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EHR Budgeting Webinar Slides

Posted on April 20, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The HIT Community recently did a webinar on EHR budgeting that I found quite interesting. Looking at the slides (embedded below), you can see that it covers a number of the important factors related to budgeting for an EHR. They talk about various cost savings and expenses you’ll have. I love that this goes beyond the EHR incentive money.

I’ve covered a lot of these various items before and I have them listed on my EHR & EMR benefits page. I also go into detail on most of them in my EHR selection e-book.

Now for their presentation slides:

You can find a link to the Live recording of the webinar on the HIT Community website.

Why You’re Never Going to Leave a Healthcare IT Job at 5:30

Posted on April 19, 2012 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

Anybody catch the recent Mashable.com or CNN articles on the feedback Facebook COO Sheryl Sandberg has received because she makes it a point to leave work at 5:30 pm every day? (You can read them here and here.) In a nutshell, Sandberg has always left the office around that time – a practice she started when she first had kids, but has only felt comfortable talking about it now that she is in upper management and (presumably) somewhat immune to corporate push back. ( Don’t confuse leaving work with not working, by the way. Sandberg, like many others, checks email at all hours.)

Mashable CEO Pete Cashmore, who authored the CNN.com story, summarizes the mini-controversy that has evolved in the tech world as a result of Sandberg’s coming clean: “In a competitive industry where your work is never truly complete, has it become socially awkward to leave work at a time that used to be the standard? And are those working eight-hour days that end at 5 p.m. being quietly judged by their co-workers? Whatever happened to “work-life balance”?

Good questions, to be sure. So good, in fact, that I felt compelled to pose a similar query to a panel of current and former healthcare CIOs – all guys, by the way – at the recent Women in Technology International (WITI) / GAHIMSS event, “Women in Healthcare IT Talk.”

Piedmont Healthcare CIO Mark Pasquale was refreshingly candid in his response: “I don’t have a work-life balance.” His point being that, as a CIO overseeing a near-future EPIC ERP system go-live, his work day never really ends, especially given how connected he is via multiple mobile devices. He also pointed out that, as 85% of Piedmont’s install team is internal, Piedmont spent copious amounts of time preparing that staff for the time commitment required to travel to Epic headquarters in Madison, Wisc., for training. Pasquale kept an open door, and said many staff members came by multiple times to hash out whether committing to such an intense project was the right move for them.

From left to right: Christopher Kunney, The BAE Company; Sonny Munter, Georgia Dept. of Community Health; Mark Pasquale, Piedmont Healthcare; Praveen Chopra, Children's Healthcare of Atlanta

Fellow panelist Christopher Kunney, HIT Strategist at the BAE Company and former CIO of Piedmont, made the point that you have to be aware of what you’re signing up for when you enter healthcare’s executive ranks. Long days aren’t unusual; they are the norm. Children’s Healthcare of Atlanta CIO Praveen Chopra concurred, adding that his wife makes him limit use of his Blackberry on vacation to just one hour a day. Sonny Munter, CIO of Georgia’s Dept. of Community Health, joked that he leaves his job everyday at 4pm – but gets going around 6 in the morning. Munter added that he makes it a point to surround himself with good staff members, which also helps in balancing his work and family obligations.

From left to right: Lisa McVey, McKesson; Gretchen Tegethoff, Athens Regional Medical Center; Patty Lavely, CIO Consulting LLC; Deborah Cancilla, Grady Health System

A second panel of healthcare executives – all female – pretty much agreed with their male counterparts. Patty Lavely, founder of CIO Consulting LLC and former CIO of three different health systems, did echo Facebook’s Sandberg just a bit in her comment on the subject: “There comes a time when you have to say, ‘This [work] will be here for me tomorrow. I need to go home and have dinner with my family tonight.”

All of the panelists mentioned the need to prioritize workplace projects and challenges in a way that is suitable to the particular balance they need in their lives. They have triaged, so to speak, their commitments, priorities, deadlines, etc. to fit their schedules.

