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A high-tech phone system that limits your need for front-desk help. Interactive check-in kiosks that let patients schedule
their own appointments. An electronic health record (EHR) system that cuts down on the paper chase and paper trail.
For busy clinicians, new technologies promise savings in time as well as costs—in theory. But in practice, is this actually
true? The jury is still out, as Medical Economics found out, after speaking to experts on the topic.
Some say the new technology will reduce staffing needs, and according to Gray Tuttle Jr., CHBC, president of the National
Society of Certified Healthcare Business Consultants (NSCHBC) and a Medical Economics editorial consultant, they will.
"Because you are relying more on technology and automation, it gives you a fair chance of making some reductions in the human
resources of the practice," says Tuttle, who is with The Rehmann Group, a large, Michigan-based CPA firm with a significant
healthcare division, Rehmann Healthcare Management Advisors. "[An] EHR saves time, and in theory, requires less transcription,
less filing room work like pulling and refilling charts. You save costs there, but you pick up a lot of new costs as well."
The new costs of the technology are usually offset by the staffing savings, however, he says. "The staff savings cover the
cost of maintenance and depreciation, in large part, of an EHR system."
The current economic environment also is an impetus for physicians considering these new technologies, with the hope of cost
savings as a final reward, he says.
"We sit down with physicians, and we have their attention," Tuttle explains. "The landscape is telling us that fee increases
are not going to be a thing of the future. I think fee reductions are going to be the harsh reality of it."
To retain historical profit levels, he says, two options exist: increase efficiency to generate more revenue to offset fee
reductions, or find ways to cut costs without compromising care or efficiency.
"I'm a firm believer that properly deploying and paying for technology can translate to cost savings on the personnel side,"
Tuttle says.
SOME SAY 'YAY,' OTHERS 'NAY'
Others say that implementing some of these new technologies may increase the need for staffing, and they can take a heavy
toll on physician and staff time, especially during implementation.
"Implementing EHR data entry slows many physicians by 25 percent or more," says Keith C. Borglum, CHBC, appraiser and broker
with Professional Management & Marketing, in Santa Rosa, California, and a Medical Economics editorial consultant. "One solution is to add a 'scribe' to do the data entry while the physician speaks with the patient."
He adds that implementing online patient pre-registration can increase efficiencies for the office staff.
And although an EHR, for example, may reduce a practice's need for transcription and filing, Borglum offers a caveat: "A danger
is that it can transfer workload to the physician from support staff. Another danger is in groups wherein some of the 'old
geezers' won't switch, and the group ends up running both paper and digital charts—a nightmare!"
Michael D. Brown, CHBC, who is president of Healthcare Economics in Fishers, Indiana, agrees with Borglum about the increased
staffing needs that new technologies can create.
"Any upgrades, including EHR, check-in kiosks, integrated phone systems, etc., have increased our staffing complement by at
least one to take care of the new technology needs," says Brown, a Medical Economics editorial consultant.