It seems like just about every vendor claims their products are simple and easy to use. Are their claims true? What exactly does simplicity mean in relation to Electronic Health Records (EHR)? Like beauty, simplicity may be in the eye of the beholder. However, let’s take a look at a few aspects of XLEMR versus other EHR systems and see how they rate on the simplicity scale.

Let’s start with installation. Our technicians can install XLEMR basic functionality on a workstation in about 20 minutes. Compare that with other client-server EHR systems which require a server architecture and a database like MySQL or Oracle. Systems like these can take hours to install and configure. Our stand-alone architecture allows us to run the entire EHR from a single workstation or laptop if necessary.

The amount of training required to become proficient with an EHR is another good benchmark. Some of the older, big-name EHR systems bundle mandatory training time into their implementation, which may require practices to close the office for up to a week at a time. While training is vital to any implementation, shutting down the office stifles revenue at a time when finances are already tight.

Although the amount of training users require depends highly upon their technical skills, XLEMR requires less training on average. We built XLEMR using Microsoft Windows and Office as our foundational building blocks. Almost everyone who uses a computer has some familiarity with Windows and Office, which helps users come up to speed more quickly. Simple systems require less training.

The Graphic User Interface (GUI) is perhaps the most important aspect of simplicity. The GUI comprises the layout of screens, menu commands, navigation, and organization of content on any given page. The organization of these items are vital to the user experience. EHRs with complicated screens and navigation will befuddle even experienced users and sap productivity. XLEMR uses a simple, linear format with tabbed navigation. This makes it easy for users to manipulate the system without getting lost in a wilderness of expanding trees and unnecessary clicks.

Again, simplicity may be in the eye of the beholder, but it is important to consider. Remember, what ever system you purchase, you will be using it for quite a while. A simple EHR will be easy to install, easy to use, and require less training. We designed XLEMR with these principles in mind. Please contact us at info@xlemr.com if you have any questions.

Thank you for reading the final installment in our series of how to manage your cash flows and avoid selling out to the hospital. We believe that independently-owned private practices provide the best care, and we want to help them stay in business. We’ve covered many topics; hopefully some of them will prove useful. This time we will look at pulling everything together by tracking your cash flows in book keeping software.

Measuring and tracking your cash flows is critical to analyzing performance. If you do not keep a history of your revenues and expenses, you will have no way of knowing if you’re effectively maximizing or minimizing them. I understand that most every practice has some form of book keeping, but how engaged are the physicians and owners? You can’t manage what you don’t measure.

Do the owners regularly review profit and loss reports? Do they analyze costs and revenues by procedure? Do they track reimbursements by payer? Do they look at outstanding balance by patient? It is important to have a basic sense of these measures. Physicians should take an active role, develop their financial awareness, and not merely delegate their responsibilities.

The first metric will help your practice decide which tests and procedures they should keep in-house, and which you should outsource. The second measure will tell you if certain payers are living up to their fee schedule, and more importantly, actually delivering on their EOBs. Finally, watching outstanding balances will let you know which patients you should send to collections or dismiss from your practice.

Software is an important tool for cash flow management. It is one thing to look at EOBs and make sure they match the amount due. However, knowing whether or not the money you’re expecting actually made it to your bank account is critical. Consider implementing automated accounting software that will help track expenses and revenues for you.

Automated accounting software can track statements and activities directly through your bank and credit card accounts. Automation increases accuracy, timeliness, and helps eliminate posting errors. If you have ever spent time using QuickBooks, you know that tracking down accounting errors is a maddening and laborious process that can take hours.

We sincerely hope you’ve enjoyed our series about managing cash flows. We understand that medical providers want to focus on caring for their patients, but a practice must be financially healthy and sustainable before it help anyone else. In these times of economic hardship and political uncertainty, only the financially savvy practices will survive. Please feel free to contact us at info@xlemr.com if you have any questions about cash flow management. Be sure to check out our website at www.xlemr.com if you’ve missed previous installments of this series or want more information about our products.

Welcome to part four of our series on how to manage your cash flows and avoid selling out to the hospital. Last time, we looked at ways to maximize your revenue. This time we examine the other side of the coin, minimizing costs. Examine your practice in detail and look for un-necessary expenses to cut.

