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Keeping on track

Whether you are a physiotherapist or a hair specialist, an osteopath or a dentist; it’s a fair bet that you chose your profession because you wanted to help people. It is also a fair bet that the matter of paperwork and records wasn’t really a factor which came to the fore when you were deciding on your chosen profession.

But no-matter what the profession nowadays it seems as though movements are circumscribed by reams and reams of paperwork. And unless something is done to rein this in, the volume of paper can not only seriously interfere with patient treatment times, it can also detract from the provision of effective treatments.

In an era in which every patient and every treatment comes with a paperwork trail, it is little wonder that records can become lost or treatments delayed as records are transferred from one place to another.  Partly in an attempt to smooth out the pathway and partly to improve self-management of long term conditions the Richmond Community Neuro-Rehabilitation Team has trialled a patient-owned folder.  The folder not only contains important contact details, it also contains details of the patient’s condition and therapies which have been agreed upon.

Since the folder was trialled in 2012, the team has seen pick-up time for new patients improve by five days. In addition 92% of patients agreed that the folder helped their therapy as they were able to use it as a continuing reference point.  But even with initiatives such as the patient-owned folder there is still the hurdle of paperwork to overcome.

Moving away from a paper based system to electronic records can make a huge difference.  Paperwork safely stored in an electronic folder can be accessed at the touch of a button.  This not only saves the time taken in finding missing paperwork it also enables health professionals to quickly call up information when patients get in touch as well as facilitating the transfer of information between professionals. All of this not only helps to improve patient treatments, it also creates valuable additional time which can be spent on treating additional patients.

No more searching through filing cabinets, no more waiting for days for the post to arrive; electronic storage of patient records can make a huge difference to the daily practices of health professionals; bringing them back on track to the reason why they joined the profession in the first place – the treatment of patients.

Back to basics

A global research study has concluded that lower back pain is the leading cause of disability and work absence across much of the globe.  Researchers from institutions in Australia, the US and the UK including the Royal Cornwall Hospital found that whilst there is no evidence linking back pain with a higher risk of early death, it can cause long term disability.

Across the world the study estimates that nearly 1 in 10 suffer from lower back pain with the figure rising to 15% in Europe.  An increasingly aging population is only going to exacerbate the issue which can cause emotional and financial as well as health problems for sufferers.

Although lower back pain has no one common trigger point, typically causes include poor posture when sitting or standing, bending awkwardly or failing to follow lifting guidelines.  Acute back pain can also cause leg pain which adds to the difficulty of moving and walking.  In its extreme form it can also impact on everyday tasks such as washing or dressing.

With the incidence of lower back pain expected to increase alongside an ever-aging population this condition places a strain on all health professionals.  Whilst doctors and health visitors are more likely to be in the front line, others such as physiotherapists, osteopaths and chiropractors will all take up the burden of day to day treatment.  Maximising patient time and minimising administrative burdens will therefore form an essential part of the way forward in treating this debilitating condition.

For the health professional this will require a switch to “always on” technology which will help patients to book appointments and stay in touch without taking up clinical time.  This includes taking steps to ensure phones are covered by internal or external support staff, appointment booking online and automatic appointment reminders.  These simple steps can make a huge difference both to treatment times and to ease the strain on overworked health professionals.

In its review of the study, the NHS Choices website concludes that it may be a cliché to say that doctors don’t understand the back but it acknowledges that lower back pain is a “poorly understood condition.” The site therefore calls for further research into the ways in which back pain can better be prevented and managed.  Pending the outcome of such research it will fall on health professionals to take steps to manage their back pain management in the most effective way possible.

Improving patient outcomes

There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don’t know. But there are also unknown unknowns. There are things we don’t know we don’t know

Donald Rumsfeld’s comments on the presence, or otherwise, of weapons of mass destruction may have passed into folklore but they do encapsulate the dilemma facing anyone who seeks to move away from the tendrils of speculation and into a position of certainty.  Particularly so in the field of research where some studies result in ground breaking initiatives whilst others merely confirm unproven but seemingly obvious theories.

For example, a Europe-wide study into nursing practices has shown that a combination of nurse education levels and patient/nurse ratios can have an impact on patient outcomes.  Whilst the initial reaction to this report may be to dismiss it as stating the obvious, an already known known; studies such as these are invaluable in both proving the theory and in quantifying the extent of the problem.

So whilst we may have thought that we knew increasing the workload of nurses may lead to poorer patient care, a study which concludes that increasing a nurse’s workload by one patient is associated with a 7% increase in patient deaths can only serve to sharply focus the attention.    The report also concludes that in return for a 10% increase in nurses with degrees the risk of patient deaths falls by 7%; something which will be of comfort in the UK where with effect from 2013 all new nurses have to be educated to degree level.

