Clear policies a must for Internet use

A column about keeping your practice in good health

By Mike Norbutcovered practice management issues during 2002-06. Posted Sept. 27, 2004.

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Ten minutes on the Anthem Web site, five minutes seeing what's on sale at Target. Twenty minutes to submit electronic claims, 15 minutes to check Orbitz airfares.

The Internet could be the greatest business tool ever invented or the greatest drain on office efficiency ever imagined. And it seems that many businesses have both opinions.

Some practices are beginning to learn this lesson, as offices link up with the great technological frontier. Practices are discovering the convenience and efficiency of being able to submit claims and check patient eligibility with insurers online, but there's always the fear that online access can add distractions to staff members who already are short on time.

The benefits of the Internet certainly outweigh the disadvantages, provided a practice can keep employees on task, health care consultants said.

"Practices aren't generally overstaffed, so there's usually more work in a day than can get done," said Rosemarie Nelson, a Syracuse, N.Y.-based consultant with the Medical Group Management Assn. "I encourage groups to ... manage by benchmarking to keep them motivated."

The duties of keeping track of employee productivity and making sure staff members don't abuse Internet privileges generally fall to the office manager, since doctors are busy tending to patients. The manager doesn't have to spend his or her day looking over shoulders, though.

There is software available that monitors Internet traffic, and some consulting firms will actually track office networks for a fee. Monthly server reports offer administrators a chance to quickly review Web sites to see if any employees spent an exorbitant amount of time surfing or stopped at some inappropriate sites.

Marie Costanzo, clinic administrator for Fayetteville Gastroenterology, a six-physician practice in Fayetteville, N.C., said the practice uses a business server to track employee Internet use, and it has strict policies on downloading and personal e-mails.

Every employee in the office has online access, however, because it is so vital to the practice's economic health. "I can't imagine the office working without it now," Costanzo said. "We have a detailed policy that outlines expectations. If it's personal use, we ask them to clock out and use it during breaks or lunch."

A practice that has recently established an Internet connection should update its policies and handbook to reflect the new opportunities and temptations. But the changes don't have to be dramatic, Nelson said. Personal e-mails could be covered under any policy that discusses personal telephone calls, just like any inappropriate use of the Internet could be included under sexual harassment rules.

It's better to be proactive with policies and safeguards than react later if a staff member sees something offensive on a co-worker's computer, they said.

Of course, policies have to be flexible and allow for accidental visits. Stephen Lennon, senior manager in the Knoxville, Tenn., office of consulting firm Pershing Yoakley & Associates, related an incident where an office employee visited a Web site with explicit material. The firm was monitoring Web use and alerted the doctors, but when they investigated, they realized it was an honest mistake.

"One of the doctors asked [the employee] to order football tickets," he said. "She's not a football fan. She didn't realize Ole Miss had a 'e.' "

Filters are helpful tools for keeping employees confined to work-related Web sites. Some filters, for example, will send an error message via a pop-up window to notify employees when they have strayed into inappropriate territory, Lennon said. Some medical sites, because of their content, could activate a filter to respond incorrectly, but that can be fixed by manually adding that site to an approved administrator list, he said.

"When you're monitoring, you're looking for the consistent, not the accidental," Lennon said. "Most policies are not set up to be that restrictive."

Mike Norbut covered practice management issues during 2002-06.

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