MEDICAL-GRADENETWORKS—WHAT YOU NEED TO BUILD, IMPLEMENT RESPONSIVE HEALTHCARE SOLUTIONS FORPHYSICIAN GROUPS AND CLINICS                    Table of content: Introduction—healthcare trends and challenges The need for medical-grade network solutions in healthcare Healthcare solutions for physician groups and clinics Network solution benefits for physician groups and clinics Strategic considerations for physician groups and clinics Deployment considerations and questions Timeline Success measurements Summary References             INTRODUCTION—HEALTHCARE TRENDSAND CHALLENGESPhysicianpractices and clinics are being called on to do more than ever before. Today’sphysicians must treat more patients, document interactions more meticulously,wrangle with more complex managed care rules, keep track of an ever-expandingarray of drugs, and pay rising malpractice insurance bills. In many cases,physicians must treat 20 percent more patients than they did five years ago togenerate the same revenue. In the face of these burdens, some practices arestruggling to remain financially viable. For manypractices, the biggest impediment to meeting these challenges is continualadministrative burden, a lack of automated clinical documentation, andinefficient practice workflow systems. Despite the dramatic advances in manyareas of healthcare technology over the past several years, most physicianpractices—especially small and midsize ones—are still using the same manual andpaper-based office management systems they’ve used for decades.

 Fortunately, awide variety of healthcare solutions are now available that can help physiciansand support staff work more efficiently and productively. The digital medicalpractice of the future will include wireless networking, Internetcommunications, and digital record-keeping systems designed to automate manymanual tasks that have been proven to enhance overall quality of care. However,for any healthcare solution to succeed, it must be built upon a soundmedical-grade network infrastructure. Systems offersa suite of robust, intelligent network technologies that deliver theperformance and security healthcare practices demand. Whether supporting simplebroadband Internet solutions or full-scale digital medical record systems, itcan provide a network solution that meets your practice’s unique needs.

Drawingon years of experience working with the most successful healthcareorganizations in the world, partners and resellers can deliver the technologyand expertise to dramatically enhance the way you run your medical practice. The Need for Medical-GradeNetwork Solutions in HealthcarePhysicianpractices of all sizes face many of the same demands and challenges. Practicesmust find new ways to:Improve qualityof care—Responding to public concern about medical errors, practices arestriving to reduce reliance on handwritten records and implement better systemsfor tracking procedures and prescriptions. For many practices, improvingquality isn’t just the right thing to do, it’s also a business imperative.Insurers increasingly link group participation and reimbursement rates topay-for-performance qualitymetrics. Many insurers are also promoting health management programs forpatients with chronic problems such as diabetes or high cholesterol.

Toparticipate in these programs and better serve their patients, practices mustbe able to efficiently document patient interactions, automate communications,and provide clinical best practices based on clinical knowledge base systems. Reduce costsand improve profitability—The success or failure of a practice depends on theproductivity of physicians and their staff. And too often, skilled caregiversspend the bulk of their time doing paperwork instead of treating patients.According to AC Group, Inc., the average practice in 2004 spends 18 percentmore time on paperwork than they did in 1998. This reliance on paper-based medical records also places a huge burden on practices, addingsubstantial costs for record storage and administrative support staff. Largerpractices can see transcription costs alone reach more than $1 million peryear. Too often, physicians are also under-compensated for the work theyperform, as many will “downcode” what should be a higher-compensatedinteraction just to save time and paperwork.

Studies by AC Group have shownfinancial loss due to downcoding can reach as high as 15 percent of practicerevenues. Enhanceorganizational efficiency—Practices must see more patients than ever before toremain financially viable, while the documentation required for each patientinteraction is steadily increasing. Simply maintaining paper-based records canbe an enormous challenge, as staff must deal with lost charts, duplicaterecords, and records that are out of the office for days or weeks duringtranscription. Practices are also searching for ways to streamlinecommunications with insurers and pharmacies, and speed reimbursementprocessing. Guaranteeinformation privacy and security— Government regulations, such as the U.S.

