessible whenever needed–this may be simpler or less expensive than developing the tools and processes for an elaborate filing system (especially for a less technically savvy office)

There are so many other practices that a small practice could take to improve both the patient experience and their internal practices. I’ve only addressed a few of them, but other things include having a waiting room computer for patients to input their information, wireless internet access for while patients wait, automated appointment schedule confirmations via email (preferred) and email, Tablet PCs for doctors to take notes, or even just coffee/snacks…(anything to ease the burden of waiting!)

Just yesterday I went brought in a prescription and CVS had to call the doctor because they couldn’t read it; this is the second time this has happened to me in my recent past. Something tells me that improving even the smallest parts of medical office practices is going to be a very long battle.

Filed under: 4-Hour Workweek, Business, Productivity, Technology

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