According to a Pricewaterhouse-Coopers study commissioned by the American Hospital Association (AHA), when a hospital's emergency room takes care of a patient for one hour, it spends another hour filling out forms. Paperwork also inundates home health care workers, who tackle a half hour of forms for every hour of patient care. The AHA cited the study in May when it lobbied the U.S. House of Representatives Committee on Small Business for a paperwork reduction act.
Clearly, health care providers are hurting for a remedy that distributors traditionally specialize in: forms management. Distributors, however, have learned that a solid forms management program doesn't guarantee safety in the medical market. They've tasted bitter medicine over the past five years as Premier Inc., Novation and other group purchasing organizations (GPOs) have locked up approximately two-thirds of the medical industry's documents business. (See "Competing with GPOs" on page 86.)
Distributors are reacting with strategies such as automating forms, targeting small practices that don't have GPO contracts and relying on time-tested relationship selling.
Spoonful of Software
Tom Dillon, Pat's brother and the president of BOSS, has watched his sales of traditional hospital forms decline by 50 percent over the past 15 years. "The printers were getting phased out, and we weren't able to get back in there on any new things," he says. Today, his health care clients include a medical university and a handful of hospitals that purchase items such as printing ribbons, paper and forms. "We've been able to keep them because of service and relationships with people in purchasing departments," Tom Dillon says.
In 1998, BOSS launched BCGIT, which provides forms management consulting and software. Headed by Pat Dillon, BCGIT's staff of seven Microsoft-certified systems engineers target hospitals and small health care practices. They bill by hourly rates or set dollar amounts, depending on the work involved. As of last month, BCGIT had 72 medical clients.
One client is a Washington, D.C., clinic with 11 therapists, four doctors and two receptionists. BCGIT spent one day observing the clinic's reception area for answers to several questions: What did patients do first when they entered the office? How did they usually pay? How did receptionists use computers, phones and writing utensils? What was the scheduling process? How were records visible and accessible to the rest of the office? Receptionists worked from 7 a.m. to 8 p.m., bogged down with scheduling difficulties.
BCGIT designed accounting software that automates insurance claims and stores patients' credit card information. It also created software that generates daily, weekly and monthly scheduling reports, individual patient schedules, information about cancellations, and more. To help clinic employees feel comfortable with the software and implement it quickly, BCGIT integrated it with Microsoft Outlook, which the client's staff already used. "They don't have to dig through files or pull out more paperwork and create more files," Pat Dillon says.
BCGIT recently created a software program that stores a hospital's patient records. From virtually anywhere, doctors can use Palm Pilots to check a patient's history, evaluate drug options and compare a patient's case with similar cases. Improvements in graphics have made handheld devices more user-friendly and popular, Pat Dillon says. "This year out of the 30 or so jobs we have bid on, more than two-thirds were for handheld devices," he says. He's undeterred by distributors who call for a return to more traditional products. "It's going to be their loss, not mine," he says. "I'm moving ahead."
"We can compete with contracts because we offer more service and we're flexible."
Jeffrey Brown
President
Print Pros Inc.
Columbus, Miss.
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While many distributorships aim to offer technology solutions to health care accounts, few provide medical software. One of BCGIT's counterparts is distributorship Advanced Business Fulfillment Inc. (ABF), St. Louis. Like BCGIT, ABF takes a consultative, problem-solving approach. But unlike BCGIT, ABF doesn't rely on homegrown software. It partners with 35 software companies, including Erisco, Amysis and Eldorado. ABF also specializes in using software to improve claims processing, helping clients comply with the Health Insurance Portability and Accountability Act of 1996. The act regulates patients' access to medical records and requires Secretary of Health and Human Services to set standards for electronic transactions among health care payers, plans and providers.
A Second Opinion
The Dillons emphasize technology as the route to riches in the medical market, but if you want other ideas, ask Kevin Kelley, president of Manassas, Va.-based distributorship Falcon Graphic Solutions Inc., or Jeffrey Brown, president of Columbus, Miss.-based distributorship Print Pros Inc. The 20-year industry veterans target
a growing segment of the medical market: small clinics, which typically don't sign group purchasing contracts. "In the private practices, you can become a sole-source supplier," Kelley says.
Kelley's products include stationery, letterhead, envelopes, appointment cards, and labels for mailing and test records. Integrated labels have replaced many multipart forms in the medical market, he says. Brown sells a variety of products to clinics, including continuous forms, internal forms, cafeteria menus, dietary programs, wearables, clipboards and drink holders.
Both distributors have enjoyed a rise in promotional product sales. And they're not alone: According to HealthCast 2010, the medical industry's promotional product purchases will grow over the next 10 years, as patients become more demanding and discerning.
Brown says customer service is the prescription for success in the medical market. "We can compete with contracts because we offer more service and we're flexible," he says. "It seems that in situations where a hospital has been told by corporate to start buying on national contract, [managers] tend to dictate to [hospitals] how they should buy, and they don't like that. They want someone who's going to respond to their needs." For example, one hospital purchases 90 percent of its printing from Print Pros because it prefers the distributorship's quick response time and personalized services, Brown says.
Print Pros' personable approach starts with a call to a prospective client. Brown visits prospects in person, introduces himself briefly, and leaves folders of shingle sheets featuring Print Pros' products and services. "They know we're going to come back and say, 'Did you read what I left you?'" he says. Brown also promotes his companies with fliers that list existing medical clients.
One of Print Pros' hallmark services is inventory tracking. A representative visits one client every two weeks to check inventory levels of 85 different forms. Print Pros does a more effective job checking inventory manually than by computer, Brown says. Combining face-to-face visits with inventory tracking encourages clients to rely on Print Pros and saves the distributorship time and money it would have spent asking purchasing agents about inventory levels.
Though health care providers are notoriously price-conscious, Brown says they eventually realize that service is a shot in the arm for their business. "They're more than willing to pay extra to get the service they need," he says.
The Pulse of the Medical Market
Aiming to reduce paperwork, doctors slowly are warming to new technologies. According to HealthCast 2010, a PricewaterhouseCoopers survey of 380 health care leaders worldwide, respondents predicted that more than 30 percent of physicians' time will be spent using web-based tools by 2010.
Dr. Pennie Bliss, a pediatrician at Smithfield Kids Care, a small practice in Smithfield, N.C., might be one of them. The practice, which buys materials from a medical supplies company and a local printer, recently bought Autocharts--portable, electronic medical charts--from software provider Medic Computer Systems. Autocharts enabled the health care firm to reduce staff costs, eliminate transcription fees, and access patient information easily and quickly. "I can work from home without dragging a bunch of printed charts that weigh a ton," Bliss says.
Bliss says if she can use Autocharts, she can use any new technology. She pays attention to technology reports from the American Academy of Pediatrics. Her practice is considering buying Palm Pilots so doctors can take electronic notes and download them into a record system rather than hand-writing notes and scanning them.
In the meantime, the government is simultaneously stacking additional paperwork in doctors' arms and looking for ways to reduce it. Last December, the U.S. Department of Health and Human Services published the Privacy Rule, a long-awaited part of the 1996 Health Insurance Portability and Accountability Act. Under the rule, health care providers must give patients greater access to and control over their own medical records. The rule covers health plans, health care clearinghouses and medical providers that conduct certain financial and administrative transactions electronically. Most organizations have two or three years to comply. On the other hand, lawmakers also are considering two paperwork reduction bills.
