personal finance
Is Your Financial Plan Efficient? annual portal activity for 1,000 patients Appointment Reminders
5,000
Appointments scheduled online
75%
Average messages sent by patients
2,000
Average messages sent by staff/physician
5,000
Lab results published
1,600
Refill requests online
1,500
complete in the office. Staff then have to collect and enter the data. But what if patients could do this themselves? Most portals make this process easier by creating patient questionnaires that can be completed online by the patient prior to the visit. We use patient interview software called Instant Medical History (IMH), which can interface with numerous EHRs and portals and has been reviewed extensively in the medical literature.5 The software generates a questionnaire personalized for each patient and creates a history comparable in sophistication and accuracy to that produced by third-year medical students. In our practice, the software is embedded in the patient portal and loads the data into the EHR. Every patient with portal access is trained to use IMH, and we remind patients by e-mail 24 hours before their visit to complete the web interview. Those who do not are given the opportunity to complete the interview in the exam room before being seen. Approximately 70 percent of our patients complete the IMH interview before their appointments. IMH improves our office efficiency and patient engagement in several ways. First, it helps patients organize their thoughts and express their concerns prior to being seen. By the time I enter the room, patients are more focused on what they want to talk about. Second, it allows for a more enhanced morning staff meeting, as we can look over the IMH output for patients scheduled that day and provide individualized
care based on what they have told us. Third, documentation is made much easier because the patient’s IMH output populates the subjective elements of the progress note. More than two-thirds of the word count in a patient record is related to the patient history. Having this information already gathered means I do not have to interview the patient and type at the same time. Instead, I can maintain full eye contact with the patient as I review their information during the consultation, which increases patient satisfaction. After the visit, I have less documentation to complete. These features allow me to comfortably meet the needs of my patients with only one medical assistant and negate any need for a medical scribe or transcriptionist. In addition, any time saved is money saved. A word about electronic visits: I do offer online consults, usually for simple acute complaints that can be safely handled without a face-to-face visit, such as urinary tract infections, poison ivy, or colds. Only one insurance carrier in our market will pay for them, so we generally bill patients a $35 fee. We ask our patients to fill out a portal interview regarding their chief complaint, and I respond with my care recommendations within two business hours. Demand is not that high; I provide only one or two a month. Electronic visits may be more helpful in busy offices with access problems, but our patient-centric portal-based workflow increases availability significantly.
By Whit Newton, CFP ®, a Northwestern Mutual Financial Advisor based in Raleigh, NC
If you’re a medical professional in your late 30s, 40s or 50s, you’ve probably started dreaming about retirement and started doing some financial planning to get there. But the question I pose to experienced doctors is, “Are you saving efficiently so you can retire with confidence as soon as possible?” Most, though they don’t want to admit it, aren’t sure and that’s not surprising. It takes time to understand the small nuances of financial products. And if there’s one thing I know from growing up in a physician household, it’s that most physicians don’t have extra time. You’re working long hours saving lives, diagnosing patients, keeping board certifications up to date, and sharing experiences with loved ones. I recently helped a busy couple who are both physicians to build a full picture financial plan. They had saved well, but they had failed to consider risks like longevity, health care costs, long-term care and more. Perhaps the biggest item they hadn’t considered was the impact that taxes could have on retirement accounts. Together, we identified a smart balance of investments across pre-tax, taxable and tax-free investments to help keep them in a lower tax bracket in retirement. They were not alone in the sense that many individuals don’t realize that retirement income is just like earned income, it’s all about what you can keep after April 15th. This simple solution helped them to save more efficiently and effectively for retirement.
Article prepared by Whit Newton with the cooperation of Northwestern Mutual. Whit Newton is a Financial Advisor with Northwestern Mutual based in Raleigh, NC. Newton is a licensed insurance agent of NM. Northwestern Mutual is the marketing name for The Northwestern Mutual Life Insurance Company (NM), Milwaukee, WI, and its subsidiaries. Northwestern Mutual Investment Services, LLC (NMIS), (securities) subsidiary of NM, broker-dealer, registered investment adviser, member FINRA and SIPC. Certified Financial Planner Board of Standards Inc. owns the certification marks CFP®, CERTIFIED FINANCIAL PLANNERTM and CFP® (with flame design) in the U.S., which it awards to individuals who successfully complete CFP Board's initial and ongoing certification requirements. Please remember that all investments carry some level of risk including the potential loss of principal invested. They do not typically grow at an even rate of return and may experience negative growth. No investment strategy can guarantee a profit or protect against a loss. THE NORTH CAROLINA FAMILY PHYSICIAN • Summer 2016
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