Joe Capko

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So far Joe Capko has created 23 blog entries.

Your smart phone’s lurking dangers

The iPhone, Android or other cell phone you depend on for everything – besides texts and calls your phone is likely keeping you busy with games; productive with email, to-do lists and calendars; in touch with Facebook, LinkedIn and Twitter; and convenienced with applications as straightforward as a simple flashlight. But how much do you really know about this rapidly growing library of applications? How well do you read the obligatory user-agreement before you install the application? Well, of those “free applications” that most of us have installed more than a few represent some potentially serious risks, especially if you have HIPAA data on your phone.  Most free applications can access your contacts, calendar and other data on your phone – and for purposes of convenience, there are perfectly legitimate reasons for this, but can you be sure the publisher will only use this data for legitimate reasons?  One shocking example came from a flashlight application for Android that, once installed, had access to nearly all the data on the phone. The potential threat from applications, malware and viruses is very complex within a BYOD environment – even the basics of keeping device system software current can be a nightmare when one is facing a multitude of different hardware and operating system platforms.  Naturally, risks of this sort should be thoroughly defined in your HIPAA risk assessment that is a requirement of meaningful use. Regularly updating and refining your risk assessment alone could become overly burdensome very quickly.  Accordingly, it's worthwhile, given the complexity and ever-changing nature of technologies, to consider a very conservative approach – we recommend practices own and manage all devices accessing patient and other critical data.

By |2015-01-26T16:54:09-08:00January 26th, 2015|

You’re only one bad login away from trouble

Physicians and practice managers love using online tools to help run their practices. Whether you’re submitting payroll, doing some online banking, reconciling a credit card statement or confirming patient eligibility you’re using a connected network of devices, any of which could pose a serious threat to the well-being of your practice. While I’ve blogged here on the importance of strong and regularly changed passwords, it’s every bit as critical to be disciplined and conservative with respect to connecting to Wi-Fi networks. Every time you venture out to a hotel, conference or café you’re likely seeing a variety of Wi-Fi networks with nothing to identify them other than a short name. Should you connect to “Starbucks-FREE” Wi-Fi? The following link describes just how simple it is for a hacker to set up a simple network with the goal of stealing the passwords and data of people just like me and you. The straightforward best policy is to never connect to an unknown network (and it’s hard to “know” a network if you’re away from home and work!). For this reason, I strongly recommend using the “share internet” feature of many smartphones – typically there is a monthly cost, perhaps $15 for access, and data usage counts against your monthly phone allowance. Click to learn just how one hacker gains control over computers like yours.

By |2022-01-01T22:52:03-08:00October 30th, 2014|

Increase productivity and enjoyment with a larger monitor

It’s commonplace to see staff and physicians hunched over their computer monitors squinting as they work.  When you consider the amount of time each day that people are working on their computers, the benefit of alleviating eyestrain with larger monitors is clear.  While many off-the-shelf computer bundles (CPU and monitor) purchased a few years ago came with relatively small monitors, perhaps 15 to 17 inches, much larger monitors can be purchased for very little – high quality 27-inch monitors currently run under $300! While we highly recommend at least 24-inch models wherever space allows, there are a couple of considerations to keep in mind.  First and foremost, while nearly all monitors are plug-and-play making basic set-up a snap, it is still crucial to fine tune your graphics settings to optimize both the resolution and the type size – even though the maximum resolution (number of pixels, sharpness) of new monitors is high and the screens large, you may find that they type size is too small. Do not reduce the screen resolution to increase text size.  It’s far preferable within Windows-based systems, to adjust through the control panel/display and adjust text size without sacrificing clarity and resolution. If your routinely use multiple pieces of software concurrently, it may well be worth exploring two-monitor configurations so that they can display more than one system at a time. Setting up a these systems, may require special hardware such as an additional video card, while it isn’t tremendously difficult, it is a task best left to professional. Monitor upgrades are a frequent recommendation in our practice assessments and I've never seen a single person that wasn't delighted to have more screen space. I trust that you’ll see the same gains in productivity that we've seen.

