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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Essential Tools for Building a Direct-Pay Practice

Essential Tools for Building a Direct-Pay Practice | EHR and Health IT Consulting |

I have been operating my direct-pay practice (I accept no insurance; patients pay me a low monthly fee for care) now for over two years. Two years means several things. First, it means that I am out of the "start-up phase" of the business; it is no longer an experiment, or a concept I am trying to prove. I am successfully making a living using an entirely different business model than most doctors in this country.

Two years also means that people see me differently. I have experienced a recent surge in patients joining my practice; many of whom were initially nervous about joining, but now see that my practice is stable.

The last thing that two years means is that I've had a chance to figure out what really works in this type of practice and what is window dressing. Here are the tools I have found most useful in building a successful direct-pay practice.

Essential #1: A good office space

I am not in a typical medical office area, but instead intentionally found a homey-looking space in a commercial office complex. I designed it to feel different from most doctors' offices: comfortable and welcoming. From the outside it looks like a house, not a medical office, and I've filled it with comfortable furniture, pleasing decorations, and coffee for patients on request. Patients will make a point to come in just to chat; and we can because our schedule allows us the extra time to connect with our patients.

This was my biggest start-up expense, but I believe it was absolutely essential in building a new mindset in my patients.

Essential #2: A staff that believes

I now have two nurses (to handle 600 patients), both of whom came from my previous practice. Both of my nurses are zealous in their belief in the direct-care model. Part of their zeal comes from the fact that their lives are so much better in this new office setting, but also, much of it is because they truly like to help patients. My practice model is all about customer service and exceeding expectations. I am really fortunate to have staff to whom that focus comes naturally.

Essential #3: The right communication tools

The one thing my patients value the most in my practice is access to me and my staff. If they have questions, they can call the office or reach me via secure messaging. While it's technically OK to use e-mail for communications (as long as patients sign a HIPAA waiver), I found that most of my patients value security in communication over ease of use. Here are three ways I communicate with my patients:

1. A good phone system. I use Ring Central which is a VOIP Internet phone system, which allows me to cheaply have a complex phone system. Voicemails are e-mailed to me; faxes are also received and turned into e-mails. I can text with patients as well as hold a conference call. It has its flaws, but overall we get a lot for a low price.

2. Messaging system. I use Twistle, which is a HIPAA-compliant "chat" system. This might be the tool my patients value the most. It works like a secure chat, with apps available for Apple and Android phones. It also notifies me via e-mail when patients have tried to contact me, and my nurses can be copied on the messages as well. I can securely send lab reports (as PDF files) or handouts regarding conditions as attachments, and patients can send images (rashes, wounds, etc.) to me from their mobile app.

3. E-mail system. While I don't encourage e-mail communication, some patients prefer it. We use our own domain hosted on Google's Gmail website. It's very easy to use and extremely affordable.

Essential #4: Billing systems

I experimented with several billing systems. I initially used Intuit Quickbooks and their integrated billing features. For a while I used ADP's automatic billing system, which worked fairly well, but didn't integrate well. Most recently, a new start-up, Hint Health has built a very elegant and easy-to-use billing system specifically designed for direct-care practices. They are very easy to work with, and solve issues quickly and easily. They also integrate with several EHR systems, and are always open to further integrations.

Essential #5: Facebook

Hands-down, the best marketing tool I have is my Facebook page. Not only does it provide an easy communication tool for patients and those interested in my practice, but I can promote posts to the exact demographic I am interested in. I promote any specials I am running for new patients, but I also promote posts or articles that highlight how my practice is different. The money I've invested here has paid itself over manyfold.

There are other tools I use regularly, but these are what I consider essential, and without which I could not have created a successful direct-pay practice.

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Hospital System Builds EMR Buy-In Using Social Media

Hospital System Builds EMR Buy-In Using Social Media | EHR and Health IT Consulting |

If you’re like most IT leaders, you’re used to leaving the social media efforts to your marketing department. But maybe you’re missing out. Here’s a nice example of how hospital CIOs can use social media to move EMR buy-in ahead using social media tools.

Just over a year ago, 24-hospital health system Texas Health Resources decided to promote the existence of its Epic EMR installation to a broad cross section of stakeholders, including employees, clinicians and the public at large. To do so, THR began making heavy use of social media tools.

