Integrating Technologies Helps VAR Stomp Out Competition

Most business concepts evolve over time. In a few cases, however, business owners have a moment of clarity where the correct business path suddenly becomes clear. The principals at Uniserv, Inc. (Baton Rouge, LA) had one such moment.

Mike O'Neal and his son, Cavin, had just finished pitching a medical billing package, called Medical Manager, to a private healthcare provider. The president and vice president of the then six-person company talked about the meeting as they entered an elevator. The client expressed interest in the billing system. But, he was even more interested in a document and image management system which would also handle patient charts. The client wanted a solution that would allow multiple users to access imaged charts at the same time. Additionally, he wanted that solution to be integrated with the proposed billing system.

"We were in an elevator leaving the client's office and the idea just came to us," says Cavin O'Neal as he recalls the 1992 conversation. "We had a billing package, scanners, databases, and the ability to write front ends for databases. We could develop a document imaging package to store patient charts and integrate it with Medical Manager."

The O'Neals spent the next year developing their own document imaging package. However, support and marketing problems doomed the project. In 1994, Uniserv began selling Westbrook Technologies' document imaging software, File Magic. In the next year, however, prospective Uniserv customers said they wanted more than a "file and retrieve" system. They wanted a document imaging system that was integrated with their billing package. After two more years of development and "going hungry a lot of nights," the O'Neals had the answer.

Uniserv had successfully integrated Medical Manager with both of Westbrook Technologies' document imaging packages (the 16-bit File Magic and the 32-bit Fortis). The result was a customized document imaging system that required less than an afternoon's training for its users. Since releasing the solution to the healthcare industry in July of 1997, Uniserv sales have risen faster than a sick patient's temperature. In the past 15 months, the company has closed 10 deals ranging in price from $150,000 to $500,000 apiece. Uniserv now has 13 employees and would double that number if it could find enough qualified people. The company's gross sales for 1998 are projected at a conservative $2.5 million.

Keeping Track Of Patient Charts
Of course, Uniserv's system solves the problem the O'Neals talked about in the elevator: multiple users viewing a patient chart simultaneously at different locations. A visiting patient is almost always greeted by a physician holding that patient's file (containing charts). While patients take this for granted, getting a chart into a physician's hand does not always run like clockwork.

Cavin O'Neal recalls one incident where a patient stopped by a physician's office following a short stay in a hospital. The patient was escorted to an examination room where he waited while office staff searched frantically for his file. Eventually, the patient's file turned up - in the trunk of the doctor's car. "The doctor had visited the patient in the hospital and took the file with him," relays Cavin O'Neal. "He then played a round of golf and threw his clubs on top of the file."

While "under my golf clubs" may be a unique excuse, office staff commonly don't refile charts. The charts sit on a desk as a reminder to call an insurance company about a billing procedure or a lab about test results.

Radio Frequency: Connecting An Integrated Solution
By integrating Medical Manager with Westbrook Technologies' document imaging software, patient charts do not have to be manually indexed. As patients enter a physician's office, their demographic data (name, social security number, insurance carrier, etc.) is entered through Medical Manager's interface. "After that information is entered, all the nurse has to do is click the ‘create' button that we built into the existing interface," says Cavin O'Neal. "A chart is then created for the patient and indexed using the data entered in Medical Manager. Instead of carrying charts to an examination room, doctors tote lightweight pen pad computers." The computers are connected to the office database through a wireless RF (radio frequency) connection.

Once in the room with a patient, doctors access charts by using any of the indexing information. Charts appear on the pen pad computer's LCD. Existing charts have also been scanned and stored, so doctors can view an entire patient file from the small computer. "Doctors use a pen device instead of a mouse. This cuts down on the learning curve because all doctors are pen literate," comments Cavin O'Neal. "They can make notations, post notes, and highlight information by using the pen device."

Dealing With Existing Patient Files
After Uniserv installs its integrated billing and document imaging system, paper charts are eliminated on a day-forward basis. But, what about the thousands of patient charts that already exist? After doing some research, Uniserv felt it had solved that problem as well. "In most cases, physicians are legally required to keep patient charts for seven years from the last patient visit (this number can vary depending on medical specialty)," says Cavin O'Neal. "In reality, most doctors keep patient files indefinitely."

Instead of scanning all existing files, office staff scan patient files as they are needed. Two days before a patient is scheduled to see a doctor, the patient's entire file is scanned. As a result, a doctor is always looking at imaged charts. "After four to five months, we have found that 90% of the patient files have been scanned," says Cavin O'Neal. "After six months, almost every active file is in the new system."

Of course, this still leaves doctors' offices to store inactive paper files. But, these remaining files take up far less space. And, more importantly, the quantity of the paper files will only decrease over time. "Most doctors will store the inactive files in a warehouse or store room," says Cavin O'Neal. "The files no longer take up expensive office space."

The Healthcare Sales Pitch
Pitching an automated billing and document imaging system to doctors is not always a simple task. "The majority of doctors are great practitioners of medicine. But, they don't have the time to provide quality care and manage their practices," relates Cavin O'Neal. "The smart doctors realize this and usually hire an office manager to run their practices."

The typical Uniserv client has an average of nine physicians working within a medical specialty and an office manager. Because the doctors aren't usually involved with managing their offices, they're often surprised during a Uniserv sales call. "We tell the doctors that it takes an average of 8 to 10 minutes of labor to access a file and refile it," says Cavin O'Neal. "If a practice sees 50 patients per day, it could spend up to eight hours in labor per day handling patient charts. Doctors usually throw up their hands in disbelief, but office managers sit quietly nodding their heads."

Reduction in labor to handle patient files is the top justification Uniserv uses for ROI (return on investment) on its system. The company also includes remote access to files as part of its ROI. Following an installation, doctors can access files from their home computer by dialing into their network. Accessing files from remote locations is also important for doctors with offices in more than one location.

Keeping Up With Demand
While Uniserv is based in Baton Rouge, LA, word of its vertical solution has spread quickly. Recently, the company completed an installation in South Dakota.

"We expected this success, but we also expected to hire more qualified people to help us grow. Finding them has been harder than we thought," comments Cavin O'Neal. "We are not at the point where we are turning down jobs. But, we are scheduling them further out at a date where we can handle them."

The conversation that spurred Uniserv's business took place in an elevator that was heading down at the time. A simple irony for a company that is being propelled upward - quickly.