Guest Spot: Doing More with Less
Seven things you can do with a small investment to save big

By: Margaret Mayer, Director, Boston Software Systems

Hospitals around the world are feeling the results of the economic downturn and the consequences are massive budget cuts and hiring freezes. Squeezed between tough economic times, a complex revenue cycle and demands for improved patient care, hospitals are under growing pressure to do more with less. With minimal time and money, you can start to relieve the pressure for your staff, systems and bottom line.

Like tossing your spare change into a piggy bank, the small things you do to reduce resources and time-to-revenue can add up to significant savings. We'll look at how using scripting technology to automate seven manual tasks plays a role in helping hospitals streamline processes and work smarter.

1. Report Generation

Daily, weekly, monthly, quarterly even annually – how many regular reports do the departments in your facility generate to manage business operations, patient census, or financial status? At South County Hospital in Rhode Island, CIO Gary Croteau has transferred the work of generating more than 50 daily reports, which are built via MEDITECH NPR and Microsoft Access, from the department managers by automating the process. Using scripting technology, all standard reports are automatically created and posted to an Intranet site as .pdfs. Now managers have access to the current and past reports at their convenience. No IT resource is required to run or manage daily report generation, allowing valuable staff to focus on areas of greater need.

2. Processing Purchase Orders

Ten hours each day. That’s how much time Computer Systems Specialist Michael Maggio at Woman’s Hospital in Baton Rouge, LA is saving by automating the purchase order process. The script searches MEDITECH once or twice a day for purchase orders that have been entered by various departments, and then checks inventories for items that have fallen below minimum reorder points. The script automatically creates a new PO or adds those items to an existing one. It then ensures that the PO meets minimum order and other requirements, and sends it to vendors electronically or via fax. Buyers receive email notification of any issues and can then add items to the order or hold it until that minimum is met. In addition to saving resources, Woman’s Hospital has eliminated unnecessary minimum order fees - penalties that had been costing more than $300 a month.

3. Cash Adjustment Posting

When Halifax Health Medical Center brought on the LSS Physician Billing & Receivables module, the goal was to bring the physician billing into its patient billing and financial services area and automate the cash posting adjustments for the physician billing. Transaction-based billing adds to the difficulty of cash posting in this environment, along with the possibility that contracts for hospitals and insurance companies may change every year. Correct patient co-pay on the account is critical to patient satisfaction when statements are distributed. On the management side, timely yet appropriate, adjustments are crucial to the facility in terms of revenue cycle management and A/R days.

If you had to allocate money to manually creating efficiencies, you probably wouldn't do it. It just takes too much time, too much money and too much manpower, to accomplish it. Fortunately, developing scripts doesn't take much time, and it creates operational efficiencies throughout the entire hospital. One significant benefit is a more productive and happy workforce, which translates to a higher quality of care in all facets of the organization.
- Bill Overbey, CIO/CFO at Hayes Medical Center

Halifax Health is running LSS with approximately 25 physician practices or departments. By automating the posting process, Halifax has saved the hospital approximately one eight-hour day per week from a posting representative. Without this automated process and the increased business, those hours could have risen significantly. The staff now has more time to post actual cash and analyze underpayments, which is more productive.

4. Employee Updates

One of the most common data entry tasks that occurs is updating employee files for annual raises. With anywhere from 1,000 to 5,000 employees in any one region, Christus Health, headquartered in Dallas, TX, needed four to five people, and more than a week of data entry, to accomplish this update. Using a script, the task is done accurately and in much less time. Often a single computer working 24 hours can automatically input the raises for an entire region’s employees (about 5,000 records), ensuring that they are rewarded in a timely manner. In addition, Christus automatically pulls personnel data from MEDITECH into the timekeeping application on a daily and weekly basis.

Other hospitals have used scripting to track and apply individual employee deductions. The script connects to a third-party Web site to transfer the file and then uploads it to MEDITECH for payroll – saving roughly eight hours per week.

5. Data Conversions and System Migrations

Greenwich Hospital in CT applied scripting technology to automatically convert registration information to centralized scheduling. More than 10,000 appointments already in MEDITECH needed to be converted into the proper time slots in a new scheduling module. The script automatically and accurately pulled appointments from a spreadsheet and uploaded them to the new scheduling application. This kind of conversion would normally take 700 man-hours or about $10,000. If it had been done on an overtime basis, it would cost the hospital $16,000. Greenwich developed the script in four hours and had it running by the end of the week.

6. Lab Registration

Robert Todd, Director of CareGroup IS at Mount Auburn Hospital and his staff realized that if they could pre-register specimen taken in the doctor’s office and headed to the hospital lab then the lab personnel could order the lab work needed without having to perform the registration based solely on the information delivered with the specimen. In addition, accurate pre-registration would save time and money by smoothing the billing process.

They developed a script which runs unattended and in real time to pre-register patients and/or specimen for lab work. The script automatically registers the patient into the hospital’s Meditech Magic system and produces an audit file detailing the number of records processed and any exceptions that were encountered. In addition, it formats and sorts an Excel™ spreadsheet that details all of the actual data sent from the physician’s office. Both files are produced daily, are date stamped, and the actual data is backed up.

"We've not only improved the quality of information that accompanies a patient or specimen to the hospital," commented Todd, "we have been able to realize faster turn-around in billing with fewer corrections and our lab personnel are ordering lab work instead of registering patients."

7. Streamline Billing

Wrong charges on the wrong accounts frustrate patients and slow revenue. Using scripting technology, Hayes Medical Center in Hayes, KS has eliminated the time-consuming task of reviewing each account, which may involve moving charges from one account to another when errors are found. In addition to saving staff time and improving accuracy, clinical staff doesn’t have to verify account numbers to accurately document services.

"Scripting has saved us time and money," said Bill Overbey, CIO/CFO at Hayes Medical Center. "If you had to allocate money to manually creating efficiencies, you probably wouldn't do it. It just takes too much time, too much money and too much manpower, to accomplish it. Fortunately, developing scripts doesn't take much time, and it creates operational efficiencies throughout the entire hospital. One significant benefit is a more productive and happy workforce, which translates to a higher quality of care in all facets of the organization."

The bottom line? Look around you. Anywhere you see someone typing data into an application there’s a potential for using scripting to automate that task. Automating these projects not only allows you to redirect staff to more productive work, it also ensures the accuracy of your data, which can save a bundle in billing.

Margaret Mayer has been focused on workflow automation and systems integration for the healthcare industry for more than 10 years. At Boston Software Systems, Margaret directs all marketing activities, including strategy and marketing communications. Prior to Boston Software Systems, she served as the VP of Corporate Marketing at New Era of Networks. Margaret earned a B.A. in English from San Diego State University, and post-graduate studies in advertising and marketing. She can be reached at margaret.mayer@bossoft.com . To learn more about Boston Software Systems, visit them online at www.bossoft.com.