While larger addiction treatment organizations certainly face their share of challenges in implementing technology to improve practice and administration, individual or small-group providers arguably deal with even steeper odds in upgrading technology. A wealth of products tailored to the individual or small-agency provider exists in today's market, but professionals have to do careful research and then take the time to learn new systems after procurement, say technology experts who work with the behavioral health field.
Charles Klein, PhD, vice president of clinical services and e-prescribing options at Netsmart Technologies, says smaller agencies need especially to understand staff capabilities and make the necessary adjustments. “Most places at least have technology for billing. But if you don't use technology much, jumping right into an electronic record could be challenging,” Klein says.
On the back end, a program's staff will have to be allowed to take hours away from billable time to learn what new technology for practice management can do for them, insists Klein, who works out of Netsmart's San Diego office. “You've got to give yourself time to learn it,” he says. “The more you want the new application to do, the more time it will take for you to learn how to use it.”
Klein says he sees several areas in which smaller clients run the risk of missteps in their effort to introduce technological solutions. He finds that when some potential clients are looking into an electronic medical record (EMR), they immediately assume they want to have a system with every possible feature imaginable.
“It may be better to start with something that is basic and easy to use but that contains what you need,” Klein says. “That will keep costs down as well.”
Clients often want their EMR to interface with other applications in their office operation, but that process can be extremely costly and isn't always necessary for sound practice, Klein says. It might still be worth it to engage in double data entry for certain functions. For example, to this point an interface with lab results is not a standard feature of EMR systems, Klein says, although eventually it will be.
Klein also believes that addiction professionals should not start calling vendors to see specific products until they have researched what products and applications their colleagues are using. “A lot of EMRs are designed specifically for specific practitioners,” he says. At Netsmart alone, various products are tailored to the therapist, large agency, outpatient opiate and public health markets.
Professionals' trade associations can serve as a fruitful resource for learning about various applications and what current users like about them, Klein says.
In what might be the most surprising mistake some professionals will make, Klein says there actually are instances where a professional or a group practice will purchase a technology solution without ever having witnessed in advance how it works. “I don't think anyone should buy without seeing a demo,” he says flatly.
Potential buyers should directly ask how a vendor would perform specifically cited functions using the technology, and should have the vendor walk through each process. If an office manager is coordinating the purchase for a small agency, it would be wise after receiving the first demo to arrange another one for clinical staff before an acquisition, Klein believes.
“I don't know of any companies that charge for demos,” Klein says. “Customers should ask for more than one.”
Process of change
To the founder of the practice management solution TheraQuick, getting small providers to embrace technology does not differ greatly from clinicians' own efforts to facilitate their clients' embrace of change.
TheraQuick's Dale Stuart, PhD, says asking a potential customer about current use of technology can resemble some of the questions a clinician might ask of a patient: What part of what you're doing right now don't you like? How does what you're doing now not meet your needs?
“We have to determine, ‘Where's the pain? Where are the shortcomings?’” Stuart says. “Is it in time? Errors? Searchability? The ability to issue reports?”
She says it remains challenging to work with potential customers who aren't familiar with the way software works beyond the most basic functions. “Some will say, ‘I know one way how to do this, and that's good enough,” she says.
Netsmart's Klein adds that office managers need to distinguish in their operations between sincere uneasiness in working with new technology (that can be addressed) and stubborn resistance that simply mirrors a negative reaction to any change (that cannot be allowed to derail progress).
Stuart's practice management product grew out of her own examination of the options that were available five years ago and her conclusions about how they could be improved upon. In a sense, customers can conduct a similar analysis in their attempt to find the product best suited to their practice.
“If I can imagine in my mind that something can be done, then probably there is already a solution that at least approaches part of that problem,” Stuart says.
Much as she finds variation in the degree to which treatment providers will do front-end research (“some people will call five to 10 times before they buy the product,” she says), she sees much variability in their post-purchase behavior as well. “About half will call in and ask questions, and about half will never call again after purchasing,” Stuart says.
Addiction Professional 2010 March-April;8(2):26-27