By |2022-01-01T22:52:06-08:00June 30th, 2014|

Windows XP – It’s time to move on and quickly!

Since April of this year, Microsoft has ceased to offer security updates for Windows XP which means that practices with even a single network-connected pc running Windows XP are violating HIPAA and ineligible for meaningful use. If any of your computers are using XP, you should move immediately to replace these computers – any hardware that came running XP is almost certainly underpowered to make upgrading software alone a worthwhile endeavor. Before you dismiss the urgency of this matter, consider that hackers often actively target non-supported operating systems because their vulnerabilities are easily revealed simply be looking to see what patches are being offered for supported systems.  Once identified, these weaknesses are relatively easy to exploit, which potentially puts your entire network at risk.   Costs of any security breach will certainly exceed the costs of buying and configuring a new pc, which is typically under $1,000.

By |2016-03-04T11:50:12-08:00June 20th, 2014|

An easy cure for password headaches

Solid, complex and properly-protected passwords are the foundation of your technological security. Maintaining good passwords is surprisingly challenging.  For one thing, the quality of solid passwords inherently makes remembering them difficult. Add an ever increasing number of passwords and you’ve got a perfect recipe for the frustration of constant password resets – a time consuming and costly headache for you and your staff. Fortunately, there are some excellent, low-cost and easy-to-implement solutions in the form of password management programs. The basic idea is that a single program keeps all of your passwords in an encrypted database. My favorite solution is the free and open-source Password Safe. After downloading and installing, simply enter your passwords – entering 30 passwords took me about 20 minutes. Thereafter, simply use this program to access all your passwords.  Any of your passwords are at your disposal with a simple click that copies it to your clipboard. It really couldn't be simpler. However, be sure to back-up your database, perhaps by sending to your gmail account, and be sure not to forget your password!

By |2022-01-01T22:52:07-08:00May 16th, 2014|

Does your smartphone pose risks to your practice?

Let's take a few moments to consider what risks you may be carrying around with your phone.  One common vulnerability is stored passwords on your phone, e.g. within a “notes” program.  Imagine the harm that could come of a thief having access to your banking accounts or practice management software.  Your firm could suffer an immediate financial hit, malicious mischief or a potentially devastating breach of patient data. The start of such grief can be your unattended phone meeting with a disgruntled employee or dissatisfied patient. These risks mean that phone security justifies your consideration. Phone security starts with maintaining disciplined control over the physical device. Naturally, your phone should not be left untended in your office, on a shared counter-top or anywhere else where it might be easily stolen.  While it seems obvious, it’s very common to see busy administrators leaving their phones behind as they scurry about the office.  Luckily, most phones have security features that can significantly mitigate your risk – although many of these features are not enabled by default.  In many phones, a four-number passcode can be readily “cracked” by a thief. Better is a quality passcode (avoid common English words) that uses letters and numbers – with iPhones this can be changed under settings/general/passcode lock.  Keep you phone’s software updated, as security vulnerabilities are fixed as they are discovered. If you use an iPhone, make sure you have the application Find My iPhone installed (and updated) and enabled. iOS 7, the latest iPhone operating system, security has been greatly improved – potentially making your phone valueless to a thief, but you must first have an Apple ID (and remember it!). Phones using Android 2.2 or greater have a built-in application that can help locate or your phone and/or completely delete the contents of your phone and any installed memory (SD) cards.  You’ll need to make sure these features are enabled on your phone (settings/security/device administrators). Regardless of what device you use, be careful when accessing sensitive information when you’re out and about as your phone may connect to an insecure Wi-Fi connection, allowing others

By |2013-10-21T16:13:04-08:00October 9th, 2013|

Introducing Capko & Morgan

We’ve changed our name to reflect the immeasurable value provided to our firm and our clients over the last five years by Laurie Morgan. If we’ve had the pleasure of working with you over this period, you’ve surely benefited from Laurie’s uncanny knack for uncovering problems and zeroing in on the most effective, elegant solutions.  For her friends and colleagues – some of whom share her stellar academic credentials and many years of experience – she has long been the go-to-source for solutions to seemingly intractable business problems. Few have Laurie’s combination of academic understanding, in-the-trenches management experience, ability to deeply observe, and her resolute determination to find solutions. We couldn’t be more pleased to recognize her contributions and to have her working beside us on your behalf at Capko & Morgan.

