Advanced /Open-Access Scheduling

Have you implemented this into your practice?

With an open mind, flexibility, physicians can reap the rewards

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We are slowly but surely seeing positive changes in our current economic state.  Sometimes the changes aren’t fast enough!  What can practices do to help increase revenue and patient satisfaction at the same time?  If you have not done so already, NOW is the time to implement Advanced/Open-Access scheduling.  The theory of this type of scheduling is “today’s work today!”  Mark Murray, MD is the self-proclaimed ‘grandfather’ of the application of ‘open access’ or ‘advanced access’ theory in healthcare scheduling and began working on the process along with colleagues in the late 1980’s.  All that is required to reap the rewards, they say, is steadfast faith and commitment.  The idea– predict demand and hold capacity.   According to Murray, “Access improvement is all about principles–supply and demand, flow, capacity.  Every organization is a little different.  They apply the principles to their own sites.  The goal is to decrease wait time and increase patient flow and revenue.


One example from the Scripps Clinic in Torrey Pines, CA

Dr. David Wetherhold, head of internal medicine at Scripps Clinic was the first to take the leap in his organization, a 300-physician, multi-site practice.  This was a true leap, as he read the materials on the concept on a Thursday and by the following Monday he and a colleague had initiated an open-access system that allowed two same-day appointments daily.  A small but important change.  Soon they were able to fill other slots through cancelled appointments and no-shows.  Time was also created by converting sick visits to routine care, which eliminated the need for return visits for physicals and other yearly requirements, and using resources previously dedicated to ‘triage’ for telephone care, which can often replace return appointments.

In about six weeks, Wetherhold and his colleague each were working with only 40%-50% of their schedules booked daily.

Two by two, doctors all around Scripps Clinic began open access to achieve what Wetherhold notes and an average of 70% open schedule daily.  Today, 95% of Scripps Internal medicine physicians and 30% of specialists use open-access scheduling.

Sure there is security in having a schedule booked with 20 patients a day for the next 2 months.  But those in the know insist an un-booked schedule can offer the same security.  Murray emphasizes, it comes down to changing the way you think and building the system according to what the patients want.

Initially, you may have to increase staff in some areas, more Medical Assistants for increased patient traffic, more Front Office staff, to handle calls and scheduling, if not on EMR systems, more Records Clerks to handle the demand of creating new patient charts or pulling charts for same day visits. Adding an additional New Patient Coordinator to handle the influx of new patients.  Finally, adding more Medical Billers to handle the increased billing and revenue generated by the increase in patients.

Demand is predictable!


Anticipated Benefits

  • Decreased wait time for appointment
  • Increased show rate
  • More predictable schedule
  • Increased provider productivity:
    • Percent of contact time
    • Improved continuity of care
    • Improved client care/Client satisfaction
    • Increased Revenue
    • Improved phone access
    • Minimized reminder calls
    • Fewer ED visits and hospitalizations

Our goal at Hire Up Staffing Medical Personnel Division

We not only want to be the staffing service of choice, we also strive to be a true consultant to our clients in the healthcare industry.  I pride myself in learning and sharing what I know to help physician groups maximize their productivity, and increase revenues, while maintaining the highest quality of patient care available to their patients. My commitment to doing so begins with making sure that I acquire the top talent in the Central Valley and match those candidates to the physician group where the training time required in doing the job is minimal due to their past experience and they can hit the ground running after a few short training sessions.  I would love the opportunity to meet with you at your convenience to discuss how we can partner to meet your practice needs.  Feel free to email me anytime at [email protected] to discuss this article or other topics that interest you, or simply schedule a meeting.  It would be my pleasure to help you in any way possible.



EMR (Electronic Medical Records) Incentives, Deadlines & Regulations

American Reinvestment and Recovery act of 2009 As a part of the American Reinvestment and Recovery act of 2009 federal stimulus money is available to physicians who adopt an electronic medical records system. The bill appropriates almost $20 billion for the incorporation of electronic health records with $1.2 billion alone dedicated to EMR/HER implementation. Incentives are paid through increased Medicaid or Medicare reimbursements for those that qualify.

In order to qualify for the EMR stimulus money physicians are required to achieve the “meaningful use” standard, this means that physicians must demonstrate that their EHR benefits the quality of health care they provide.

Physicians that accept Medicare payments can receive up to $44k in federal stimulus funds across five years which began in 2011 or the first year where the first stage of “meaningful use” standards are achieved. However, under the Medicaid program, providers with more than 30% of their patients paying via Medicaid (20% for pediatricians) can receive up to $64K in incentives over the five year period starting in 2011. Be advised that if EMR/HER deadlines are not met by 2015 that government may assess a series of strict penalties. It is imperative to note that there are three stages to meaningful use and only one has been formalized as of January, 2012. Additional deadlines for meeting the Meaningful Use standards of Stage 2 have been postponed until 2014, Stage 3 is of course set to be addressed after the implementation of Stage 2.

To avoid being penalized, physicians and administrators should prepare by knowing the process, time limits, and requirements of adopting EMR software. EMR conversions promise to create a more efficient, accurate and productive healthcare business, all at a lower cost as well as reduced turnaround times on physician’s medication orders and patient records request. As more health providers adopt EMR systems the industry overall will become more efficient. Change is sometimes uncomfortable and often times necessary, I am always here to help you along the way.

Over the course of the last five years I have had the opportunity to work with several practices both large and small, independent and government funded to meet the first stage of “meaningful use”. As a recruitment and staffing organization that has the ability to provide practices with employees for contract assignments I have placed a great number of individuals directly in the medical records departments to assist the practice and to help with the day to day operations of medical records while at the same time beginning the process of scanning and indexing records into their new EMR/EHR systems. I have noticed that most practices go into these projects thinking it will only take a few months to complete the projects (of course this is dependent on the size of the practice). We have all learned that this process takes much longer than originally anticipated, in some cases it takes well over a year! If your practice is in the process of converting, at the beginning stages of a conversion or would simply like to discuss how I can help facilitate a conversion, feel free to reach out to me at [email protected]

– Melanie