While you have likely heard of the potential of these systems to offer real benefits — by reducing your practice costs, increasing the speed of reimbursements, and enhancing your practice’s productivity — you also undoubtedly have heard “horror stories” of practices that experienced just the opposite.

Although some practices have made the transition relatively smoothly, others have struggled with implementation delays, productivity slowdowns, unexpected costs, and marginal outcomes. Clearly there’s a big difference between simply investing in a system and gaining real benefits from the technology.

What Makes the Difference?

It goes without saying that you need to select the right system for your practice, and you need the right training and support to get the system installed, your patient data transferred, and your EHR up and running. But if that’s all that’s needed, then practices buying systems from the same vendor and getting the same level of training from the same implementation teams and consultants should experience the same results, correct?

Unfortunately that frequently isn’t the case.

The fact is, there’s more to a successful Electronic Records system implementation than simply investing in the right technology. There’s more to it than just taking advantage of training programs, consultants, and technical support.

Something else is needed — and the presence or absence of this essential third factor is what frequently makes the difference between practices that reap the full benefits from their systems and practices that don’t.

Click here to download the full pdf article: How to Overcome the Hidden Barrier to EHR Adoption & Meaningful Use.

It’s one thing to know that you need staff buy-in, it’s another thing entirely to know how to get it.

When it comes to failed EHR implementations, more often than not, the missing link is getting people on-board with the change.

Here are some steps you need to take to get participation, cooperation and collaboration from staff members at all levels, and increase your chances for a more rapidly successful EHR implementation.

1. Convey The Urgent Need For Change

   Making a major change in your practice is hard enough. Trying to make that change when people don’t recognize the need for it is a recipe for failure.

   Everyone in your practice needs to understand the factors that make the new EHR desirable or even essential – for example: the ability to streamline work and enhance patient care, the opportunity to reduce costs and increase productivity, and the ability to adapt to changes in patient needs, 3rd party demands and new government decisions.

   However, while you may make a great logical case for change, people don’t make decisions based on logic alone. Emotions are a powerful factor. You need to make sure that your staff not only understands the logical reasons for change, but also understands what the consequences will be to them personally if the change isn’t successful.

   When you present the new system as a way for the practice to continue to operate profitably – despite challenges, to continue to provide quality care to your patients, and to continue to provide your valued staff with employment, you’re likely to capture their attention.

2. Keep People Informed

   People don’t really fear change. What triggers fear is uncertainty.

   The worst thing you can do is to keep people in the dark about your plans. This encourages rumors and leads people to start grumbling about their jobs and worrying about their futures.

   When it comes to implementing an EHR in the practice, one of the biggest concerns people have is whether the new technology will take away their jobs.

   In light of today’s economic realities, no one really expects guarantees of job security. However, what they can and should expect are honest answers to tough questions.

   People will want to know:

   • How the change will impact their work and their futures
   • What will be expected of them
   • What new skills they will need to meet these expectations
   • How they will be trained and supported for these new challenges
   • How their performance will be assessed

   The fact is, new technology will make some tasks unnecessary, and some skills irrelevant.

   However it’s important for you to recognize, and to communicate to everyone, that when work gets reorganized, and when certain tasks are no longer necessary, people can be moved to more profitable activities.

   For example, if implementing the new system will allow you to increase your patient load, you may need staff to shift to more patient-centered activities in order to take advantage of these new opportunities.

3. Harness the Power of Collaboration

   Regardless how large your practice is, a new IT system will impact the work of staff members at all levels. To get the maximum value from that system, and to increase the speed of getting to that value, you need discretionary effort and enthusiastic collaboration from everyone in your practice

   First, when it comes to design of the system and the reengineering of the workflow, you must get your staff’s perspective. They are closest to much of the work of the practice and can offer suggestions and ideas that can facilitate implementation and reduce the expenses and the temporary productivity slow-downs that inevitably accompany any new EHR implementation.

