Spine Centers of Excellence: Space Development and Communication Issues
Once the business model has been developed, the next critical phase focuses on physical space, staffing, equipment, computer network and communication structure requirements. Issues to be addressed during this phase include support staff organization, clinical and administrative data flow, management and operations of the Spine Center. The creation of a seamless stream of data between physician offices and the Spine Center is particularly appealing to patients as their medical history, chief complaints and prior treatments become part of one centralized record that is shared by the team. Thus, instead of having to fill out forms for each individual doctor’s office, patients supply this data once and it is made available to each provider. The integration of data and communication among the providers on the team eliminates the perception of “fragmented” care and promotes improved overall medical management. Based on patient reports, this feature alone is a key draw for the Spine Center; it conveys a strong sense of comprehensive, coordinated “patient-focused” care. Thus, considerable attention must be devoted to the communication structure and the flow of information amongst all parties involved on the team.
Step 1: Space Development
In order to address the clinical as well as business operations of the Spine Center, the following should be created during this phase:
- Layout floor plan of the Spine Center - depending on the space requirements and availability, it may be necessary to retain a space planner for functionality
- List of equipment requirements (with pricing) for outpatient clinical as well as administrative functions
- Computer network and communication network layout with list of hardware requirements (including pricing)
- Staffing requirements list, including job descriptions and minimum experience requirements for each position
- Organizational Chart for the Center
- Management control policies for all departments within the Center (i.e. front, back office, billing/collections, etc.)
Step 2: Select and Implement IT
As mentioned above, the communication infrastructure is paramount to the long-term success of the Spine Center and is a key marketing feature relative to patient satisfaction. It is important to identify and price the ideal operating software for the Center, including point-of-care data collection, operations, billing, collections, scheduling and clinical outcomes capabilities. Particular attention should be given to interfacing with all participating physicians’ private practices, including porting and converting of databases to and from the practice to facilitate coordination of care as well as communication among those involved in the treatment plan. Patients particularly appreciate the reduction in paperwork and repetition of their medical histories. In order to provide some measure of accountability to third party payers and referral sources, outcomes data collection should be addressed early on as a necessary component of measuring the efficacy of the center and its team of providers.
In order to distinguish the Spine Center as a true center of excellence, nationally established criteria for outcomes measurement can be established as benchmarks. When possible, independent collection of outcomes by a third party is preferred to preserve the integrity and credibility of the data. Quarterly distribution of this information should be made available to key employers, insurance carriers, medical groups and referrals sources. Written proposals from identified vendors for the appropriate software package, including installation, training and support should be secured. Thereafter, presentations and demonstrations of system should be set up with the key vendors and clinical providers of the Spine Center.