Sunday, July 08, 2007

Group IT maintenance

Our IT person will be starting our group computer maintenance program this month. This means updating the anti-virus protection if needed, performing manual and utility-based cleaning of the registry, services, files and folders etc (that means making sure all those things work properly), enabling the proper security services, performing internal system checks for overheating and cleanliness (CPU, Hard drive, fans), and cleaning if needed (the insides of computers get dusty and need to be vacuumed sometimes).

He will come to each office to do that. I think it is much better to have a professional come by periodically, rather than leave it as ad hoc for each practice. We decided to pay for this out of group funds. As well, he will be available for each of us as needed (we have needed him several times already), and we pay for that individually.

Our group administrator has now done house calls for almost all the practices, leading to immediate results: scanning started, use of EMR for encounters, improvements in scheduling functions. You need to have someone go to each office to see what the issues are, and to fix them. Many of the issues do not involve IT, but rather changes in work flow processes.

The pharmacist has now scheduled more of my patients; she has seen some off site (with the data entered straight into the EMR), and some at my office. We have a joint appointment for a challenging patient later this month.

We have progress on the Family Health Team's Big Office, with several physicians indicating an interest in moving there; at least two FHNs will move in as a group. It looks increasingly likely that I will move as well. I have informed my partner, and will keep him up to date on the progress of negotiations; I have told my staff as well.

This will give me a chance to think about reconfiguring my office for the EMR. My current exam rooms are 10 ft x 8 ft, and I see no reason to change that; it works. The only difference in going from paper to EMR was that I put in a $50 small stand where the printer sits. There is no paper clutter on the desk, and I don't have all the reqs that used to take up space.

The big difference will be in the front office; that is where the majority of the paper metastasizes. The filing cabinets are there, and much of the paper shuffling happens there. There is now a lot less stuff sitting on the desk at the front; most of that is from my partner's practice. I also need less waiting room area, since patients wait less (flow is better). I don't really need to allocate any space to store handouts (pretty much all the useful ones are available on-line or scanned in); I think I will reduce the amount of space for samples, since I use those less. There will need to be 1 small area to store paper reqs in case of a black-out, that can probably be shared between several offices.

My current front office and waiting room is 16 x 20 ft (320 sq ft); my small lab is 9 x 9 (81 sq ft), for the autoclave and vitals area; each of two exam rooms are 80 sq feet; the consult room is 10 x 9 (90 sq feet). If I practice in a 2 physician "pod", we will need 580 sq feet for the lab, 4 exam rooms and 2 consult rooms. No space needed for chart storage; no front desk space for files: 250 sq feet for front/reception. Without corridor space, that is 830 sq feet. I will also need some room for closets etc. I estimate we could do with 1,000 to 1,100 sq feet for two physicians, with ample space left over. I have 1450 now.


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