A mature practitioner was open to the use of technology in his family practice, but felt that an electronic health records system would restrict his ability to effectively document his patients with numerous, complex health care issues. The practice's initial introduction to technology occurred when they implemented digital dictation devices seven years ago. This reduced turnaround time substantially.

In 2003, MediNotes was installed in the office. Each exam room had a computer installed, yet for the most part the computers were not used for data entry. Meanwhile, transcribed notes coming back from digital dictation were loaded into patients' electronic charts for future use.

In 2005, electronic prescribing was in its infancy, but Beth Schiller & Associates knew that there would be an opportunity for this physician to start using some of the benefits that e-prescribing had to offer without the overwhelming feeling of "jumping off the cliff" into the electronic health record world. A certified reseller of Rcopia by DrFirst, Beth helped the office implement the Rcopia e-prescribing system. It was an instant hit. Within one hour of initial training, he was off and running, and the staff was excited to implement ERx. Prescription management had been such a burden, but now could be managed easily and accessed remotely for after hours needs. After several months of successful electronic prescribing, moving to an electronic health record no longer looked so daunting.

Beth Schiller & Associates devised a plan for the doctor to convert the entire practice to paperless over the course of one year. Beth Schiller & Associates customized a few key templates and implemented voice recognition with Dragon Naturally Speaking to allow the physician to personalize and thoroughly document the reason for the visit. A template for the remainder of the note was designed to meet the needs of the physician.

Staff members have scanned essential clinical documents and retired the paper chart. Staff also used a fax server to reduce the amount of hand scanning needed. The regular fax machine, along with its cartridges, was retired. Secure remote access was initiated to allow the physician to log on remotely and see patient charts. New documents faxed or scanned in the office were partitioned off to a task basket for electronic review and signoff.

As hospital laboratories initiate lab interfaces, the practice will be migrated to direct interfaces to further reduce the amount of faxed information. Plus, this will provide for discrete data objects. Data mining will commence to take advantage of any Medicare or other payer "P4P" incentives. All these tasks done with 1.75 employees split over two locations.

Infusing technology into the practice reduces labor time and waste.

Beth Schiller & Associates received a call from a dermatologist whose billing manager of many years decided to leave the practice. The physician was in a panic, and needed training and support for the billing manager's replacement. Beth Schiller & Associates provided practice management, billing consultation and training so that the practice could continue to have a revenue stream without skipping a beat. Working onsite and remotely offsite via the internet, Beth Schiller & Associates provided "on the job training" for a two-month period while the new individual came up to speed.

But that's not all. After looking at how claims were being processed, Beth Schiller & Associates recommended the use of Validator software in conjunction with Lytec to provide free electronic claims transmission and electronic remittances to significantly reduce the accounts receivable and average lag time for payer reimbursement. The practice had been using an outdated duplicate entry system for Medicare electronic submission. It was also still using HCFA paper claims for the remainder of the business. Beth Schiller & Associates provided instruction and mentoring to effectively use some of the collection tools that the Lytec software provided, along with some "best practice" methods for keeping A/R as low as possible.

Beth Schiller & Associates not only stepped in during a potential crisis, but also brought this practice into the mainstream at a significant savings to their bottom line.

Beth had been talking with a specialist over time about evaluating his practice, but he never had time to engage her about it. However, that all changed one day, when Beth received a call from this specialist, who was in a panic. His office manager was leaving and he didn't want to have to hire another individual to replace her. He asked Beth to come into the practice and evaluate the work that needed to be done and make recommendations immediately. Without the help of Beth Schiller & Associates, the physician feared the revenue stream could be severed.

Beth went into the practice, evaluated current skill sets and made recommendations to free up the physician's only other employee to spend more time on billing tasks and working the accounts receivable. Tricks of the trade were taught, and on-the-job training helped assure the physician that his only employee would be able to manage the new tasks. Digital dictation was outsourced, speeding up the turnaround time. The physician now has one less employee and finds his dictation ready for review the next day. For the longer term, the use of templates with Naturally Speaking voice recognition will be employed.

Again, Beth Schiller & Associates stepped in and streamlined the work process, eliminating the impact of that employee loss.