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Top 5 IT rules for smaller practices

October 26, 2011 | Michelle McNickle, Web Content Producer

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Although so many health IT-related discussions tend to focus on large organizations across the country, it's important to remember the smaller practices whose needs differ. In fact, implementing new technologies into a smaller practice can be tricky, depending on the amount of data you have and your willingness to pick up on current IT trends.

We asked Shahid Shah, software IT analyst and author of the blog  The Healthcare IT Guy, for his thoughts on outfitting these small practices with the right health IT. He says some legwork is needed to ensure proper selection, and making sure new technology truly streamlines work in a smaller practice is essential.

Check out Shah’s five IT rules for smaller practices: 

1. Ease into the technology. First and foremost, Shah said to ensure new technology won't do any harm.  "All technology takes time to implement," he said. "What's important is that while you're working toward improvement, you don't harm your business in the process." He continues by saying technology shouldn't make a practice, department or clinic worse than it was before the technology was introduced. And after it’s fully implemented, "it should start improving, or ‘healing’ [the organization]."

2. Focus on interoperability and best of breed. “Our desired tendency is to go for 'all inclusive' or 'complete solutions,' but healthcare is too complex for any single vendor or package to do everything,” said Shah. But by focusing on best of breed and interoperability, an organization can grow at its own pace and choose solutions it really needs, as opposed to technologies vendors think it needs. 

3. Ask the right questions.  “Ask the right questions of your vendors and staff when they’re selecting any new technology," said Shah. "Don't worry about features, functions, and technology." Instead, Shah suggests "worrying" more about your business by asking yourself a few simple questions, such as: 

  • Will my patient be more satisfied because I’m using the system?
  • Will the outcome of care be improved because I’m using the system?
  • Can I spend more time on my patient’s care versus documenting the encounter?
  • How many more patients per day will I be able to see because of the system?
  • Can I go home earlier because the system helps me finish my work faster?
  • How many fewer lawsuits will be filed because I used the system?

4. Make sure the technology fits your desired outcomes (not tasks). Almost any type of software will improve some aspects of your business, said Shah. However, the real question is whether the software improves the aspects you care the most about. Shah suggested when asking technical questions, start with some of the ones seen below: 

  • How can I easily transmit my patient’s medical records in a safe and secure manner without spending all day making copies?
  • How many more lawsuits will I win because I used the system?
  • How will the system be able to increase my patient population or help me market my services better?
  • How much faster can I get paid for my services after I’m using the system?
  • Can I get secure access to my data while I’m away from home or the office?

5. Be sure it can handle the different data you have. “When you’re choosing technology, be sure to look at the kind of data you’re capturing regularly and ensure the vendor you choose and the deployment model you pick are geared toward the data you create, rather than the kind of data the vendor can store,” said Shah. He added that almost all vendors are great at structured data, but few are good at managing non-structured data, faxes, images, and similar information. “When looking at ‘cloud providers’ (online software) make sure the larger data you capture can be fit through your network pipes,” Shah added. “Most vendors or technology providers focus you on what kinds of data they can manage. But, any reasonable office deals with [multiple] kinds of data, and you need to make sure your selection can manage it. For instance, consider the following: 

  • Structured data (fully coded ICD, CPT, etc)
  • Semi-structured data (machine understandable but with keywords and such)
  • Unstructured data (natural language)
  • Images
  • Faxes
  • Audio
  • Video
  • Chat logs, email logs

In closing, Shah added most software systems handle structured data quite well. “In fact, EMRs are an excellent way to capture structured data,” he said. “But in my experience, structured data makes up only a small fraction of healthcare data. Semi-structured data, and completely unstructured data, along with faxes, make up a big portion of data.” Medical images make up an even larger portion of “the healthcare data pie,” he said, while video, email, chat and other upcoming technologies will be taking up larger portions of the database space as well. 

Follow Michelle McNickle on Twitter at @Michelle_writes.

Michelle McNickle
Web Content Producer for Healthcare IT News
Follow Michelle on Twitter @Michelle_writes
Related Topics:
  • Michelle McNickle
  • Shahid Shah
  • Data Warehousing
  • Electronic Health Records
  • Network Infrastructure
  • Privacy and Security

Reader Comments (1)Login to Post a Comment

shamons says: Disagree with one point
January 04, 2012 | 9:30PM GMT

Michelle and Shahid,

Most of the time, both of our comments are complimentary to each other, you on the Healthcare IT Guy blog and mine on the Healthcare IT Podcast blog (http://itpodcast.org/blog)...but this time I have to disagree with item number 2 on your list, specifically to "Focus on interoperability and best of breed". While you are correct that healthcare is complex, considering that the target of this article is "Smaller Practices", I don't think it is reasonable to expect smaller practices to be able to realistically manage the complexities that accompany best-of-breed healthcare solution. The finger-pointing between multiple vendors when an HL7 interface experiences problems is enough to drive a seasoned technologist mad at times...much less a non-technical office manager in a small practice. Also, while every practice is different, I have yet to find a single physician practice that was so "unique" that an out-of-the-box EMR solution with multiple modules wouldn't suffice. Finally, best-of-breed means multiple licenses with multiple vendors, with multiple maintenance contracts and extensive costs. With revenue streams already being threatened for small practices, the additional costs of the software, maintenance agreements, and support could potentially be double or more the cost of an "adequate" integrated solution.

Each practice has to evaluate the potential system solutions against their own business needs. You did a great job in your article mentioning the importance of reviewing technology capabilities against desired business and clinical outcomes as well as the clinic's various data requirements. I believe there are a number of integrated solutions that can met the majority of a practice's needs in these areas without forcing the business to develop technology competencies that are complex and expensive to maintain. My personal argument would be to "consider integrated solutions whenever possible, and only pursue best-of-breed solutions when business need requires the use of specialized systems or capabilities".

Thanks for the article...I'll keep on reading!

Spencer Hamons
ITPodcast.org
http://itpodcast.org/blog
@spencerhamons

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