   Second, if you want to mobilize people to not only cooperate, but to give their best effort, you need to allow them to participate in developing plans. You may have heard the expression,
   “People who plan the battle, rarely battle the plan.”
   If staff members at all levels are involved with the development of the implementation strategy, they will have a vested interest in its success.

   The way to do that is through a series of interactive workshop-style staff meetings that elicit staff ideas and engage staff members in creating their own future.

4. Show People What’s In It For Them

   The real secret of successful change management is to show people what’s in it for them. You can accomplish this in two ways.

   First, by showing how the change will positively impact people’s work and enhance their job satisfaction.

   Today many practice staffs are exhausted by the ever-increasing workload. Senior staff members often have to put in additional hours to get all of the paperwork done. When patient charts are lost, delayed or incomplete, physicians are frustrated and staff members often bear the brunt of that annoyance. And when patients are kept waiting due to inefficient workflow, poor communication, or missing information, who frequently has to listen to the complaints? The nearest staff-member.

   Different practices, and different departments within a practice, will have different issues that frustrate and annoy people. The point is to identify the specific issues that get in the way of optimum performance and to show how the change will help to alleviate these.

   The second way to show people what’s in it for them is to attach rewards and recognition to specific goals and milestones.

   Offering staff bonuses for increased practice productivity, increased referrals and increased patient satisfaction can be very effective in showing people what’s in it for them and building a real team effort in the process.

   However, it can take a while to get to significant performance increases. Establishing intermediate milestones, “small wins” – like getting a specific system module successfully up and running, or achieving a certain reduction in transcription usage – can go a long way to building momentum and can help to convert any lingering skeptics.

   These kind of rewards and recognition are tangible pay-offs that fuel the fire of motivation.

The July 2009 issue of Money magazine offers a vivid reminder of the power of recognition — thanks to the glowing box of carrots jumping out at you on page 21.

In the magazine’s accompanying article, Get Your People To Work Harder… without pushing them so hard that they quit, Tyler Cowen, professor of economics at George Mason University, explains that while doling out bonuses for superior performance is an effective approach, a tight budget doesn’t mean that you have to resign yourself to sluggish performance.

Low-budget approaches can actually yield even better results when it comes to motivating the performance you want.

Cowen cites a study by Kaisen Consulting showing that employees actually ranked “financial reward” as only 6th in a list of workplace motivators. “Far more important are recognition and a sense of accomplishment. So,” he exhorts, “ladle on the praise for a job well done.”

The fact is, psychological research has proven time and again that offering regular praise and appreciation is a highly effective employee motivation strategy.

That’s why business owners and managers who regularly recognize and praise high-performing employees achieve higher levels of productivity, employee retention, and customer satisfaction than managers who don’t.

That’s also why their businesses tend to wind up with greater bottom-line financial performance as well.

Yet in the day to day rush of a clinical environment, it’s easy to either forget to recognize people or to offer only cursory and non-specific praise.

To get the best results from praise and appreciation, it’s important to be as specific as possible.

People need to know why they are being praised, and what they did to earn the positive attention. When people are clear on why you are recognizing them, they are more likely to repeat the behavior you want.

The following article from Dr. Kevin Freiberg and Dr. Jackie Freiberg, best-selling authors and highly sought-after speakers and consultants, offers 25 terrific “templates” for offering praise and recognition that you can easily adapt for your workplace environment.

As you read the article, note how each statement is aimed at an individual.

General statements such as, “Good job everybody” are nice, but don’t pack the same motivational punch.
 

25 Ways To Recognize People’s Contributions

Before you recognize someone stop and think about it for a minute. What competencies do you value? What attitudes do you look for? What results are you seeking? What were the critical factors in your success? How has this person demonstrated one or more of these things? The brain teasers listed below are intended to get you thinking creatively about recognizing your employees in an authentic and specific way. Remember that the people you report to need recognition too!