By |2022-01-01T22:52:16-08:00September 26th, 2013|

Huge gains in revenue as employee monitoring increases

by Joe Capko Frequent readers of this blog will appreciate that we consistently recommend that management foster a culture of support and mutual respect toward all staff.  Consistently, the best-run practices  invest in their employees and, correspondingly, reap the benefit of a highly-motivated, creative and responsible staff.  While we still advocate such an approach, one recent study that looked into the effects of electronic monitoring on restaurant workers got us thinking that there may be relevance to the medical practice. As in medical offices, employee theft is a considerable problem in the restaurant industry. It is estimated that 1% of revenues are lost to theft – a huge problem when profits average, as in the casual dining segment studied, about 3.5% of revenue.  The study, Cleaning House: the Impact of Information Technology Monitoring on Employee Theft and Productivity (), found striking changes in staff behavior upon the start of employee monitoring. The employee monitoring was via the algorithm-based Restaurant Guard product sold by NCR and can be integrated with their POS systems.  This electronic system is designed to flag employees that have a relatively large number of suspicious activities within the IT system, e.g., transferring a food order from one table to another, voiding partial orders, etc. To cut to the chase, bottom line revenues increased dramatically – almost a three thousand dollar a week!  What is perhaps most surprising is that the vast majority of the increase to the bottom line was a result of improvements on the sales side – meaning that while employees stole less, they also actively sold more, especially more high-margin drinks. Restaurants are particularly vulnerable to this type of theft because they tend to be high-volume enterprises with a relatively large number of cash transactions.  Nonetheless, with patient financial responsibility being an ever increasing part of your practice, we have to accept that the consequences of theft can be direr than ever for medical practices, too. It’s our hope and expectation that EHRs and practice management systems will eventually offer tools to alert busy managers to irregular patterns in staff behavior that may indicate theft. 

By |2022-01-01T22:52:16-08:00September 6th, 2013|

Free Staff Time by Implementing a Patient Portal

Chances are good that your EHR includes some easy-to-implement patient portal features that can save your staff time and increase the profitability of your practice.  As an example, consider your current intake process for new patients. Most practices still use a paper form that is filled out by patient at the time of the first appointment and that is subsequently re-entered by staff into the EHR – a needlessly cumbersome and tedious process for the patient and staff.  Fortunately, almost all EHRs that include patient portals can help automate this process, sometimes completely. In the best implementations, patients can log-in to the portal and complete their forms whenever they prefer – and the data entry task for your staff essentially disappears, saving time and eliminating possible errors.  How might this feature alone affect your bottom line? Paul Louiselle reported in the Journal of Medical Practice Management (Nov/Dec 2012) that his pediatric surgery practice will save roughly $23,000 in staff time in the first year alone by automating new patient intake forms. Many duties of your front desk staff are highly repetitive and, as such, are potential opportunities for automation.  We take for granted phone trees that can help by providing directions or hours of operation in addition to simply routing calls, but it’s important to remember that at one point even these phone systems were cutting-edge technologies.  Patient portal functionality, will become ubiquitous in coming years - the sooner you implement, the more your practice can profit.  If you cannot take on another task, don't get discouraged. Many practices we help have existing staff that will embrace a new career challenge – understanding the potential for a patient portal to help your practice can be a wonderful opportunity for one of your staff to really shine. Among their many functions, patient portals often offer secure electronic communication between patients and physicians, lab results, prescription refills and other clinical features. The adoption of these and other clinical functions warrants caution.  Physicians are often and rightly concerned about how communicating with patients via the patient portal will affect reimbursement.  Physician owners or practice

