With so much discussion about healthcare in Washington, D.C., it has been difficult to avoid the topic. Generally, we hear the conversation center on the cost of care and insurance, particularly when we focus on the sound bites. But if we dive a deeper, we get more towards the heart of the matter: how do we better patient care, improve outcomes and lower cost?
Having spent a significant portion of my career in Healthcare Information Technology, I certainly could tell some cringe-worthy stories of the operational inefficiencies that I have witnessed! However, despite the tremendous challenges that existed (and still do), I found the work very fulfilling because there were great people willing to look at problems and implement process fixes that enabled technology to provide tremendous value.
I recently attended a healthcare conference where the speakers spent a fair amount of time discussing the political landscape, as well as the general state of the domain. A physician speaker lamented that a part of the issue is that healthcare processes are designed primarily around billing and coding, and not clinical workflows. As this comment indicates, it is tough for providers, from individuals to institutions, to balance the needs of the clinical and business sides of healthcare.
There is no doubt that a comprehensive solution to healthcare will involve all parties: patients, clinicians, institutions, insurance companies, employers, the government, etc. But each stakeholder must exert positive change in the areas which they control. Clinicians and providers must look to their own processes and workflows to maximize efficiencies, control costs, improve care, increase patient satisfaction, decrease employee unhappiness over poor process and decrease risk.
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Being in healthcare technology allowed me and my colleagues to be exposed to many different parts of the healthcare process and become experts. In some cases, we knew more about the end-to-end operation of a department better than those within the department. While they were only focused on a small part of the process in which they were expert, we needed a more holistic view to be successful. This position truly allowed us to work closely with departments to empower positive change.
One of my favorite departments to work with was Radiology. Perhaps because the specialty grew out of the invention of a technology (the X-ray) that was initially not embraced by the medical community, they are more open to looking a new ideas and technology to improve the state of care.
I have many examples of where we worked with Radiology to make processes more efficient, increase patient and clinician satisfaction and lower turnaround times. I offer one example to show how a relatively small investment in time and technology can have an outsized return.
Most modern Radiology departments operate with a “picture archiving and communication system” or a PACS. This replaces the old printed film and lightbox method (still often seen on TV). Despite this digital tool, there are often other physical artifacts associated with the exam. For example, outpatients are often given a paper requisition for imaging from a referring physician. This requisition includes key information, such as the patient history and the reason for exam, which Radiologists need to reference while reading the patient’s digital films in PACs.
Like most large healthcare providers, the organization I worked for has Radiologists in multiple locations. Further, to provide the best patient care, exams are often routed to a certain Radiologist based on their sub-specialty expertise. For example, a Radiologist could be particularly expert in Neuroradiology or Abdominal Imaging or Thoracic Imaging. However, the best person to read the exam images and report may be 60 miles away. As a result, the associated, non-digitized paper brought in by the patient needed to be faxed or brought by courier to another location. This process of sending and getting the paper in the hands of the right staff introduced considerable delays, lower efficiency, risk and potentially patient satisfaction issues. It was also extremely frustrating to clinicians who were waiting for a single piece of paper to complete their work and close the clinical loop.
After reviewing the process and business problem, we invested in relatively low-cost scanners and custom system integration that allowed paper to be scanned immediately on patient arrival and made available in the PACS, where it would appear on screen with images to be read by the Radiologist.
There was an immediate decrease in turnaround time in Radiology reporting. This led to increased efficiency, lower risk, better patient care and higher employee satisfaction throughout the workflow. What I particularly like about the solution is it meets the process stakeholders where they are and uses technology in a manner complementary to the workflow.
While any one change will not solve the all healthcare challenges we face, operational improvements like this compound and help to improve patient care, enhance outcomes and often lower cost. So regardless of the progression of the national debate, clinicians and providers should look to improve with the smaller wins.
This is also an important lesson in any business. Look at your processes and ask your employees for input: you will find ways to enhance revenue, lower cost, better customer service and mitigate risk. Remember, these don’t need to be huge initiatives with sweeping changes—small changes add up quickly and set you down the road of operational excellence.
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About the Author
As Trilix’s primary technical leader, Randy ensures all engagements and solutions are of the highest quality—working with clients from presales through execution to make certain they have business-outcome improvement based engagements.
He has more than 20 years of experience driving vision and intelligently leveraging solutions in technology, having previously worked as a Client Engagement Partner at Atrion, Director of Development at multiple healthcare software vendors, and IT Director at Lifespan, among other roles. He is a Certified Scrum Master and received his Master of Science, Information Technology, from Carnegie Mellon University (while working full-time and still finding time to spend with his wife and two kids!).
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