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Doctors’ Urgent Care Offices: A Case Study
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Doctors’ Urgent Care Offices: A Case Study

Case Study: Improves Cash Flow with DocuTAP EMR and PM

 

Clinic:

9 clinic locations

Opened in 1982

 

Staff:

200 staff members

25 management staff

 

Patient Volume:

30-60 patients per day per clinic

 

Clinic Offerings:

Urgent Care

Occupational Medicine

Workers’ Compensation Visits

 

Uses full DocuTAP platform, which includes:

 

DocuTAP Customer Since:

2013

Company Profile

Doctors’ Urgent Care Offices is a privately owned urgent care organization serving patients in Ohio and Kentucky. DUCO was started in 1982 and is primarily located in suburban Cincinnati and Dayton, Ohio. DUCO has grown to nine locations and serves from 30 to 60 patients daily at each location.

DUCO’s patient mix includes all ages from infants to seniors, and its target market is active, on-the-go individuals and families that need medical care at a time convenient for them. A key healthcare player in both Cincinnati and Dayton, DUCO was an early arriver to the urgent care industry in the 1980s. The practice deliberately built locations in suburban Cincinnati around the Interstate 275 loop—avoiding competition from established health systems. In addition to urgent care, DUCO offers workers compensation services, sports physicals, flu shots, DOT and pre-employment physical exams, and other occupational medicine services.

Doctors’ Urgent Care Offices (DUCO) was ready to modernize its practice by switching all locations from paper charting to an EMR to support digital patient record sharing, improve claims processing and resulting cash flows, and for Meaningful Use attestation.

Challenge

An established and well-run healthcare enterprise, DUCO had been charting on paper since opening its first location over 30 years ago. Being comfortable with their existing workflow, adopting an EMR system was not top priority for the practice. But once Meaningful Use, digital file sharing, and revenue cycle improvements made the switch prudent and cost effective, DUCO knew the time had come to embrace new technologies. New technology was also needed to stay competitive, improve speed of care for patients, and ensure favorable billing results.

On paper, DUCO was not able to efficiently track essential data to improve workflow and billing. Key numbers such as door-to-door patient times, average reimbursement per patient, claim turnaround time, and the number of rejected claims were either completely unavailable, or required days of manual work to calculate in some instances. DUCO also knew they were losing money due to incomplete documentation, coding, and charges not appropriately captured on paper. They wanted a solution to improve claim turnaround times and claim acceptance on first pass to insurers in order to improve cash flows.

Solution / Approach

DUCO began a thorough hunt for an EMR in 2011—including all levels of staff in its decision. Forming a committee of physicians, staff, and management, DUCO evaluated more than 10 EMRs and narrowed its choices down to four. After the four EMR companies offered personal demonstrations, the urgent care chose two EMRs to see in action at an existing urgent care before making a final selection.

DUCO chose DocuTAP as its EMR and PM vendor. “DocuTAP looked so smooth and effortless,” said Mike Jeffers, Executive Vice President of DUCO of their onsite software evaluation. “The other urgent care-specific EMR we watched looked like it had too many workarounds,” he added. Other factors DUCO liked about DocuTAP were quick patient registration and record retrieval, and clarity of clinical and billing data.

DUCO switched from paper charting to DocuTAP in 2013, going live with one clinic and adding the eight remaining locations within two months. Management is happy with data transparency, along with claim rate improvements and processing speed. Staff enjoy customizable provider templates, patient registration speed, and task automation—like issuing discharge instructions, sending ePrescriptions, and viewing lab results.

“DocuTAP is very strong from the clinical side. The way you can set up templates, document information, and quickly check a couple of boxes, and document a detailed exam is impressive. And the ease with which you can do it, DocuTAP just seemed better than other systems.”

— Mike Jeffers, Executive Vice President

Results

In response to the needs of today’s on-demand patients, DUCO partnered with DocuTAP as its EMR and PM provider. DocuTAP has helped to remove thousands of papers from DUCO’s clinics—while also improving clinical workflows, cutting steps from claims processing, and winning over a staff who had developed a very efficient system of paper charting. Here are a few areas in which they have seen important improvements:

 

Ease of Use and Workflow Improvements

Staff who were computer-shy have adapted well to DocuTAP’s intuitive and user-friendly interface. Left-hand tabs in the charting screen make steps easy to follow—and providers agree DocuTAP’s urgent care specific software is much easier to navigate than large health system EMRs.

“Staff who don’t use computers think the system [DocuTAP] is easy to use,”

— Tabatha Ealey, Office Manager

“DocuTAP is user friendly. It is very straightforward, and the flow isn’t that much different than paper charts. It’s easy to manage. We worked to set up templates to make the system efficient. And we continue to do that. It’s nice that DocuTAP allows you to do that customization,” reiterates Jeffers. Having details from previous patient visits only a few clicks away versus having to dig through paper charts has been greatly appreciated by the staff.

“The pulling of records, on DocuTAP now, you can bring up a chart, you can just hit the arrow back and see all the past recent visits. Before you’d have to go through the file drawer and find the most recent chart. If it was a chart older than six months, it was in storage, and it would take several days to get the chart. Now, it’s just a couple clicks away,” Jeffers explains. DUCO is now saving time previously spent on retrieving charts from files and offsite locations.