By |2022-01-01T22:52:16-08:00August 29th, 2013|

Hiring Lessons from Google

Turns out that even Google finds it difficult to hire the right people.  Google has a history of being notoriously single-minded in its quest to hire "the best and brightest."  In Google's case this meant that only applicants that had advanced degrees from elite institutions and graduated at the top of their classes need apply.  In a recent interview published in the New York Times, Google's Laszlo Bock, Senior Vice President of People Operations, discussed some surprises that emerged from studying Google's hiring techniques. If Google is right, virtually nobody is better than anybody else at interviewing prospective employees. High GPAs, test scores and skill in brain teasers are all practically useless.  According to Laszlo, the best interviewing questions are those that uncover both how a prospective employee behaved in a situation and their attitude toward a particular work challenge.  Using a consistent set of questions that probe an applicant's behavior - such as how they solved a problem - and attitudes seems to be most useful. Google now asks all employees to assess their management twice a year. In our experience far too few practices take the time review the performance of managers from the perspective of those that they manage. Employees should have an opportunity to rate their managers on their transparency, clarity and fairness. Providing honest feedback to managers is essential if they are to improve their performance. Performance in this case means increased staff morale, lower turnover, higher patient satisfaction and, of course, higher profitability. Leadership is often a week area within medical practices. Key leadership attributes are fairness, consistency and predictability. With a challenging day-to-day workload, many practice administrators and physician leaders fall short on these measures. These shortcomings affect not only staff morale, but also the bottom line since staff often disengage from refining office procedures that can improve patient care and profitability. Read the short interview here: http://nyti.ms/1cOFANS        

By |2022-01-01T22:52:18-08:00July 2nd, 2013|

Think your staff work only for money? Think again

If you haven’t read Dan Ariely’s entertaining, highly-readable and best-selling book Predictably Irrational, consider adding it to your summer reading list. Ariely, a cognitive psychologist at Duke, designed and conducted many experiments that illuminate some surprising reasons that guide behavior. Many of these experiments have relevance for the way that medical practice administrators manage their staff for greater productivity. Many of Ariely’s study participants are college students that are paid modestly for their efforts to complete routine tasks – i.e., their incomes are low enough that small increases should matter.  In one such experiment, the subjects were paid to identify and circle instances where the same letter appeared side-by-side on a page of text.  Test subjects were paid for each page on a descending scale - the most for the first page and less for each subsequent page - until they declined to continue.  Students were randomly assigned to groups that would have one of three variations on this basic theme: 1)      Subject wrote name on page, the examiner visually scanned the page and gave a verbal cue to acknowledge the work before placing the work on the pile of worksheets. 2)      Subject did not write name on page. Examiner simply placed the finished page on a pile without visually scanning or acknowledging. 3)      Subject did not write name on page. Examiner immediately placed finished worksheet into shredder. If participants cared solely for the compensation they received, the study results would indicate that all three groups ceased to work at approximately the same pay rate (remember the descending pay rate).  The study results showed that the group that had its work shredded immediately upon completion stopped working at almost twice the pay rate than the group that had its work cursorily acknowledged. The group that had its unnamed worked immediately placed on a pile? It stopped working at very nearly the same pay rate as the group that had its work shredded! These findings are consistent with what we find in our tour of medical practices across the country.  When we talk with practice staff members, we find that the

By |2022-01-01T22:52:31-08:00June 19th, 2013|

Does an employee’s sudden prosperity signal new trouble for your practice?

A staffer’s increased prosperity might be coming at your expense. Sudden and unexplained personal spending on the part of a staffer can be a warning sign that embezzlement may be taking place, but there’s another and sometimes even more damaging explanation that you should be concerned about – employee patient data theft. The theft of confidential and legally-protected patient data is on the rise and is already extremely widespread – millions of patient records have been compromised and the costs to the associated practices are many millions of dollars. Some schemes involve employees selling records as "leads" to unethical lawyers or others. Your controls over patient data are as important as your practice’s financial controls.  Every practice should have well-defined policies with respect to accessing patient data - e.g., inappropriate accessing of patient data is grounds for dismissal.  Practice administrators and physicians should periodically audit how many (and which) patient records employees access – ask your software vendors on how best to generate the necessary reports.  Any device that can be stolen, accessed remotely or have data copied from it is a potential vulnerability.  I recommend every practice conduct a thorough assessment of the risk of patient data theft every year.