Staff salaries are probably the biggest expense next to rent on your office. Do not jump to conclusions; we are not suggesting you fire your staff. As you implement EHR and automate your office, you will need less staff. Repurpose idle staff to new tasks, such as scanning your old charts, or pursuing denied claims. Let natural attrition thin out your staff. Think diligently about whether or not you should replace a staff member when they quit. A solid EHR implementation and automation should cut down required manpower.

Dictation and transcription are expenses we frequently encounter. Out-sourced transcription can sometimes be so expensive that eliminating it will easily pay for EHR. In-house transcription is not cheap, either. You have to pay staff for their time when they could be doing something more productive. Consider switching to an EHR that works with Dragon Medical, the well-respected industry standard in voice recognition software. Dragon can give you the familiar dictation workflow without the added expense.

Support and maintenance contracts are a necessary evil in this day and age. Many things require them, your EHR, practice management system, and possibly large medical devices in your office. You may even have a managed services contract with a local IT provider. Review each contract in detail and see if you are getting value commensurate with the cost. If not, try to re-negotiate or eliminate the contract.

Automated patient reminder systems help minimize costs associated with missed appointment or overdue bills. If your staff is manually calling patients to verify appointments or follow up on collections, consider an automated system to make the calls for you. Again, this will allow your staff to focus on more productive tasks.

Does your practice have old charts in storage? We have seen practices store charts in exam rooms that could otherwise be generating revenue. Other practices rent offsite storage for their old charts. We even talked with a large practice which planned to build an entire new building to store their charts. Scan those old charts, back them up offsite, and then shred those old paper charts.

Please return for our next and final installment, where we will discuss tracking your expenses and revenues. Please contact us at info@xlemr.com if you would like more information about minimizing your costs. We would love to hear from you. Please visit us on the web at http://www.xlemr.com for back issues of our newsletter and more information on our products.

Thank you for joining us for part three of our series on how to manage cash flows and avoid selling out to the hospital. This time, we will talk about how to optimize revenue from encounters. As they say, knowing is half the battle. The other half is action. There are two basic strategies for maximizing your patient revenue. The first is to work harder.

Physicians are the bottleneck in a medical practice. Practices can increase their revenue by seeing more patients each day. How can we accomplish this when providers and staff are already worked to the bone? First, limit your time per encounter as much as possible.

Providers in high-volume practices see about 30 patients per day on average. Does the provider take too long seeing the patient? Do the patients insist on engaging in excessive chit-chat? If you can shave down encounter time and see one more level three patient per day, that will add something like $1000 to your bottom line each month, assuming you work five days a week. If you have multiple providers, your gain could be substantial.

In addition to reigning in long winded providers and patients, eliminate administrative tasks as much as possible. If your practice still uses paper charts, you are wasting time faxing, filing, printing, stapling, and shredding. Have you ever lost 10 or 15 minutes due to a misplaced chart? What about all the paperwork that requires duplicate data entry for patients’ demographic information? If you’re still using paper, switching to a certified electronic health record (EHR) will help automate your office, speeding up your workflows. It will also speed up records requests and help eliminate time-consuming pharmacy calls due to formulary issues.

A third method to reduce encounter time is delegation. Does your physician micro-manage the encounter by capturing everything themselves, from the vital signs, to the past medical history, chief complaint, and history of present illness? If so, they are wasting precious time doing the job of their medical assistant when they could be focusing on their core competency. Delegating data entry will go a long way towards speeding up encounters.

In addition to working “harder,” practices should learn how to work smarter. Coding at appropriate levels can increase revenue by about 20% annually. Many providers down code to stay off the audit radar, fearing that their documentation may not support higher levels. Switching to EHR makes it easier and faster to document for levels three, four, and five. Chances are you already doing the work to support higher levels, so don’t feel like you are gaming the system when you should legitimately code higher.

We hope you will join us next time when we discuss how to minimize your costs and expenses. There are many other ways to maximize your revenue; we have only scratched the surface. If you would like additional ideas, please feel free to contact us at info@xlemr.com. Please visit us on the web for past issues of our cash flow series. Go to http://www.xlemr.com and click on news. We look forward to hearing from you soon.