So, can healthcare IT folks – providers or vendors, executives or otherwise – ever be off the clock, never mind leave the office between 5 and 6? Share your stories and advice in the comments below.

Crocodile EHR Sales – All Mouth, No Ears

Posted on April 18, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m a regular reader of a number of venture capital bloggers. I love entrepreneurship and consider investing a hobby that I love learning about. One of the best VC bloggers out there is named Mark Suster. I recently saw one of his posts titled, “The Danger of Crocodile Sales.” While Mark takes his post in a few different directions I think we have our fair share of Crocodile Salespeople in the EHR world.

Before I get into some thoughts, here’s how Mark describes a crocodile salesperson: “My favorite was when a guy told me to beware of Crocodile Salesmen. What’s that? ”You know, big mouth and no ears.””

I know I’ve been in some EHR sales presentations that were off the charts good at selling and demoing an EHR product. Based just on that sales presentation I could see how a physician would be very interested in buying that product. Everything went like clock works. They hit so many of the buzz points for doctors that make for a really compelling sell.

The problem comes that with half of the things that are said, in the back of my mind I’m thinking…and now let’s hear the rest of the story. Or the related…what about this, this and that nuance?

Don’t get me wrong. I think there are a lot of really good EHR salespeople who have the best interest of the physician at heart. Plus, there are a number of EHR companies that support this type of sales process. The challenge as I see it is helping the doctors to ask the right questions so they get the right information.

A crocodile salesperson, as described above, makes it a challenge for a physician and their practice to get the information they really need. In some cases you can see why an EHR salesperson exhibits the crocodile characteristics. Some of them just don’t have the in depth knowledge of their product to be able to veer off their sales demo script. They’ve nailed the sales demo, but fall apart when you veer into uncharted territory.

This is exactly why a doctor should make sure to take the EHR salesperson off script. You don’t have to be a jerk about it in the process. You just need to make sure that the sales presentation covers the points that you need covered. Do it in a polite and appropriate way and great EHR salespeople will be happy to go the direction you want to take the presentation. I know doctors time is limited, but it’s worth taking the extra time to get the right information. Ask any physician who’s switched EHR software if they’d wish they’d spent a little more time understanding their first EHR selection. I argue that it is the most important part of an EHR implementation.

My best suggestion to a doctor is to always consider how the EHR software being demonstrated will work in their office. Don’t get so caught up in the bells and whistles of what the product could eventually do in your office that you forget about how you’re going to do your regular tasks. Another common error is for physicians to be so rigid in their requests that they’re not open to any deviation from the processes they’ve used for the past years. No EHR will fit every physician workflow in every way. Consider whether you can see reasonable alternatives to your current processes.

If you want some other suggestions on asking good questions during your EHR sales demo, check out my e-Book on EHR selection. There’s a whole section of it devoted to the topic.

Selecting the right EHR is a hard thing to do. Getting the right information about an EHR and how it will work in your practice is critical. So, be sure to ask the right questions and don’t let crocodile salespeople waste your time and theirs. Make sure that they understand the specific needs of your practice before they start showing you how their EHR software solves those needs. You’ll both be better for it in the end.

Cutting EMR Training Budget Can Create Serious Problems

Posted on April 17, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Not long ago, American Medical News ran an article on training up medical practice staffers for EMR use. The piece concluded that while practices may save some bucks on the front end, they generally end up regretting it later.  An anecdote from the piece:

Nine months after All Island Gastroenterology and Liver Associates in Malverne, N.Y., went live with its electronic medical record system, practice administrator Michaela Faella realized things had not gone as smoothly as planned.

Even though the staff had used other health information technology systems for many years and considered itself tech-savvy, it had taken everyone six months to learn how to use the new EMR system. Several months later, the staff still had not become proficient at it.

The problem was not with the staff, but that the practice cut training short to save time and money. “Training was not placed high on the priority list, and we paid the price for it,” Faella said.