By |2022-01-01T22:52:32-08:00April 10th, 2013|

13 for 2013 Tip #10: Engage staff

Most practices have an underutilized resource - namely, their employees' ability to identify and solve problems. As practices deal with the day-to-day business, it's all too easy to fall into a routine-inspired complacency. To establish some positive momentum, make a point to ask each of your staff to identify problems and possible improvements - and give everyone an opportunity to contribute their ideas during your regularly scheduled staff meetings. We think you'll be surprised at the sources and quality of ideas that emerge. Be generous with your appreciation and praise and you'll see a staff that is happier and more motivated than ever.

By |2022-01-01T22:52:35-08:00February 4th, 2013|

Does Satisfaction Make Patients Sick?

A recent UC Davis study revealed a surprising finding - an inverse relationship between patient satisfaction scores and health outcomes.  In other words, those most satisfied with their healthcare providers were, on average, sicker and more likely to die than their less satisfied counterparts! As might be expected from these findings, healthcare costs were also higher - by about 9% -  among highly satisfied patients. The study compared health outcomes and patient satisfaction scores of over fifty thousand adult respondents of the Medical Expenditure Panel Survey, a product of the Agency for Healthcare Research and Quality under the U.S. Department of Health and Human Services.  The survey is designed to be representative of the U.S. adult population and is the most comprehensive data set of its kind. Response rates for the survey have varied between approximately 60% to 70% over the last decade. Among the possible explanations is that physicians, motivated in part by physician compensation structures that consider patient satisfaction, stray from standard treatments and instead meet patient expectations. Under this scenario, patients are satisfied because tests and procedures are viewed in a more-is-better light, but clinical outcomes suffer, e.g., patients receive treatments that carry risk as a result of false positive lab results. The trend toward elevating patient ratings in measures of quality of care are likely to continue with the Center for Medicare Services (CMS) starting this past December with its initial phase of 1% rewards or penalties for hospitals under Value Based Purchasing. One-third of the evaluation process relies on patient data, i.e., survey data. These intriguing study findings certainly call for further research to solidify our understanding of the value of patient satisfaction ratings.   This study and our firm's experience especially calls into question the value of very broad measures of patient satisfaction, e.g, how satisfied are you overall, because patients are notorious for confusing bedside manner with the quality of clinical care. The implications of this study may be far reaching, but enterprising providers can take simple steps to educate their patients, preferably long before they see them in the exam room. With email and social media making communication easier and less expensive,

By |2013-01-24T14:40:12-08:00January 24th, 2013|

13 for 2013 Tip #3: Cash management quick-check

Do you accept cash payments at your practice? The start of a new year is a great time to review how your practice handles cash -- to determine if your internal controls could use some tightening up. With cash, the biggest temptation is to handle these "small" amounts more casually than other payments.  When cash payments are rare -- a $30 co-pay here, a $25 co-pay there -- it can seem that they're less important to the bottom line.  But, over the course of a year, even a single $30 cash payment per day amounts to close to $8,000!  Keeping tabs on those "unimportant" cash payments is actually very important, indeed. The biggest pitfall: mixing cash receipts with petty cash.  This all but ensures these amounts won't be deposited and may not be properly tracked.  Petty cash should never be more than about $50 or so -- just enough to handle small payment amounts for the office that cannot be handled by credit card or check.  Allowing petty cash to grow creates a temptation for misuse -- or worse, theft. Cash should be deposited regularly -- ideally, every day -- for security and for effective tracking for practice evaluation and tax reporting.  Receipt stock should be monitored, and the cash received should be reconciled against the day's postings by some at the practice who doesn't collect it and post it to the billing system (in smaller practices, this might need to be the physician/owner).

