Just Another Day in the Office
My daughter had a toothache. After an initial appointment with her dentist, she was referred to an oral surgeon. The first day we visited their office was a particularly busy one. The bright office was packed with people. As we sat in the designer chairs, waiting for her name to be called, we could hear a steady stream of harried conversations coming from behind the giant reception desk, spoken in hushed but clipped tones. The sense of frustration and anxiety seeped across the broad counter, filling the otherwise-cheery office with a sense of quiet unease. With repeated visits for my daughter and then my wife (the surgeon was very good, and we had all needed care for some time), it became apparent that this was not just a momentary crisis, but a cultural norm for the office staff in this practice. Curious as to what was causing this, I tried to listen in, and caught snippets of complaints passed between coworkers.
“This computer is so slow!”
“I can’t get into the account--”
“Are the printers down again?”
I looked around at the other patients sitting beside us and it occurred to me that if I could hear it, so could everyone else in the full waiting room. “They need to be our customer!” I thought idly.
The thought became less idle as I continued to reflect on my experiences in the office over the next few weeks. Any dental practice can have a vague atmosphere of anxiety, mostly coming from patients with common phobias, but the administrative staff, who could be helping to mitigate it, were living in an environment of ongoing IT pain. How could they become the first line of defense against those fears if they were stuck in the rut of fighting technology, on an endless stress-cycle of their own, day in and day out? How much different could it be for both the patients and staff if they were able to resolve some of that pain? My observations had taken place over a series of months, and it was obvious from their long-suffering and beleaguered tones that this hadn’t happened overnight - why hadn’t anyone done anything to improve the situation by now?
Then it was my turn to be seen; simply put, this practice had been weighing heavily on my mind. When I arrived, I didn’t just write my name on the line, settle into one of those barely-comfortable chairs, and pick up People Magazine -- I started to ask questions. The answers I got were much of what I had previously overheard: they had frequent problems accessing their electronic medical records (EMR), the network was always running slow and timing out, they were being locked out of and losing access to accounts. As a point of reference, I asked who their service provider was.
“Oh, we have a guy, Steve; I don’t know where he is, but he's been here forever.”
As I started to move away from the desk, Anna, another of the harried receptionists, made a comment about how their phones worked just as well as their computer systems - meaning not at all. “Why can't we get a phone system that works with our workflow?” she asked. When I asked what she meant, she explained that the administrative staff moves with the surgeons because there are multiple offices that the surgeons rotate through. On any given day one office has to forward over a dozen calls for a specific surgeon to one of their three other offices; but the lines and call forwarding system never works, and it eats up hours in their day, with some patients’ needs never getting met because they can’t get ahold of their surgeon.
As I mulled over the interconnectedness of network IT and phone systems, the door to the hall opened.
“Mr. Knotts, he’s ready to see you now.”
And I was ready to see him. As the surgeon prepared for my exam, I started with, “So, I have this company…” I told him about what we do at PEAKE Technology Partners and how I had overheard his staff talking about some of the problems they’ve been having. Just the briefest of an acknowledgement of the issues from an outside source seemed to open the floodgates for him. He let out a groan and said, “I know, and we want to make changes, but--” He proceeded to explain how a few of the newer, doctor-owners like himself wanted to try a different approach to their IT and address some of the problems the staff have, but the other doctor-owners have been working with Steve for 25 years and just don't seem to see any issues. With a sigh and a shake of his head, he leaned over me and the sheer nature of the appointment stalled any further conversation on the matter.
As I parked my car in front of the office two weeks later for my follow-up appointment, I mentally reviewed the brief conversation from my last visit. The problems the staff were dealing with were relatively small in the grand scheme of IT problems, but it had become such a pervasive struggle, it had infected every aspect and perspective inside that once-welcoming office. Sure, it wasn’t that bad yet, but I could only imagine it was going to get worse.
When I walked through the door, there was something in the air, a cloying sense of quiet panic, that made me suspect that “worse” had already arrived. When I was greeted at the desk Anna asked my name and date of birth -- expected questions. Then she proceeded to ask me why I was there, what time my appointment was, what provider I was seeing, when I had last been in the office, if I had any copay and did I have my insurance card with me? Something was not right. As I pulled out my card, I casually asked if anything had happened. Again, the dam was broken.
“We’ve had a server crash; everything has been down for 3 days”
“We have no schedule; no supplies have been ordered!”
“We lost all our patient records, we had to go completely to paper.”
I looked around aghast at the stacks of paper covering every inch of spare desk behind the counter as I was regaled with horror stories of having to reschedule major surgeries because they were unaware that they needed to schedule an anesthesiologist that day and there was none available on call.
Hearing my voice, my surgeon hurried out to meet me in the lobby. Opening the heavy glass door, he beckoned me in.
“We need to talk.”