As the piece notes, many practices assume that the training bundled into the cost of their new EMR will meet their needs, and find out to their regret that this isn’t the case.  (In fact, I’d argue that this is more the rule than the exception, based on anecdotes I hear in the field and in conversations with physicians.)

A consultant quoted in the piece suggests that practices should consider three main issues when planning for training:

1) How much data they’ll be dealing with, which can vary greatly depending on whether all data is imported in advance or done patient by patient

2) Whether the practice will be integrating new systems into the EMR, such as e-prescribing, or conversely, adding an EMR to existing systems

3) Whether using the EMR will call for using new hardware such as tablet computers

Personally, I’m not satisfied by that list at all.

What about, first and foremost, assessing the staff’s existing skills more precisely, walking staffers through the various layers of the EMR on a daily basis, forming teams of superusers within the organization to help the less skilled and taking steps to be sure EMR problems don’t interrupt critical functions (a backup/workaround plan for the short term)?

What do you think?  Does the list above cover the critical EMR practice integration issues?  Am I just being testy?

So, EMRs Do Reduce Tests Ordered? Partners Says Yes

Posted on April 16, 2012 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

About the same time last month, I brought your guys some unwelcome news – that physician access to electronic records perhaps doesn’t reduce the number of tests subsequently ordered, and hence doesn’t reduce healthcare costs as much as previously thought.

Except that maybe it does. At least that’s according to an article in Chicago Tribune that summarizes the findings of a study by Partners Healthcare, and a research letter published in the Archives of Internal Medicine (full text, PDF).

According to the study:
– It looked at health information exchange and test data between Mass. General Hospital and Brigham and Women’s over a 5 year period from Jan. 1, 1999 to Dec. 31, 2004.
– The study looked at 117,606 patients during this period. Of these, 346 patients had recent off-site tests, of which 44 were done prior to the HIE rollout.
– The study found that for patients with recent off-site tests, there was a 49% reduction in number of tests ordered.
In number terms, the number of tests ordered per person reduced from 7 in 1999 to 4 in 2004.
– There was however a slight increase in number of tests ordered for the population that didn’t have any prior testing done during the same time period – increasing from 5 per person to 6 per person.

These findings directly contradict the Health Affairs study that I mentioned earlier. The Chicago Tribune article has a little researchers-play-nice subsection at the end where the Health Affairs and Partners researchers try to interpret each other’s contradictory results.

If I may add my 0.02:
– Even though the Partners study follows a larger population of patients, the data that is used to calculate the reduction (346 and 44) is way too small
– The Health Affairs studied some 28,000 patients spread across 1,187 doctor’s offices, while the Partners study followed a larger population of patients at two huge Mass. hospitals that entered into a partnership with each other.

While this not directly discounting anything each group has found, I would think the HA study is more representative of what’s going on in different parts of the country, where doctors are using different (in capability/costs) EMRs and labs to get their results. In Partners case there may well be a tacit agreement on EMR brand, or even tacit trust between the labs/facilities that each hospital uses.

Very interesting though, and I’d really love to see what else comes out on EMR and healthcare costs.

EMR, HIPAA & EHR Jobs

Posted on April 13, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today I happened to meet with someone who was working a Las Vegas job fair. It was convenient for me to stop by while he was there, so I did so we could talk business. I’ll be honest that it bothered me a little bit personally to see the hundreds of people standing in line waiting to enter the job fair. Sure I’d seen and heard the reports of the 5000 people who showed up for 750 jobs. Although, it’s quite a different thing to see it first hand. Thankfully, I had my business discussion and left before I had to hear the hard stories that I’m sure many of them could share. Then again, I’m sure I would have also seen some amazing optimism and excitement from those looking to land a job to change their life.