First, the chain build a microsite promoting the EMR, which included videos explaining the benefits of the Epic system to key users such as doctors in urban practices.  In many health systems, the effort might have stopped there, aside from perhaps an e-mail announcement or two.

In this case, however, system leaders like Ferdinand Velasco encouraged everyone involved to talk up the site — and the existence of the Epic EMR — across the social media universe. Dr. Velasco, vice president and chief medical information officer, personally recorded the videos on the microsite. THR then used Facebook, Twitter and  YouTube to drive traffic to the microsite and other related information.

Velasco, who talked to about the project in October 2010, said that the idea was not to spend lots of money on a social media campaign, but rather, just to get the information out there. “I don’t recommend you spend a lot of time and effort putting a major production together,” he told the site. “This way, it allows you to organically as the need for information evolves and emerges through those interactions.”

Fast forward to today, and it seems THR’s social media efforts have borne fruit. According to one social media marketing publication, THR now ranks in the top 5 percent of all hospital systems in EMR adoption.

This may be, in part, because THR didn’t stop with using social media to broadcast the EMR’s existence. Since the microsite launch,  execs have installed a private, behind-the-firewall social network tool to help move the in-house conversation forward.

Now, as the system brings the EMR to more hospitals, doctors are sharing information via the social network and helping their peers be successful, according to

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Five Keys to Help Physicians Connect via Social Media

Five Keys to Help Physicians Connect via Social Media | EHR and Health IT Consulting |
So physicians, you've finally come to the realization that you need to be present in the digital world in order to be found. According to Pew Research, 80 percent of us go online first to answer our questions about health — before we call our family or friends or doctor. And you have updated your ancient website with a fancy new format that can be viewed in a browser, but also on mobile devices … right?

But you still don't have visitors to your website. And those people who do visit don't make appointments to see you at your practice. What are you doing wrong?

Too many of us use our websites as if they are traditional marketing materials: brochures, direct mail, etc. We place flashy descriptions on our home page about our services; we include our impressive credentials; maybe we even post on Facebook or send out Tweets about how great our practice is. And if we're really ambitious, we license some articles from Mayo or other sources, include some stock photos to make it pretty, and add those to our "blog" or digital newsletter.

But that's all about you.

In the digital world, it's not about you, it's about them. It's about your patients and your prospective patients. Frankly, they don't much care about where you received your degrees, or about your website's flashy features. They're looking for help answering their health questions. They're looking for evidence of expertise and authority in their area of need. They're looking for evidence of a caring physician who will listen to them. They are looking for human connection.

So how, exactly, do you achieve these goals? May I humbly suggest five keys to online content that connects with patients?

1. Understand your patients. You can't deliver if you don't know what they want. How to know? Easy: Listen. Keep a small notebook in your pocket during clinic. Record frequently asked questions (FAQs). Keep a similar record of patient FAQs at the receptionist's desk. Have these patient FAQs collated weekly to determine important themes. Then you can create content that people are looking for.

2. Serve them. A great content brand passionately serves its community's needs. Your content must be interesting and informative, but most of all, helpful. Above all else, great content helps solve your community's health problems.

3. Be consistent. Provide online content with a consistent tone, and consistent delivery. All of your marketing materials should deliver the same vision, image, look, and feel — the same message — to your community. Keep to a schedule: If you produce a quarterly newsletter, don't produce it weekly for a while, then every six months for a while. Be consistent.

4. Demonstrate expertise. By delivering helpful and accurate content, your practice becomes an authority. Your community will see you as their go-to source for any information related to your specialty. They will return. And when they need to make an appointment, they will call your practice.

5. Provide unique, quality content. Maintain a high standard, and don't stoop to licensed articles from other sources. Those will appear on many websites and dilute your authority. Your site may even be penalized for "duplicate content" by search engines. Better to produce less quantity and greater quality.
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Social Media Platforms and Techniques for Medical Practices | EMR and HIPAA

Social Media Platforms and Techniques for Medical Practices | EMR and HIPAA | EHR and Health IT Consulting |

In my previous post I talked about the benefits of using social media in a medical practiceand I said that the next post in the series would take a look at the tools, techniques, and social media platforms you should use to help you realize the benefits of social media. This will not be an exhaustive look at social media platforms or the way to get the most out of them. However, it will be a good place for you to start and will offer some techniques that those who’ve started might not have heard about.

