Physician On-Call Scheduling and On-Call Management Blog
by Justin Wampach

How Much Does On-Call Cost your Hospital Today?

Posted by Justin Wampach on Wed, May 23, 2018 @ 10:54 AM

One of the most important steps in getting your new on-call management system project approved and budgeted by hospital administration is to be sure you have a credible cost-benefit analysis that you can use to show why the benefits of your project outweigh the costs and by how much. Without a strong analytical document, it is going to be difficult to convince anyone that you have done your homework.  

Current Costs & A Poor Experience 

How Much Does On-Call Cost your Hospital Today?

What most people tend to forget when creating cost/benefit documents is what it’s costing them today to achieve bad results. This may sound minor, but in fact, may be one of the most important sections of this document. Many hospitals and healthcare organizations do not fully recognize how much money they are currently spending to be unhappy.

This number is imperative so that you have something to compare your investment number to. For example, if on-call costs for your hospital $25,000 per year and you are getting bad results, then wouldn’t it be great if you could spend $15,000 annually and get better results that everyone is happy with? The answer is yes.

But imagine how it would look if you forgot to mention today's cost and instead you just asked to spend $15,000 to make the system better. People need to have something to compare numbers to. This isn't a new topic, I have written about cost justification in the past.

A Cost-Benefit Analysis Outline:

  • Executive Summary

    • One paragraph description of the overview of the project

    • Recommendation (based on the cost-benefit analysis presented below the following project is recommended)

    • Supporting reasons

    • Financial costs outweigh the returns

    • Tangible versus intangible benefits

  • General Information

  • Purpose  

The purpose of the cost benefit analysis is to determine whether implementing a new on-call management system is the best option for your organization to pursue at this time:

  • Overview: what problem is trying to be solved and by whom
  • Description of the problem
  • Overview of the challenges associated with the problem
  • What you are spending today
  • Total costs today to get results you are not happy with
  • Description of Alternatives Considered

  • Cost of a New On-Call Management System

    • Benefits: cost reductions, recurring benefit, hard and soft cost considerations
  • Summary

The outline above should give you a good start at making your case to management. Don’t get too worried if it takes a few attempts. Remember for every project they approve, there are probably five - 10 that are rejected. It’s all about priorities and need.

What You Will Learn From Preparing a Cost-Benefit Analysis:

  1. Clear understanding of the problem
  2. Picture of the market and how others have solved similar problems
  3. Research regarding what it currently costs today to get bad results
  4. Alternative ways to solve the problem
  5. How to build your case

Call Scheduler can be tailored to your needs, let us explain how! Request Consultation

 

Topics: call scheduling software, call scheduling

Is On-Call Information Restricted, Proprietary or Public Information?

Posted by Justin Wampach on Tue, Oct 07, 2014 @ 04:38 PM

ID-100282595Recently we were asked to complete a few “security” questioner forms from both current customers and potential new customers.  The second question on the form was “what type of data will be involved”?  The choices were restricted, proprietary and public.  Seems like an easy enough question, after all it was question number two of fifty.   I was wrong, after careful thought it is a much larger question that we have not given enough thought to before filling out these forms.  We have always taken the position that on-call information is most likely public information or at most proprietary because it’s only a doctor’s name and phone number, but here’s what we found upon further research.

Restricted information such as Personally Identifiable Information (PII) is information that can be used to identify, contact or locate a single person or to identify an individual in context.   PII can include first and last name, social security number, date and place of birth, mother’s maiden name, email address, NPI number, telephone number or information that is linkable to an individual such as medical, educational, financial and employment information.

Another type of restricted PII is a patients Protected Health Information (PHI).  This is individually identifiable health information that can include demographic data, that relates to: the individual’s past, present or future physical or mental health or condition, the provision of health care to the individual, or the past, present, or future payment for the provision of health care to the individual, and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.  Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number). 

Proprietary information is information that is not public knowledge and is viewed as the property of the holder.  This can include certain financial data, non-medical test results, trade secrets, inventions or data that is used to make a business more successful.

Public information is all information that is not considered confidential. 