On my drive home, I couldn’t help but think about the healthcare IT job situation. We’ve often written about the shortage of qualified healthcare IT & EHR talent to be able to service the onslaught of EHR software that we are seeing right now. Even for EHR vendors it’s a bit of a dog fight to get the very best people to work for them. Yet, I’ve also heard on EMR Thoughts from far too many healthcare IT certificate program students that can’t find a job. I’m not going to lie to say it makes my heart break. I do what I can and refer them to people I know who help with this stuff for a living, but it’s hard.

I think Jennifer Dennard must feel very similar to me since she’s written on the healthcare IT Worforce development and social media resources for healthcare IT job seekers to just name a few of her posts on the subject. It’s just a hard contrast for me to see hospitals and other healthcare related companies that can’t find qualified people and so many people still without jobs.

I’m not sure how many people know that I have an EMR and EHR job board. It’s not a real big thing, but it has a ton of different EMR, EHR, HIPAA, and Healthcare IT related jobs posted there. Here are a few that were posted specifically for the EMR and EHR community:
EMR Software Programmer
Director, HIPAA Compliance
Ambulatory EMR Server Administrator

The jobs listed above appear in the sidebar of many of the Healthcare Scene websites. Hopefully this is one small way to help both EHR and Healthcare companies find qualified talent and help those searching for a job in healthcare IT learn more about the needs and open jobs.

Do Emergency Departments Have A $30B Identity Problem?

Posted on April 12, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Given the pressure to produce, produce, produce, most doctors squeeze far more patients into their day than they’d prefer, and often, the endless rush leads to many clerical mistakes. In the emergency department, the problem is even worse, as EDs handle immense, variable volumes of encounters which make it hard to allocate staff to meet patient care needs, much less check basic patient demographic and personal data for accuracy.

In both environments, it’s easy for patient name misspellings or identity mismatches to slip by. In fact, according to vendor MiddleGate Med, fact-checking and finding say, updated addresses for clients can be so taxing that many hospitals simply give up and send out bills which patients never see. This costs U.S. hospitals $30 billion per year, according to the company.

Right, hospitals write off more then 12 percent of all revenue on bad debt, according to some researchers. “That means they’ve already tried to clean up their database and get this right, and they haven’t managed to change it,” said one hospital executive.

MiddleGate’s new product, IdentiCare, is designed to help hospitals verify patient information quickly and accurately.  It comes as Web-based system, which then ties into the hospital database through an HL7 interface.  “We just want to make sure that the hospital has current and accurate information on them so you can get bills out of A/R.”

Another benefit, which MiddleGate doesn’t stress (but should) is that better patient identification techniques can help make sure that hospitals meet the FTC’s Red Flag rules requirements, which are designed to prevent medical identity theft.  Since hospitals aren’t used to following the standards set for typical creditors, any help here is welcome, no?

All that being said, has MiddleGate taken the right approach to closing leaks in the hospital revenue cycle?  Are there other pressure points which are equally important in improving hospital collections and profitability? (For example, might it be better spending time on how to streamline online communication, especially rapid claim adjudication, from the inarguably solvent carriers rather than chase down $20 co-pays?)  What do you think?

P.S.: By the way, a former client of mine estimates that if you don’t collect the co-pay before the patient leaves your office or ED, much less bill them accurately and quickly, less than 20 percent will ever pay at all.  I can’t vouch for that number, but my guess is that the CEO I worked with is right.  But I’ll share more of his conclusions in another piece.

Who Moved My Cheese (or Paper Charts)?

Posted on April 11, 2012 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I got just a glimpse yesterday of what clinicians must feel like when they log into an EMR for the first time – giddy with anticipation, hopeful that its use will ultimately lead to better patient outcomes and easier workflows for all. On the flipside, there was also frustration, impatience, and a bit of confusion.

