Staffing: How will new technologies affect your need for personnel? - A consensus as to whether these technologies will reduce costs and staffing needs has not yet been reached. Opinions and anecdotal
Staffing: How will new technologies affect your need for personnel?A consensus as to whether these technologies will reduce costs and staffing needs has not yet been reached. Opinions and anecdotal observations are as varied nationwide as physician practices are.

Source: Medical Economics



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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.


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Comments from our Readers
 Posted 2010-07-09 10:41:25.0
I am the office manager of a solo physician internal medicine practice. We made the decision to purchase an EHR 3 years ago. It continues to be a work in progress. I would say that it took us at least 1 year before we were comfortable with the EHR, caught up with the scanning and routing, and had a product that was somewhat customized for our needs. The cost has been deep. Initially, there is the purchase of the product, new hardware and the multiple hours of training. Then there was the extra cost of customizing the product. Additionally, there is the cost of seeing fewer patients. Perhaps in a single specialty practice, EHR works better. However, in primary care, EHR takes longer for the physician. Therefore, he sees fewer patients. That resulted in the need to higher a mid-level practitioner to service the practice. Medical Assistants are asked to be involved in more charting entries, in order to free up some time for the providers. Clerical and clinical staff are responsible for scanning and routing of hundreds of pages each week. Certainly, there are many benefits to have the EHR. Primarily, the ease of finding the chart, a particular document, medication tracking, message tracking, etc. However, in primary care, I do not see a financial benefit.
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