Health care IT decision-making

Between increasingly picky payers and voracious electronic health record demands, your practice’s information technology department is becoming the beating heart of your practice, with zero tolerance for downtime, delays or false starts.

However, unlike your clinic, optical or ASC, your IT department is a cost center, not a profit center. As a result, you may delay hardware and software updates as you prioritize the budget for new clinic equipment that generates revenue, or shift budget dollars to salary increases to retain and attract the best employees. This can be short-sighted.

We are in the process of saying goodbye to our IT manager of more than 10 years. He is helping us transition to an outside company for IT support. During his tenure, he “became one” with our 11 in-house servers and 125 desktop PCs. Mike knew how to keep them running far longer than recommended. He knew the work-arounds that saved money and seemed able to predict when it was time to bite the bullet and spend the dollars needed for replacement equipment or software. There was some staff frustration as we prioritized certain upgrades and not others, but choices had to be made to be fiscally responsible.

For any super-techies reading this, the policy of not adopting new software or hardware just as soon as it becomes available may be irritating or seem backward. It surely is ideal to stay up-to-the-minute current with all technology. But as we face reduced reimbursements and lower profit margins, it’s critical to tightly manage each integral piece of the practice. We’re learning that in the present environment, we can’t afford to stay “up-to-the-minute.” We often have to settle for “up-to-the-month,” and in the future, we may only be able to afford to stay “up-to-the-decade.”

Balance is the key. It’s crucial to not slip into a comfort zone that gets you too far behind the times — or too far out ahead of them. Resources need to be allocated among all practice segments in their due time. But excessive IT upgrade delays are a false economy, and an area where neglect can lead to abrupt interruption in functionality or cash flow.

In our case, we hadn’t realized that as Mike was working to meet his equipment budget, he was buying multiple brands of refurbished PC’s, five at a time. This was actually not a problem when he was available to service the units and software. But when we hired an outside IT company and they prepped to update PC software via a server and not go desktop to desktop like an in-house guy easily does, we realized that we had 37 different models of PC’s, making it challenging to upgrade centrally.

This provided us with a very clear picture of one of the many differences between having your own in-house IT staff and hiring a company to provide that service. Both approaches can work very well. But they function very differently.

The lesson is to not be lulled by what you have that is merely working in each department today. Keep current in all aspects of your practice and ask lots of questions about how a decision you are making today will impact the practice 5 years from now.

Corinne Z. Wohl, MHSA, COE, is the administrator at Delaware Ophthalmology Consultants and can be reached at czwohl@gmail.com or 609-410-2932.