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PRSRT STD U.S. Postage PAID Permit #12 Indiana, PA 28TH ANNIVERSARY The Leading Source for Healthcare Business News Issue 1, 2014 — $3.00 How to Increase When is the Right Time to IT Efficiencies Add Provider Coverage? Within the Medical Scribes vs. PAs/NPs Healthcare By Dr. Michael Murphy Medical scribes and medical scribe vendors are riding a Industry new wave of change in the American healthcare system where doctors and hospitals are being consistently called upon to do more with less. But if there’s one thing to remember in medicine it’s that there’s not always a one size fits all solution for every problem. Dave Pieton continued on page 3 KFMR: Helping Employees Working Businesses By Doug Coombs Improve Its The healthcare industry is facing from Home Increase an uncertain future. Governments, employers, and patients are Financial putting pressure on healthcare Employers’ Liability providers to reduce prices even as By Beth Slagle Positions costs continue to increase. While By Kathleen Ganster hospitals differ in size, specialty Trends in medicine may and many other variables, it will lead to a growth in nurses and often be an ongoing commitment other medical professionals How much is a name worth? to operational efficiency that will working at least part-time If you are a business owner, or differentiate successful providers from home. Statistics a business owner hopeful, that from those that fail. Increased reveal that the market question is extremely important. operational efficiency can improve for telemedicine patient Dave Pieton, a valuation the fiscal health of a hospital by monitoring grew 237% specialist with KFMR, helps improving its adherence to medical between 2007 and 2012 and business owners determine the standards and improving its patient continues to grow, according value of intangible assets including satisfaction scores. to a 2013 report from trade-names every day. continued on page 6 continued on page 5 continued on page 9 PMSLIC is committed to its physician-policyholders, therefore we promise to treat your individual needs as our own. You can expect caring and personal service, as you are our first priority. For more information contact your agent, or call Laurie Bush at PMSLIC at 800-445-1212, ext. 5558 or email [email protected]. Or visit www.pmslic.com/start for a premium estimate. A NORCAL GROUP COMPANY WWW.PMSLIC.COM 2 > Issue #1, 2014 wphealthcarenews.com HEALTHCAREFOCUS continued from page 1 Care Act taking effect it’s likely you need to be preparing either through hiring additional staff, training existing staff, tbu more Medical scribes work hard to master the complexities of likely, both. various EHR systems to help doctor’s focus on medical decision making rather than being highly paid data entry specialists. As Assess EHR comfort levels scribes continue to become the standard practice in emergency The next step is to assess your physicians’ comfort level with departments from coast to coast some groups are critically EHR’s. Many physicians find them challenging and get in the way evaluating their provider to patient staffing ratios and whom they of patient care. National data on EMR implementation has shown, use to work those provider hours. that physician productivity decreases and persists 6 months after But when is it the right time to add medical scribes? No doubt the implementation. A medical scribe solution could be the best answer simplistic mind looks at scribes as a line item, but are they really and most cost effective an added cost or if implemented correctly a net revenue item? Would it be a better investment to hire a nurse practitioner (NP), Consult your Press Ganey and HCAPS scores or physician assistant (PA) who potentially can do more within the organization than just document on EHRs? Next you can consult your Press Ganey and HCAPS scores to That answer historically depends on the needs and size of your see where there is room for improvement, regardless of whether organization, but I would argue it depends more on the provider your scores are high or low overall. For example if patients are to patient staffing ratios, which really should drive decisions about complaining about long wait times to see a doctor, more than their additional coverage. Most large emergency departments with quality of interaction with the doctor then either a scribe or mid- more than 20,000 annual visits likely have the resources and needs level provider solution will reduce the door to provider times. to bring on both scribes and PAs/NPs. What if your hospital is smaller than that? Does it make more sense for you to bring on a Making your decision PA/NP rather than a medical scribe or vice versa? The prevalence of both medical scribes and PAs/NPs are the result of the changing landscape of healthcare in America. Your Looking at the numbers critical analysis should consider the cost benefit of a scribe or For many hospitals PAs and NPs have proven to be an effective means PA/NP, take into account how your physicians are incentivized, of dealing with the demand for more doctors without having to pay the and the overall provider and patient satisfaction. It’s important to full salary of a doctor. Nationally, the average salary for a Emergency be prepared for the big changes ahead, but it’s also important to : Medicine doctor is about $250,000 per year, versus $87,000 for nurse consider other options when increased coverage is demanded. practitioners, and $79,634 for physician assistants. Dr. Michael Murphy is co-founder and Chief Executive Officer of However, for an average of $20-$23 per hour you are able to hire ScribeAmerica, LLC. He co-founded ScribeAmerica in 2003, and a medical scribe with the ability to customize their hours to fit the it is now the country’s largest and most successful medical scribe needs of your organization. So taking an 18k volume ED where you company with a staff exceeding 3600 employees operating in see on average 2 patients per hour but experiences boluses of up to over 40 states nationwide. Today, ScribeAmerica is the recognized 5 patients per hour. The department may want a PA/NP for about leader of the medical scribe industry and remains at the forefront of 6 hours per day to cover those busy hours, however cannot hire professional scribe education, training, and program management someone for 6 hours and are forced to pay for a 10 or 12 hour shift nationally. For more information, visit www.scribeamerica.com. and thus significantly affecting the revenue flow. Replacing the PA/NP with a medical scribe will put a spring back in your provider coil and allow you to see those large volumes of patients that you once could not, without one. At the end of the day, you have a net revenue positive of $200,000 annually while not compromising patient care. In today’s Healthcare environment, this is a significant impact on the bottom line. Medical scribes enable a physician to see and treat more patients.. Whereas a PA or NP can help divert patients with smaller problems away from a doctor to allow them to focus on the most serious cases. A study by medical system reviewer Software Advice found that NPs and PAs on average can perform about 80 percent of the same tasks that a doctor can. When is a right time to add PA/NP? Well let’s look at a 60k volume ED with an average provider to patient ratio of 2.08. This site has 56 physician hours and 24 PA/NP coverage daily. Due to decreased reimbursement and a new lower payer mix, the emergency department now requires a subsidy from the hospital to keep its doors open. Instead of taking this subsidy why not consider changes to the staffing model to increase your PA/NP utilization and reduce your physician hours? If you were to go to 36 physician hours and increase your PA/NP coverage to 48 hours you could even add 60 hours of medical scribe coverage and be budget positive roughly $320,000. Protecting your data, The above approach reduces the provider to patient ratios to 1.98 every step of the way. and emphasizes the physician as the quarterback, assisting the PA/ NP with most cases. Data Recovery Data Destruction Consult the budget Computer Forensics With those numbers in mind the next step in your decision- IT Asset Management making is to consult the budget. Can you really afford to hire, a Security Risk Management PA/NP or a medical scribe, considering that reimbursements cuts E-Discovery / Litigation Support are a common theme in government discussions. reclamere.com If the answer is no, you might consider looking at it in another [email protected] way. Will your organization in its current form be able to effectively weather the big changes taking place in the American healthcare system over the next year? Between the ICD-10 implementation, 905 Pennsylvania Avenue t Tyrone, PA 16686 t (814) 684-5505 the Two-Midnight Rule, and the major provisions of the Affordable wphealthcarenews.com Issue #1, 2014 > 3 SOCIALMEDIA Improve Your Productivity With These 7 Social Media Tools By Daniel Casciato stumble upon a few weeks ago. Ever stuck for a title for your blog post or even an article you Whether you recently started managing your may have written? 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