I followed him to his office, and, as I made myself comfortable on a couch that was much more inviting than the stiff dental chairs, he told me a familiar story. This was a wake-up call. What had once been “just” an underperforming and chronically neglected IT environment had now failed. He gave me a brief glimpse into their history: a small private practice that grew into a multisite, 100+ employee organization with daily use of digital imaging and a complex EMR to maintain. Their IT sophistication simply had not scaled with their practice. He said that, in the midst of this catastrophic crisis, “Steve-the-IT-guy” had no sense of urgency, and that finally, finally the rest of the doctor-owners saw the need to do something different. Unfortunately, it took losing a great deal of time and money to create a catalyst for that forward momentum to begin.
We agreed on a time and date for an official meeting with the rest of the ownership to discuss how PEAKE Technology Partners could help. As I walked from his office to an exam room, however, I couldn’t stop thinking about what else they had already lost.
The Hidden Costs of Underperforming IT
At around the same time, PEAKE had just partnered with another medical group. They were a typical practice, no big problems or pain at first glance, but we immediately had recommendations. There were vulnerabilities, systems to be fixed, changes that could be made to improve all aspects of their healthcare IT. As we so often are, we were met with:
“That’s too expensive. We’ll do X, Y and Z, but not A, B, or C.”
Within a very short amount of time, that same client was the victim of a ransomware attack on one of the same vulnerabilities we had recommended to be fixed. This attack resulted in a $30,000 ransom and the entire system was down for four workdays. Appointments and procedures were canceled, patients were turned away; in the end, their lack of diligence and foresight cost much more than just the ransom amount.
This is what everyone thinks about as the “cost” of IT failure. Cybersecurity is the hot button topic and in the news every day, and for good reason.
There is another cost, however, one that is silent and hidden. It creeps in quietly and starts destroying a practice a little bit at a time, unseen and unnoticed, until a major crash uncovers widespread, degenerative damage. When the inevitable failure happens on the heels of a chronic company culture of neglected and underperforming IT, you discover that not just your finances are affected. In fact, the worst damage ends up being to the three additional aspects of what makes or breaks a practice: patients, staff, and reputation.
Damage to Patient Perception
When the daily everyday operations of a medical office are plagued by time-stealing and stress-inducing IT complaints, it’s not just the financial bottom line of the practice where the damage is seen. It’s in the waiting room as the receptionist tries to check patients in but the EMR keeps logging her out; as the PA attempts to use the phone system intercom to signal to the doctor that their next patient is ready, and is never heard. It’s in the exam room at the computer terminal where the nurse is trying to pull up a patient’s file unsuccessfully; as the patient has to wait twice as long as normal because the physician is locked out of her account and can’t read the patient’s history to prepare for the appointment. It’s at the check-out desk as the scheduler realizes that all the appointments she made today were not saved; as the insurance and billing specialist continues trying to make the computer send the summary of services to the printer as they click “check eligibility” for the 10th time. It’s in the patient’s home as they have to call the office over and over because the call is dropped every time a receptionist tries to transfer their call to a provider; as the patient tries to access their test results through the portal and is informed that it’s down for maintenance, again.
Patients are witness to all of this. They see, and they hear -- and not only do they hear what the members of the practice are saying, but they also hear a silent message. Conveyed through the near-constant technical malfunctions and interruptions is generalized disorganization and unprofessionalism, a lack of trust-worthiness, questionable data security and business practices, and an insufficient amount of care taken to deliver the convenience and experience necessary in this sector. In a day and age when data security is at the forefront of every healthcare consumer’s mind and high-tech service delivery is not only desired but expected, this type of patient perspective can cause a practice to lose patients, and quickly. Additionally, if your support staff is unhappy and at their wit’s end with the most basic and repetitive of tasks, it creates an office atmosphere that isn’t a comfortable situation for anyone to experience.
Damage to Employee Morale & Retention
In the same vein, we come to the next area of damage that can be seen when analyzing chronic IT neglect in a medical practice. Employees are obviously affected; however, often the effect on them is measured in the hours it takes to solve IT problems and the amount of money it costs a practice in salary and revenue. While those are important and, at times, staggering numbers (which we cover below), this negative IT environment eats away at your company culture and employee morale in a way that is equally damaging. This is an industry where the turnover rate was on an upward trend in 2017 at 20.6%, according to a study by Compdata Surveys, but the healthcare unemployment rate the same year was at a 10-year low of 2.5%. As such, healthcare professionals such as medical receptionists, nurses, billing specialists, and physician’s assistants are in increasingly high demand, and if your company is no longer a good working environment for them, there are opportunities all around and no real reason to stay.
