Technology increases efficiency, cuts staffing
July 1, 1999
Technology increases efficiency, cuts staffing
Staff have more time for patients
Every time Ruth Lander, FACMPE, feels overwhelmed by her work as practice administrator at Columbus (OH) Oncology Associates, she tries to figure out how she can automate some of her daily tasks.
As a result, the practice operates so efficiently that its level of full-time-equivalent (FTE) employees per physician is far below the national average for oncologists in group practice with active chemotherapy departments. The national average for oncology group practices is 7.1 FTEs per physician, according to a recent benchmarking session for the Administrators in Oncology-Hematology Assembly, a special assembly of the Englewood, CO-based Medical Group Management Associa tion. Lander’s practice, however, has 5.14 FTEs per physician, based on the practice’s 1998 numbers.
Columbus Oncology Associates makes use of the latest technology for everything from managing staff time within the practice to marketing the practice on the Internet. One new endeavor is sending letters to referring physicians via fax modem using voice recognition transcription software. (For more on the technology the practice uses, see story, p. 93.)
"The goal of technology is not to eliminate patient-staff contact, but to enhance staff efficiency so they’ll have time for the patients," Lander says.
For instance, instead of hiring an additional PBX to deal with the large volume of calls at peak times, the practice implemented a partial voice mail system for billing, scheduling, and administrative calls. The system gives callers a choice of using an automated menu and voice mail or speaking to a live person.
Because Lander’s practice provides oncology care, she feels it would be risky for patient care calls to go into voice mail.
"We don’t let nursing calls go into voice mail. Those patients talk to the receptionist and nursing," she explains.
When new patients are being interviewed, staff tell them they can call a different number that will allow them to bypass the receptionist and go directly to voice mail for the department they are calling. Many patients choose to use this feature.
"We haven’t made it a complete voice mail system. Other physicians and older patients don’t like voice mail," Lander says.
Lander finds the technology useful for taking care of many business matters. "I’m often away from my desk, and so are many of the people I call. We often take care of things by using voice mail, fax, or e-mail," she says.
In the past, the receptionist often had problems contacting nurses to let them know patients had arrived. The nurses often were on patient phone calls, in the midst of other patient treatments, or talking to one of the physicians. The arriving patient either had to wait, or the receptionist had to leave her desk and let nursing know the patient had arrived.
Now, instead of using the telephone to notify nursing that a patient has arrived, the receptionist just types the patient’s name into the computer and it pops up on a computer screen in the nurses’ station. This keeps the phone lines free for the nurses to get patient phone calls and cuts down on the time the patient has to wait.
The practice uses an off-the-shelf software product and a personal computer for the notification system.
Automatic results
Before the practice installed an automatic lab result system, physicians often had to walk to the lab to get results before they saw a patient. With the new system, physicians and nurses can retrieve the lab results automatically via computer near a patient exam room or a chemotherapy treatment room. This has saved nurses many trips to the lab for results to check complete blood counts before starting a chemotherapy treatment.
"There’s no wasted time. Nobody has to take the results back to them," Lander says.
Before the practice contemplates any major purchase, a cost-benefit analysis is performed. In fact, the practice was highlighted in the Medical Group Management Association’s 1998 report, Performance and Practices of Success ful Medical Groups, for its superior performance, particularly in "productivity, capacity, and staffing."
Lander started learning about technology when she took her job with the practice in 1987. "I’ve seen the whole computer revolution in the workplace," she says. She claims no special computer expertise, just "a thirst for learning, efficiency, and organization.
"I believe in doing things the best way possible if it’s in my control," she adds.
To keep abreast of the latest technology she might use in managing the practice, Lander attends trade shows and seminars, networks with fellow oncology administrators, and reads numerous periodicals. But she’s careful that her forays into new technology don’t take up all her time.
Collecting information
To keep from being inundated by phone calls from technology firms, she picks up literature instead of leaving her card or signing up for drawings for prizes at the trade shows.
"And, if the articles in the periodicals aren’t helpful to me, I still will look at the ads to see new product offerings," she adds.
She conducts periodic operations audits to find ways to improve the way the practice works. "I feel confident we can figure it out without hiring a consultant," she says.
She encourages employees to make suggestions on how to operate more efficiently and has a suggestion box for those who don’t feel comfortable talking to management about changes.
"The way we have fixed a lot of things is by walking the halls and keeping our eyes open. If we see a problem more than once, we look at how it can be fixed," she says.
To manage her own job, Lander has "everything I could possibly forget" in her handheld mini-computer. All the addresses and phone numbers she needs are stored in the mini-computer and can be exported to print out labels for mailings.
"Now I don’t have to carry around a 50-pound day-timer, and I don’t have to worry about losing it," she says.
Once she did drop her handheld device on the pavement and broke it, but within a couple of days she had downloaded everything from the main computer at the practice and was back in business.
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