Wednesday, January 16, 2019

Social Media Tips for Medical Practices: A How-To Guide

The benefits of using social media in a medical practice are becoming increasingly recognized, which makes the pressure to get involved even greater. As medical practices become more and more sophisticated at using social media for knowledge sharing, marketing, and other forms of communication, those who fail to participate will fall behind. These social media tips for medical practices can help you get started.

Practice Check-Up: How scheduling strategies can reduce disruptions and long patient wait times

This is the second in a series of articles aimed at highlighting key areas practices should examine in an effort to improve practice performance. This month we focus on how effectively managing the appointment schedule can have a positive impact on both patient and practice satisfaction.

It’s rare that an appointment schedule in a medical office survives a day without any changes. No-shows, cancellations and last-minute emergencies will always crop up and cause shifts and changes. But these changes don’t have to disrupt the flow of the office. Here are a few things to consider:

To double book or not to double book
Many practices experience no-shows and/or a high demand for appointments when the schedule is full. To address these situations, many practices will book multiple patients into a single slot. However, double booking will likely guarantee some bad patient experiences. If you have a double booking system in place right now, the California Medical Association (CMA) recommends you review that process.

One thing to consider before double booking is the patient’s “show” record. Double booking two patients with perfect “show” records in the same slot is likely to guarantee a long wait for one of them. But, it may be a reasonable strategy to consider double booking if your scheduling system can provide information on the patient’s track record of showing up on time. If you have information on the probability of the patient keeping the appointment, consider double booking a patient with a perfect “show” record with another that has a poor “show” record. Double booking without this kind of information will almost certainly create a traffic jam at the practice and at least one unhappy patient.

Taking charge of your appointment schedule
Oftentimes, there is no rhyme or reason to how patient appointments are scheduled. In an effort to meet patient demand, sometimes patients are simply crammed into an already busy schedule without considering the appointment type and/or the amount of time needed for the appointment. For example, new patient visits generally require about twice as much time as an established patient visit, while follow-up appointments are typically the shortest.

If your practice doesn’t have a schedule template, create one by identifying the amount of time required for each different type of appointment. Working with the physician(s), determine the average amount of time the physician needs for new patient visits, established patient visits, follow-up visits, well care visits, etc. Build that information into your scheduling system so when you are creating an appointment, the amount of time is automatically calculated based on the type/need.

More in-depth triage
Beyond the schedule template, it can also be helpful for schedulers to do a more in-depth triage with patients to identify whether additional time will be needed. For example, an established patient visit to address multiple complaints will likely require more time than the average established patient visit. Training your office staff who are responsible for scheduling to ask specific questions such as, “Do you have any other issues to discuss with the doctor?” as well as encouraging patients to be on time (or even early) in order to prepare them to see the doctor will help to keep your practice running on schedule.

Pad the appointment time
Practices often make the mistake of advising patients to arrive at the time of their scheduled appointment. However, if the patient’s appointment is at 8 a.m. and he or she arrives at 8 a.m., after check-in at the front desk, completion of any necessary paperwork and rooming of the patient, it would be impossible for the physician to actually see the patient at 8 a.m. and therefore immediately puts the physician behind schedule. Imagine how far behind the physician will be if that patient is late to their 8 a.m. appointment!

While some practices report they advise patients to arrive 10-15 minutes early, let’s face it, most patients don’t comply. They remember their appointment time and rarely arrive any earlier.

One way to address this is to pad the appointment time by 10 minutes or so. For example, if the patient’s appointment is at 8 a.m., the practice may wish to advise the patient that the appointment is at 7:50 a.m. This allows time for check-in, paperwork and rooming so the patient is ready to see the physician at his or her scheduled appointment time of 8 a.m., which maximizes valuable physician time.

Following some simple, but well thought-out scheduling strategies can maximize the number of visits in a day, prevent a chaotic work environment and improve patient satisfaction.

Understanding The Covered CA Grace Period

RCMA/CMA has made significant progress through our advocacy efforts to help ensure that physicians are not on the hook for unpaid claims in months two and three of the three month grace period. Instead, coverage will be suspended during those two months. We have prepared an easy to understand fact sheet to help physicians and their staff understand what the grace period means for their practices and their patients.

Download  Understanding the Grace Period for Subsidized Exchange Enrollees FAQ Sheet

Five Inadvertent HIPAA Violations by Physicians

Doctors do not plan ahead to violate HIPAA, but in this digital age, they may be doing it because they did not plan ahead. The recent final rule of the HITECH Act outlines that even if the physician is unaware of the violation, they may be fined a civil penalty of $100 - $50,000 per violation. It is time for even the most resistant doctors to pay attention to how they handle protected health information (PHI). Here, we will outline five common ways physicians are breaking HIPAA/HITECH privacy and security rules, and may not even know it.

