Michelle McNickle, New Media Producer
5 keys to MU and adopting a 'lawyer business model'
August 2, 2012
A lot has been written about meaningful use, and although many claim it's "all good," Steve Ferguson, patient management officer at Hello Health, believes its drawbacks, such as the cost of IT and the changes it means for a doctor's practice, could outweigh the benefits of potential HITECH Act stimulus funds.
"It seems like a lot of new work for little, if any, actual gain," said Ferguson. "So here’s an idea: instead of, or in addition to, chasing MU money, what if doctors started re-thinking how they do business on a very basic level? And rather than reinvent the wheel, what if they borrowed aspects of the very successful lawyer model?"
"What if doctors in primary care adopted aspects of the lawyer business model?" Ferguson continued. "What if they charged for access to information – or at least the time their staff put into providing that information? What if doctors turned their charts into a revenue center?"
Ferguson outlines five keys to MU and adopting a lawyer-like business model.
1. It's about finding the ROI on the ROI. According to Ferguson, the first "ROI" means release of information, and "is a great little unexploited aspect of primary care," he said. "The second ROI is the more popular, almost mythical concept of return on investment – mythical, at least when doctors in small practices embark on the path of acquiring an EHR." But, he added, the issue is, it doesn't exist. "It's like the Loch Ness monster of practice financials, unless, of course, doctors begin to think like lawyers."
[See also: Meaningful use final rule to see 'minor revisions'.]
2. Doctors need to adopt a lawyer-like mindset. Primary care doctors, said Ferguson, should consider setting up a protocol within their practice that requires staff to manage all requests for information like a lawyer. "Run these requests through the practice management, accounts receivable, or even EMR system," he said. Set fees for each type of request, based on what sort of entity is making the requisition. "For example, a life insurance company needs a patient chart to process a claim? $100," he said. "A lawyer needs files for a case? $200. A specialist needs the last three years of labs for a new patient referral? $50. You get the idea."
3. Education is key for all parties involved. "Generate invoices, no freebies, be organized, and be professional," said Ferguson. Doctors need to educate their staff as well to get them to buy in. "They must educate their referral network at the same time," he said. "Explain to them that this is how they roll now. Why not? The lawyer doesn't blink an eye." If transacting like this is out of a doctor's comfort zone, he added, he/she should try working with a company that offers this sort of service.
[See also: Meaningful use off to a great start in 2011.]
Showing 4 Comments
Steven Ferguson say: Patients & Data
August 03, 2012 | 10:46 AM GMT
Just want to clarify a point here. I'm not suggesting patients pay for access to their records.
Great comments, btw!
Steven Ferguson
tanya meyer say: Interesting but Missing the mark
August 02, 2012 | 21:40 PM GMT
I want to agree with the above commenter- Most haelth care providers do charge a nominal fee for these kinds of transactions that are HIPAA approved.
While I understand the concern about making EHR's more cost beneficial to providers- I do not believe moving to a lawyer's business model is the right move. Firstly, Medical information is a very different beast than legal information. When Someone is requesting their information - it is usually for treatment or coverage purposes. Treatment can mean the difference between illness and health at best- and life and death at worst. The information belongs to the patient- it is their record. Lawyers charge for their advice. Doctors already charge for their advice in the charges they submit or charge for counseling and research.
SO one would first have to deal with HIPAA, and then the fact that Doctors already charge for their advice- and third- these obscene charges will always be passed on to the patient- and as I understand we are in the process of trying to figure out how to minimize health costs.
A better solution might be for Dr's to look into more cost effective cloud based EHR's rather than building their own from scratch. It is all about scale- a hospital often can make up the excess of costs due to the volume of their services. Smaller health care providers might not- and these providers might benefit from a cloud based EHR provider.
Randy Haynes say: Maximizing providers ROI on ROI
August 02, 2012 | 14:27 PM GMT
Michelle, I agree with Steve's suggestions, but have a few comments. Most providers do charge something for these B2B medical record transactions, but these "custodian" fees are regulated by state law and are generally quite a bit lower than the examples provided.
The main problem is that physicians don't have a HIPAA compliant way to exchange electronic records with these business requestors. Typically, a physician will mail an invoice for the records once a request is received. The provider then will print and mail records (despite having an EMR) once the requestor sends payment, resulting in a very expensive and inefficient process, often taking 30-60 days to obtain a single chart.
We launched ChartSwap to solve this exact problem. We are focused on facilitating these medical record transactions that don't into the traditional health information exchange (HIE) model. HIE's aren't designed to provide the access to these requestors and also don't offer the workflows to support these transactions. ChartSwap has integration all of the required workflows, including consent, payment and electronic signature.
Back to Steve's point, physicians do need to find ways to maximize their EHR investment and eliminate paper processes. ChartSwap is free to providers and our goal is to reduce cost and turnaround time for these requests for providers, requestors and the end users of the records.
Please contact us at www.ChartSwap.com if you are interested in learning more about our platform.
Anthony Matusiak say: 5 keys to MU and adopting a 'lawyer business model'
I think Steven Ferguson has missed the mark on this topic all together. Meaningful use is meant to teach the physician how use technology to provide better care to a patient population . Doctors using paper versus information technology are creating more errors and losing business (FACT). Majority of EMRs offer a practice management to increase and track billing and clinical side. When used properly the money you receive by attesting to MU more than pays for the cost of a mid-priced EMR.
The Health Care system needs a change for the better, you purposed leveraging patient information when the HITECH act is meant to facilitate health information sharing. Health IT is meant to inform all stakeholders involved of the entire record of health from providers, to patient to payer and government to lower to over cost of care for everyone.
Why thinking as a lawyer is wrong: The primary care doctor holds the information a specialty doctor needs such as those three years of labs. If the speciality doctor is to charge $300 for those records the specialty doctor would tell the patient go gather these records or have them redone adding a layer of cost and complexity that halts treatment in a system that relies on rapid real time action and results.
Health care is about improving the quality of care hence why our health care system today is strained. We pay for a service and that doctors only treat by volume not by outcomes. Engaging the patient to interact and take a more active role in their care, along with the doctor using all the technologies available will improve the care while reducing the cost on the patient/payer. This process will lead to cost saving and the ability to treat a larger population of patients, leading to more dollars to pay for that EMR cost.