By |2022-01-01T22:52:36-08:00January 10th, 2013|

Do you have staffing troubles ahead?

A poorly-timed departure of a key employee can really put a crimp on your enjoyment and profitability. Recent survey data reported in the online Business Insider cite a lack of trust in corporations and wanting to be their own boss as the top two reasons these workers leave. These data bolster our oft-repeated recommendation that every practice administrator should put a high priority in nurturing the careers of their key employees. After all, how better to foster trust than to take a sincere interest in your employees well being?  What's more, such interest often takes the form of giving more responsibility and autonomy to these employees thereby helping to satisfy their desire "to be their own boss." Read more about here about the 5 Reasons Why Gen X Workers Quit.

By |2022-01-01T22:52:37-08:00November 16th, 2012|

Scheduling for Profitability and Patient Satisfaction

Many practices fail to appreciate how critical a role scheduling has in a practice's profits and the way patients perceive care.  As an example, consider how an ineffective reminder system can cause a cascade of ill consequences for your practice: the patient forgets their appointment -- the provider sits unproductive -- patients can't get into see their "fully-booked" provider.  Both practice profitability and patient care are compromised. To avoid these scheduling problems, it's important to periodically review your scheduling operation from a patient's perspective. For each step make sure you have a comprehensive understanding of the full range of outcomes. Do you know, for example, what happens when your reminder system fails to deliver to a patient?  Is someone on your staff charged with following up? Do you effectively track "no-shows?" Do you have goals for reducing them? Whether you conduct a review of your scheduling procedures using an outside consultant or your own staff, you may be surprised to see a boost in morale because scheduling staff have a tough job and are rarely consulted by management. Understanding the challenges that your scheduling staff face and their ideas for improving processes are great first steps toward increasing your practice's finances and improving the mood of patients and staff alike.

By |2022-01-01T22:52:38-08:00October 25th, 2012|

Are you the Brilliant Jerk?

The New York Times recently published an illuminating article entitled What Do You Do With Brilliant Jerk?  The piece struck a chord with me because the process the article described -- a brilliant founder, essential to the creation of an organization, eventually becomes a thorn in its side -- is something we see all the time in our work with practices. The emergence of the Brilliant Jerk in medical practices is a natural and predictable consequence of changing demands as practices grow. When practices change, personality traits that were invaluable can become highly problematic, e.g., a brilliant clinician who cannot artfully interact with his colleagues or staff on operational or  business matters. The plight of the Brilliant Jerk is not enviable. Practice profitability is a function of the efficiency and productivity of the entire clinical and administrative staff. For example, Brilliant Jerks often fail to appreciate management guru Peter Drucker's advice, "Accept the fact that we have to treat almost anybody as a volunteer." The Brilliant Jerk's behavior is generally at odds with a harmonious and efficient operation because they fail to appreciate the value of others within the organization. It isn't easy to contemplate whether you've become the Brilliant Jerk, but it is certainly worth considering, since your career and financial well-being are at stake. First, consider how many of your professional relationships are strained relative to your colleagues'. Second, consider how much you have adapted to the changing needs of your organization.  If you are finding yourself in strained business relationships within an organization that has experienced considerable change while you have the same attitudes and "standard operating procedures," well, it's quite possible you're becoming your practice's Brilliant Jerk. If you suspect that you are the Brilliant Jerk, you have an excellent opportunity to test your brilliance in adopting an urgently-needed program of remediation. An objective assessment from a consultant that has the breadth of experience to give you some practical advice, or perhaps from a career coach, can be a good place to start. And you might be surprised how much you get out of the effort: improving relationships with your colleagues