Healthcare Insurance Portability and Accountability Act (HIPAA), mandate strictprivacy measures and guidelines for securing healthcare information. Aspractices move to digitize information, a locked file cabinet or record room isno longer sufficient to protect confidential patient data. Practices that failto adequately protect patient information can face fines, legal liability, andworst of all, loss of confidence among patients and partners. Provide abetter patient experience—As practices see more patients, physicians arestruggling to provide personal attention and ensure patients are notinconvenienced. Practices are searching for new ways to streamline theappointment-making process, reduce time spent on hold or in a waiting room, andenable administrative staff to more quickly locate information and respond whenpatients call with a question. Healthcare Solutions forPhysician Groups and ClinicsTo respond tothese demands, physician practices are deploying a host of new technologies tostreamline workflow, automate manual and paper-based processes, and improveoverall patient care. These include: Mobilitysolutions—Wireless-enabled computer kiosks, pocket PCs, tablet PCs, and IPphones put information at caregivers’ fingertips, and bring digital records andnetwork applications to the bedside. Remote connectivity solutions allowphysicians to securely access medical records and applications from anywhere,at anytime, on almost any device, over the Internet via secured connections.

 Electronicmedical record (EMR)—These solutions digitize manual, paper-based records,provide best practice clinical knowledge base information, streamlinerecord-keeping processes, and provide a single, comprehensive view of thepatient. EMR systems incorporate all aspects of patient interactions, frommedical and family histories, to health maintenance reminders for chronicconditions, to drug interactions, to automatic insurance coding. Mostimportantly, an EMR system makes patient information universally and instantlyaccessible to all authorized caregivers and staff, eliminating the need to huntfor paper-based charts. Documentimaging—Imaging applications enable practices to smoothly make the transitionfrom paper-based system to digital. These applications can rapidly integratepaper records into a network-based system, and eliminate the huge costs ofstoring, maintaining, and retrieving thousands of medical charts. Webconnectivity—Practices increasingly use the Internet to communicate withinsurers, pharmacies, and even patients. The ability to securely transmitmedical information online can speed claims processing and streamlinecommunications with other facilities.

 While solutionslike these were once only possible for large hospitals and medical groups,technological innovations and falling prices have made them viable options forsmaller practices. However, to reap the benefits of modern healthcaresolutions, practices need a robust, reliable medical-grade networkinfrastructure to support them. Such a network must deliver the optimalperformance and security that medical applications demand, but in a way thatcan be easily managed by a small practice with little or no IT expertise.  A full suite ofnetwork solutions to support a single physician office, a large clinic, andeverything in between. These solutions incorporate industry-leading technologyand expertise, but in affordable, highly manageable packages designed to fiteven the smallest practices. These solutions include: Wirelesslocal-area networks (WLANs)—Wireless networks give caregivers greater mobilityby delivering critical patient information wherever they need it, over a widerange of computing platforms.

Aironet® wireless access pointsdeliver superior performance and manageability, along with the stringentsecurity required when sharing sensitive information in a wireless environment. Core networkdevices—Offers a larger portfolio of network routers, switches, and securitysolutions than any other network technology provider. From small office routingand security to intelligent, high-speed switches serving hundreds of users,access routers, Catalyst® switches, and PIX® SecurityAppliances deliver unparalleled intelligence, scalability, and performance. Remote connectivity—Secure IP virtual private networks (VPNs) enable practices to safely extendhealthcare applications and information to remote facilities, hospitals,medical conferences, and even physician’s homes by encrypting data as ittravels over the Internet. With a VPN, healthcare information cannot becompromised, intercepted, or read by anyone other than the authorizedrecipient.

  Offers both hardware andsoftware VPN solutions for end-users, and all access routers and securityappliances offer built-in support for VPN connectivity. Networksecurity— Security solutions can protect sensitive data across the entire wiredand wireless infrastructure, from the network core tothe physician’s home office and everywhere in between. Using these securerouters and switches, firewall security appliances, intrusion detectionservices, and network management tools, practices can protect themselvesagainst even the most serious security threats. Of course, notevery practice needs all of these components. Larger practices considering afull transition to a paperless office need a full-featured, end-to-endmedical-grade network solution. Smaller practices may start with just a smallwireless LAN or secure Internet access.