So basically considering the on-line definitions above made our decision even harder to decide which check-box we should use on the form.  In the world of Call Scheduling software the data elements that we deal with are a providers first and last name, and a preferred method of contact such as office, cell home phone or pager number.  Although to create a call schedule we also collect information about their medical specialty (cardiology, radiology, or family practice), education level (MD, DO, PAC, NP) and any special skills that they may have (OB skill, Interventional skill).   Additionally we collect “day-off” information such as vacations, day’s off and CME.  According to the definitions above, all of this information goes far beyond public and proprietary information and into restricted category of personally identifiable information (PII).  Remember that other information in this “restricted” category is information like your medical record, your social security number and your credit card information.  So is this implying that the information contained on a call schedule or in on-call scheduling software should or needs to be guarded the same way as your medical record, social security number of credit card information?  Really?  Is this the same information that when I started in the industry several years ago was being faxed to a hospital or an answering services without much regard for privacy?  Is this the same information that today is sent via unsecured email, printed out via paper and put into a 3-ring binder and used daily by many hospital staffers to create a daily call roster?  Could this really be that same information?  

So how do we decide?  I think in the end this must come down to impact.  What happens if things go wrong and the information gets into the wrong persons hands?  In the case of a medical record or social security number or credit card information, the impact level is quiet high.  Worst case scenario on your medical record could be discrimination in some way.  The impact of your social security number and credit card information becoming compromised could be financial fraud and identity fraud, which are a very large issue.   All of these scenarios could potentially have a pretty substantial impact on your life both personally and financially.

If someone got a hold of a groups on-call schedule calendar for a particular month that information has a potential low impact because it has a very limited adverse effect on individuals.  At most, the impact could result in minor harm to the individual, the harm would be much more of an inconvenience such as changing a telephone number.  If in the end which category on-call information should go into does come down to impact, on-call information should not be in the “restricted” category.  The impact is not great enough.  But I think others may disagree. 

By the way when we completed the security forms, each of the requesting organizations had a different interpretation as to which category they said we should fall into.

Key Takeaway:  On-call information is important enough to at the very least be consider proprietary and by some organizations restricted information.  The more important something is the more valuable it is to safeguard.  The more valuable it is to safeguard, the more expensive it is.  I guess that’s not bad….for us as a company.

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

Topics: call scheduling software

How Much Customization Should Your On-Call Software Require?

Posted by Justin Wampach on Thu, Feb 06, 2014 @ 11:34 AM

describe the imageSoftware development is very expensive, time consuming and risky and should not be taken lightly.  Software companies spend years iterating the development to create systems that can be sold and generally accepted into the market.  I can’t imagine why any software business owner would develop something that does not meet the market’s general need.  If you are looking at on-call scheduling software that requires or even offers large or unlimited customization, you are looking at a vendor who did not develop their software for you, and are trying to squeeze a square peg into a round hole.

Our development philosophy at Adjuvant is to strive to have 80% of the features that our target market customer need to do their job out of the box, without any customization.  As healthcare changes, ambulatory practices and hospitals continue to have their needs change around on-call schedule creation and system wide data management.  This is a moving target that lends itself well to a web software model that is always developing or modifying to meet the industry needs.

The reason for this approach is that although we recognize that each organization is different, the similarities far outweigh the differences.  Many of the differences are people’s individual different styles of working and are not actually true differences.  For example, every physician practice that we work with wants tally reports so that they can prove that the schedule that they have created is fair.  The tally report is part of the 80% standard, what is different is how people want the information displayed.  The reason for this is that most users have spent so many years creating their own system to get their work done that if it doesn’t do it “their way” they don’t want to use it.

This is very similar in other industries as well.  For example when the first computerized accounting software was released in 1973, SAP’s software allowed companies to do their purchasing, invoice verification, and inventory management automatically.  Although this was revolutionary, most small companies had no desire to make the switch.  One of the main reasons for this was that they did not want to standardize their process.  Ironically also in 1973 the Financial Accounting Standards Board was created.   Chances are if your company went with SAP in the 70’s it was because you were a large company that demanded standardization.  You would not want each business unit creating their own process for accounting.  Low and behold in 2014 do you know any business that does not use standard accounting software? 

