Progressive Focus©

Progressive Focus© Newsletter


Volume 2, Number 3 Fall, 2001
Helping You Manage the Expectations of Managed Vision Care

In This Issue:

Are You Effectively Using Technology and Office Computerization to Enhance Your Managed Vision Care Experience?

Five Questions To Ask Yourself When Evaluating Your Electronic Managed Care Future

In a managed care world, with its increased administrative hassles and decreased margins, you can't afford to under-utilize or miss opportunities to become more efficient and productive, and to lower costs. Technology and office computerization offer such opportunities, and we'll discuss some of them in this issue of Progressive Focus©.

Let's begin with five questions you should consider in evaluating your practice's readiness for the coming years.

  1. Is my computer software up to date or, at a minimum, easily and cost-effectively upgradeable?
  2. Is my computer hardware robust, and can various peripheral technologies be linked easily and cost-effectively?
  3. Do I understand what's in the pipeline now or soon to be available?
  4. Is my system secure, and can we protect confidential patient records from inappropriate internal and external access?
  5. Is my staff comfortable and competent with computers, or do I know of resources to bring staff up to speed on hardware and software issues?
What, My Practice?

Using those questions, take some time for an evaluation of where your practice is today vis-à-vis your use of office automation and computerization. Especially as it might impact on your managed vision care business, into which of these three, admittedly broad categories do you fall?

1) Those with a computer terminal at every or nearly every workstation, and with a well-trained (and cross-trained) staff. Those with exam room equipment connected to a central data repository. Those that actively promote the practice on a website. Those that electronically monitor optical shop inventory and ordering, and use the analyzed data to act upon dispensary sales trends. Those that are venturing into electronic patient records, voice recognition, digital imaging, and telemedicine. Or...

2) Those with plenty of terminals, but with an under trained staff. Those that under utilize system resources and capabilities, and limit use of their computers to the most obvious, mundane tasks such as appointment scheduling, eligibility verification, and claims submission. Those with technologically passé systems, unable to take on the challenges of today's sophisticated health care practice. Or...

3) Those with one terminal, usually in the doctor's office, but used only for his/her e-mail. Or those with one terminal, located at the front desk, and displaying its screen-saver most of the time. Or those that make no use of computers and, instead, rely on pen, paper, punch ledgers, file folders, typewriters, and postage stamps.

Did You Know...?

Most ODs are now involved in some sort of e-commerce. As an example, VSP's Eyefinity reports more than 16,000 offices currently link through their system. These ODs bill electronically and can process lab orders with some 300 optical labs also connected to Eyefinity.

Since its introduction at Vision Expo East 2000, Eyefinity has handled approximately 14 million transactions, and company representatives believe that use of their systems will increase even more as new services are offered.

What Key Office Functions Should Be Computerized For Addressing The Managed Vision Care World?

Obviously, answers will differ by circumstance. Here are some things that any optometric practice can and certainly should be doing electronically (or planning to do), particularly when thinking managed vision care. This is not a complete list, but it is a starting point for your practice evaluation.

Word Processing (e.g., referral letters to primary care physicians and ophthalmologists; transcriptions; reports; general correspondence; office brochures, web site design, and small-scale practice promotion; mailing functions),

Scheduling (e.g., appointments and recalls; reminders),

Accounting (e.g., accounts payable and accounts receivable; write-offs; patient billing for deductibles and out-of-pocket fees; claims submission and reconciliation; cash reports and daily activity; income and expense statements; payroll; general ledger),

Clinical (e.g., electronic medical records; digital imaging; telemedicine consults with other practitioners; access to preferred practice patterns and best protocols/treatments),

Practice Management (e.g., measuring productivity for the practice, by doctor, and by FTE staffer; costs and profitability by doctor and by area within clinic; volume, costs, and profitability by third party plan; monthly, annual, and year-to-year practice trends; referral profiles and trends),

Optical Dispensing (e.g., frame and contact lens inventory and vendor management; frame board allocation; optical lab orders and quality control; tracking specialty lens sales by type and by percentage of total sales; Rx archives).