In all cases, its expert partners andresellers can provide the technology, experience, and support to help you makethe right choices for your organization. NETWORK SOLUTION BENEFITS FORPHYSICIAN GROUPS AND CLINICS Healthcaresolutions built on a robust, secure network infrastructure can deliver a widerange of benefits to both clinical caregivers and support staff. Thesesolutions can enable: Improvedpatient care and safety—Digital clinical applications and real-time informationsharing result in a more unified, up-to-date view of the patient, and faster,more accurate care. Physicians who can update records, look up potential drugreactions, and write digital prescriptions right in the examination room cansubstantially reduce the errors and delays associated with handwritten,paper-based systems. Studies from AC Group have shown that average medicalcosts per year can decrease by as much as 13 percent with certified EMRsystems. Enhancedprofitability and reduced costs—Practices that make full use of solutions likeEMR and practice management systems can usually see more patients and add morephysicians to the practice without increasing support staff. When dealing withinsurers, these solutions can speed insurer payments, reduce documentation, andeliminate undercoding of patient interactions. Practices that can betterdocument patient interactions and quality can also qualify for reducedmalpractice insurance rates.

Moving to digital record-keeping also dramaticallyreduces the costs and labor of creating, managing, copying, and storing paperfiles. Measuring supplies and storage costs alone, some industry groupsestimate EMR can save $3 per new chart—a potential savings of thousands or tensof thousands per year. On average, AC Group has documented improvedprofitability of between $12.50 and $25 per patient visit. Improvedefficiency—When clinical staff can access comprehensive, real-time patientrecords by simply clicking a mouse (instead of having to hunt down a paperfile), they can much more rapidly answer questions, process claims, and preparephysicians.

EMR systems can dynamically integrate withinsurers, for instance, notifying caregivers which drugs are covered each timethey write a prescription. The increased mobility afforded by wireless devicesand remote connectivity allows physicians to work effectively wherever andwhenever they choose. Most importantly, networked solutions and automatedsystems allow caregivers to spend more of their time seeing patients, insteadof doing paperwork.

On average, AC Group estimates that physicians can saveabout four hours per week, nurses save six hours per week per physician, andstaff save an average of eight hours per week per physician.  Better patientexperience—Network-enabled healthcare solutions can provide noticeableimprovements at all stages of patient interaction. Secure Web-based servicescan speed the pre-registration and check-in process. Instant access to patientmedical records can help clinicians better stay on schedule, reduce wait times,and enable fast, often instantaneous responses when patients call withquestions. With a secure network, practices can even extend Web-based servicesand information to patient waiting rooms.

According to AC Group, physicianswith enhanced digital technology have reported a 32 percent improvement inpatient satisfaction. Prevention of adamaging security breach—The costs of even a single security breach can besubstantial, including lost data, lost productivity, diminished patientconfidence, and large fines and penalties. By building solutions upon a highlysecure, intelligent network infrastructure, healthcare practices can avoid allof these pitfalls and use new solutions with confidence. STRATEGIC CONSIDERATIONS FORPHYSICIAN GROUPS AND CLINICS Could yourpractice benefit from modern healthcare systems and technologies? Consider thefollowing strategic questions to assess your requirements for network-enabledsolutions: Quality ofcare—Does your practice occasionally face errors or duplicated procedures as aresult of illegible or incomplete paper records? Would physicians benefit fromhaving real-time patient, insurer, and drug information available in theexamination room via pocket or tablet PCs? Do your record-keeping systems allowyou to identify patients with chronic conditions and stay in communication withthem to ensure they keep up with their treatment? Efficiency ofworkflow systems—Can clinicians and support staff locate patient recordsquickly and easily throughout the workday? Does your practice frequently dealwith lost, incomplete, or duplicated records? How much time do skilledcaregivers spend documenting interactions? How much time could be saved if theycould document interactions digitally, in real time during the patient visit? Practiceprofitability—Are physicians spending the bulk of their time seeing patients,or performing administrative tasks? Are physicians being fully compensated forthe work they perform, or are they under coding to cut down on paperwork? Doyou require several full-time employees just to maintain paper-based medicalrecords? Working withinsurers—Are you relying on phone and mail to communicate with insurers? Do youcurrently have to wait weeks or months before receiving payment? Would youqualify for different provider groups or higher reimbursement rates if youcould better document quality? Informationsecurity—Are your current or planned information systems in compliance withprivacy regulations? Can you protect patient data at every point within yournetwork? Technologyexpertise—Do you have the internal expertise to effectively deploy and managenetwork-enabled healthcare solutions? Or would you benefit from working with atechnology partner with extensive experience deploying and supportinghealthcare systems? DEPLOYMENT CONSIDERATIONS ANDQUESTIONS While largepractices may have an experienced IT staff to manage deployment, smallerpractices should strongly consider working with a technology partner. Certifiedresellers and partners have a wealth of experience, both with network technologiesand healthcare processes and systems. These partners can manage all aspects ofplanning and deploying network solutions, allowing practices to focus onmedicine.

