| There is an increasing trend towards cash-based | | | | staff person scheduling appointments for patients, |
| medical practices. Some are the high end | | | | the practice could implement a web-based |
| "Anti-Aging" or "Age Management" practices that | | | | self-service appointment scheduling system. There |
| consider aging as a treatable condition that can be | | | | are several low cost systems on the market |
| delayed substantially through the application of | | | | today that offer a high level of configurability to |
| hormone replacement, nutritional supplementation | | | | accommodate physician schedules, multiple |
| and other non-conventional medical modalities. | | | | appointment types and pretty much any |
| Other cash practices are typical family practices | | | | scheduling complexity that a human can manage. |
| that have become frustrated with the insurance | | | | Further, since many of the practices operating in |
| model and have embarked upon the new | | | | the new paradigm offer nutritional supplements |
| paradigm of cash-based medicine. All of them | | | | for sale, an internet shopping cart is the natural |
| share the basic tenet that they do not maintain | | | | solution for this rather than having a staff person |
| contracts with insurance companies and instead | | | | taking orders. Once again, there are multiple |
| requires patients to pay cash for medical services | | | | commercially available tools that can meet this |
| rendered. | | | | need. Broadly then, the needs of cash practices |
| To be successful and profitable in the insurance | | | | can be summarized by the following list of |
| model, practices have to have very high daily | | | | requirements: |
| patient volumes (35 - 40 for a single practitioner | | | | - Patient Management Database (profiles, |
| family practice) in order to generate the revenue | | | | demographics, inquiries) |
| necessary to earn just a "professional" level of | | | | - Electronic Medical Records |
| income. Along with the high volume comes a lot | | | | - Appointment Scheduling |
| of overhead including a large office and multiple | | | | - Marketing and Communications for prospective |
| supporting staff just for starters. Due to the | | | | patients and patients |
| volume combined with a number of logistical | | | | - Shopping cart |
| factors (patients coming late, office inefficiency, | | | | - Accounting/Financial Management |
| etc.), patients typically have to wait 30 - 60 | | | | Continuing with the approach outlined above, cash |
| minutes or more from their scheduled | | | | practices could implement multiple commercially |
| appointment time, all of this just to spend an | | | | available tools to meet this unique need set since |
| average of 6 minutes with the physician. The | | | | the typical Practice Management Systems that |
| inefficiency of this model is at least partly | | | | are offered today continue to target the |
| responsible for the relatively low overall | | | | practices operating in the insurance model and |
| effectiveness of health care in the US when | | | | don't typically include shopping carts, true |
| compared with other industrialized nations. | | | | self-service appointment scheduling, a marketing |
| The "New" Physician Enterprise | | | | and communications engine or financial |
| The "new" physician enterprise is all about | | | | management. But using the approach of |
| prevention, new revenue streams, operating in a | | | | implementing multiple disparate systems creates |
| "cash" model, maintaining a high-quality physician | | | | yet another inefficiency as patient demographics |
| patient relationship yet operating with | | | | have to be entered and maintained in multiple |
| corporate-like efficiency. Technology is the enabler | | | | systems and importantly, there is no support for |
| of the new Physician Enterprise and the right | | | | the ideal business process in this scenario. |
| technology needs to be fast to implement, easy | | | | Enabling Technology for Cash Medical Practices |
| to use, accessible 24x7 for patients and staff and | | | | But now, there is a new option for cash medical |
| be very cost-effective. | | | | practices that face these issues. Using XML, HL7 |
| In the new paradigm, physicians see as few as 7 | | | | and today's integration technologies, it is possible |
| - 10 patients per day, have a much smaller staff, | | | | to integrate the 3rd party applications in "the |
| significantly lower overhead and have the | | | | cloud", allowing all systems to share a common |
| capability of truly participating in wellness, | | | | database for demographics yet precluding the |
| identifying root causes of diseases rather than | | | | practice from having to host any hardware or |
| just focusing on symptoms and therefore | | | | software. In this target environment, practices |
| positively impacting outcomes. The patient pays | | | | can use multiple self-service applications, integrate |
| the physician in cash bypassing the insurance | | | | them using a modern integration approach and |
| model and all of the accompanying reimbursement | | | | add workflow to provide additional efficiencies. |
| rules that many believe interferes with effective | | | | This approach has a low cost of entry, relatively |
| patient care and favorable outcomes. | | | | low total cost of ownership, yet delivers significant |
| But without effective technology to enable the | | | | benefits to the practice. |
| practice, the cash practice will still suffer from a | | | | Undoubtedly, the big software companies will |
| higher than necessary staffing and overhead | | | | eventually see this niche and deliver fully |
| costs just like the insurance model practices, thus | | | | integrated applications to serve them but for now |
| impacting the long term viability of this model. The | | | | cash practices have at least one viable option to |
| primary enabling technology for cash practices can | | | | leverage technology to empower physicians to |
| be broadly categorized as "self service" | | | | practice medicine, patients to receive better care |
| technology. For example, rather than having a | | | | and the practice to be profitable. |