Abstracts

During the Nurses[apos] Special Interest Group at the American Epilepsy Society 57th Annual Meeting, the complex problem of non-revenue generating activities was discussed. General consensus revealed a universal consternation and frustration with this issue. Optimal patient care requires conscientious allocation of time and effort that cannot be billed as separate items in a medical practice. Theoretically, these costs should be recouped as overhead expenses through office visit fees. Realistically, the costs to maintain a practice are increasing disproportionately to the amount of revenue coming in. Patient related phone calls, a major non-revenue generating activity, need to be defined and evaluated. The International Center for Epilepsy is a university-based, adult practice with three Epileptologists and three full-time Patient Coordinators. In order to identify non-revenue generating activities and substantiate a time commitment, our center decided to track phone calls for six weeks. A form was devised to capture the type and time elements of daily phone calls. Each coordinator was instructed to record aspects of phone calls to monitor subsequent investments of time and actions. Items tracked were calls from patients, to patients, calls requiring physician input, requests for prescriptions, letters or forms, faxing information, providing samples, calling other facilities or physicians. The number of calls was tabulated for six weeks. There were 843 contacts recorded. (The average call time was 10 to 30 minutes.) Patient initiated calls represented 35%. The coordinators[apos] time was 55% which included returned calls (17%); completion of form/letters (4%); prescriptions called and/or faxed (20%) and miscellaneous requests (14%). Ten percent of calls required physicians[apos] time. This six week effort of monitoring calls was under-recorded due to: (1) time required in keeping track; (2) developing new habit; (3) not tracking calls handled by the receptionist/office manager. Our need is to establish a record-keeping system and incorporate a practical methodology to clearly demonstrate patient care versus cost-effectiveness. We must improve documentation since non-revenue generating, patient care activities provided by the coordinators appear to reduce demands on the physicians[apos] time. Time is money.