Those working within the healthcare profession have always “known” that the more patients presenting for treatment equals the less time available for each patient and consequently the more likely that symptoms may be missed and care not be provided to the standards expected.  But studies such as this one highlight the effect of time and patient pressure.  For some the solution will be to educate further, to take on more staff; but when budgets are tight that is not always possible.  Finding ways to work smarter, to automate, to outsource the routine, to free up time for patients is the way forward.

Before this study we knew that time and education equalled improved outcomes but we didn’t know to what extent.  Now this part of the health service puzzle has moved from a known unknown into a known known and that has planning implications for all who practice healthcare and want to maximise patient outcomes.

Healthy advice

Stories of sandbags and dredging may have captured the headlines but lurking beneath the disasters is a danger which if left unchecked could cause even more misery for thousands.  That danger is the health implications of excessive rainfall.

On a day to day basis we don’t pay much attention to our waste.  Yes, we wash our hands but in general we don’t stop to consider where our waste goes.  We just assume that it is dealt with.  But with flood waters pouring into drains and septic tanks, our waste is suddenly a lot closer than we’d like to believe and that can cause long term health problems for the unwary.

In recognition of this Public Health England (PHE) has issued some guidance on “the potential health impacts before, during and after a flood as well as advice and support on the response and recovery.”  In addition to warnings about the dangers of sharp objects hiding beneath flood waters and advice on packing an emergency bag in case of evacuation the PHE advice also covers areas such as sanitation and food safety.  The PHE advice also brings to the fore the psychological impacts of flooding which can cause symptoms such as tiredness, distress, anxiety and sleeping problems.

Whilst the NHS is generally the first port of call for those whose health and wellbeing has been affected by the floods, in the longer term other health professionals will be drawn in to the mix.  Those such as counsellors and psychotherapists may be required to treat psychological traumas whilst physiotherapists, osteopaths and others look after people who have been injured whilst coping with the floodwaters.  Even the simple advice to move precious objects upstairs is going to result in a fair amount of back and other strains for those who are unused to such exercise.

With so many affected, in some areas already overburdened health professionals are going to be put under further pressure.  Finding ways to defer some of the day to day tasks such as telephone answering, diary management and the maintenance of patient records could help to deflect some of this pressure as well as maximising the time available for treatments.  Whilst at least the flood waters bring with them warmer weather which reduces ice slips and strains this is cold comfort to those who require treatment from weather related ills.  With the Government warning that things may get worse before they get better this is one story which sadly may run and run.

Securing payment

Christmas may be the season to be merry but it is also the season when credit cards tend to receive a hammering. To help shoppers the credit reference agency Experian has put together seven tips on managing cards wisely. These include making payments on time, never withdrawing cash on credit cards and keeping an eye on the total amount of credit which you have across all of your cards.

But credit cards are not just for Christmas and used wisely they can be an important tool in financial management, both for purchaser and for provider. Whether spreading the cost of purchase or securing payment, credit cards can be mutually beneficial.

That is one reason why Clinic Appointments are now pleased to be able to offer a secure card processing service for offsite payments. The service accepts both credit and debit cards and can be used as a means of helping to ensure that payment will be collected from clients who book an appointment either online or via a call to one of our receptionists. At the time of booking we reserve a payment amount on the client’s card, with the payment either being taken in full once the appointment has taken place, or in the event of a no-show an amount being debited in accordance with a health practice’s stated cancellation policy. Should the client choose to pay by other means the reserved payment can simply be released.

Just by being asked to provide card details up front, clients are far more likely to attend their appointments; benefitting both the health practice and the patient. And as you’d expect from a Clinic Appointments service, the Card Processing Service is secure. So when your patients cancel their appointments with a flimsy excuse, simply don’t show up for appointments or promise that ‘the cheque is in the post’ you may want to consider secure card processing. It will help you to maximise cash flow potential but more importantly, especially if run alongside our appointment reminder service, you will be helping to ensure that your patients turn up for treatment; benefitting them and their health in the long term.

We continue to look for ways in which Clinic Appointments can help our health practitioner clients to streamline their businesses and maximise patient treatment times. In the meantime may we take this opportunity to wish all of our Clinic Appointment clients a Happy Christmas and a very prosperous New Year.

Booking time

The dawn of the ‘internet revolution’ may by now be lost in the mists of the past but it seems as though at last the benefits of internet connectivity have moved into mainstream living.  This Christmas more than one third of all shopping will take place on line with features such as click and collect proving popular.

As we toast the end of the year with internet tills ringing we are also shortly to be waving goodbye to another British institution.  The Government has announced that the paper car tax disc is to be phased out.  With authorities relying on purely electronic records the move will save time and resources.