And What's In The Future?

The opportunities to benefit from technological advances seem unlimited, and examples of high-tech systems designed to benefit your practice are everywhere. One example worth a look is VisionWeb.

This company's site (now in Beta test stage) is designed to create instantaneous connectivity between practitioners and industry. It will allow you to order Rx lenses, frames, contact lenses, and optical supplies, all with a mouse click. You'll be able to track the progress of your eyeglass orders tray by tray, and you'll use software with built-in algorithms designed to prevent Rx ordering incompatibilities and/or mistakes.

You'll have access to web page design tools, and to volumes of educational content for both practitioners and patients. You'll be able to import the patient educational material directly to your own practice's web site. And that's just a taste of what VisionWeb executives tell me they're planning.

They, as everyone else involved in this technological revolution, are keenly aware that today's availability may not meet tomorrow's demands. So look for this site and others to evolve rapidly as technologies change.

Answering Those Five Questions

If you believe that in the years ahead your practice will be significantly dependent upon third party plans (either through direct contracts with HMOs, PPOs, and IPAs, or with vision plans), then you need to prepare today for tomorrow's greater challenges. Today it's clearer than ever before -- your survival depends upon the entire practice working smarter and more efficiently.

This does not simply mean working harder, working more hours, and seeing more patients to offset reduced third party revenues. That's the standard line, you've heard it before, and it's so very irritating.

But it does mean working in ways and using resources that reduce per-patient costs and allow more dollars per patient to flow to the bottom line. It does mean improving quality and patient satisfaction, and it means focused marketing, all resulting in more returning and new patients. It does mean working on the cutting edge of technology so that you're perceived by physician and optometrist colleagues (and, of course, by patients) as a premier practitioner in your community.

And so let's return to those original five questions and consider some of the issues.

1)  Is my computer software up to date or, at a minimum, easily and cost-effectively upgradeable?

Though a discussion of practice management software packages goes beyond the limited scope of this newsletter, it is possible to say just a few words about operating systems.

If you're among those who still work in a DOS or Windows 95 environment then the answer to question #1 is "no." You have almost no likelihood for on-going, reliable upgrades on those "ancient" platforms. Even if you're using Windows 98 or 98ME you could find that soon you're falling dangerously behind the curve. Windows 2000 might offer you some sense of stability today, but many experts urge caution --there may not be consistent support once Microsoft jump-starts the XP operating system.

So you might want to look into what other operating systems offer, perhaps Macintosh or Linux or Unix. Obviously opinions vary, but numerous IT (information technology) experts are convinced that these operating systems are more flexible and better suited for many medical office tasks such as electronic medical records, integrating data from exam instruments, and telemedicine.

You'll certainly also need to consider the practice management applications that you'll need to run in a managed care world. For example, will your most important contracts require that you verify eligibility using software or an interface easily "plugged" into your system? Or will you have to use proprietary packages that require a lot of customized programming? Will you be able to purchase whatever software you might need, and will you be able to upgrade on your own? Or will you be able (or obligated?) to "rent" software through an Applications Service Provider (ASP)?

And you'll need to determine which software vendors hold the greatest promise for continued development and technical support. You certainly don't want to be caught in anything at all similar to the recent and very costly unhappiness that's befallen all users of the Ivy office management system.

2)  Is my computer hardware robust, and can various peripheral technologies be linked easily and cost-effectively?

You also need to look carefully at your basic hardware capabilities. If you're running an office server now then you're likely to need something even more robust in the not-so-distant future. At a minimum, your needs for managed care data storage and retrieval will certainly be increasing.

You should also look into terminal capacity both in the front and back offices and in each exam room, (and, perhaps, even a terminal for patient use in the waiting room). How many additional terminals might you need to add if your practice were fully automated? And, most certainly, you'll want to investigate your hardware's ability to interface with the newest generation of exam instruments (auto refractors, fields testers, etc.), and with video cameras and digital imaging systems.

