Implementation Made Easy (From the Perspective of a CA)

For DCs and chiropractic assistants, implementing something new into practice is an exciting thing! Often a new protocol or device that the doctor has researched and/or learned about at a seminar or convention becomes next on our list to implement for patient care.

Already with patients who can be helped in mind and perhaps a new niche or market to explore, ideas of expansion and practice cash flow are among the expectations with this implementation. As a CA, we even share in the anticipation of these many possibilities. For those CAs who have perhaps ventured this path of implementation before, there may be a bit of apprehension tugging at their minds as well.

New implementations are often approached with the "plug-and-play" model, as opposed to a more organized and planned method. Although there are always exceptions to the rule, the result with this strategy often comes with some painstaking lessons and may even contribute to a lackluster effect in our highly anticipated successes.

Common Implementation Challenges

Regardless of what has been implemented, inefficient or missing action steps to get there create many common challenges that, unfortunately, can stifle what could otherwise achieve amazing potential.  We often learn the hard way that our well-placed motivation can quickly become unintended recklessness. Challenges you may relate to include:

• Scheduling uncertainties, causing the doctor to become delayed and resulting in longer patient wait times
• Coding unknowns, resulting in potential incorrect code use for data entry and patient or insurance billing
• Incorrect expectations that insurance coverage is available, only to potentially learn the hard way that the service has to be written off or may become patient responsibility
• Conflict with patient relationships due to unintended misinformation or miscommunication
• Fee schedule unknowns and concerns
• Inadequate staff training, resulting in uncertainty regarding how to communicate with patients and answer questions
• Lack of materials or resources available for patient education
• Doctor / CA frustration due to the obstacles at hand
• Ill-planned marketing, resulting in underwhelming growth
• Unknown risks and liabilities to state boards or other governing entities

If you find that you identify with one or more of these implementation obstacles, rest assured that we have all been there at least once and, for some of us, many times over. Oh, the many practices I have been in that have various devices, equipment or products sitting untouched on shelves or tucked away in a storage room!

Solutions: 4 Key Steps to Successful Implementation

Fortunately, be it the implementation of new treatment protocols, modalities or therapies, nutritional services or products, or a new provider type or specialty, the fundamental process is the same. The following steps for implementation may prove to be an immense help to your practices by effectively preventing derailment due to the obstacles listed above and giving you a more solid footing with your next implementation.

Step #1: Making the Decision and Setting a Goal Date

Implement only one new thing at a time! For larger implementations, you will likely find it beneficial to prepare a general business plan to help you strategize a bit more thoroughly. It is always helpful to establish an appropriate goal date for the official implementation. Make sure that when considering this goal date, you allow adequate time for important preparation-related tasks.

Step #2: Identify and Delegate Action Steps

If you have drafted a business plan for this new implementation, you will refer to that as you work to fill in the blanks and progress toward official implementation. There are some common action steps necessary for a well-planned practice implementation, regardless of what is being implemented. The following checklist details the most common ones:

• Evaluate the practice schedule for seeing patients to determine if changes are necessary
• Review applicable payer policies for coverage detail
• Prepare or acquire resources for patient education
• Confirm appropriate CPT / HCPCS code(s) for data entry and/or billing
• Verify state marketing guidelines for compliant printed and online marketing
• Establish appropriate fees
• Identify your approach for marketing and begin to execute
• Review, update or create consent, acknowledgment or related forms, if appropriate, for patient authorization

Step #3: Invest in Training

Schedule time for doctor and team training. Although first-hand experience is generally recommended, it may not be fitting or possible in some scenarios. Utilize other sources of training, such as videos / webinars and reading materials.

Training should always include some level of role-playing. Consider common questions that may be asked by patients and how those questions can be best answered. Discuss how your team will introduce and explain this new implementation to your patients.

Step #4: Launch

Once you have completed the necessary action steps and training, you are ready for the official launch of your new implementation. You will find that, by having covered your bases in advance, those common bumps and bruises that occur will be reduced to a minimum or averted completely.

Having assisted with numerous implementations over the years, I have found it to be extremely beneficial for the practice, patients, doctor and CAs to follow an organized path. As you embark on your next implementation, may you have smoother seas along the journey!