Early in my career as a physician practice administrator, technology was no more than a fleeting concept. We scheduled patients in a paper appointment book, live receptionists answered the phones, and we used fax machines to share patient information with other healthcare providers. Patients had one or two insurance plans. We sent them home with a super bill and they sent it in to their insurance. The insurance company paid 80% of the charges and the patient paid 20%… Ah the good old days of indemnity plans. In the last 30 years, the industry has dramatically changed and continues to evolve ever faster.
Looking back to the early 80s, Health Maintenance Organizations (HMOs) were the new thing; healthcare quality was strictly based on utilization. Of course there were peer review committees, benchmarks, research studies, and care guidelines that providers followed, but nowhere near to the extent that they exist today. Managed care was based on controlling costs by administering and monitoring healthcare services through the “gatekeeper,” placing the primary care physician at the helm. Providers were mostly concerned with keeping patients out of the hospital for long stays and limiting referrals to specialists, particularly those outside the plan’s provider network. HMOs focused patient care on controlling costs, not on health outcomes.
Business offices were the first to implement automation, and I’m not talking about a bigger, fancier copy machine to handle all those ledger cards. The development of electronic practice management systems changed everything about the way practices are managed. Today, patients request their appointments online through a patient portal. The practice is notified automatically whether the patient is covered by insurance before the patient sets foot in the office. As soon as the visit is over the charges are electronically sent to the insurance company. The practice can see within minutes what insurance will pay instead of having to wait weeks for a check to arrive with a paper EOB. With the touch of a button, it is now possible to see appointment history and provider productivity metrics, know exactly where your revenue is coming from, and analyze payment trends.
Can you imagine dealing with ICD-10 without an electronic practice management system like NextGen® Practice Management (NextGen PM)? Watch one of our ICD-10 Webinar sessions and download our ICD-10 eBook, and we’ll walk you through the steps you should be taking now to be prepared.
Flash forward to the 1990s. As recently as 18 years ago there were no electronic health records (EHRs). Before digital health records, there was no way to measure patient care without manually looking for information. Peer Review Organizations (PROs) and Quality Improvement Organizations (QIOs) would go through paper charts to evaluate and document patient outcomes. This set the stage for Meaningful Use requirements and a way to regularly report clinical information from the practice.
Today, we have come full circle. Providers are being compensated for their “performance,” with performance being defined both by the management of, and level of improvement of, their patients’ health. With the evolution of the Patient Centered Medical Home, the primary care physician is still at the helm, but instead of being the “gatekeeper” they are now more of a guide. Technology gives them greater visibility into what is going on with their patients and allows them to proactively manage their patients’ needs. With the focus shifting to outcomes, patient care needs to be tracked, measured, and reported upon, all of which would be impossible without an EHR as the foundation of the practice. Outcomes metrics derived from technical applications, data sharing, and clinical reporting capabilities are vital in the healthcare industry of today.
NextGen Healthcare has been helping healthcare practices since the beginning of the technology boom in this industry. Check out our 8 Series EHR to see how we’re continually evolving right along with the industry. We’ve got the experience, the expertise, and the right solution to help you meet the rapidly changing requirements of today’s dynamic healthcare market.