First, a word of warning. When starting to work with social media, be sure to pace yourself appropriately. As you start working with a specific social media platform, you might want to start “sprinting” and dive really deep into the product. That’s a great way to develop a deep understanding of the platform, but it’s not sustainable. After doing a deep dive into a social media platform, find a sustainable rhythm that your practice can sustain long term.

Social media is a marathon, not a sprint.

Facebook – With nearly 800 million active users, it’s hard to ignore the power of Facebook. Given these numbers, the majority of patients are on Facebook and they’re likely talking with their friends about their doctors. Unlike many other social media platforms, most people are connected to their real life friends on Facebook. That means the focus of your work on Facebook should be to help your most satisfied patients be able to remember to share this with their friends as the need arises.

On Facebook this usually takes the form of a practice Facebook page that your patients can “like.” Invite your patients to like your Facebook page when they’re in your office or through your patient portal. You can even test some Facebook advertising using your internal email list to get your patients to like your page. However, the most important thing you can do is to make sure you regularly update your Facebook page with quality content. That way, they will want to like your page when they find it.

When it comes to content, put yourself in the shoes of your patients and think about what content you would find useful as a patient. Don’t be afraid to post things that represent the values of your practice, but may not be specific to your practice. In most cases, what you’re sharing on Facebook is more about helping that patient remember your practice as opposed to trying to sell them something. For example, it’s more effective to post something entertaining that your patients will like and comment on than it is to post some dry sales piece that they’ll ignore.

Twitter – Similar to Facebook, you want to create a two step process with Twitter. First, think about content you can post to your Twitter feed that would be useful to your patients and prospective patients. No matter what marketing methods you employ to increase Twitter followers, if your Twitter account isn’t posting interesting, useful, funny, entertaining, or informative content, then no one will follow you.

Second, find and engage with people in your area that could be interested in the services you offer. Finding them is pretty easy thanks to the advanced Twitter search. When you first start on Twitter you’re going to want to spend a bit of time on that search page as you figure out what search terms (including location) are going to be most valuable to your clinic. Sometimes you’ll have to be creative. For example, if you’re an ortho doctor, you might want to check out search terms and followers of a local youth rec league.

Once you find potential patients on Twitter, follow them from your account and engage with those you find interesting. Just to be clear, a tweet saying “Come visit our office: [LINK]” is not engagement. Offering them answers to their questions or links to appropriate resources (possibly on your website, blog, or Facebook page) is a great form of engagement. You’ll be amazed how consistently following and engaging with potential patients over time will build your Twitter profile. Once they’ve followed your account, you have created a long term connection with that person.

As I suggested in my previous post, Twitter can be a great way to find patients, but it can also be a great way for your practice to connect and learn from peers and colleagues. I’d suggest using different accounts for each effort. The tweets you create for each will likely be quite different so don’t mix the two. However, the same search and engagement suggestions apply whether you’re connecting with patients or colleagues. The search terms will just be quite different.

Physician Review/Rating Websites
There are dozens of physician rating and review websites out there today. Some of the top ones include: Health Grades, Angie’s List, ZocDoc, Yelp, Google Local, and many more. Which of these websites you should engage with usually depends on where you live. In most cases one or two of these websites are dominant in a region. For example, Yelp is extremely popular in San Francisco while Angie’s List is very popular in the south.

Discovering which one is most popular in your region is pretty easy. Many of your patients will have told you that they found your practice through these sites. However, you can also do a search on each of these services and see which ones are most active. A Google search for your specialty and city is another way for you to know which services are likely popular in your area.

Many of these sites will let you claim your profile and be able to respond to any reviews. Do it (although, don’t pay for it). Responding to reviews is a powerful way to engage your patients. If they post a bad review, keep calm and show compassion, understanding, and a willingness to help and that bad review will become good. Plus, that negative review could be an opportunity for you to improve your practice. If they post a good review, show gratitude for them trusting you as their doctor.

Once you’ve discovered which website is most valuable in your region, encourage your satisfied patients to go on that site and post a review of your practice. In some cases that might be handing the patient a reminder to rate you as they leave. In other cases, you might send them an email after their visit asking for them to review you on one of these sites. With mobile phones being nearly ubiquitous, a sign in the office can encourage a review as well.

There are hundreds of social media platforms out there today. However, if you focus on the platforms and techniques I mention above, you’ll be off to a great start. Mastering these techniques will make sure you get the most value out of your social media efforts.

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