1. As I watched you handle that (customer, supplier, shareholder, etc.) today I was impressed by your ability to…
2. You are an extremely valuable member of the team because…
3. As I watched you lead the meeting today I realized how (smart, motivating, competent, fun, etc.) you are because…
4. You bring the kind of attitude and work ethic to our firm that inspires me because…
5. I see you running the (department, division, company, etc.) someday because…
6. I knew you could do it because…
7. You did a remarkable job because…
8. I’m proud of you because…
9. It’s clear that you are a quick study because…
10. Thanks for being “on top of it,” I have a lot of confidence in you because…
11. You have such a unique way of dealing with (people, details, technology, conflict, etc.) because…
12. You bring the right ingredients to this (project, company, team, etc.) because…
13. Thank you for speaking up; it took a lot of courage to…
14. Thank you. It was great to see you take responsibility for…
15. I like the way you were thinking and acting like an owner when you…
16. I admire your imagination and creativity because…
17. It’s exciting to work with you because…
18. I appreciated the way you listened so carefully before you…
19. You mean a lot to this (department, division, company, etc.) because…
20. I trust you because…
21. I like the way you collaborated with…
22. You make the rest of us laugh because…
23. I respect you because…
24. The best thing you did (in that meeting today, on that trip, on that proposal today, etc.) was…
25. You have a special knack for… For example…

 
By Dr. Kevin and Dr. Jackie Freiberg, world-class speakers, thought leaders, and authors of the best seller NUTS!, its sequel GUTS!, and recently BOOM! 7 Choices for Blowing the Doors Off Business-as-Usual. For more resources on improving your individual or business brand, visit our home page at http://www.freibergs.com or http://www.freibergs.com/cooltools/

And while hiring the right people to begin with is a big part of the equation, there’s a lot you can do right now to bring out the best in your people – regardless who they are, and regardless how they have performed in the past.

A great example of the power of management to motivate employees comes from Toyota.

In the early 1980’s, Toyota and General Motors partnered in a first-ever collaboration between the Japanese company and a major US automaker.

For Toyota it was a golden opportunity to establish operations in the US and to benefit from GMs vast
distribution network.

For GM it was a last-ditch effort to save a failing plant.

You see, the deal that GM offered Toyota was to take over the management of their Fremont California factory – the worst performing plant in the company. A plant with overhead costs 30% higher than GMs other plants, 20% worker absenteeism, frequent strikes, poor customer service ratings, and dismal sales.

Not only that, to close the deal Toyota had to agree to reemploy the same union employees who had performed so poorly for GM.

Yet despite these obstacles, Toyota agreed. And within 2 years the plant’s production had grown to twice the average of other GM factories, costs had decreased to 50% of average, worker absenteeism had fallen to 2%, and customer satisfaction ratings – and car sales – had increased significantly.

How did Toyota managers do it?

Not with a new factory or equipment. The old plant had remained virtually unchanged.
And not with new workers – 85% of the staff were rehires from the old factory.

Toyota managers accomplished the seemingly impossible with a highly effective management strategy.

They motivated these formerly disgruntled and unproductive employees by making them feel that their work was significant. They empowered employees to solve problems and make decisions. And they got employees at every level to actively participate in improving the factory’s operations.

You can use these same proven principles to motivate your staff to a higher level of performance.

Read more about Toyota’s strategy in this article (pdf) Motivating Sustained High Performance: Psychological Lessons From Toyota

You can learn the specifics of implementing these employee motivation strategies in your clinical practice in our new audio-seminar: A Profitable Practice Is Everyone’s Business: How to Maximize Staff Performance and Productivity For Increased Bottom-Line Results

You need to be able to deliver care more efficiently and cost-effectively.

You need to be able to attract and satisfy your patient customers.

You need to be able to move quickly to make the most of change as it comes at you – to adapt to new electronic recordkeeping and reporting systems, new billing and payment structures, new care delivery strategies, and new regulatory requirements.

You need to maximize every strength, asset, and resource your practice has.