1)    Texting PHI to members of your care team

It’s a simple scenario: you’ve just left the office, and your nurse texts you that Mr. Smith is having a reaction to the medication you’ve just prescribed. She has included his name and phone number in the text. You may know that texting PHI is not legal, but feel justified because it is a serious medical issue. Perhaps you even believe that deleting the text right away will protect you – and Mr. Smith

In reality, this text message with PHI has just passed from your nurse’s phone, through her phone carrier, to your phone carrier, and then to you – four vulnerable points where this unencrypted message could either be intercepted or breached. In a secure messaging app, this type of message must be encrypted as it passes through all four points of contact. Ideally, both sender and recipient should be verified and have signed a business associate agreement (BAA).

2)    Taking a photo of a patient on your mobile phone

To some this will sound silly, to others, it is as common as verifying a rash with a colleague or following the margins of a cellulitis day by day. Simple enough, but if these photos are viewed by eyes they are not intended for, you may be in violation of your patient’s privacy. It’s important to be aware of where and how patient information and images are stored. Apps that allow you to take a secure photo are just as important as sending the message securely. DocbookMD allows photos to be taken within the secure messaging app itself – never stored on your phone or within your phone’s photo album. Always use this type of feature when taking any photo of a patient or patient information.

3)    Receiving text messages from your answering service

Many physicians believe if they receive a text message from a third party, like an answering service, they are not responsible for any violation of HIPAA – this is simply not true. Many services do send a patient’s name, phone number and chief complaint via SMS text. The answering service may verify it is encrypted on their end, but if PHI pops onto the physician’s screen, it is certainly not secure on their end – and this is where the physician’s responsibility lies. Talk with your answering service today to see how they are protecting you at both ends of the communication.

4)    Allowing your child to borrow your phone that contains PHI

Many folks allow their kids to play with their phones – maybe play games on apps while in the car. If your phone has an app that can access PHI, then you may be guilty of a HIPAA breach if the information is viewed by or sent to someone it is not intended for. The simple fix is to utilize the pin-lock feature on your messaging app – and for double-protection, always password protect your phone!

5)    Not reporting a lost or stolen device that contains PHI

Losing your smartphone or tablet is a pain for many reasons, but did you know that if you have patient information on that device, you could be held responsible for a HIPAA breach If you do not report the loss right away. The ability to remotely disable an app that contains or handles PHI is an absolute must for technology that handles communications in the medical space. Be sure to ask for this feature from any company claiming to help you be HIPAA-compliant in the mobile world. Remember: Being HIPAA – compliant is an active process. A device can claim to be HIPAA secure, but it is a person who must ensure compliance.

Tips for Small Provider Practices to Plan for the ICD-10 Transition

Although the final rule on the proposed ICD-10 deadline change has yet to be published, it is important to continue planning for the transition to ICD-10. The switch to the new code set will affect every aspect of how your organization provides care, but with adequate planning and preparation, you can ensure a smooth transition for your practice.

You should consider the following checklist to help keep your efforts on track with your transition:

  • Educate staff and leadership about ICD-10
    • Appoint an ICD-10 coordination manager and delegate a steering committee  to manage the transition 
    • Train staff on changes in documentation requirements from health plans and how this will affect work flow 
  • Perform an impact assessment
    • Examine existing uses of ICD-9 codes in order determine aspects of work flow and business practices that ICD-10 will potentially change. Be sure to evaluate planned and ongoing projects as well
    • Create a list of staff members who need ICD-10 resources and training, such as billing and coding staff, clinicians, management, and IT staff
  • Plan a realistic and comprehensive budget
    • Estimate a budget that includes costs such as software, hardware, staff training, and any initial change in patient volume
  • Coordinate with external partners
    • Contact system vendors, clearinghouses, and billing services to assess their readiness and evaluate current contracts
    • Ask your vendors how they will support you in the transition to ICD-10 and request  a timeline and cost estimate
    • Analyze existing health plan trading partner agreements
  • Get ready for testing
    • Request a testing plan to schedule from your vendor
    • Conduct internal testing within your clinical practice as well external testing with payers and other external business partners after you have completed the planning stages 

Keep Up to Date on ICD-10.
Please visit the ICD-10 website for the latest news and resources to help you prepare!

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