EHR and Health IT Consulting
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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Seven Ways PAs Strengthen the Team, Deepen the Bench | Physicians Practice

Seven Ways PAs Strengthen the Team, Deepen the Bench | Physicians Practice | EHR and Health IT Consulting |

Physicians often ask me whether they should consider hiring a PA and how to integrate one into their practice.

Much like a sports team’s game plan, every practice functions differently. But if you need to draft a new player, consider what areas of your practice could use some relief and what skills that player needs to complement your practice. A PA can be the leadoff batter, collaborating partner, supporting player, or the rebounder.

At the core of PA training is team-based care through the medical model. We practice with our physician partners and enjoy being the all-around players that execute the fundamentals of medicine in a way that expands the team’s capabilities, resources and positive outcomes.

Here are seven ways PAs may benefit your practice:

1. Make room for more patients. If you are already working overtime, another provider may be the only way you can grow your practice. For services that are incident-to a physician’s services, the reimbursement rate is at 100 percent. For other services, reimbursement is 85 percent of physicians' fees. Our ability to see our own panel of patients, or share yours, will generate revenue and more than cover the cost of our salary and benefits.

2. Free you up to handle the most-complex medical cases or those that will generate more revenue. For example, surgeons want to operate and can turn over some of the pre-op and post-op care to PAs.

3. Improve your work-life balance. Having a PA manage patients with chronic conditions, help manage phone calls, and share other responsibilities can give you back hours in your day.

4. Give patients what they want. Patients want to spend time with their provider, and you want to extend this coverage so patients feel good about their care. When you and a PA work as a coordinated team, patients will not feel slighted if you do not see them on each visit.

5. Assume administrative roles. PAs can create wellness programs, initiate and lead group appointments, and perform as lead PA or the clinical interface to the business office.

6. Improve care coordination. PAs can help you coordinate care between your office and other providers or locations, for example specialists, physical therapists, or hospitals/outpatient surgery centers.

7. Focus on CMS requirements. There are many new requirements for quality outcomes, EHR use, and patient engagement. A PA can give the team the additional knowledge, skills, and time that it needs to hit these goals.

Currently there are approximately 100,000 certified PAs in the United States. According to the National Commission on Certification of Physician Assistants (NCCPA), every week certified PAs work 3.8 million hours enabling them to increase healthcare access by treating 7 million patients in every clinical setting across the U.S.

PAs can increase team wins:
Ultimately, patients seek healthcare from providers with whom they are most comfortable and get the best service. PAs can help meet the needs of your most demanding patients, deliver on quality and satisfaction targets, and increase revenue.

So if you are considering adding a player to your team, now is the time to make your move. Assess current strengths, determine skills needed, and draft a PA to be the utility player, who can help bring your team to the next level.

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New Medical Practice Staff Performance Reviews: 5 Tips | Physicians Practice

New Medical Practice Staff Performance Reviews: 5 Tips | Physicians Practice | EHR and Health IT Consulting |

Many practices hold a 90-day review with new staff members to discuss performance, areas that need improvement, and provide kudos for a job well done. Here are a few tips to help ensure you are making the most of these important evaluations:

1. Gather perspectives. Speak to physicians and staff members with whom the employee works closely. While you can (and should) observe the employee in action, it's impossible for you to understand exactly how that new staff member works with and interacts with his colleagues and supervisors in various situations. "I try to get their perspective on things they're seeing on the floor that maybe I don't see," said Cynthia Blain, director at healthcare consulting firm SS&G Healthcare.

2. Criticize right. The 90-day review presents a great opportunity to identify how the employee can improve and what she needs to work on. But remember: Motivation and correction is much more about giving people something to work toward, than it is telling them to stop doing something, said Carol Stryker, founder of practice management consulting company Symbiotic Solutions. For instance, rather than telling a staff member she needs to stop looking down when she speaks to patients, ask why she is having trouble making eye contact. Then say, "What can we do to help you make eye contact, because that's a real important part of making patients feel welcome."