3)  Do I understand the technology that's in the pipeline now or soon to be available?

There are many, wonderful new technologies available now or in the development pipeline. They can and will help you and staff deal with the burdens of managed vision care.

Here are just a few of the administrative tasks your office can or will be able to do to lower costs, raise efficiency and productivity, increase margins, and make everyone's life just a little easier. If you're not doing these now your planning should include them to enhance your managed vision care experience.

  • Internet claims (completion, validation, submission, tracking, verification and reconciliation),
  • Internet lab (ordering, verifying, and tracking spectacle lenses, contact lenses),
  • Internet eligibility and benefits verification,
  • optical scanning/bar coding (tracking frames and contact lenses in and out of inventory),
  • card swiping (capturing credit card or member I.D. card information from encoded magnetic strips; tracking and using that data for focused marketing and promotion).

4)  Is my system secure, and can we protect confidential patient records from inappropriate internal and external access?

This is one of the most important questions you must address today and in the years ahead. On the one hand, state and federal laws regarding patient records confidentiality will put your computer system to the test. Many health plans are starting to look at how their providers secure patient records both inside the practice and when transferred to other offices. And there's no doubt that HIPAA, once clarified and finalized, will put additional, costly burdens on every practice.

But perhaps even more worrisome than an internal mis-handling of confidential records is the threat to every system of external attack. It seems that nowadays there's a constant stream of news stories about hackers who are successfully attacking computer systems world wide. 13 year olds are compromising supposedly secure systems and, in some cases, doing incredible damage to the data stored therein.

Managed care plans are increasingly concerned about security in their contracted providers' offices. Any system in your office must be password secured for internal access. That's easy enough, and any system should do that without a second thought. (If you want still greater internal security consider biometrics -- e.g., a mouse that responds only to specific thumbprints.) But protecting your data files from outside intrusion, that's another matter all together.

Security holes in some popular programs allow hackers easy access to remote computers. In some cases they'll plant a "Trojan Horse" program allowing the hacker to access a computer and read (or alter) anything on the hard drive. Other programs will actually "call home" and send data to a hacker's computer anywhere in the world. It's frightening.

So you must look into how any system you have or consider will screen, track, and, if necessary, block external probes. There are various methods to stop unauthorized penetration --firewalls, for example. But they vary in sophistication and effectiveness. What may work for you at home probably won't do the trick on an office system.

5)  Is my staff computer-educated, or do I know of resources to bring staff up to speed on hardware and software issues?

Obviously all the best software and hardware won't do you a bit of good if your staff can't use it to the fullest capacity. So you'll need to tap into educational resources.

In particular you'll want to look into the services offered by the health plans and vision plans with which you'll be contracted to provide care. In some cases these entities will provide in-service training --for example when the plan has you connecting directly into its mainframe. Be sure to ask.

And don't be reluctant to ask the vendors (those who sell or lease examination equipment tied into your computer) to provide in-service training as part of your purchase or lease agreement.

Be sure to see the next issue of Progressive Focus© for more news to help you manage the expectations of managed care.




Copyright © 2003-2007, Gil Weber, MBA. No part of this newsletter may be reproduced or distributed in any form whatsoever without the author’s prior written authorization.

These materials are intended to provide useful information about the subject matter covered. The author believes that the information is as authoritative and accurate as is reasonably possible and that the sources of information used in preparation of the materials are reliable, but no assurance or warranty of completeness or accuracy is intended or given, and all warranties of any type are disclaimed.

The materials are not intended as legal advice, nor is the author engaged in rendering legal services. The materials are not intended as a replacement for individual legal or professional advice. Information contained herein is presented only for illustrative purposes, and it should not be used to establish any fees or fee schedules, nor is it intended and it should not be construed as encouraging any user of the materials to take any actions that would violate any state or federal antitrust laws, tax laws, or Medicare or Medicaid laws.

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