To do that, you need the genuine commitment and teamwork of everyone on your staff.

The Power of An Engaged and Committed Staff

Study after study has proven that an engaged and committed workforce is directly related to increased productivity and a stronger bottom line in any business.

Organizations with a highly engaged and committed workforce:

• are 50% more likely to have above average customer loyalty
• are 38% more likely to have above average productivity
• produce 36% higher returns to owners than organizations with
  only average employee commitment

And in healthcare specifically, increased staff engagement is directly associated with

• Significantly lower absenteeism
• Significantly lower staff turnover
• Significantly fewer malpractice claims
• Higher than average earnings per patient

Sources: Gallup Organization, Contented Cows Give Better Milk, by Bill Catlett & Richard Hadden, Built to Last, by Jim Collins & Jerry Porras, WorkUSA 2000 Survey

In A Profitable Practice Is Everyone’s Business, you’ll discover proven strategies for getting maximum commitment and contribution from staff members at every level.

You’ll learn how to easily inspire and motivate your staff to go the extra mile in reducing overhead, increasing patient satisfaction, and maximizing the productivity and profitability of your practice.

Click the play button below to listen to a sample track from the audio-seminar:

Click here for more information on how to maximize the performance and productivity of your medical practice staff.

Now if you’re thinking “what’s the difference – aren’t a business plan and a strategy the same?” you’re not alone. Most people confuse the two – but having a business plan for your practice does not mean that you have an effective practice strategy.

Business Plan

Business plans are most often drawn up for financial reasons – planning for a new practice start-up, financing a major acquisition like new technology or real estate, or expanding the practice. Since they are often used to inform lenders, partners, and vendors about your practice’s plans for financial performance and growth, they tend to focus on income, cash flow, and balance sheet projections. Once they fulfill their function, they are often put on the shelf and rarely consulted.

While having a good business plan may get you the capital and terms you want, an externally focused business plan does little to ensure the future success of your practice.

The best business plans, however, aren’t just used to provide information about your practice to outsiders, they are also used internally to provide direction to your entire organization. For this kind of plan, you need a well thought out practice strategy.

Strategic Plan

A practice strategy isn’t primarily for outsiders, it’s for you, your partners and everyone on your team.

It directs both the internal operations of your practice as well as any external marketing and promotion activities you do. And most importantly, it helps you make the right decisions about staff hiring and training, new services to offer, and investments of both time and money.

An effective practice strategy starts with goals – where you want your practice to be in 5, 10 or 20 years. This includes the demographic group of patients you will serve, the size of your practice, and the type of care you will deliver.

To develop an effective practice strategy, you not only need to identify your goal, but you must thoroughly evaluate the current state of your practice. This includes your practice’s strengths and weaknesses as well as the opportunities around you and any threats you face.

When it comes to evaluating strengths, most practice owners take too narrow a view. They tend to focus either on their own specialty training and the credentials of the staff physicians in the practice, or on the equipment or technology the practice has.

A better evaluation comes from taking a broader view. This includes looking at the strengths and capabilities of all staff members, at less obvious resources such as relationships with nearby businesses and organizations, and even at established patient relationships.

The most thorough evaluations include interviews with key staff at all levels. An added benefit of these interviews is that they can reveal previously unrecognized opportunities for your practice.

You also need to evaluate your practices weaknesses and any threats you might face in the foreseeable future. The right strategic plan will overcome or compensate for any weaknesses in your practice by matching strengths to opportunities. It will also help you protect against threats before they sneak up and take you by surprise.

What a Strategic Plan Will Do For You

The goal of the strategic planning process is to come up with the right business model and image for your practice. In other words, how will your practice deliver care and how will you be positioned in the eyes of patients and referral sources?

Once you have the right strategic plan for your practice you are in a much better position to determine the best tactics, or specific actions to take, to achieve your practice goals. You’ll also be better able to build a more effective team, train staff members, design the right policies and procedures, and implement the right marketing and practice promotion tactics.

