“Our revenue is down.”

“The office feels chaotic.”

“Good employees are leaving the practice.”

“Patients are unhappy.”

“There is so much to do – we are spending every day just trying to keep up.”

“We want to grow, but the idea of more patients walking through the door seems overwhelming.”

Sound familiar? If so, it may be time to consider process re-engineering.

What Is Process Re-Engineering?

Process re-engineering means taking a hard look at all areas of your practice and:

  • Creating new plans to improve patient satisfaction
  • Determining how to cut operational costs
  • Figuring out how to stay ahead of the competition
  • Reviewing what doesn’t work
  • Reviewing what works
  • Strategizing how to work more efficiently

An efficient and effective workflow through a medical practice is dependent upon each process working well. With that said, process re-engineering will uncover multiple areas that need to be addressed in order to improve the overall function of the practice.

Who Needs It?

The only constant in healthcare is change. If you are not re-evaluating your practice and being actively critical of the day-to-day functions and infrastructure, you are setting yourself up for bigger issues down the road.

If you have expanded your practice, merged with another practice, noticed multiple problem areas or realized you have not re-evaluated your practice in the last 10 years, now may be the time.

Mergers and acquisitions have become more and more common in the healthcare industry. Often, what is thought of as just a larger practice should really be viewed as a brand new business. Old processes and systems may not work as well in the larger entity. Staff may have kept their jobs through the merger, but may not be a good fit with the combined practice. New processes to enhance workflow and ensure efficiencies may need to be created in order to satisfy an increase in providers or patients. Perhaps there are now multiple locations, all of which may have their own challenges with communications, marketing, staffing and oversight.

Finding multiple problem areas in the practice is a common issue because the processes of a medical practice are so intertwined. One breakdown can cause multiple system failures. Process re-engineering looks at each segment of the practice as it relates to the bigger picture and often identifies potential issues in the making.

Process re-engineering for those practices that have not completed a large-scale evaluation in 10+ years is important because of the continuous changes that have occurred in the healthcare industry, such as:

  • E-prescribing
  • HIPAA compliance
  • ICD-10
  • Meaningful use
  • PQRS

With each new compliance initiative, new systems and processes need to be created and they can be overwhelming to incorporate. While you may have checked all of the “compliance” boxes, chances are just adding new systems one after the other has taken a toll on the efficiencies of your practice. Healthcare is a complex industry and when change is implemented, it often creates a domino effect. In resolving one or two issues, there may have been many more created.

How Do I Do It?

The hardest part of the process is being willing to actually do it. Often, physicians can admit that things are not working properly and may even have an idea of where problems exist, but they are not willing to make the sweeping changes necessary to improve the process. Practice leaders must recognize the need for change and understand the necessity of process re-engineering.

The value in undertaking process re-engineering lies in your commitment to being open to the experience. It means not holding onto “how we’ve always done it” or allowing ego to stop progress. Process re-engineering is a commitment to changing practice systems, job responsibilities and culture. It is a complex undertaking involving multiple areas of the practice and requires support from physicians, managers and support staff.

Key team members from each area can provide valuable input on which systems work well, which ones should be maintained and which ones need further evaluation. In addressing the re-engineering as a team, the practice promotes both cooperation and acceptance of the newly developed systems.

Assessment and Planning

The initial steps begin with a high-level assessment of the mission, goals and patient needs:

  • Are your day-to-day operations meeting your mission and goals?
  • Who are your patients, what do they need from you and what are they getting?

Many times a practice may find it is operating on assumptions. Once there is an assessment of where you want to be versus where you actually are, the process can begin.

Create a Team

The process re-engineering team will need to handle the following:

  1. Conduct honest, unemotional reviews
  2. Make key decisions and recommendations
  3. Be communicators to the rest of the practice

Team players should include:

  • A physician
  • Billing
  • Clinical staff
  • Front desk
  • Senior management

The team should have a mix of depth and knowledge, constantly encouraged to verbalize ideas and concerns. They must understand the value of their input in creating new processes for the practice.

Business Needs Analysis

This step in the process helps the team prioritize and determine which improvements require the most effort. Start by forgetting everything the current process entails. Then, on paper create the perfect system for each area of the practice. Think in these terms: If you could start from scratch, what would you create?

Identify Needs

Compare your new perfect system to your current process and identify:

  1. Specific problem areas
  2. Solidifying goals
  3. Business objectives

Prioritize the areas for change based on highest impact and easiest implementation in order to start the process. Some changes may require rapid deployment as multiple departments will be affected by the change. Others may take place over a period of months due to planning needs.


Process re-engineering involves changing:

  • Practice culture
  • Processes
  • Staff behavior
  • Systems
  • Technology

Most projects underestimate the cultural impact of the changes. As a result, they do not achieve the full potential of their change effort. Many people fail to understand that change is not an event, but rather a management technique. Your staff may have been excited about the idea of change until it was actually bestowed upon them. An important step towards any successful re-engineering effort is to assure the staff understands the need for change. It’s also important to build excitement prior to change, and build support, education and encouragement parameters after change. Organizations do not change unless people change. The more change is managed, the less painful the transition will be.

If you need help re-engineering your practice, contact us today 973-998-8008.

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