Are Pathways the Answer?

Right now...yes they are.  If your physician organization hasn't approached your commercial payers to develop a quality initiative with pathways then it is vital you and your physician leaders insist on a program.  Why?  Because if you don't then an external disease management company will and you will have no leverage in treatment decisions or future negotiations.

Next week, I will be talking with CHOP members at the CHOP Business Summit in Denver about pathway programs and why they are necessary in payer negotiations. 

Clinical treatment pathways are designed to provide high quality patient care through clinically proven, evidence-based treatment protocols.

A Clinical Oncology Pathways Program is intended to help patients, physicians, and payers. Physicians who elect to participate will be rewarded for a "Pay-for-Quality Initiative" for delivering the right patient care at the right time while helping to manage drug costs associated with quality oncology care.

If followed, a physician-driven pathway program can provide cost-effective care and improve the quality of healthcare delivery without comprising integrity or delivery of treatment. Pay -for-Quality Pathway Programs claim to:

• Reduce variability of care

• Optimal outcomes

• Minimizing and better management of toxicities

• Reduce errors, misuse, hospitalizations

• Allowing for a greater predictability of treatment cost

• Improve outcomes and patient quality of life

• Demonstrate success through measurement and performance reporting

• Support alignment of appropriate incentives

• Maintain viability of community based oncology to serve the patients

• Utilize technology and informatics solutions

Patient Satisfaction

Patient satisfaction is as important to the medical practice as it is to any other business. Knowing what your patients want and expect from you and then making sure they get those things will help keep your doors open for a long time.

Here are some patient satisfaction basics that should help keep your patients happy and loyal:

·      Offer convenient scheduling. Try to offer some scheduling for patients that work during normal business hours. Whether it's opening up one evening a week or whether it's opening early a few days a week, patients will appreciate that kind of access.

·      Give patients access. If a patient calls in with a problem, let them speak with a nurse or a doctor. If the nurse or doctor isn't available, make sure you have a system in place to get the nurse or doctor to call the patient back within a reasonable amount of time.

·      Be convenient. Accept credit cards, debit cards or other forms of payments. It'll make your patients more likely to pay and they'll be grateful for the opportunity.

·      Do some leg-work for patients. Consider calling or faxing prescriptions into the patient's pharmacy if they wish. This will save the patient the 20 minutes they'd otherwise sit at the pharmacy waiting for the prescription to be filled.  Or if you have a relationship with a specialty pharmacy, fax or transmit the prescription and allow the pharmacy to assist the patient.

·      Ask how you're doing. Consider implementing patient surveys. Encourage patients to give honest opinions about everything from comfort of your office to wait time to interaction with nurses, physicians and staff.

OMB has a sample patient satisfaction survey available at: http://www.oncologymanagersbriefcase.com/forms_details.php?for_id=310

Oncology Managers Briefcase is a subscription based website. Members will be asked to login to access the link above.  The sample survey is located under Practice Management in the forms section.

Know Who You Are Hiring - Background Checks

Today's technology enables all sorts of collection of background data on just about anyone you want to hire. You need to understand, however, what is and what isn't involved in a background check.

A background check can consist of any number of reports about a person to be used for employment purposes. The legal term for this kind of report is a "consumer report" or an "investigative consumer report," depending on where you're located.

There are specific types of information you can learn from a background check. They include:

·      Employment history

·      Professional licensing

·      Educational history

·      Credit history

·      Criminal record

·      Driving record

·      Medical history

·      Workers' comp claims

Some practices prefer to conduct a background check on their own. Such checks can be time-consuming and expensive, and require a certain degree of expertise. Other practices prefer to hire out their background checks.

Regardless of whether they’re done in-house or outside, you’re required to notify the applicant and get permission if you’re going to be conducting a background check.

OMB has sample background check templates available at: http://www.oncologymanagersbriefcase.com/forms_details.php?for_id=385

Oncology Managers Briefcase is a subscription based website. Members will be asked to login to access the link above.  The background check templates are located under Operating Policies in the forms section.

The Nursing Shortage and the Oncology Practice

The current nursing shortage is hitting everyone hard. In some areas, it's next to impossible to find new, qualified staff to keep an oncology office running. Because the nursing needs of an oncology practice are more significant than many practices, we find ourselves in a unique situation.


One oncology practice can't, of course, fix the national problem. There need to be changes in education and in public policy to address the situation over the long term. Educators need to encourage nursing as a career choice, and general nursing education needs to include more oncology content. At the same time, loan repayment programs and scholarships need to be put into place to further spur interest in the field.


On a very micro level, though, there are some things you can do to deal with the nursing shortage. They focus on making your practice attractive to nurses, and they include strategies to recruit as well as retain.  Pay and benefits are, of course, at the top of the list. If you want to be sure and be staffed, pay well. If you can’t afford to pay competitive salaries, you’re going to have a hard time keeping the doors open.


Beyond that, there are secondary tactics you can consider. Offering nontraditional or flexible scheduling, for example, may bring in some nurses. Providing on-site child care or child care assistance can help. Even simple things like ergonomic workspace will aid your cause.


Ultimately, it’s up to you as to how satisfied your nurses are, and how attractive your practice is to new recruits.


Check out the OMB library, powered by Amazon for books on this topic, including: “Think Business! Medical Practice Quality, Efficiency, Profits”.  Authored by Owen Dahl; MBA; FACHE; CHBC