Helping a Hospital Regain Control

This not-for-profit healthcare system includes an acute care hospital, a rehabilitation hospital, an outpatient surgery center, several kidney dialysis centers, multiple Centers for Health and Cancer Support Homes, and a network of over 20 regional clinics. The hospital embraces the use of technology to improve operations, and previously implemented several solutions which focused on improving outcomes including electronic medical records (EMR), inventory and vendor management, revenue cycle management, and a denials tracker. But when it came to the supporting documentation, remittances notices, and vital records that underpin and coordinate between the various platforms, the paperless efforts abruptly ended.  Doctors and nurses used EMRs to log patient care and many critical documents (such as ERNs) were received electronically, but the hospital’s business office had no means to easily gather the disparate supporting records in a single place to submit for payment, appeal a denial, or work collections. Subsequently, they were forced to print EOBs, create paper files, and in many cases generate multiple convenience copies so each employee had access the required information.

In addition to the physical waste and negation of the original electronic documents, the business office was saddled by inefficient processes. There was no way to sort claims to be worked by strategic priority (e.g. procedure code, dollar amount, or looming deadline).  Instead, claims were simply divvied up by the patient’s last name.  Additionally, employees needed to hand deliver files or retrieve printed documents, which meant valuable time was spent “in transit” away from their desks.  Without detailed visibility into the process, managers lack an efficient method for confirming whether critical tasks were being completed, identifying potential bottlenecks, or maximizing productivity.

Beyond the Finance office, the Human Resources department was also feeling the strain of paper-intensive and manual processes. Since the hospital is required to maintain employee records for a minimum of 10 years after their departure, the Human Resources department was literally overflowing with physical files for both past and present employees. The documentation included paperwork associated with employee onboarding, tracking employee training and performance reviews, and so on.  Additionally, all hospital employees are required to complete an annual health evaluation which coincides with their hire date. These processes and the associated documentation required intensive manual handling and intervention. As a result, human error was common and managers lacked visibility into the current and upcoming workload.