Similarly, Astrologers began recording detailed information about their patients’ medical conditions in 1596.  Over the next 350+ years physician offices began to create standards for recording patient health information.  Although each clinic was different in how it charted, much of the same information was contained in each patients chart.  Today when an organization purchases EMR software they are not customizing more than 20%.  The EMR Company has done its research and is “tuned in” to its market to know what the majority of their customers need.  The point I am trying to illustrate is that the similarities are much greater that the differences. 

When it comes to physician on-call scheduling software the situation is similar.  Most groups throughout the US, Canada and even places like Australia do things generally the same.  The differences come in peoples individual preferences. 

Don’t get me wrong, there are some very compelling reasons to make some customizations, such as;

  • You can modify any feature you wish
  • You can dictate special lay-outs, forms, color, and button placement
  • You can make things look and act like the “old way”

 There are also some major things to remember about customization, such as;

  • Customizing features for an admin-staff member who may leave or change positions down the road is risky and expensive
  • Custom development takes a considerable amount of time and money to scope and create requirements
  • Custom development takes time to develop
  • Custom development takes time to test
  • Custom programming is very expensive and often requires re-do’s
  • Custom programming typically requires custom support
  • User needs and preferences change over time making customization irreverent
  • The process you are customizing is unlikely able to be used by other departments
  • You lose the ability to cross train schedulers among multiple departments           
  • The ability of your vendor to say “that’s just what you asked for”

Take the time to find the similarities before you find reasons to customize.  Demand that your staff do things the way most others do it in your industry, even if that means change.  Standardized processes are developed for the good for the organization, nor the user doing the work.

Key Takeaway:  Choose an on-call software vendor that has created and followed the industry standard features.  There is no reason to reinvent the wheel and build your own software when general software is widely available.  Any more than 20% customization is too much in my opinion.

Topics: call scheduling software

Are you a victim of someone else's decision not to by oncall software?

Posted by Justin Wampach on Thu, May 24, 2012 @ 02:13 PM

dont be a victimIn many physician owned medical groups business decisions are made in a group setting.  Often times the group's administrator will collect items that require decisions and bring them to a bi-monthly meeting where the stakeholders can decide if and how they want to spend the groups money.

In a previous blog post "Call Scheduling: A Thankless Job" I talked about the history of why there is a doctor creating the schedule in the first place.  I also give some advice on what to do if your partners do not value the extra work that you do.

I speak with physicians all the time who are tasked with creating the call schedule, but when they ask their partners for some assistance in the form of software like Call Scheduler, they deny the request.  Why do they do this?  I think it is because creating the call schedule is not their problem, and they either don’t realize how difficult it is, or they don’t care.  If the shoe were on the other foot, their decision might be different.  The unfortunate thing about this scenario is that many times the physician scheduler does not want to push back or make waves and instead will just "do it" to keep the peace.  This causes dissatisfaction between the physician partners and it will manifest itself in some way at some point within the group.  It may not be identified or even discussed, but believe me; if you have been the victim of this behavior someday you will want to get the group back.

Just yesterday I received an email from a newly minted Chief Resident.  As you know, one of the glorious duties of the Chief is to create the call schedule for the troops.  Most cases the University department has a small budget to help the Chief out with expenses like call scheduling software.  This young doctor told me that he has to pay for it himself.  I was surprised that he was willing to do that.  What that says to me is that the work is so bad that a student would be willing to pay for a solution that ultimately benefits the University.

In situations other than the Chief Resident, a doctor that has been given a difficult task, such as physician call scheduling, without any tools to complete the job, should strongly consider giving the job back to his or her partners.  Why?  Because if it is important to your group that the right doctor show up in the right place at the right time (EMTALA law) to serve your and others patients, than it should be important enough to the group that the person doing the job has the proper tools to do the best job possible, especially if your time is as valuable as a physician.

