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From the May 2002 Issue |
Best of the Best: HMT announces winners from its annual What Works competition and recognizes best healthcare technology solutions. By Robin Blair and Philip Lassalle
Without question, HMT’s What Works case histories represent a bird’s eye view of how you, healthcare IT professionals and users, employ technology in a daily quest to solve problems and improve healthcare delivery. What Works case histories emanate from you, the user and the reader, and describe in finite detail the problems, quandaries and situations that healthcare IT can ameliorate and resolve. Each year, the editors of HMT are proud to impanel respected judges from among the user, vendor and consultant communities of healthcare IT to read and evaluate What Works case histories from that year. These judges determine for us the top three winners and honorable mention awardees from among the year’s contenders—in effect, the best of the best of healthcare IT. We invite you to enjoy recaps of our top three What Works stories from 2001, updated to demonstrate continued and even expanded use of technology solutions, and to share with us recognition of our esteemed panel of judges. The top three winning healthcare (user) organizations will receive engraved plaques from HMT commending their achievement in information technology utilization. The suppliers associated with these winning case histories will receive tabletop plaques commending their work that they can display at trade shows and conventions. Judging Criteria Judges scored each case on the following five weighted criteria: Benefits to the user. Did the solution quantifiably help the organization solve its problem and achieve its goal? Were the results as expected or even greater? What were the unanticipated benefits? Was this the best solution for the particular situation? Applicability. How applicable was the solution to other healthcare organizations with similar objectives? Installation, implementation and ease of adoption. How easily installed and implemented was the solution? To what extent did the vendor support and train staff during the transition period? Scalability. Could the solution be expanded to include more transactions or users, or greater impact within the organization, but without significantly higher costs or infrastructure development? Creative challenge. How well did the technology address or work around technical or administrative challenges such as limited budgets, legacy systems, or a multitude of disparate IT programs? Submit Your Own What Works Submit your own story as a What Works. Contact the Health Management Technology editors and we will send you writing guidelines and will walk you through the process. Essentially, each What Works follows a formula:
All What Works articles published in 2002 are automatically entered in the 2002 competition. Your organization, and the way in which it utilized technology to improve the delivery or business of healthcare, could appear in these pages next year. 2001 What Works Affinity Health System, Oshkosh and Menasha, WI, for achieving noiseless communication with floor nurses via use of the DEFINITY® Wireless Business System from Avaya Communication, www.avaya.com. See “Calling All Caregivers,” HMT, January 2001. Presbyterian Healthcare Services, Albuquerque, NM, for achieving a 50 percent reduction in claims denials and A/R days with HealthQuest 2000 from McKesson, www.mckesson.com. See “One System Fits All,” HMT, December 2001. Bayshore Community For implementation of access management technology that allowed the hospital’s radiology department to increase the number of procedures performed monthly by 24 percent.
Up to 10 staff members answered phones to schedule appointments for ultrasound, C.T. scans, MRIs and nuclear medicine appointments, but with paper appointment books, still only one patient at a time could be scheduled. Staff scheduled every procedure for an hour’s duration, even though most took only 30 minutes, because in a manual environment, they were forced to accommodate pre-procedure and during-procedure wait times by scheduling additional time into each appointment period. Patients and referring physician offices were often kept waiting “on hold,” so referring physicians continued to send patients to the radiology department without appointments, expecting them to wait. Of course, patient satisfaction suffered. In 2000, as part of its e-business initiative, Bayshore Community Hospital began exploring ways to use the Internet more effectively in day-to-day operations and to optimize its radiology scheduling. About the same time, the hospital was approached by scheduling.com, offering access management technology on an application service provider (ASP) basis, and decided to implement it for C.T. scan, diagnostistic X-ray, MRI, nuclear medicine and ultrasound procedure scheduling. Achieving Results Implementation took four months. Patient registration sent registration transactions to scheduling.com. Interface traffic came through a Cloverleaf interface engine secure through a Netscreen VPN to scheduling.com’s Neon engine hosted at Quest. To prepare, the vendor trained Bayshore staff remotely, using WebEx, an Internet collaboration tool, to minimize travel and time expenses. By go-live, a total of three end-users were scheduling appointments using six electronic