Just before bedtime, I fired up Calorie Counter, my newest iPad app. As with any community you join, I first had to fill out a member profile, which took some time. I then had to learn through trial and error how to navigate through the program – search for, find and choose the foods I had eaten earlier that day, make adjustments for portion sizes, then log the data. The app’s drop-down menus included some of the foods I ate, but not all. “How do I add foods to the stock menu?” I wondered, thinking at the same time that this must be what doctors feel like when they can’t find what they need in an EMR.

It didn’t take long, and I’m sure now that I’ve at least done it once, future data entry will be more intuitive, and quicker. I do wonder about the rate of retention for this type of app, though. Do people stick with it for more than a few days or weeks?

I’ll have to either keep a running paper list of the foods I eat throughout the day, or bring my iPad with me wherever I go in order to log my calories. I was bummed that I couldn’t find this particular app for both the iPad and iPhone. (Those that were developed for both just didn’t seem to be as robust.) Perhaps this twinge of disappointment has been felt by doctors who have fallen in love with their new EMR, only to realize they can’t access it via their chosen mobile device.

It will take dedication on my part to keep up with daily logging of calories and activity, but I am convinced it will be worth it. After just one day, I’ve already had a nutritional wake-up call: Just seeing how much cheese I eat has made me decide to cut back before bathing-suit weather.

The beauty of the app isn’t the comprehensive list of foods already plugged in from which to choose from, but the calorie recommendations it makes based on members’ profiles (weight/height/activity level/age/gender, etc.) and the analytics that will result after I have a few days/weeks/months logged. Patterns will emerge that will give me a clearer picture of my diet – foods I should keep eating, those I should eat in moderation, and those I should avoid all together as long as I’m trying to reach a certain daily caloric intake. Not quite as important, but still similar in my mind to the aggregating power EMRs have when it comes to clinical data.

Other than keeping up with the daily log, I also have the option of joining the Calorie Counter community on Facebook, and I think there’s a brief tutorial out there I can take a look at. Depending on my time available, I may not do either – a course of action I’m sure a few doctors also opt to take with their EMRs, which I assume is ultimately detrimental to the results they’ll see with the technology.

In addition to trying to get a bit healthier, I’m overcoming my resistance to change (as if I really want to eat less cheese!), which as my colleague John pointed out in a recent post at EMRandHIPAA.com, is “the number one reason doctors aren’t adopting EHR software.”

But change is usually good, and as John also points out, “resistance to change is going to be the reason why EHR adoption will become the norm.” I’ll let you click over to his post to find out why. In the meantime, I’m going to try and resist the bagel with cream cheese that seems to be calling my name from the kitchen.

Ruined Healthcare IT Words

Posted on April 10, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I know that I spend far too much time talking, writing, tweeting, posting, commenting, obsessing over everything EMR and Healthcare IT related, but doing so has had some interesting consequences when it comes to certain words or abbreviations. Let me give you some examples of Healthcare IT words or abbreviations that have been tainted one way or another.

Meaningful – I honestly can’t even use this word any more. Meaningful Use has ruined the word meaningful for me. I definitely can’t use the word meaningful in healthcare anymore without cringing. It’s like a permanent built in pun for meaningful now. Plus, meaningful just isn’t meaningful anymore because it’s been used so much. Meaningful will be forever tainted in my vocabulary.

PHR – I expect we’re going to see the general death of the word PHR. Too many failed EHR softwares have ruined this word. I’m sure we’ll still have many of the functions and features that PHR software offers and many PHR software will be around, but we’re going to see a new branding of what they do. Yesterday I heard one called Patient Relationship Management (PRM I guess) which could be a good replacement for the tainted PHR term.

mHealth – This word is a bit like PHR in that we’re still going to see plenty of mobile health, but I think the term mHealth is going to go away. Eventually mobile will just be an extension of healthcare IT and healthcare in general. We’ll still see some residual naming, but most won’t differentiate.

I’m sure there are a lot more. What other healthcare words or abbreviations have lost life for you?