I think the worst thing you could do is say, "ok" and go on about your duties.  If you can, demand that your group fix the problem.  You’re a Doctor; your time is very valuable and, should not be wasted.  If this is your scenario remember your time is being undervalued, you are being undervalued and being on-call is being undervalued.  Don't let that happen, in this case you have the ability to make it stop.

If you are the victim of someone else’s decision not to buy on-call software, hopefully this will be some good food for thought.

Topics: call scheduling software, oncall, on call, adopting on-call software, on call schedule

10 Mistakes Doctors Have Made Buying On-call Software (part 2)

Posted by Justin Wampach on Fri, May 11, 2012 @ 09:48 AM

describe the imageDoctors who wish to enhance their practice and provide better care and service to their patients and themselves by using physician scheduling software are on the right track. Unfortunately, they don’t always go about it the right way.

Last week we posted three of the top ten mistakes that doctors have made when purchasing call scheduling software.  Here is a recap of the top 3, along with number four through ten.

  1. Wanting too many bells and whistles. 

  2. Trying to save a penny. 

  3. Thinking someone else understand your business.

  4. Losing sight of the basics – KISS:  Your primary aim is to improve your productivity, and you should always keep this in mind! Anything else should come later. For example, we have clients who request payroll integration in their on-call software. But delaying an order or cancelling an order based on just this one feature is unjustified. Nice to have is not the same as “essential” – and adding too many features just results in “bloatware”. It is a mistake to want your software to do too many things right from the start. Get what is essential, and build from there.

  5. Waiting for something better:  Doctors often keep on waiting for something better to come along. Unless you don’t jump in the water, you aren’t going to learn how to swim. Some of the best run private hospitals have been early adopters of technology. Today they might still be using legacy systems, but they are much better run than non IT friendly setups. It’s true that software will evolve over time, but you cannot wait for perfection. Software is always a work in progress, which gets improved and polished incrementally.

  6. Thinking your staff shares your vision:  Many good doctors buy the perfect software and then find that it does not help them at all. Often they blame the software for being unfriendly or useless. Most doctors fail to understand that their staff is one of the key stake holders in this process. Unless the staff uses the software, it is bound to fail. The software may be the best in the world, but if it is not used properly, it isn’t living up to its potential. Doctors need to be firm and to share their vision for the software with their staff. It is a mistake to assume that software will be easily adopted by support staff, nurses and fellow doctors. Provide lots of training – and if some members refuse to use this, you need to take them to task.

  7. Not nurturing innovation:  The biggest stake holders in this industry are the doctors. It is important for them to nurture innovation. Sometimes it is valuable to take a risk or allow a software company to go that extra mile in providing a feature which will change the process flow of your clinic. Doctors who refuse to try out products which provide extra features or new age ideas because they do not understand its utility are closing the door on innovation. A doctor who asks me to block some modules to save money because he feels he will not use them is basically closing his own mind to the potential of using new processes to improve his practice. Do not buy the module in the beginning, but keep an open mind.

  8. Underestimating the complexity of your needs:  Running a clinic is running a small business. It’s a complex enterprise, and often doctors over-estimate their ability to do a good job. Ideally, you should be focused on taking care of your patients, so your staff can run the clinic. If you find you are spending time on routine administrative tasks, this means you are wasting your time and money. There are only 24 hours is your day – learn to use them sensibly. A good doctor scheduling software program will help you to improve your productivity and that of your staff, if you use it to its fullest extent.  Don’t get stuck buying a cheap program which was designed for a small shop – you will end up being unhappy and dissatisfied.

  9. Delaying a decisions:  The single biggest mistake a doctor makes in buying call scheduling software is when he delays his decisions – whether it is thinking about his needs; talking to the vendor; spelling out his requirement; installing the program ; or getting training for his staff. As a result, the vendor is frustrated; the doctor is confused; the staff is anxious. Start small – but start today!