Most importantly you’ll be able to reduce costs. You won’t invest time and money in activities that aren’t likely to yield the results you want. You’ll be able to operate more efficiently and put systems in place to manage and monitor results, rather than having to manage individuals, revisit decisions, and frequently operate in crisis mode.

With the right strategic plan, you can build a practice as large or small as you want, while maintaining efficiency and high productivity at all staff levels. Your patients benefit from the efficiency, you and your staff benefit from the increased productivity. And isn’t that what operating an exceptional and profitable practice is all about?

No matter what your specialty is, where you practice, whether you have a solo practice, or a large group, the step-by-step system you’ll discover in the the audio seminar How to Position Your Clinical Practice For Outstanding Success will help you craft a winning strategy for your practice.

Finally, an audio-seminar that allows you to unlock the hidden potential of your practice with an easy-to-follow, step-by-step system.

In today’s healthcare economy, whether you operate a specialty practice, or you’re in primary care, you can’t assume that simply providing quality healthcare and keeping up with coding and regulatory requirements are enough to sustain a successful practice.

The fact is, like any business, your practice, regardless whether it’s solo or a large group, will never achieve its maximum potential if you and your team simply work longer and harder. Today, you need the right practice-building strategy to take you from where you are, to where you want to go.

In this audio seminar program you will learn a step-by-step system for creating a clear “brand” for your practice. This “brand” will allow you to more easily attract the precise group of patients you want – the ones your practice can serve the best.

You’ll also discover a system for developing a winning business strategy for your practice, one that maximizes your practice’s existing resources and strengths, gives your practice a significant competitive advantage, uncovers opportunities your practice is well-positioned to benefit from, and positions your practice for maximum bottom-line performance.

Click here for more information on How To Position Your Clinical Practice For Outstanding Success

While Michael has done a great job of filling his practice with patients, he has not achieved the autonomy, satisfaction and lifestyle that he expected.

Like so many physicians in his position, he believes that declining reimbursements and the “deterioration of medicine” as a profession are the cause of his dilemma. However, we were able to show Michael a number of highly profitable orthopedic practices around the country, whose physician owners had enviable lifestyles.

So, clearly, having a successful medical practice today is quite doable – if you follow a strategy.

Michael’s major problem comes from jumping right into practice without planning out his business strategy. As a result, his practice is running “by default.” He has a heterogeneous patient population that comes to him largely because he’s “in their plan.”

Here are a few steps Michael needs to take now, to begin to turn his practice around:

Treatment Plan

1. The first thing Michael needs to do is recognize that he has the power to direct the future of his practice. He needs to change his perspective from “coping” with decreasing reimbursements and increasing paperwork, to deciding on the hours he wants to work, the types of patients he wants to see, and the specific procedures he wants to do.
    
   If he wants a high volume practice, he can have that. But he needs to increase his staff, and develop better business systems so he can more efficiently care for a larger number of patients.
    
   If he wants a lower volume practice he can have that too. But he needs a strategy for attracting those higher profit cases that will enable him to keep his practice small.

2. Second, Michael needs to position his practice. Right now he’s a generalist. And while there’s nothing wrong with seeing all kinds of orthopedics cases, he gives patients no specific reason to choose his practice, other than his being “in their plan.”So Michael is stuck having to accept whatever insurance companies are willing to pay.
    
   As Al Reis and Jack Trout pointed out many years ago in their monumental book, Positioning: The Battle for Your Mind, positioning is how you and your services are perceived by your prospective customers.
    
   It goes without saying that being perceived as one of many “general” orthopedists will make Michael’s practice less valuable to his patients than if he is perceived as a specialist – for example, a specialist in arthroscopic surgery.

3. Third, once he clearly identifies what he wants to deliver — lets say arthroscopic surgery — Michael needs to evaluate the patient population he wants to attract. He needs to make sure that he’s promoting the benefits that this group of patients wants and needs.The way to do this is to develop an effective Patient Value Proposition.
    
