Practice Management

What It Takes to Be an OD Who Doesn’t Have to Come Into the Office

By Justin Bazan, OD

Feb. 21, 2018

A productive day at the office, in which you see the maximum number of patients you can, offering solutions that enhance their lives, is wonderful. But so is not coming into the office, and being able to manage your practice without being there yourself. I’ve learned how to use technology to my benefit to make off-site management efficient and effective.

Be Productive While On the Road
The first technology that’s essential to work remotely is online access, but not just any online access–consistent service that doesn’t go down sporadically, or become so slow that you aren’t able to download, upload and save your work. Today, strong online access doesn’t require you being at home, or even in a coffee shop.You can often get just as much work done on the move as you can sitting on your couch at home.

Planes are better than buses, buses are better than trains. In fact, I’m writing this while on a bus from Virginia to New York City, where I live and practice. I’m also able to help my front desk staff not get overwhelmed by taking a look at the inbox and schedule. We didn’t have anyone work the weekend before Christmas, so as the owner, I wanted to help out by cleaning up the schedule and the inbox, so when we got back at 8 a.m. the day after Christmas, things would go smoother. We rely heavily on Gmail G Suite for our e-mail, Solutionreach Limelight for our online scheduler and RevolutionEHR. Once your systems are digital, you can become mobile. Aside from seeing patients (so far), I can take care of nearly all responsibilities that I have as an owner remotely.

What else was I able to accomplish on this road trip?

I was able to look at files that were e-faxed over to me. I was able to catch up on charting. And I’m talking about full access to all of the patients data including their special testing like OCT, visual fields, Optos, etc. I use Splashtop to remotely connect to an exam room computer that has access to the programs that allow me to view that data.

I was able to get accounting done because my bookkeeper gives me online reports to review. I was able to clean up my accounts receivable, and even handle my collections, as I use Transworld Systems, a collection agency that has an online portal.

While I’m away for extended periods of time, it’s important that I keep the pulse of the practice. I can watch and listen to what’s going on via our security cameras, which can be viewed via an app or web site. Customer service can be monitored by checking our reviews. E-mails also give me a great way to see how we are taking care of people and how issues are being handled. Although I haven’t done it in a while, I can even call a meeting via iPhone Facetime.

Maintain HIPAA Security in Communications
E-mail communication is not something I worry about. Consent between patients and doctors is enough for me. Click HERE to read more about securing e-mail communications.

Also, we don’t use regular Gmail. Instead, as noted, we use G Suite (including Gmail for our own domain), which we have set up to be HIPAA-compliant. Click HERE to learn about how to secure e-mail via G Suite.

I also don’t worry about transmitting charts via fax machine. Legally, the HIPAA burden is on the sender. Once it’s on our G Suite cloud, we are in HIPAA compliance.

To send charts we use Virtru with Gmail to send it securely and in HIPAA compliance.

Cost of Remote Productivity
Internet: can vary from free to $100, or more, per month.
G Suite Gmail: $5 per user per month
RevolutionEHR: $300 for the first doctor
Solutionreach with Limelight: About $450 a month
E-Fax: $10 per month
Splashtop: can vary from free to $60 per user per year
Transworld Systems: can vary from $12 per account to 50 percent of collections
Security cameras: $300

Technology Allows for Streamlined Staff & Space
I’ve worked in offices that use paper charts, and have zero newer technology, which see six patients an hour with one doctor. They are very efficient by some peoples’ definition. But I would never want to create an environment like that at our office. We have only one front desk, one optician, one tech and one vision therapist, yet two doctors are able to see up to four full comprehensive exams, four office visits an hour, not to mention a 45-minute vision therapy session. I also know our use of space is topnotch, as we do all that in 800 sq ft. Keeping thousands and thousands of paper charts would be impossible in our office space.

Identify What You Least Like to Do
A few months after I opened my practice I knew that I hated billing. By having an EHR and an online clearinghouse, I was able to hire an off-site billing specialist to handle our insurance claims and insurance accounts receivable.

While I’m in the office I see patients. While I’m away, my duties shift to overseeing and optimizing. I will spot-check work as a form of quality control. I enjoy marketing, so I will work on that, and a lot of that is online in the form of social media, which can be accessed anywhere, anytime. I like knowing where the money is coming from and where it’s going, so I also work on accounting.

Field Employee Questions in Real Time
For timely situations, employees will Google Hangout with me first, and if they get no response, they will text me. Most of the time they will e-mail me. Some of the time they will make a task in the EHR to get my attention. I don’t want to be the person they first turn to for help. Most of the programs we use have a help section, or a way to contact support. For other stuff Google is a great resource. The last thing they want is for me to just pull up Google and solve their issue.

Virtual Reality: The Next Frontier of Remote Management?
I’m intrigued by virtual reality. A VR front desk person might be years away, but I’m open to it. Telemedicine also may offer exciting possibilities. I’m not sure if it would make us more efficient, but telemedicine might make it more convenient for me to provide patient care from locations other than my office, which would be nice. I definitely envy my friends who globe-trot and work remotely while doing so–I strive to be more like them!


Justin Bazan, OD,  is the owner of Park Slope Eye in Brooklyn, N.Y. To contact him:

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