In fact way back in the early days of the internet the benefits to be gained from the saving of time and resources were widely predicted but in the intervening period it has sometimes seemed as though all that the internet has done is bring more work.  In the early days ‘dial up’ was so slow that many people could get in their cars and drive to the shops faster than they could order goods online.  Now thanks to improved internet speeds allied with programmes designed with ease of use and speed in mind, the internet has at last come into its own.

One benefit of this improvement is the way in which health service providers are able to manage their diaries.  For the health practitioner the time spent in booking appointments is effectively ‘dead time’; time which is spent away from treatment and time which potentially impinges on another patient’s treatment.  That is why practitioners turn to services such as those provided by virtual assistants who can take calls and manage bookings on behalf of the health practitioner.

Now there is a new service available from Callagenix which not only saves the health practitioner from taking calls, it also saves the client from having to telephone.  Online booking enables clients to browse and book an appointment at a time to suit them.  This quick and simple appointment service perfectly ties in with the general move towards using the internet as the first port of call.  The service is flexible and practitioners can choose whether to accept new or existing clients via the online service as well as restrict online booking to certain treatments or to certain times of the day or week.  Time saving, easy to use and flexible; online bookings are a perfect example of the way in which the internet can make life better for all.

Chinese Whispers

A GP who is at the forefront of patient engagement and empowerment has revealed that 99% of his communications with physiotherapists are still carried out on paper.  According to the Chartered Society of Physiotherapy, Dr Amir Hannan said ‘I don’t think we use email as productively as we might or technology in general.’

With letters being used as the prime communication method, it can sometimes be weeks before the results of patient treatments are conveyed to the general practitioner, resulting in delays in considering appropriate follow up treatment.  This affects the perception and actuality of patient care and can in some cases lead to a worsening of the patient’s condition.

In fact, Dr Amir highlighted the way in which delays in receipt of letters can result in the patient having to brief the doctor on the methods and results of treatments.  Whilst this does play into the hands of those who advocate patients taking responsibility for their care, it also means that treatments and findings can be filtered with a ‘Chinese whisper’ effect resulting in distortions.

Dr Hannan’s comments were echoed by NHS England’s director of systems, strategy and technology, Beverley Bryant, who confessed herself to be amazed “how much paper flies around our hospitals”.  As we have previously reported, one solution to this paper mountain is to adopt smarter practices which benefit from the use of current technology.  The health care authorities are working towards this end but there are options available now for those who need to find a way to communicate more effectively.

One of the main barriers to swift communication is the simple lack of time available to those who want to maximise patient treatment time.  Every time papers are filed, every time the phone is answered, every time an invoice is sent out is time which takes health practitioners away from their core task.  Simply by using the services of a virtual assistant to take control of telephone answering, diary management, electronic records and invoicing enables practitioners to free up valuable time.

Working smarter, not harder may be a mantra which is parroted around the business-speak airwaves on a regular basis but it does carry an element of truth.  Health practitioners took up the call to treat and improve the lives of others.  By concentrating on that calling and leaving the day to day admin to others, everyone benefits.

Time to ski

With Bonfire night safely out of the way it is time to turn our thoughts ahead to the winter ski season. Whilst some forecasters have predicted a harsh winter ahead for the UK in 2013, the Met Office recently took pains to stress that it is still too soon to produce an accurate forecast and accused those who are predicting “the worst winter in decades” of crystal ball gazing.

Whatever the outcome, UK winters are still too unpredictable to guarantee good snow leaving ski enthusiasts having to look elsewhere to get their skiing fix. This means that the annual exodus to the European slopes and further afield is about to get underway.

The first week in November has already brought a good snow covering to some alpine resorts, resulting in predictions of an early start to the season and no repeat of last year’s green slopes.  Hopefully the weather conditions will bring good safe skiing but whilst the majority will return safely from their adventures, there will be some who suffer on the slopes and need attention on their return.

It’s not surprising therefore that whilst eager skiers travel outwards, back in the UK physiotherapists and other health professionals are bracing themselves for a busy winter.  Broken limbs, strains and pulls are an inevitable consequence of skiing accidents.  Add in those whose year-round sedentary lifestyle has not prepared them for the physicality of skiing and chiropractors, osteopaths, and physiotherapists alike are an unforeseen consequence of a winter holiday on the slopes.  And if winter in the UK does turn out to be harsh then there will be an additional crop of home-grown injuries to treat.

Hopefully some individuals will have thought ahead, consulting health professionals for pre-ski exercise regimes which will prepare them for a holiday on the slopes. And hopefully some people (particularly the elderly or frail) will have prepared for icy conditions at home, stocking up on essential supplies or arranging for additional support perhaps from a neighbour or health professional. But many won’t be prepared and even if they are, it is impossible to guard against accidents. All this means additional demands on the services of health professions who in turn will need to gear up their timetable to run as smoothly as possible. This includes taking steps to ensure that the time given to treatments is maximised.