appointment books. Staff found the system extremely easy to use. One member of the management team was even able to logon and schedule a patient appointment during off-hours, never having used the system before. In the first four months of utilization, the radiology department increased the number of procedures performed per month by a total of 24 percent as follows: nuclear medicine, 8 percent; ultrasound, 60 percent; C.T. scan, 17 percent; MRI, 3 percent. The increased four-month volume produced an additional $36,000 in incremental revenue, and the hospital projected an additional $100,000 per year as a result of the increased efficiency. Also significant, the department reduced the wait time from the scheduling phone call to appointment day from an average of two or three weeks down to just two or three days, and sometimes less. Updated Results Linda Woods, vice president of information services for Bayshore Community Health Care, confirms that the results demonstrated during the technology’s first four months of operation sustained over the course of its first year and beyond. Increase in procedures per month? Accurate. Increase in incremental revenue to the hospital? Accurate. Continued staff satisfaction and decreased wait times for patients to be scheduled? Again, all accurate, she says. Perhaps one of the most telling aspects of IT success for a healthcare organization implementing new technology is when the organization predicts, in the beginning, that it will expand utilization of the technology in the future. Woods says that Bayshore appreciates an ASP platform because expansion is possible without the usual start-up fees and capital hardware investment. Bayshore recently added automated access management to the cardiology department through scheduling.com. SOURCE Linda Woods PRODUCT/COMPANY
Originally printed as “Picture Perfect Solution,” HMT, August 2001. Arizona Telemedicine Program Telemedicine program brings quality healthcare services to even the most remote sections of the state.
Solution That’s exactly what has happened since legislation was enacted five years ago appropriating funds to the University of Arizona’s Health Sciences Center’s operating budget, resulting in the formation of the Arizona Rural Telecommunications Network (ARTN) and based on the following goals:
The ARTN was created and implemented using a distributed backbone with switches at Northern Arizona University and at two University of Arizona sites. The remote sites link into the nearest backbone switch, creating a more competitive, cost-effective scenario since more service providers could potentially offer ARTN leased lines. The system was implemented using an asynchronous transfer mode infrastructure with ASX™-1000 switches from Marconi of Pittsburgh, PA at the backbone. Little training was required for the ARTN staff on the backbone equipment. A Marconi ASX-1000 switch was deployed at the Health Sciences Center in Tucson, and the first remote site, the Mexican-border town of Nogales about 90 miles south, was brought online as quickly as telecom service could be established. Results and Benefits Patient Visits. Ninety-six telephysicians representing 60 medical subspecialties have seen more than 11,000 patient cases. They also have used telemedicine to reduce risky travel for patients with unstable medical conditions. Cost Savings. The estimated cost for a rural patient’s “visit” to an urban health center has dropped from $520 to $105. One of the original goals of the program also was to counter the high costs incurred with transporting inmates from the Arizona Department of Corrections’ institutions to outside physician referrals. Using telemedicine, the department has reduced the average cost for an inmate’s healthcare visit from $415 to $140. Another healthcare user saved $182,000 over a 12-month period by averting air evacuations of 26 patients, at $7,000 per evacuation. Grand rounds. Healthcare workers at rural sites routinely participate in interactive videoconferencing originating from the Health Sciences Center in Tucson. These “grand rounds” in internal medicine, pediatrics, public health and psychiatry often take place at noon, so rural doctors can learn the latest medical practices over lunch. Program growth. With federal grants from the U.S. Departments of Agriculture, Commerce, and Health and Human Services, the original program has been expanded beyond the eight original sites to include seven multi-specialty sites, six Department of Corrections sites, and connections to the Flagstaff Medical Center and Northern Arizona Behavioral Health Authority with 12 behavioral health sites. Recent Updates Kevin M. McNeill, associate director of the network, confirms that the program continues to meet with success in serving the needs of Arizona citizens. He reports that the ARTN also has recently added 11 more sites in conjunction with the federally funded Indian Health Services for services to the Navajo community. Four new switching stations are included in this expansion, providing healthcare services to an additional 25,000 square miles of territory, extending beyond state lines into New Mexico. SOURCE Dr. Ronald S. Weinstein PRODUCT/COMPANY Marconi ASX™-1000 Originally printed as “Powering the Arizona Telemedicine Program,” HMT, June 2001. Mid Delta Health Systems For implementation of home health mobile computing in rural Mississippi.
