E-mail increases work, but technology can help
Case History #3
E-mail increases work, but technology can help
When Gregory Pecchia, DO, began communicating with his patients via e-mail on his home computer five years ago, he found that the process improved patient satisfaction and enhanced patient care but created additional work for him and his office staff.
But with a new integrated electronic practice management system that operates through an application service provider, Pecchia says he has been able to incorporate the e-mail into the office work flow automatically, reducing additional work for the staff.
Pecchia is one of four physicians and a physician assistant, with Family Practice Physicians Inc. of Orange, CA. For a monthly fee, the office contracts with Alteer Corp. of Irvine, CA, for its Alteer Office, an Internet-based practice management model that integrates clinical and administrative functions of physician practices.
The system integrates the entire work flow of the doctor’s office into one system. With patient e-mail, the system triages all e-mail communications, directing them to the appropriate staff. For example, requests for appointments go to the scheduler; prescription refills and lab report requests are directed to the nurse; and questions about patient care are sent to the appropriate physician. E-mail questions and answers automatically become part of the patient record.
Pecchia began the electronic communication process by writing his home computer’s e-mail address on a prescription pad and handing it to patients. "I urged them to communicate in an appropriate manner in a situation that was not time-sensitive. I was trying to enhance the capability of our patients to feel empowered in being able to communicate with the health care team," he says.
The process allowed him to find out more about patient needs and increase his rapport with patients, he says. But the process created a new challenge — how to incorporate the information into the patients’ medical records without increasing the office workload.
At first, Pecchia printed the communication at home and either faxed it to the office or brought it in with him. Later, when the office had computers, he e-mailed the document from his home PC to the office PC. The e-mail and Pecchia’s answer were attached to the patients’ paper charts.
"It was absolutely inefficient. It required a task I didn’t have before and that the office didn’t have before. Even though on the front end, the patients’ perception of quality increased, true delivery of quality was in some question," he says.
For instance, sometimes Pecchia couldn’t reply to the patient immediately because he didn’t have the chart. Even when he moved the e-mail system to his office, it still took time to get access to the chart. "Once the volume increased to about 10 e-mails a day, we found ourselves with a job description that we didn’t have an employee for — a new routing function. Patients were benefiting, but staff found themselves taking on more work," he says.
Through his involvement in computer upgrade committees at the hospitals where he practices, Pecchia met the founders of Alteer Corp. and volunteered his office as a beta site for the new practice management system. The new system allows him to do everything but examine the patient from home, Pecchia says.
Combining Internet technology and electronic medical records has allowed the practice to reduce staffing by two full-time equivalent positions with a savings of $50,000 to $60,000 a year, while allowing physicians to increase the time they spend with patients, he says.
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