Thus, the story reads as such: as more IT functions get glitchy and fail without improvement, employee job satisfaction and morale declines. This, in turn, causes a higher rate of turnover as employees jump ship and head for greener pastures, which damages your overall company culture. A poor company culture makes it extremely difficult to hire high-quality professionals, either in the place of those you’ve lost or as a practice expands. Finally, when a practice is understaffed, or staffed with under-qualified and inexperienced new hires, employees become overworked and, once again, job satisfaction and morale take a nosedive. It’s a vicious cycle that is sure to destroy a practice no matter how skilled the physicians are or how excellent the care is.
Damage to Practice Reputation
It is at that point that the trifecta of underperforming IT damage is found: in your practice’s reputation. Where your physicians went to school, how many research papers they have published, what score your patients give you on Vitals.com and Yelp, the extra services you offer, even the centrality of your location and the demographics of your clientele -- none of this matters if you can’t attract and keep patients or employees.
The healthcare market is packed with providers each trying to get their own slice of the market, and demand continues to climb. According to a census published by the Federation of State Medical Boards in 2016, there were 953,695 active physicians practicing in the United States, and there has been an estimated 11% growth in per capita healthcare spending since then. Consumerization of the market is upon us as well; Americans are clamoring for more data to fuel their healthcare choices and price transparency laws, publicly posted hospital scorecards, and the news and advertising industries are answering.
In this competitive environment, practices can’t risk anything tarnishing their public image, and in a culture where everyone, patient and employee alike, frequently and loudly airs their complaints on a variety of public and accessible platforms, interference with the comfort and satisfaction of those two groups can drive a practice’s reputation into the ground, and its future success along with it.
This damage doesn’t happen in a day. It is the result of long term, seemingly-minor IT irritations that become a daily build-up of pressure which eventually weighs down what could have been a successful practice if everything simply worked.
The Hard Facts
As if that damage isn’t enough, added to that are the additional losses that are taken in the form of money and hours. Here, numbers may speak louder than stories.
- The average doctor creates $2,378,727 annually in revenue for their affiliated hospital (Merritt Hawkins)
- The average private medical practice’s yearly revenue is $2,516,813 (CompHealth)
- A medical practice’s employee salaries range from about $44,000 per year for your entry-level Medical Administrative Assistant (Glassdoor) to an average of $313,000 for a physician (Medscape).
Combine those numbers with statistics on IT downtime:
- Businesses spend an average of 14.1 hours annually in IT downtime (Aberdeen Group). So, $2,420 in revenue is going down the drain for every hour you spend on IT downtime - an average of $34,122 per year. 81% of companies claim to be unable to afford more than 8.76 hours of annual downtime (Information Technology and Intelligence Corp); that’s $21,199. Can you afford that?
- A survey by IT staffing firm Robert Half Technology found that workers waste an average of 22 minutes every day dealing with IT-related issues (Robert Half). That translates into about 91 hours, or more than two weeks, per year.
- An average of 30 minutes is spent each week by employees attempting to fix IT problems (Compass America) - So you are spending an average of $42 to $301 per week on hours an employee is spending on IT problems; that’s $2,184 to $15,652 per year.
- An average of 200 minutes of company time is spent resolving a single incidence of IT downtime (IT Process Institute) a single Incident costs $8067 in revenue and $210 to $1,505 in salary.
And there are more:
- An average of 545 hours of staff productivity is lost by a company to IT downtime (Coleman Parkes)
- Cost-saving with an IT budget goes up 37% for each well-managed computer compared to an unmanaged one. (Gartner)
Beyond the Numbers
The numbers can be overwhelming. The technology can be infuriating. The changing demands of a competitive market can seem impossible to meet. But that’s not what healthcare is about. The core of healthcare is about people taking care of people. That’s it. Everything we do in the practice of medicine should support that ideal -- including, and perhaps especially, the IT environment that surrounds it. A well-managed and high functioning technology infrastructure can create a sense of excitement, innovation, and ease, and provide a quality of service that can inspire lasting loyalty from both patients and staff.
It was fortunate that I was in the right place at the right time to help my oral surgeon’s practice recoup and recover from the crash of their damaged IT system. We are working together to repair and rebuild, and I am certain that the practice will not suffer any lasting effects.
However, it didn’t have to come to that. It took a catastrophe, a near-total failure, for this practice to hear that wake-up call. You have a choice. You don’t have to wait; you can choose to heed that call right now. You can revitalize your practice and become more competitive. You can show your employees that you care about what makes their jobs easier and their days better. You can assure your patients that they made the right choice when they put their trust in you. You can inspire confidence in your ability to meet every need with relevancy and comfort.
No matter where your practice is in its IT journey, there is always room for improvement and it’s never too late.
The time is now to wake up and treat the chronic IT pain in your practice. You don’t have to do it alone, though -- we at PEAKE Technology Partners are here to help.
For more information on IT efficiency for your medical practice, visit our contact page or call us at 866.37.PEAKE. Our team of Healthcare IT experts have perfected the PEAKE process to ensure our clients maintain seamless support from their technology and reliable technical support from our helpdesk.