3. Be detail oriented. Frame the review (and your conversation with the staff member) around their job description. Be on the lookout, however, for smaller details when it comes to professionalism and patient relations. For instance, consider whether the staff member is willing to ask questions (a good thing), and if he is always asking the same questions (a bad thing). Similarly, don't focus on how often he makes mistakes, but on how often he learns from those mistakes, said Stryker. "If you make the same mistake repeatedly then we've got a problem — you have to learn from that."

4. Gauge engagement. You want your staff members to be engaged and committed to helping improve your practice. Consider how many suggestions the staff member has made that were helpful and whether the staff member is willing to share her input and ideas, said Stryker.

5. Ask for input. The 90-day review isn't just for you to share your thoughts, it's also the new hire's opportunity to share his thoughts, experiences, needs, and questions. Ask the staff member how he feels about working in the practice, how the orientation process could be improved, and so on, said Troy Jaklich, president of Legacy Human Resources, which specializes in medical offices.

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Physicians Must Lead the Charge to Improve Patient Care | Physicians Practice

Physicians Must Lead the Charge to Improve Patient Care | Physicians Practice | EHR and Health IT Consulting |
Communication, coordination, and follow-up are highly prized entities in patient care. Indeed, without these entities, little can be accomplished, and the more complex the issues are, the more important these entities become.

Sadly, great communication, coordination, and follow up become less and less evident in patient care the more complicated the patient's care becomes. This is especially true when the case entails a high degree of social issues as well as health issues. It is clear to any experienced physician and case worker that the more complex the patient's condition is, the stronger the need becomes for optimal communication, coordination, and follow-up.

I maintain that ensuring optimal communication, coordination, and follow-up requires a system that motivates physicians and healthcare systems with positive incitements. There is an urgent need for clear and obvious mechanisms that create negative feedback loops every time communication, coordination, and follow-up care are inadequate, and that strongly encourage the opposite.

Until now, no practical guidelines have existed that define how to establish and maintain such motivation at the system level. Good practice guidelines exist for specific diagnosis groups, but even here, the motivations are most often less than clear.

This is by no means to belittle many good practices that see traction in specific communities, such as Patient-Centered Medical Home recognition criteria, but these are predicated rather by top down mandates from entities such as the National Committee for Quality Assurance and enthusiastic practitioners than by concerted and positive financial and motivational structures.

For these reasons, it falls on physicians to lead the charge to improved communication, care coordination, and follow-up care in their own practices. Here are a few small changes that I recommend that all physicians begin making:

1. Ensure that all nurses active in your practice and visiting nurses have cell phones. Having these numbers for ready access 24/7 can mean the difference between coordinated care and catastrophe for the patient.

2. Gather your ranks, and get a town hall meeting going where physicians proclaim their willingness and energy to make things improve for those in most need of optimal communication, coordination, and follow-up.

3. Bring in experts who can help define what is doable within the given financial framework to make primary prevention and health promotion front seat drivers instead of passengers on an evidence-based express train that no one knows where it is going.
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Why the next wave of health IT innovation will build on EMRs, cater to physican happiness

Why the next wave of health IT innovation will build on EMRs, cater to physican happiness | EHR and Health IT Consulting |

There’s no shortage of primary physicians, but rather a shortage of primary physicians who are able to use their time efficiently in today’s healthcare environment.


That’s why the industry is moving away from the first version of the EMR, according to Dr. Lyle Berkowitz, the associate chief medical officer of innovation at Northwestern Memorial Hospital and Medical Director of IT & Innovation at for Northwest Memorial Physicians Group in Chicago.


The inaugural EMRs are basically computerized versions of paper records that weren’t necessarily designed with usability in mind, he noted. So rather than saving time and making administrative processes easier, they’re in some cases adding to doctors’ workloads.

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