“Order sets are a time-saver. You hit one button and have an entire plan. I am more consistent with my treatment, and I am in better communication with my patients.”

— Rick Brantley, M.D., Physician Advocate

He continues, “Templates also speed up documentation. Eighty to ninety percent of my cases are the same, so I only need to check abnormals versus writing out normals, abnormals, orders, and scripts before. I easily save a few minutes per patient [using DocuTAP]. In general, our providers like the EMR and love the layout.”

No one seems to be missing the thousands of patient charts taking up clinic office space either. “We remodeled certain office spaces because we don’t need the space where the paper files were before. Staff and patients don’t bump into each other anymore,” Jeffers said. Literally, DocuTAP has improved not only digital, but physical workflow in DUCO’s clinics.

DocuTAP has assisted DUCO in improving patient care overall. Before, multiple steps were required for ordering labs. Now, lab interfaces allow DUCO to use DocuTAP’s quick pick lists for lab orders and results are finalized days faster than before. Dr. Brantley shares, “Paper got lost all the time, faxes of results would need to be given to the doctor by the medical assistant, and then the doctor would need to read results, and enter it into documentation—and our interface has removed all those steps.”

Jeffers reflects, “The way the staff can use the system, DocuTAP allows you to better anticipate the needs of the patient by showing what needs to be done by the physicians.” He admittedly acknowledges if he were to take DocuTAP away from staff, they wouldn’t be too happy. The double checks within DocuTAP keep physicians following standard practices—and documentation is cleaner and more complete than on paper charts for DUCO.

 

Claims Efficiency and Data Transparency

Using paper for over three decades, DUCO had a difficult time measuring door-to-door times. Sign-in sheets gave a starting point, but ending points were hard to gather and required a significant time investment. Now with DocuTAP, management knows each location’s average wait times and door-to-door times instantly.

Collection rates at the front desk have improved significantly with DocuTAP’s real-time insurance verification tool. And because of the integrated practice management (PM) system, claims go out much faster. “Before we had a courier drive around to all the offices, get the paper charts, bring them to accounting, register them, have the coders add the charges and get them out.

“You can literally get claims out in a day or two [with DocuTAP].”

— Mike Jeffers, Executive Vice President

Due to documentation entry delays in the previous month, DUCO would always rush to do end-of-month reporting. Caught in a delayed cash flow cycle, DUCO noticed DocuTAP help cut 10 days off their average claim time. “Between 2013 and 2014, we cut 50 percent off the time of claims processing. We have fewer rejected claims too, and are catching charges we didn’t before on paper,” notes Jeffers.

One of DUCO’s favorite features has been the Coding Made Easy tool—which automatically applies diagnostic codes, adds modifiers, and performs other repetitive coding tasks so coders can concentrate on more complex visits. Jeffers states that “Coding Made Easy helps make sure we catch certain items. That’s been very helpful to us to make sure we are billing correctly. When you have fewer issues, insurance companies pay claims faster and faster, which is great.”

Jeffers also sings praises about DocuTAP Analytics—a drag-and-drop report creation tool that gives him and management data transparency. “Analytics has been a key step forward in data mining, understanding payments by insurer, and analyzing trends (and spotting outliers in need of addressing). It’s great to have instant access to data with DocuTAP Analytics,” shares Jeffers. DUCO can make smart business decisions about hours, staffing, and services armed with real-time data unavailable before launching DocuTAP.

 

Software Requests and Super User Training

DUCO enjoys the responsiveness of the DocuTAP software developers addressing their feature requests. “It feels like we were helping DocuTAP write their updates, because what we were asking for, they’ve added. DocuTAP has been very responsive [filling software requests]. That’s important—especially with technology, as things are always changing,” Jeffers emphasizes. Dr. Brantley echoes, “DocuTAP is open to working together. They listen to our feedback, and work hard to make us more effective in helping our patients.”

With a wide array of functionality available, DUCO wanted to make sure they were using DocuTAP software to its full capacity. DUCO decided it would be a good investment to send several staff members to DocuTAP Super User Training.

Kelli Oney, Office Manager, capitalizes on her Super User training by helping make office functions more efficient and sharing knowledge points with her colleagues. “I learned shortcuts for reports and workers’ comp claims, and formed a better understanding of the lab process,” she explains. Monica Ernst, Revenue Cycle Manager, enjoyed meeting DocuTAP employees. “We came back with items to try, but the ongoing contacts we made during the training were useful,” she adds.

All the attendees of Super User Training agree they are now more confident working with staff and assisting other managers with questions—and the personal connections with the DocuTAP team makes it easier to work through questions with DocuTAP Support.

 

Final Thoughts

Doctors’ Urgent Care Offices has a long, storied history in the southwest Ohio and northern Kentucky urgent care space. They plan to continue this tradition of leading the way. The future holds exciting possibilities for DUCO with potential telemedicine service expansions, new clinic openings—and current affiliations with nearby health systems.

“DocuTAP is a partner, not a vendor. Our personal relationships within the company, their willingness to work together with us, are what we appreciate the most,” says Dr. Brantley. “We found the right software with DocuTAP. They continue to evolve, and I appreciate their work. I wouldn’t want to switch to another urgent care EMR,” Jeffers concludes.

 

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