By |2022-01-01T22:52:39-08:00October 8th, 2012|

Costly (and easily correctable) telephone mistakes

All of us by now have had the feeling of being held captive by a merciless phone tree or being asked, "Can you please hold?" before being left in limbo for five, ten or even fifteen minutes or more.  Like you, patients don't like having their time wasted when calling your practice. Nonetheless,  many practices have taken high demand and technological developments as an excuse for failing to review and refine the systems they have in place for serving their patients over the phone.  If you've recently reviewed your online presence and encountered a negative review, you can appreciate how important it is to establish with your patients a sense that you are dedicated to taking good care of them regardless of whether they are in or out of the exam room. Improving patient phone service needn't be an overwhelming chore for your all-ready busy office. In fact, this process is ideally suited for working on around your schedule as there are many components that can be improved in fifteen minute blocks. Most modern telephone systems have impressive reporting capabilities, despite the fact that most practice staff usually know nothing about them. Make it a priority to generate reports that can serve as benchmarks for your practice's performance in this area. How long do callers wait on hold? How many calls come in relative to your patient visits? When are calls coming in? One very common problem is the rush of calls that often occurs as the practice opens up after the lunch hour. As the lunch hour is the most convenient times for many of your patients to call, the simple fact is that you should have telephone coverage over lunch.  Rotating this assignment through your staff is easy to implement -- you'll get more new patient bookings and smooth the flow of calls, meaning happier patients and staff. You should have a current diagram of your phone tree that illustrates that patients can find their way through the tree in a timely manner.  Consulting with your systems reports, eliminate branches of the tree that are infrequently accessed. You've

By |2022-01-01T22:52:39-08:00May 10th, 2012|

Office Squabbles? Three Areas to Look for a Fix

Do you have conflicting personalities in your office? Do such differences result in petty squabbling?  While inter-office conflicts are common, there are a few things an administer can do to greatly reduce conflict in the workplace.  It's important to address conflicts before they affect the professionalism of your practice, the morale of your staff, and your practice's productivity. Most of what is attributed to personality conflicts in the workplace can be traced to a just a handful of sources for which you most likely are responsible! Job descriptions: It's all too easy for disputes to emerge when responsibilities are not well defined. In today's changing medical field, jobs change -- don't let those job descriptions lead to finger-pointing in the office. Clearly delineated responsibilities allow staff to both receive credit and take responsibility for tasks. Without clear definitions it's too easy for misunderstandings (of differences in performance) to escalate into personal resentments. Cross-training: The counterpart to clearly job descriptions is that your staff should be well cross-trained and able and willing to fill-in where they are needed. Cross-training has the benefit of helping everyone in the office truly appreciate what important roles the others are fulfilling.  Additionally, it shows that you are interested in the well-being and career and skill advancement of your staff.  There's a fine line between a groove and a rut!  To the extent you are able, provide variety in the work environment so that your staff doesn't fall into an abyss of boredom. Fairness: If your staff perceives that some receive preferential treatment, morale will suffer and, with falling morale, it's only to be expected that friction will increase.  An under-appreciated fact is that perceptions of fairness and openness to communication go hand-in-hand. If your staff feels they can approach you to complain because you have a sincere interest in their well-being, you are well on your way to resolving squabbles among your staff. Challenge yourself to hear that which is difficult for you to hear. No one is free from biases and your staff can serve as a mirror to your own policies -- it's important

By |2022-01-01T22:52:42-08:00September 30th, 2011|

The Time is Now for ICD-10 Planning

Regulatory requirements that affect the medical practice are changing rapidly.  While the primary focus may seem to be on EHR systems and meaningful use to obtain those stimulus funds, there are other mandatory system changes that need to be addressed now, starting with the conversion to ICD -10 code set. The new code set represents an important advancement in diagnostic coding and conversion to it is required.  Limitations of ICD-9 include limited descriptive reporting and inability to adapt to advances in medical procedures and technology. The new system promises more flexibility and descriptive capacity. As a result, more accurate healthcare data reporting is expected. Due to the significant structural differences  between the existing ICD-9 diagnostic coding system and ICD-10 coding system, the transition to ICD-10 code set is one of the critical areas of change for physicians in the near future.  Medical practices will be required to adopt the use of the ICD-10-CM code set by October 2013. Since the new system is relatively complex, you’ll want to make sure your entire staff receives the training they need as early as possible. One potential benefit for doctors that “under code” is that more precise diagnosis and procedure codes will enable more accurate reimbursement. Additional benefits include an improved ability to measure health care services, reduce coding errors, a decreased for supporting documentation with claims, and the ability to use administrative data to evaluate medical processes and outcomes. October 2013 may seem a long way off, but given the magnitude of this conversion it is important to address this change now in order to avoid severe work disruption and delayed or lost payments. The first step in planning for the conversion to ICD-10 is to assess the organization’s readiness for adapting the new codes and understanding the impact of the change on your practice. Practice leaders should meet with billing system IT representatives and develop an implementation strategy, time-line and budget to accomplish the conversion. The timeline should include adequate time for testing the system and it should contain a plan for providing essential education and training for the team members.