All this means that health professionals need to gear up their timetable to run as smoothly as possible.  Missed appointments not only means a lack of income but also another patient who will not be speedily treated.  Having to interrupt treatments to take phone calls means that treatment may not be as effective as it should be.  And if calls are missed then patients suffer and diaries are not as full as they should be.

The answer is to bring in the services of a virtual assistant.  With calls answered, diaries can be maintained as full as practicable without patent treatments suffering.  Add in an appointment reminder service and no-shows are reduced again helping diaries to be maintained at an optimum level.  Skiing can be fun, but when something goes wrong, a speedy return to fitness with quick and professional help is the best way to prepare for the next season on the slopes.

Taxing times

From time to time HMRC decides to set up a task force to investigate the tax affairs of a certain business sector.  For example in the past it has reviewed car dealers in the Midlands and fast food outlets in London.  Now it is the turn of health professionals to come under the spotlight.

Announcing the initiative on 7 October, HMRC have given health professionals until 31 December to sign up for the campaign and until 6 April 2014 to pay any outstanding tax.  By doing so they will face far lower penalties than if they fail to sign up and HMRC subsequently discover amounts of unpaid tax are due.

Doctors, dentists, nurses and social workers are not covered by the campaign but the HMRC announcement highlights other health workers who they will be looking at including:

Physiotherapists, occupational therapists, chiropractors, osteopaths, chiropodists, podiatrists, homeopaths, dieticians, nutritional therapists, reflexologists, acupuncturists, psychologists, speech, language and art therapists.

Whilst the vast majority of health professionals will already have their tax affairs in order, the campaign is a reminder that being a health professional is not just about treating patients.  Managing diaries, booking appointments, invoicing and collecting fees, ordering supplies and preparing accurate accounts all take time out of the working day.  Larger practices may have the benefit of a team of back-office helpers but health professionals working in smaller practices may find themselves juggling patient time and treatment time to the detriment of income and professionalism.

That is when the services of a virtual assistant can come in handy.  Appointing a virtual assistant service to answer the phone, manage the diary, book appointments, invoice and file patient records can free up valuable time both for patient treatments and to provide some free time at the end of a full day.  Of course there are some tasks that a virtual assistant won’t be able to perform, such as being there to receive medical supplies, attend CPD training or complete tax returns but with time freed up from other tasks, at least the health professional will not be under as much time pressure when other tasks need to be completed.

In announcing their latest initiative, Marian Wilson, Head of HMRC Campaigns, said “I urge health and wellbeing professionals to take advantage of our quick and straightforward way of bringing their tax affairs up to date. Help, advice and support is available.” Full information including a video and direct phone number is available via the announcement on the HMRC website.

Divide and conquer

A hospital in Derbyshire has been reaping the benefits of a new cleaning rota.  Using an idea gleaned from overseas, the Royal Derby Hospital split its cleaning workforce into teams, each responsible for specific areas such as corridors or toilets.  Previously a single cleaner had been responsible for an entire ward or area of the hospital.

The new system of team cleaning by area has lead to a reduction in cross-infections, traditionally a pre-cursor of the need to close wards for deep cleaning.  In fact this new working pattern has been so successful that the hospital has been put forward for two Nursing times awards including the Golden Service award.

Hospital bosses have also found that by using teams rather than a succession of individuals, cleaning patterns are more flexible.  This in turn has reduced the incidence of wasted cleaning processes, such as cleaning a patient area just before a patient is due to be discharged as well as ensuring teams are on hand in case an emergency clean is required.

The story is a perfect example of the way in which those at the forefront of health provision are finding ways to work smarter rather than harder.  For example many health providers are looking to make savings by replacing follow up appointments with telephone calls or using the phone to make routine check-ups on those with ongoing problems.

It has to be acknowledged that telephone coaching is not universally successful if used in isolation as a study by UK researchers revealed earlier in August.  They concluded that telephone coaching of those with long term conditions is not effective unless it is carried out as part of an integrated system of care.

Health professionals too are using this “divide and conquer” principle to maximise patient treatment time and minimise disruptions.  Simply by outsourcing their phone answering to a virtual assistant service, health professionals can ensure that their phones will be answered, appointments made and reminders sent out whilst the health professional can concentrate on treating their patients.  With no need to interrupt a treatment to answer the phone and no missed calls, professionals such as osteopaths, chiropractors and others can provide a more streamlined and efficient service to their patients.

Contact us today to discover how Clinic Appointments can help your clinic. Book your free demo call now to learn more.