 Practices shouldconsider the following five areas before deploying a network security solution: Strategy—Understandyour healthcare solution needs and objectives, and make sure you have thesupport of senior clinical and administrative staff. Identify and quantify thebenefits you expect to gain from the solution ahead of time, so you can measurethe effectiveness of the deployment. Process—Workwith a technology partner to clearly define the methods and practice forimplementing a network-enabled solution. What network solutions does yourpractice currently have in place? How will these systems, as well as currentworkflow processes, integrate with the new solution? People—Practicestructure and culture must support your strategy and goals. Proper training ofeveryone who will interact with the system is critical, as is working with bothclinical and support staff in the early planning stages to ensure that thesystem will meet everyone’s needs.

 Technology—Reliable,scalable, and manageable computer networks, applications, and tools areessential to an effective healthcare solution implementation, as isinteroperability with your existing IT environment. Will you need to upgradeyour network to support the solutions you want to deploy now and in the future? Service andsupport—Do you have an experienced office IT staff, and if so, do they have theskills, equipment, and access to implement and support the solution? Will youneed to use outside services to plan, design, deploy, and support your networksolution?  TIMELINE Deploymenttiming can vary greatly depending on the type of solution you intend toimplement. A small wireless LAN can be fully deployed in hours or days. Afull-featured solution incorporating wireless, EMR, document imaging, andcomprehensive security will naturally take longer. One of thebenefits of this network technologies is that you don’t need to deploy the fullsolution all at once. Practices can start with a limited deployment, andincrementally expand the solution later as needs change. Network technologiesare flexible enough to scale with a practice as it grows. Regardless ofthe size of the implementation, a typical deployment timeline should includethe following basic elements: Organizationalassessment and strategy development—Work with your technology partner todetermine the current state of your practice’s network infrastructure, obtainthe support of senior stakeholders, and develop a strategic vision for yourhealthcare solutions.

 Evaluate andselect technology—Let your partner help you determine the best software andhardware to support your needs and strategic vision. Prioritize your criteria:interoperability, scalability, performance, etc. Build model andtest—Your technology partner and your staff will connect organizationalprocesses to technology features (a process known as “mapping”), customizeconfigurations, and conduct testing.  Train—Familiarizeusers with new technology, tools, processes, and operating activities. Fulldeployment—Implement the full solution to the entire practice and network.  Figure 1 illustrates a sample implementation timeline for ahealthcare practice with up to 50 physicians.  Figure 1                       SUCCESS MEASUREMENTS The mostimportant benefit of a healthcare network solution is the ability to betterserve your patients. But network solutions for physician practices and clinicscan deliver other measurable benefits, including: Improvedpatient care through greater access to information Increasedflexibility as to where and how clinicians work Reduced errorsby eliminating paper-based systems Reduced coststhrough streamlining manual processes and eliminating paper files Faster claimsprocessing and higher reimbursement rates Ability to seemore patients with a smaller support staff Ability tolocate information and answer questions more quickly Reduced patientwait times Faster, easierpre-registration Compliance withprivacy regulations          SUMMARY With mountingpressure from insurers, government agencies, and patients, physician practicesneed to reexamine the ways they work and interact.

As physicians see morepatients and insurers demand more documentation, the manual healthcare systemsthat were adequate in the past will become less and less able to meet newdemands. This can help you build a network foundation that will optimize yourworkflow systems and grow with your practice—even if you don’t have a large ITstaff. These solutionsare not just for large organizations. It offers the widest range oftechnologies in the networking industry, and offers solutions forsingle-physician practices, large, multi-site clinics, and everything inbetween.

By working with these methods today, you can begin to implement thesolutions that will transform the way you operate your practice, and lay afoundation for new levels of quality, efficiency, and profitability.                      

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