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    Ciara Lewin
    Ciara Lewin, MBA

    Outsourcing is widely used by medical practices and hospitals; yet for many, there may be trepidation about using this system of resource and work allocation.

    From clinical tasks to operational duties, outsourcing can help save time, money and better align your practice’s resources with your organizational goals.

    Where to start

    When deciding whether outsourcing is right for your organization, there are a few questions to consider:

    1. Are there any tasks that your team does on a regular basis to keep your operations on schedule?
    2. Do you have a process or employee who checks the quality of work or can easily provide guidance and feedback if questions arise?
    3. Is it difficult to see the benefit of having an employee do a job that is not justified by their pay rate or skill set?
    4. Is there a task an employee performs that often gets delayed or is not completed due to lack of time?
    5. Are your patients’ or stakeholders’ needs not being met?

    These questions can help your organization decide whether part(s) of your operations can be outsourced, and whether the planned outsourcing is task based [also known as business process outsourcing (BPO)] or knowledge-based outsourcing (KPO).

    Making the right choice

    Deciding on what kind of vendor you should outsource to can be a bit daunting. To assess them, ask them this series of questions from Day 1 of engagement:

    1. Can you share within 24 hours your current quality management process?
    2. What was the last training that your team attended as it relates to my scope of practice? What takeaways did you gain from that training?
    3. Do you offer flexible payment models to include performance-based compensation?
    4. Can you provide three references for companies you’ve worked with in the past year?
    5. How do your work processes align with our organizational vision and mission?

    The responses to these questions will help reveal how vested the vendor is with your company, how prompt a task can be turned around and if they are operating in a continuous improvement environment.

    Putting it to practice

    For medical offices, outsourcing can be an evolving process that brings value financially, operationally and help create sustainable workflows. Here’s an example of the kinds of tasks and duties that can be outsourced:

    Dr. Johnson has a 10-year-old practice staffed with a practice manager, two nurse practitioners (NPs), three nurses and two administrative assistants who assist with front-end and back-end tasks. His office manager often wears many hats, including overseeing practice efficiency, revenue cycle management, staffing and physician needs as they arise. Dr. Johnson has seen his revenue wildly vary, yet he is confident that opening a second practice will benefit the organization. On average, the practice sees 90 to 140 patients daily, but many long-time patients want more time with him, which affects the schedule. Dr. Johnson feels there is room to improve and hiring more NPs doesn’t seem to be financially viable.

    After speaking with an outsourcing consultant, Dr. Johnson sought help from remote nurses based in the Philippines to improve efficiency. This allowed the practice to triage patients via telehealth services, complete patient medical history, review systems and begin documenting in the practice’s EHR before the providers see the patients. After a brief examination, medical decision making and plan of care, providers can move to the next patient while a remote nurse reviews the entire visit with the patient. The remote nurse answers questions about the plan of action, including possible complications from medication; schedules the patient’s follow-up visit; accepts payment for services rendered; and ensures the patient can access the patient portal to view their medical records, payment history and ask questions. The visits ends with a brief patient survey, which is published on Dr. Johnson’s website and social media profiles, gauging patient satisfaction.

    The 32-minute visit has left the patient feeling heard, appreciated and connected to expertise while the providers were able to focus on their medical decision making and helping more patients. In this new model of care, patients are happier, providers are more at ease, point of care payments are at an all-time high and cancellations are low. In-office nurses become more focused on assisting physicians on more complex cases and with the influx of new patients.
    In this example, there are four areas of outsourcing that occurred, all of which provided immediate value to the patients, practice and physician. They are:

    1. Clinical support (qualified nurses can speak to the patients, assist the healthcare providers and serve as a liaison for medical concerns);
    2. Administrative support (the remote nurse has promptly documented the pertinent clinical information into the EHR saving both time and potential omissions in the medical record);
    3. Financial support (the remote nurse can accept payments before the visit is concluded thus improving profitability for the practice); and
    4. Marketing support (feedback from the patient can be easily captured and promoted to further patients of Dr. Johnson and his growing practice).

    In our upcoming article, we will delve into clinical and administrative support and how you can seamlessly integrate vendors without sacrificing operational efficiency.

    Ciara Lewin

    Written By

    Ciara Lewin, MBA

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