  10. Not providing enough time for training.  While doctors understand that learning a new medical procedure can take time, unfortunately, they are not willing to invest the same time in training their staff – and themselves – in learning how to use the software properly.  This can cause a lot of frustration and when this happens, many doctors just give up on the idea of using any software at all, because they feel their staff is either too busy or not willing to learn something new.  Give your team the benefit of the doubt, also lead by example.  Show your team how important this change is by being a part of it.

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Topics: call scheduling software, physician software, physician scheduling, on call, on-call software, physician scheduling software, doctor scheduling software, on call schedule, call scheduling

6 Sure Signs You're Ready for a Call Scheduling Change

Posted by Justin Wampach on Fri, Apr 27, 2012 @ 10:56 AM

change ahead

When a medical organization gets ready to make a change to their physician call scheduling system there are several early indicators to success that you should be on the look-out for.

  1. You're willing to make modifications to your current process.  This is a "biggie".  It is imperative that you come to the table with an open mind.  Unless you are creating custom software specifically tailored to your groups needs, you will need to be somewhat flexible regarding the old way versus the new way.  Have a discussion with your providers to gain a good understanding of the things that your group will and will not modify.

  2. You're willing to make some changes to your current rules.  Similar to number 1, you need to have some bit of flexibility here unless you are prepared to have the software built for you.  Remember this is very expensive.  Most companies like ours work hard to deliver 80% of what most medical groups needs when it comes to creating, maintaining and publishing call scheduling software.  It is not cost effective to develop the other 20%.  Instead of looking at this as a limitation, look at it as an opportunity to standardize your practice with other practices.  Also be aware that if you need to accommodate every rule that every doctor comes up with, you will be doing a lot of manual scheduling (not that there is anything wrong with that).

  3. You're willing to make some changes to your schedule length.  There is a mathematical equation that helps us determine what the optimum length of a call schedule should be to get the best tallies.  That equation is based on the number of providers you are scheduling, the number of jobs you are scheduling and the amount of vacations/days off that you allow.  Be open to this.  Most software will not be a good fit if you are trying to make weekly schedules and need fair tallies.  Most of the scheduling limitations today stem from the schedulers available time or the large number of changes from the providers after the schedule is "final".

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  4. You have identified your group’s top 3 needs.  This is another "biggie".  Take time to meet with your providers and understand what are the top 3 "deal breakers" or according the Urban Dictionary "an element in the making of a deal, essential to one of the parties. Without it, that very party would never consent".  Clearly understand what the group cannot live without.  I would caution you to limit your list to a few.  When and if your top 3 needs have been meet, then go back and see what the next needs should be.  The purpose of this is to understand what is important and focus your efforts there.

  5. You have established a budget or have funds available.  Although most people I talk to say that they don't have a budget, they do have discretionary funds available to accomplish certain strategic initiatives.  If you do not have this available you are probably not too serious about solving your problem.  That's ok, let’s just be clear about where you are in the buying process so that you are not bombarded with "are you ready to buy yet" from your sales person.  I would also encourage you to develop a budget to accomplish things that are important to the group’s success.  This will allow the group to move forward quicker regarding decision making.

  6. You have time set aside to configure and learn a new program.  If you are "up to your eyeballs in alligators", now may not be a good time to take on an additional project.  This should be taken into consideration.  Not having time or not making time can derail a new software project faster than anything else I have seen.  If a real problem exists that needs to be solved, people will make time.  If your boss is not giving you time to learn and implement, I would ask if this is really a priority project.  Also keep in mind the type of time we are referring to is "uninterrupted time".

Key Takeaway:  If you are not ready to change, don't.  Take a careful look at the list above and be realistic about your answers.  Not ready now does not mean not ready ever.  Plan your change and your outcomes will be worth it.

Topics: call scheduling software, oncall, on call, call scheduling

Everyone's a winner in a paid trial of call scheduling software

Posted by Justin Wampach on Fri, Apr 20, 2012 @ 10:00 AM

winnerWould you purchase a car without test driving it? Would you buy a pair of pants without trying them on? We follow the rule of "try before you buy" every day without even thinking about it. Of course, we should follow that same sound principal when we're purchasing an important business tool such as physician scheduling software.

