Update: Making progress toward paperless system
When Practice Marketing & Management last spoke with John Nosek, MPA, CMPE, administrator of the Greensboro (NC) Orthopaedic Center (see PMM, December 1997, p. 157), he was in the midst of a quest to remove paper from his practice. The goal was to cut file staff, increase transcription productivity, and recoup the initial $140,000 investment in hardware and software within two years. He was also contemplating the purchase of a hand-held wireless pen/pad system for his physicians.
In the last six months, there has been some progress, Nosek says. Another file clerk has been eliminated from the practice through attrition, saving about $23,000 per year in salary and benefits.
But the issue of hand-held computers is still being debated, with cost the key sticking point. The price of the unit and software is about $7,000 each, he says. "There would be one for each physician and each technical assistant and nurse. We would need 12 units and two spares. That's over $100,000 when you get to the cost plus tax."
The alternative is to have a hard-wired computer in every exam room. "That's 30 exam rooms, and each PC has a network card and optical card. The per-unit cost would be about $2,000, plus another $1,500 for the software. When you add it up, we're getting close to the same cost."
But the advantage with the PCs, Nosek continues, is that you can have images available for physicians, while the FM wireless hand-held units can't have the optical data and images included. Images would have to be brought up at the nurses stations.
Another issue which may affect the final decision is the new Medicare compliance guidelines which could require a very detailed exam. "We know we are doing the right things, but we have to have better detail in our documentation."
Finally, Nosek needs to consider how power outages would affect either system, he says.
"I think that going paperless will be necessary to survive," he concludes.
"This is a three-year journey for us. So far, only about 5% of practices are automated, but that will increase a lot in the near future. We know we are on the right path, though," Nosek says. "Our patient surveys show they are happy with our service, with our timeliness of response. And because our staff can get information to the patients faster, the stress level is down."
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