Before mobile computing, MDHS nurses drove to a branch office to collect forms for each day’s work, completed all forms manually during the day’s patient visits, and returned the forms to the branch office at completion, sometimes making more than one trip per day. All patient data still was manually entered into the MDHS system. A few years ago, MIS Director Kevin Shirley worked with then Joey Technologies of St. Petersburg, FL, toward development of computerized forms that would accommodate home health computing and the uploading of data from handhelds to central office. (Editor’s note: Joey Technologies was acquired by JetForm Corporation in November 2000. JetForm subsequently launched a global rebranding effort under a new name, Accelio Corporation.) Going Mobile With robust computerized forms that looked, on screen, just like his paper forms and with Clio CE handheld devices, Shirley introduced an initial team of 20 nurses to mobile computing. Through multiple in-service sessions at home office, novice users were paired with power users to gain familiarity with specific forms, hands-on experience with computerized data input and comfort with the hardware. Training was completed in December 2000, and the units were deployed in January 2001. Nurses used an electronic mailbox to download forms for each day’s patient visits. Each nurse received only the forms she needed for that day including electronic versions of standard OASIS forms, patient assessment forms, discharge or transfer forms, plus an electronic timesheet form. When completed forms were validated and closed, the nurse electronically sent them to home office for distribution. With 20 nurses as initial users, mobile computing allowed MDHS to save a total of 500 nursing hours per month, which allowed the organization to increase the number of patients a nurse could visit per day from six to eight. It also helped reduce reimbursement turnaround time from three or four weeks to about 10 days. Updated Results Today Kevin Shirley says his whole team of nurses is up on the technology, and that Mid Delta plans for added software functionality—and provides enhanced technology training for the nurses. The Mid Delta software has evolved into a software product from DataEvolution Corporation called NurseSys™ with significantly expanded functionality including: a digital signature system so patients can “lock” completed forms they have signed; a GPS capability for map generation to patient locations; automatic PDF generation of completed forms; an encryption system for secure information transmission; single button synchronization; and automated downloading of newly changed forms. Shirley says MDHS has already added the automated PDF generation feature and plans to incrementally add the rest. “These are not just niceties. They are necessities. They will be a necessary part of our complete system so we can remain in compliance with federal law—and competitive in the marketplace.” (Editor’s note: In first quarter, Accelio Corporation President and Chief Executive Officer A. Kevin Francis announced that Accelio and Adobe Systems Incorporated reached agreement whereby Adobe would acquire all outstanding Accelio shares. At press time: Pending approval of the acquisition by Accelio shareholders, Accelio expected to be integrated into Adobe’s operations by mid-April 2002.) SOURCE Kevin Shirley PRODUCT/COMPANY
Originally printed as “Working Wonders,” HMT, June 2001. Panel of Judges Health Management Technology acknowledges the generous contributions of our esteemed panel of judges for the 2001 What Works Awards. These healthcare IT professionals have donated their time and expertise to the reading and evaluation of 20 competing stories and to determination of the winners. HMT sincerely appreciates their efforts and their contribution to judging excellence in healthcare IT.
Calling All Judges If you are a CIO, CFO, IT vice president, director of nursing informatics or other senior level executive in a healthcare delivery organization and are interested in serving as a What Works judge for the 2002 competition, Health Management Technology wants to hear from you. Judging takes place between mid-November 2002 and mid-January 2003. Please contact Editor Robin Blair at 941-966-9521, Ext. 112 or e-mail rblair@healthmgttech.com. © 2002 Nelson Publishing, Inc |
Readers of Health Management Technology—especially those who contribute editorially—know that our What Works case histories have identities and personalities all their own.
Bayshore Community Health Services is a network of specialized services that includes Bayshore Community Hospital, a 225-bed acute care hospital in Holmdel, NJ. Two years ago, the hospital felt its radiology department impressively represented the organization’s commitment to and investment in state-of-the-art equipment—yet it was impaired by a manual scheduling system.
For thousands of Arizona residents, leading edge healthcare exists 150 miles away or more. With a population spread over more than 113,000 square miles, a single academic medical center at the University of Arizona in Tucson, and academic specialty medical services available primarily in Tucson and Phoenix, Arizona was a state poised to profit from telemedicine.