By |2011-10-27T16:54:55-08:00September 9th, 2011|

Profit with a Clear View of Your Practice’s Competitive Landscape

Whether you're contemplating expanding your practice, starting a new practice, or simply wondering what your practice's profit potential might be, your profits depend on your understanding of local patient demographics. With a host of free online services available, it's easier and less expensive than ever to understand your area's demographics and how they might represent threats or opportunities. You need to know how well your area is being served by your practice-type! One very useful website is www.city-data.com that supplies wide-ranging demographic information on thousands of communities. Among the most telling information is the population and growth trends of your service area -- where your patients come from or nearby areas new patients could come from. Often service areas are defined by geographical barriers, valleys, rivers, etc..  When we work with medical practices, we find that compiling data from the various communities in their service area (and other areas of interest) in a spreadsheet is invaluable.  First, we take note of these population demographics: total population, population growth, income and, naturally, any demographic segment particular to your type of practice, such as women, children or the elderly. Next, combine the separate community data so that you can have a single figure for "service area" for each demographic segment. Now that you've compiled data to define the demographics of your service area, you can compare how your service area compares to nearby or similar-sized areas anywhere in the country.  Is there a relatively high, low or average number of your practice-type in your service area when compared to similar other regions? You'll need to employ your first-hand knowledge to help you define the "service areas"  that compare to yours. Be mindful of population density, income and geography and you should be able to identify at least two competing service areas. You can plug these data from their respective communities into your spreadsheet to calculate the same measures you have for your service area. Now that you've become somewhat of an expert on the population, it's time to gather information on the physicians. You'll goal is to find the number of physicians (FTEs)

By |2022-01-01T22:52:56-08:00March 8th, 2011|

Marketing Your Practice with a Code Update Event

By Joe Capko, Capko & Company Every year, changes to the CPT codes take medical practices by surprise -- even though everyone knows the updates are coming.  Whether it's because doctors and administrators assume that coding changes won't likely apply to their specialty, because it's hard to find time to go through the materials, or just due to old-fashioned procrastination, most of the practices we work with wind up ignoring the new codes until they start finding out the hard way that the codes they've been using are no longer valid -- i.e., once claims start to be rejected. Naturally, this is a costly problem for all practices, as these rejected codes can mean payment delays of six months or more. Here's the good news.  Since most (if not all) of the other practices you work with as referring partners are facing the same pain-in-the-neck, why not turn this hassle into a marketing opportunity?  You can do it by hosting a Code Update Seminar -- call it a "code party" if you want to be less formal about it -- and invite the practice managers and administrators from the other practices you work with to learn about the changes.  You arrange for a coding consultant to present an overview of the changes, along with a meal or some snacks -- depending on the size of the group you're inviting, you may need to rent out a large conference or event space at a nearby hotel or business center.  Depending on your preferences (and those of your colleagues), you could schedule an early morning breakfast event, a lunch event, or an evening or weekend seminar. If this seems like too much effort or expense, you can try the "lite" version: a smaller, more intimate, group hosted in the office reception area during non-clinic hours. Helping to solve a problem that your colleagues all share while also giving your administrative staff the chance to network with their counterparts at your key referring partners is a wonderful way to promote your own practice without "selling."  Be sure to have some tchotckes (pens, post-it

By |2011-01-17T19:03:22-08:00January 17th, 2011|
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