Try before you buy, that seems to be a common theme now days.  I hear it suggested in everything from living together before you are married to purchasing physician scheduling software.  Why, because most people learn some very valuable "stuff" when they try something.

Here are some valuable reasons to try before you buy:

  1. Get a real look under the engine.  You will probably learn something new when you get "full access" to software.  Most product demos hide some of the real gems until after you become a customer.  A trial is a good way to see what's under the hood.
  2. Test results versus your results.  It’s an old marketing trick to display some amazing results or claims on a website or during a demo.  Where the rubber meets the road is when you put your data into a system and see what the results are.  Now will it still meet your needs?
  3. Tests drive the training and service department.  Did you ever notice how nice everyone is when you are buying something?  You tend to see true colors shine through after some of the "newness" has worn off.  If the team is still nice and helpful after 90 days you have probably picked a winner.  Most people can't fake it that long.
  4. Find the hidden gems.  Many times after you use something new you will find a few hidden benefits that you never realized you needed.  These are really fun because they were unexpected.  Some software customers tell us that the gems can sometimes outweigh the original headline features, meaning that they find savings and benefits in different ways.
  5. Limit your risk.  No one wants to look foolish in front of their professional partners.  As I have learned (the hard way) it makes sense when trying something new to limit your risk.  Most of the time when purchasing something like call scheduling software the largest risk is the term: of the agreement.  With a trial you can be sure that everything is a good fit before you make a commitment.

Is a paid trial of call scheduling software ever a waste?  In my opinion, no.  Everyone’s a winner.  You will learn some very valuable lessons and in the end you should know more than when you began.  Sounds like a win to me.


 

 

Topics: call scheduling software, physician scheduling, on call, on-call software, physician scheduling software, call scheduling

3 Cost Effective Steps to a Modern On Call Schedule

Posted by Justin Wampach on Fri, Jan 20, 2012 @ 03:21 PM

old school new schoolHow much time do you currently spend creating, maintaining and publishing your physician oncall schedule?  What tools do you use to assist you?  If you are still creating the schedule by hand and then entering it into Excel or Outlook so that it is accessible to your Doctors online, you might be a good candidate to modernize your process.

The reasons for modernization are pretty simple to understand, the main features that most new users love are:

  1. The ability to program rules into the system
  2. A scheduling engine that will assist you in placing people in jobs
  3. Automatic tallies to prove fairness
  4. Easy way for providers to request and document time off 
  5. Simple way to view the on-call information online

If your ready to take the next step and look at the "new way" here are a few tips that will assist you so that you do not waste your time.

1.  Access your requirements.  What are the top 3-5 things that you expect the software to assist you with.  Put them into a priority list.  Remember that software will not solve world hunger or all of your scheduling needs, make sure you know what is most important for you to get the most value.

2.  Evaluate solutions.  Go to www.google.com and search for call scheduling software or physician scheduling software. Check out a few of the top search results companies and see what they have to offer.  Use the top 3-5 requirements that you discovered above and make sure the software has those features.  Check out a demo.  Look at the references page to see what their current customers think of the product.  The best piece of advice I can give you for this step is to make a decision.  Updating a software system in an office should be a fairly simple decision.  Just make sure that you have an out if it turns out not to be the right choice. 

3.  90-day-trial.  I am a big advocate of trying before buying.  Keep in mind that call scheduling software requires set-up and data entry to use the system, but it is worth the effort for a fair evaluation.  As long as you have a full feature trial I would also suggest finding a paid trial.  With a paid trial you will most likely have free training and support.  These are critical services as a software newbie.  I would pick a trial over a money back guarantee any day, why?  Because in a “money back guarantee” you’re not the one who decides if you get your money back, the person that has your money is.  Don't pay for services in advance and take that risk.  All SaaS call scheduling software providers offer monthly, pay-as-you-go options.

Modernizing your on-call scheduling process with software is an easy investment that will become more valuable each time you use it.

 


Topics: call scheduling software, oncall, physician scheduling, physician scheduling software, doctor scheduling software, adopting on-call software, on call schedule