In the late 1990s, Mid Delta Health Systems (MDHS) in Belzoni, MS, took the lead in adopting mobile computing for the home health sector. With a service reach that extends 120 miles north of home office and 40 miles to the south, MDHS has 11 branch offices serving 22 rural counties—and 100 nurses that travel.
Jeff Amrein is the founder and chief executive officer of Advanced Imaging Concepts Inc. in Louisville, KY. He is responsible for establishing the overall vision and mission including product research and development and investor relations for the company, a developer and provider of a computer-based patient record system utilizing high-speed document imaging technology specifically for hospitals and physician offices. Jeff is a graduate of Murray State University with a B.A. in computer science and has more than 13 years of computer networks and software development experience. He has been published in national medical industry publications and has spoken at TEPR and MGMA conferences.
Marilynn S. Black is the vice president of information systems at Norton Healthcare in Louisville, KY, where she is responsible for IT strategic planning and operational service support. This includes management of a multi-million dollar budget for telecommunications, network engineering, data management, systems integration, computer operations and end user computing for Norton, an integrated delivery system with more than 2,000 beds serving the Louisville population. She was formerly vice president of information systems at Presbyterian Healthcare Services in New Mexico, and IS director at Children’s Hospital of Orange County in California. Marilynn attended San Diego State University and has more than 30 years of healthcare management experience.
Jim Gabler is a research director in GartnerGroup’s Healthcare Industry Research and Advisory Services, where he provides healthcare research and counsel in areas of IT management, linking technology investments to business value, and communications with non-IT executives. He has more than 20 years of healthcare experience including positions with consulting and vendor organizations, and as the CIO for two large integrated delivery systems. Jim was one of the founders of the Health Level Seven (HL7) standards group, and is a nationally known author and speaker. With a B.S. in mathematics from Harding University and an M.S. in computer science from Texas A&M, he is on the HMT Editorial Advisory Board and is an HMT contributing author.
John D. Halamka, M.D., is the CIO of the CareGroup Health System in Boston, where he is responsible for all clinical, financial, administrative and academic information technology serving 3,000 physicians, 12,000 employees and 1 million patients. As associate dean for educational technology at Harvard Medical School, he oversees the application of information technology tools for knowledge management, faculty/student evaluation and courseware development. He is a practicing emergency physician in the Beth Israel Deaconess Emergency Department, and also serves as the CIO of the Harvard Clinical Research Institute. He is the author of three books on technology, and has served as a technology columnist on several publications.
Sachin Kheterpal, M.D., is general manager, strategic marketing, in clinical information systems at GE Medical Systems Information Technologies. Previously, he was principal and chief operating officer with SEC Inc., a healthcare IT consulting and software design firm purchased by GE in 2000. He has led the design, development and implementation of nationally recognized clinical information systems at major academic medical centers and community hospital networks. His research focus is the design and implementation of clinical practice guidelines and processes in the acute care setting. He was the 1999-2001 Fellow of the Center for Healthcare Economics at the University of Michigan Business School and completed his medical training at the University of Michigan Medical School.
Demi Rewick, R.N., is the director of clinical applications for the Healthcare Improvement Division of PeaceHealth, an integrated delivery network in the Pacific Northwest with six acute care hospitals in three states, 3,000 employees and 250 employed physicians. PeaceHealth was voted one of the “most wired” by Hospitals and Health Networks journal in 1999. Demi is a registered nurse and a graduate of UCLA. Her nursing background includes a range of staff nurse, nursing management and clinical quality improvement positions. She has directed the development and implementation of automated clinical information systems for PeaceHealth and serves as president for IDX’s national user group for its HIS product.
Sharon L. Stewart, the IS director of clinical systems and interfaces for Texas Health Resources (THR), returns for her second year as a What Works judge. Now in her 13th year at THR, Sharon and her IS team select, develop, implement and support clinical information systems applications for 13 acute care hospitals, an extended care facility, a psychiatric facility, two homecare agencies and several ambulatory facilities. With a degree in business administration-finance from the University of Texas at Arlington, she has held several positions at THR, as well as IT positions at two Texas hospitals and the Annuity Board of the Southern Baptist Convention in Dallas. Sharon is also an HMT contributing author.