Revenue Cycle Management is So Popular Because Most Physicians Aren’t Business People

Posted on I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In a previous post, I asked the really important question: Is Revenue Cycle Management Sexy? I was amazed and impressed by the discussion that spurred out of that post. People were talking revenue cycle management details in the comments, on Twitter and even on their own blogs about how revenue cycle management is indeed sexy.

Turns out that a number of doctors wouldn’t be practicing medicine today if it weren’t for revenue cycle management companies that support these doctors. Keeping doctors in business is sexy to me. I know that the media often spins revenue cycle management as the rich (doctors) getting richer. They also love to talk about revenue cycle management companies taking such a huge chunk of a physician’s reimbursement. Let’s look at these two factors.

Are Doctors Rich?
First, it’s a little bit of a misnomer that doctors are all rich. Doctors don’t do anything to help this image since so many of them drive around in their high priced Mercedes and BMWs. There are many doctors (specialists top this list) that do make a very large amount of money. Many primary care doctors and certain specialties make much less. Don’t get me wrong. Every doctor I know is making plenty of money to live and live well. In fact, they’re making more than the average American. Although, when you look at their overhead, medical school expenses, etc you wouldn’t classify most doctors as rich.

Plus, let’s be honest for a minute. Many doctors are great at caring for patients and terrible at running their practice. Most physicians aren’t business people. There’s nothing wrong with this. In fact, some of the very best doctors are terrible business people. In these cases, many doctors turn to revenue cycle management to help them improve the business side of things. In some examples, no revenue cycle management assistance for a practice means the practice goes out of business. Hard to classify a practice that can’t collect money and goes out of business as someone that’s rich.

Revenue Cycle Management Company Fees
I’m sure if we looked across the spectrum of revenue cycle management companies, we could likely find some bad actors that are really gouging doctors more than they should because the doctor is in a vulnerable position. However, I think this is more the exception than the rule from what I’ve seen. In most cases where I see revenue cycle management in play, it’s because the practice for one reason or another couldn’t keep up with the demands required to do good revenue processing or didn’t have the expertise to do it well.

The problem is those doctors who are great business men don’t understand why their colleagues would allow a company to take a percentage of their reimbursement. What these great businessmen/doctors seem to miss is the choice that most doctors are really making when they choose to get assistance with their revenue cycle from another company.

The real choice for many doctors is whether they’re ok paying 7% of their reimbursement in return for a huge increase in how much reimbursement they actually receive. It’s just basic math really. If I can increase a doctors reimbursement more than the percentage I take, then it’s a good choice for many (definitely not all) doctors.

Could the doctor just increase the reimbursement themselves without having to pay a fee to someone else? Sure they could. In fact, many try this approach over an extended period. Then, many realize that they’re not very good at that part of the business. They realize that an outside revenue cycle management company can help them find missed claims that will now get paid. They realize that revenue cycle management companies can help those providers get paid faster.

Revenue Cycle Management and EHR
Some of the most popular EHR companies are built around this fact and offer the EHR for free or nearly free as a compliment to the core revenue cycle management. Plus, more and more EHR companies are building in some sort of revenue cycle management component. In many cases this is a good way for an EHR company to generate revenue, but for many practices it’s also a great service for them.

Of course, I’ve also heard from the many EHR vendors who don’t provide these revenue cycle management services to their providers. They usually give me an exasperated “How can doctors pay of their reimbursement to these companies?” A part of me understands this exasperation completely since I’m an entrepreneur like these EHR executives. If I were in a physician’s shoes I’d figure out the business process myself instead of giving a big chunk of my reimbursement to another company. This just ignores that many doctors can’t (or in many cases don’t want to) figure out the business process. In these cases, a percentage of their reimbursement is a better business decision.

Conclusion
The biggest challenge to revenue cycle management is doctors don’t want to admit that they need a revenue cycle management company. By doing so, they’d be admitting their not business people and that’s a really hard thing to do. Although, in many cases it is the best business decision.

Next up in my series on revenue cycle management I’ll talk more about the relationship of EHR and RCM.