The Four Critical Steps to an ePractice

by Randale Sechrest

Editor's Note: This essay was originally prepared for a US audience, but the concepts may well apply wherever you practice.

The Internet continues to take on more relevance every day to each and every industry - it is quickly becoming the medium of choice for communication in all areas of our economy. While the healthcare industry may have lagged behind other industries in the acceptance of this technology, it now appears poised to embrace the benefits of the Internet. In this new era we are entering, one defined by practice marketing and branding, you as a provider need to have an understanding of the opportunity the Internet provides you.

You need to know how to put this technology to work for your practice or organization.

It should be clear by now that understanding and employing these new concepts provides your organization with the ability to utilize the Internet for communicating with your patients, marketing to potential patients and supporting your healthcare "product". It also provides a vehicle for communication and collaboration between you and your referring providers and colleagues. Finally, it provides a common communication and storage mechanism to increase the efficiency of information management within your own organization.

You will come to rely on these technologies more and more.

Many orthopaedic surgeons are beginning to realize the similarities in the nature of their "service-based business" to every other service sector business. The next logical step will be to begin a bona fide evaluation of the quality of your ability to deliver high quality "service" in addition to high quality healthcare. Read that last sentence again and do not assume they are one in the same. The history of the US healthcare delivery system has been to deliver very high quality healthcare but not necessarily high quality service. The two do not necessarily go hand in hand.

Successful service will mean taking a patient-centric approach as well as bringing some level of consistency to your healthcare "product". That product must be nurtured, improved and (dare I say) marketed to the potential customer. The healthcare services you provide today do not simply represent a series of unrelated interactions provided by independent professionals to a relatively captive patient population. The services you provide represent your product.

To effectively compete in the marketplace, it will become critical to clearly communicate what your product is and why your potential customer, your patient, should choose your product over the competition's product. In a competitive marketplace, customer satisfaction with your healthcare "product" will become the key to success.

A fundamental shift has occurred in the concept of marketing due to the Internet. The Web allows a nearly unlimited amount of information to be presented to the potential customer of any product or service. For the first time in history, an in-depth comparative analysis of the benefits of one product (or service) over another is possible with the click of a mouse. While hyperbole and jargon are still evident, the Web is forcing a change in focus of marketing activities towards creating information that withstands comparative analysis as well as scrutiny for accuracy.

For the healthcare provider who eschews the notion of advertising, this is an extremely important point. Your potential patient is demanding access to comparative information. Simply being absent from the analysis will not be an option too far into the future. Your absence will be as damning as mediocre data and information. There are far too many players on the field today who are more than willing to supply information to the healthcare consumer. The traditional mechanisms for building a referral network will not disappear; but they will definitely be impacted by the forces at work in the Network Economy.

The Internet is not the entire solution by any means. It does represent a key part of the overall strategy at your disposal to improve the entire "value proposition" of your service offering. For many businesses, the Internet is becoming the core element around which is built a comprehensive strategy for improving and supporting a product line. The "healthcare product" can benefit from this approach as well.

To understand more about how we might put this new tool to use, let's begin by understanding the critical elements that must be in place to effectively utilize this tool. Then, we will define several key concepts that are discussed when the conversation turns to the Internet and business. There are several different concepts that involve technologies developed for the Internet. These concepts are simply variations on the same theme where the Internet-derived technologies are applied for very specific purposes.

The Four Critical Components to an ePractice

There are the four key components that any healthcare organization, from the single practitioner practice and larger, needs to address in moving business processes to the Internet. It is necessary for each of these components to be in place for the organization to create an environment to begin to actually use connectivity effectively. If any of the four are missing, receiving the full benefits of the medium will be significantly hampered. It should be stated at the outset that an internal champion prompting the change is crucial. Without genuine buy-in from the leadership of the practice or organization, the changes will most likely be slow and incomplete.

Hardware Infrastructure

The organization must make an investment in sufficient hardware to serve the needs of the organization. The hardware infrastructure is the transport mechanism for information. Trying to connect the organization with outdated computers and inadequate local networking connectivity is difficult and probably doomed to failure. The hardware infrastructure within your organization will become the basis for your communication system - take some time to evaluate and choose an appropriate hardware partner that will be able to provide you with good quality products and support. For some organizations, a few mail order computers and a simple network that can be maintained by an internal employee may suffice. For others it will be a significant initial investment and a significant ongoing expense. There is no single way to determine whether the hardware infrastructure is adequate. But, if you find that your staff are all waiting to use the same computer that has a dial out line to the Internet, its probably time to wake up.

Connectivity

Once the infrastructure exists to take advantage of it, connectivity to the Internet is the next basic need for the connected organization. A reliable Internet connection, e-mail accounts for the entire staff and an initial web presence are all aspects of connectivity. In the vast majority of the United States a dial up Internet connection can be purchased for under $20 per month. The choices for connecting to the Internet are exploding every day all over the country. While the choices may be bewildering, it isn't hard to find someone willing to connect you to the Net and provide you with an array of services through that connection. The speed of the connection is getting faster and faster every day as the price continues to drop. Soon, physicians will be offered free service to connect their back offices and waiting rooms to the Internet simply because their attention (and that of their patients) is worth more to the service provider than the cost of the connectivity.

Training

This brings us to the most neglected aspect of connectivity in the healthcare organization - training. In the past, companies in many diverse industries have delayed or simply failed to make a successful use of technology by spending huge sums on hardware and expecting the employees to learn how to use the technology themselves. Unless there is adequate training provided to employees, the investment in technology might well be wasted. Today, the situation is much different due to the rapid penetration of the Internet into all aspects of our lives. Computer skills once were used primarily on the job. Today, basic computer skills are a part of life for many. The ability to use the Internet is becoming as important for much of the population as the ability to use the telephone. This creates a situation where the training issues may be less severe than in the past. You may find that your staff already has many of the basic skills necessary, they are simply waiting for a reason to use them on the job.

Applications

Computer manufacturers have always understood that it is the availability of applications that drive the hardware. Boiled down to basics this means that a user needs something compelling to use the tool for. In terms of the healthcare organization, there must be a compelling reason to "cross the chasm" from an unconnected to a connected organization. In today's environment, e-mail alone is probably a compelling enough application to prompt the move. The benefits realized by many organizations, and individuals, simply by adopting the use of e-mail for communications have been compelling enough to warrant developing the infrastructure to take advantage of this tool. Once the groundwork has been laid by adoption of this simple technology, it is much easier to transition to more complex applications of the technology. There are a multitude of services and applications, both healthcare-specific and generic that are available to the connected practice, and many more on the way.

Towards the ePractice

Once these four elements are addressed, the framework is in place to begin to successfully exploit the technology. The next steps are to put the technology to work for the organization by developing the resources to communicate to the "customers" of the organization. Successfully completing these four critical steps will provide you with the tools you need to incorporate tech technology into the everyday workflow of your practice. You will be poised to take your practice to the next level - the ePractice.

Randale C. Sechrest, MD

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