Especially in the Health and Human Services market, “productivity” can be a four-letter word. But this does not have to be the case with the right strategies and communication. All for-profit or not-for-profit organizations must cover costs and provide meaningful benefits to hire and retain staff.
Clinical productivity implies the number of monthly billable hours a therapist completes, which can impact the organization’s growth. Some providers may have trouble discussing and agreeing on clinical productivity, but it’s a crucial conversation. It takes a specific amount of dollars to run an organization, with many insurance approvals, documents, and state licensing requirements for staff members that must be completed before you can get paid.
When considering clinical productivity, many factors come into play. Clinical productivity may involve client wait times, the length of a visit, client satisfaction, and client retention. Other factors include staff turnover or absenteeism, which can indicate employee dissatisfaction and workplace inefficiencies. Every healthcare organization should set a goal for clinical productivity, determine success, and make effective changes that will help them reach that goal.
Organizations should also consider the client’s diagnosis and acuity and how those affect billable hours. For example, you may have a client with mild depression and a client with major depression. While both clients have similar diagnoses, they have different needs and levels of care. One will likely need less clinical (and billable) time than the other.
High expectations of billable hours may be difficult for clinicians and contribute to burnout. They can also create a vicious cycle of reduced productivity. Research shows that physicians spend around 35 percent of their time documenting patient data. Another study found that physicians spent an average of 16 minutes and 14 seconds of each patient encounter using EHRs, with documentation taking about a quarter of that time.
What is a realistic goal for clinical productivity? For behavioral health, experts recommend 65 percent of the time spent providing billable services. This may vary depending on your organization’s goals and needs. Online, we see rates of 50 percent to 70 percent.
Unfortunately, many organizations need more clinical productivity, often due to inefficiencies in the documentation process. Streamlining your processes to become more efficient, and reducing the amount of time spent on non-billable services, can help improve the rate of billable hours.
Since the passing of the HITECH Act of 2009, nearly all provider systems from large to small are using some sort of electronic health record. Here are a variety of ways you can cut out some of the “fat” from your workflow and reduce the friction you may experience with your technology and documentation processes:
- Offer flexible scheduling and walk-in times for high-acuity patients.
- Offer digital payment options through a patient portal or phone apps such as Venmo.
- Implement a “real-time” admissions and intake process that immediately sends client intake forms and other documentation.
- Push documents and “buy-in” to the patient as much as possible by sending paperwork and questionnaires to a patient portal or text-messaged forms.
- Use automated credentialing interfaces for staff members’ state licensing and insurance verification.
- Use real-time, automated insurance eligibility checking.
- Adopt nationally recognized standardized assessments.
- Adopt nationally recognized progress note templates.
- Send alerts to clients, reminding them about appointment times.
- Send educational material to patients and others regarding diagnosis and care plan.
- Use wearables that connect with documentation or the EHR to track clients’ important health indicators such as temperature, heart rate, physical activity, and EKG readings.
- Incorporate individual and group telehealth services for increased connection and easier client correspondence and monitoring.
- Use secure, HIPAA-compliant service recording, transcription, and analysis applications.
- Implement across-the-team analytics and visit summaries that need to be reviewed and signed off on.
- All EHRs, if separate from the core system, need to integrate third-party tools such as natural language processing to expedite and educate clinical team members and patients.
In addition, regular connections with clinical team members to discuss client access, progress, and a continued focus on best practices are critical. I use the term connection rather than meeting since these set informal 10 – 15 minute check-ins are very valuable.
Clinical productivity and documentation are challenging topics to discuss within organizations. It can be difficult to start a conversation about them and even more challenging to make significant changes. There will always be outliers that keep you on your toes. At the same time, you should ensure your organization always keeps quality of care and client satisfaction as your crucial focus.
For many of these changes, you simply need the right tools to help make it happen. If you’re unsure what those tools are, I’d be happy to help you consider which applications would be best for your clinical practice. Please reach out if you’d like to start that conversation.