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Handling I.T. Responsibilities


By Zack Martin, Managing Editor February 1, 2008

In 2002, Graybill Medical Group had a computer network that was “patched together,” says Leslie Chapman, director of finance at the 33-physician practice with five locations. Back then, the computer troubleshooting was split up among business center staffers, Chapman says. When the problems went beyond their capabilities, the husband of a human resources employee, who had some technical skills, came in to help out.

But the Escondido, Calif.-based practice’s technology woes eventually grew beyond easy-to-fix hardware and software problems, Chapman says. And its practice management system, which was deployed in 2000, was three upgrades behind. So the practice hired its first full-time I.T employee, Chapman says. Since then, Graybill has seen its I.T. staff grow to five full-time employees who help support an integrated practice management and electronic health records system from NextGen Healthcare Information Systems Inc., Horsham, Pa.

While hiring a full-time information technology specialist is becoming a necessity for a growing number of smaller group practices, many others continue to split up the tasks among existing employees, says Cynthia Dunn, R.N., senior consultant at the Medical Group Management Association’s Health Care Consulting Group, Englewood, Colo. For many practices, hiring a full-time I.T. technician is still considered a luxury because of tight budgets, she notes.

Many practices have in-house employees who take over some technology responsibilities, turning to outside support for the larger problems, Dunn says. But there was too much to be done at Graybill to handle in this way, Chapman says, because the practice was implementing a new version of its software and building a new fiber optic network at all its locations.

The practice’s first I.T. hire was a jack-of-all-trades, Chapman says. She dealt with server problems, networking issues and software challenges. Later, the practice hired more specialized staff to make sure the new networks would be properly configured to work with the NextGen software. Today, it has two I.T. staffers who handle software support and three to deal with all the other technical issues.

Three of the I.T. staffers are formally trained technicians, Chapman says. The other two, including a former medical assistant, were already working at Graybill in other capacities and received I.T. training to step into the new role. The medical assistant had in-depth training on NextGen software so he could help train the physicians and answers any clinical questions they may have.

To Hire, Or Not To Hire?

While Graybill has been able to justify its five-person team, some other practices—especially the smallest ones—have not. Cost is often the main obstacle for a full-time tech, MGMA’s Dunn says. Salaries and benefits can be as high as $75,000 a year.

“Most physicians can’t imagine paying someone that much to take care of their computer system,” she says.

As a result, most smaller practices end up dividing up tasks among existing staff, she says. “They look at their current team and assess the acumen there.”

The tipping point usually comes when a practice has more than one location or grows beyond 12 physicians, Dunn says. “Expectations are that your system will always be up, and when you have multiple systems at multiple sites, the odds of something going wrong increases,” she says.

Some practices, including Pediatric & Adolescent Associates, have concluded that their practice administrator can handle most I.T. duties. Craig Gillispie, administrator of the 11-physician practice based in Lexington, Ky., says he likes the technical support aspect of his job. “I enjoy the I.T. stuff and I’m reluctant to give it up,” he says. “It’s one of the more enjoyable aspects of my day.”

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