   For example, Michael needs to promote his services in terms of the benefits his patients will get. “Athroscopic meniscal repair” doesn’t mean as much to a patient as “Be free of knee pain.” Instead of “minimally invasive endoscopic spinal surgery,” “get rid of your back pain today, and be walking again tomorrow” highlights the benefits of the minimally invasive procedure as well as the ultimate result the patient is after.*

4. Finally Michael needs to make sure that every piece of literature that comes out of his office – every brochure, every ad, every letter or article reinforces his practice’s new “specialized” position in the mind of his current and prospective patients as well as his referral sources.

Once Michael has a practice-building strategy in place he can more effectively select the right tactics that will move him toward his goals.

Instead of taking a shotgun approach, he’ll be able to target the exact patients he wants with laser precision.

Plus with a clear strategy, he’ll be able to put systems in place that will allow him to deliver quality care, while still having a life.

——–

*Needless to say, we’re not suggesting that you “guarantee” the results of any treatment or procedure. What we’re talking about here is making sure that your prospective patients can understand the value of your services – in their language.

Don’t assume that they have already researched specific procedures and treatment plans for their conditions. Don’t assume that they understand professional terminology. You can explain procedures and treatments in your informational materials, or when they present for their first appointment.

Determined to get off to a fast start he designed a snazzy, four-color, tri-fold brochure, took out an expensive yellow pages ad, participated in every insurance plan he could, and pressed the flesh with countless Primary Care Physicians to generate referrals.

His strategy to fill his practice paid off. Soon his waiting room was full and his appointment book was overflowing.

But something’s wrong.

Now, 4½ years later, he finds himself cramming too many patients into too little time just to cover his overhead, inundated with paperwork, and having none of the autonomy and satisfaction he was looking for when he moved from “physician employee” to “owner.”

When you look at how Michael went about starting his practice, on the surface, it looks like he did everything right.

He leased space in a great location, promoted his practice extensively, developed good relationships with referral sources and took care of all of the billing and paperwork for his patients.

But the fact is, the results he got didn’t come anywhere near his expectations.

Now he is both overwhelmed and disillusioned. He wonders whether he has a future in private practice. And, like many physicians, he questions whether it’s even possible for a dedicated doctor to have a rewarding private practice in today’s economy.

Diagnosing The Practice

The real problem isn’t with the state of medicine today or with the economy. We can point to a number of orthopedists who own satisfying practices and have enviable lifestyles.

The problem isn’t even with the tactics Michael used to build his practice.

After all, they brought in the patients!

The problem is that Michael didn’t begin with the end in mind. He didn’t have a plan to guide his actions. So while he was able to build up a full, (practically overflowing) practice, relatively quickly, it was a very different practice than the one he envisioned. It offered him none of personal satisfaction, financial security or confidence in the future that he expected after 4 ½ years.

Before Michael can solve his practice’s problems, he needs an accurate diagnosis.

Symptoms: Too many patients. Overworked, underpaid, disillusioned doctor.

Etiology: Doing anything and everything that looks like it will bring in the patients and increase practice revenue.

Diagnosis: Lack of Strategy

Like most physicians who struggle, at this point Michael is so busy with day to day patient care that he doesn’t have time to step back and look at his practice objectively. If he did, he would see that the reason his practice looks like it does is because of the actions he took when he first opened his doors – and the actions he has continued taking ever since.

Michael, like so many other physicians, has no real business strategy for his practice. Sure, he has an income goal, but he has no clear vision of the practice he needs to create in order to achieve it.

And since he doesn’t have that clear vision, there is no path for him to follow. This means that he has no criteria for selecting the right practice-building options for him. So he ends up jumping on every opportunity that looks promising, from expensive practice management, software and billing services, to new practice marketing and promotion deals.

This floods his practice, but wreaks havoc on his cash flow.

Next Post… Treatment Plan