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Midtown Family Clinic
Case Study
In 199
0,
Dr. Harold Thompson
opened
the
Midtown
Family
Clinic
, a small internal medicine practice,
in
an
area with an increasing number of new
family residences.
Dr.
Thompson
has been
the owner and manager
of the medical practice
.
He has two
registered
nurses, Vivian
Halliday
,
and
Maria
Costa
, to help him.
Usually, o
ne
n
urse
takes care of the front desk while the other
nurse
assists the doctor during the patient
visits.
They rotate duties each day.
Front desk duties include all admin
istrative
work from answering the
phone, scheduling appointment
s
, taking prescription refill requests, billing,
faxing,
etc.
So if
on
Monday
Nurse Halliday
is helping the doctor, then
it is
Nurse Costa
who
takes care of the front desk and all office
work.
The two nurses are constantly busy and running around
,
and patients are now accustomed to a
minimum 1
–
2
hour wait before being seen.
I
f
one nurse is absent,
the situation is even worse in the clinic.
The clinic has three
examination
rooms so the owner is
now
looking into bringing
a new
physician or nurse
practitioner on board.
This would help him grow his practice
, provide better service to his patients,
and
maybe reduce the patients
’
waiting time.
Dr.
Thompson
knows that this will increase the admin
istrative
overhead
and the two
nurses will not be able to manage any additional admin
istrative
work.
H
e faces
several challenges and
cannot afford
to hire an
y
additional staff
,
so
Dr.
Thompson
has to optimize his
admin
istrative
and clinical operations.
The practice is barely covering the exp
enses and salaries at the
moment.
Dr.
Thompson
’s
practice operation is all paper
–
based with paper medica
l records fillin
g his front office
shelves. The only software the doctor has on his front office computer is a
stand
–
alone appointment
scheduling system
.
Even billing insurance companies is done in a quasi
–
manual way.
For billing insurance,
the front office nurse has to
fax all the needed documentation to a
third
party medical billing company at
the end of the day.
The medical billing company then submits the claim to the insurance
company
and
bills the patient.
The clinic checks the status of the claims by logging into the medical billing system,
through a login that the medical billing company has provided the clinic to access its account.
There is no
billing software installed at the practice, but the nurses o
pen Internet Explorer to the URL of the medical
billing company and then use the login provided by the
third
party medical billing company. Of course, the
medical billing company takes a percentage of the amount that the clinic is reimbursed by the insuran
ce.
Although t
he medical practice
has the one PC with the scheduling software and an internet connection, it
does not have a Web site
or any other technology
, and essentially still op
erates the same as it did in 199
0.
One problem that
is
immediately
noti
ceable
is that
there is no quick way to check
patients
in
,
and if the
nurse is on the phone while
a patient tries
to check
in,
then the patie
nt has to wait until she has completed
her call
.
The doctor could be also waiting for the patient to be checked in
,
wasting
the doctor’s valuable
time.
Also
many
patients experience long waits on the phone when they are trying to schedule an
appointment, while the nurse is checking in patients or responding to another patient’s request in the office.
Every year, the
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