Since relocating to Central Florida in October 2008, Jeanetta Lawrence has helped usher in the high-tech age at Jewett Orthopaedic Clinic in a manner embraced by “prosumers”— patients who are proactive consumers and expect increased accountability, accessibility, availability and accommodation—while also boosting the bottom line.

 

“My ultimate vision is to create a clinic without walls,” said Lawrence, assistant executive director of the 75-year-old practice, which has seven locations in the metro Orlando area. Growing pains, outdated systems and limited technological tools had hindered the group’s ability to achieve peak performance.

 

Lawrence, a Fellow in the American College of Medical Practice Executives (FACMPE), began building a vision and a plan for how the group could enhance its efficiency and effectiveness, and ultimately, improve the patient experience. Her goal: To implement technology that would eliminate duplication of efforts, streamline systems, and allow physicians and staff to focus on providing patient care.

 

The plan involved seven different technology products: a computerized time clock, new accounting system, payroll package, new practice management system, electronic health records, digital x-ray, and PACs system.

 

The new electronic time clock and payroll system improved the practice’s efficiency by increasing accuracy, reducing paperwork and duplication of efforts among several departments, automating calculations and better determining staffing needs.

 

“We’ve been able to significantly reduce the extra time we spent tracking our time,” explained Lawrence. “And our new system has allowed us to eliminate the passing of paper, to more easily request and approve time off, and even push messages out to our team members to keep them better informed.”

 

Lawrence upgraded Jewett’s phone system to help meet patients’ needs in a timelier manner. The new technology alerts staff if someone has been on hold too long, and desk monitors help staff to better track and process the calls they receive. Now, patients are informed of their wait time.

 

A firm believer in benchmarking performance to help achieve optimum results, Lawrence was challenged with the inability to pull the right kind of data and reports from Jewett’s existing accounting, practice management and billing systems to measure performance against peers nationwide and insure a competitive edge in the marketplace. She researched and implemented a new accounting system that allowed Jewett to better track and allocate resources based on detailed line items. She also identified new practice management software that could produce a full range of reports, based on every individual field in the system. Once those systems were in place, she tackled the task of educating the managers on how to read and apply the results of the data gathered. 

 

“With accounts receivable, it had to be easy, and it had to be clean,” explained Lawrence. “We wanted a system that would result in clean claims processing. Our goal is to have all of our claims scrubbed and as clean as they can possibly be before they go out our doors to help ensure maximum reimbursement in a timely manner. And the more claims we send out and have paid, the less human resources we have to spend looking at those that come back in.”

 

Jewett also made sure the staff could put in their own edits and post charges electronically.

 

“Our goal is to have technology do as much as it can so we can focus our resources on providing optimum patient care,” said Lawrence. “And even though many of these projects were significant investments and only implemented within the last six months, we’ve already achieved a reduction in our overhead expenses.”

 

Lawrence transitioned the practice to electronic health records (EHR), beginning with a hybrid EHR that allows staff to scan documents, e-prescribe and more easily report and send data without requiring full data scribing. As a result of this system, performance quality report incentive (PQRI) has already almost tripled in just one year. 

 

Behind the scenes early on, Jewett had spearheaded a retreat to involve practice members in establishing strategic goals for what they hoped to achieve moving forward. The administrative team was then tasked to move forward with technology implementation. Lawrence included staff members from management to data entry personnel in the selection of the vendors and systems.

 

“We wanted to make sure our end users had the opportunity to provide input and be comfortable with the choices we made,” said Lawrence.

 

Training remained one of the greatest challenges for Lawrence, who was tasked with bringing more than 250 team members up to speed on the new practice management system that replaced a system that had been in use by the clinic since the mid-1990s.

 

“Jewett has on average 600 patient encounters per day across all of our locations,” said Lawrence. “With the extensive training we conducted and by having the vendor’s project team on the ground at ‘go-live,’ we did not feel the need to lighten our schedules, and we were also very successful with our go-live. The goal for each provider was to have five ‘chartless’ patients the first day of going live (October 7, 2009), 15 the second, and all patients fully transitioned to the electronic system the third day.” 

 

On the first day, half of the physicians were using the new EHRs. By the end of the second day, everyone was chartless.

 

“I was so proud of everyone and very excited,” said Lawrence. “We did our due diligence and invested in training our team, and that certainly paid off with both of these major technology transitions.”

 

Lawrence continues to explore technology applications that could improve Jewett’s performance, such as centralized scheduling, a Web portal and on-line patient registration, and kiosks within the office.

 

“My goal remains to gain the most efficiency we can and get our patients through the clinic in a smooth, timely manner,” she said. “I believe there are three cornerstones to any great medical practice that wants to remain viable today. The first involves having the right technology tools—which we now have. The second is outstanding patient care–which Jewett has provided for almost 75 years now. And the final element is patient satisfaction. Now that we have the first two in place, we’re better able to focus on maximizing the third, and that’s just what we are working together to do.”