A 2006 REPORT that indicates there are more emergencies than necessary in the nation’s emergency departments has hospitals looking to automation to clean up the process – and the bottom line.
“The emergency department is not the (hospital’s) back door – it’s the front door, an entry point for 40 to 60 percent of a hospital’s patients,” says Todd Cozzens, CEO of Wakefield, Mass.-based Picis, which has been offering EDPulseCheck for approximately seven years. “It’s the most visible portal to the community.”
And that portal is only now being recognized for its value.
According to a 2006 Institute of Medicine report titled “Hospital-Based Emergency Care: At the Breaking Point,” the number of people visiting EDs rose by 23.6 million between 1993 to 2003, while the number of hospitals fell by 703 during that span (the number of emergency departments decreased by 425 and the number of hospital beds dropped by 198,000). This causes overcrowded emergency departments, overworked hospital staff, fragmented care and “an especially urgent need to apply information technology to the delivery of emergency care.”
According to Cozzens, roughly 30 percent of all North American emergency departments have some sort of technology, while less than 15 percent are outfitted to a point that they would be considered IT-dependent. But those figures, he says, are changing rapidly as hospitals move to automate their EDs.
Mount Sinai Medical Center in New York City deployed EDPulseCheck three years ago, and has seen a 50 percent decrease in the amount of time it takes to move a patient through the department. In addition, the hospital has seen an increase in revenues of some $7.5 million, as well as improved documentation and billing and a drastic decrease in lost or incorrect data.
“We didn’t just try to automate what we did,” says Dr. Kevin Baumlin, MD, director of Informatics and assistant professor at Mount Sinai’s Department of Emergency Medicine. “We tried to improve on what we did.”
Dallas-based MEDHOST, which has been offering its EDIS system since 1999, offers a program that captures charges at all points of the ED system and creates an audit-proof bill.
“For once, they’re actually documenting what’s actually being done,” says company CEO Craig Herrod. “We’re taking the guesswork out of” the billing process.
ED programs offered by MEDHOST and Picis, among others, track patient progress on a monitor, diagramming beds, patients and staff much like a restaurant charts tables, customers and waiters/waitresses. Touchscreens and hand-held devices allow doctors and nurses to call up critical information on patients and treatments, prescribe medicines and schedule surgical procedures. Automated systems move the patient through the ED to discharge or a hospital room, create a electronic health record and establish an audit-free billing record.
Quite a change from the ED of, say, just a few years ago.
“Automation was a novel idea back then,” says Patricia Daiker, a registered nurse and director of marketing for MEDHOST. “Nowadays, you have a more savvy healthcare market.”
While Cozzens points out that large hospitals can save anywhere from $2 million to $6 million a year with an automated ED, Mount Sinai’s Baumlin says hospitals need to see the ROI before committing money to an ED upgrade. Some might not have the funds to sink into a massive ED project, he says, while others might be hesitant to disrupt the system in place.
“It’s hard because hospital budgeting doesn’t happen like that,” he says. “You have to be able to budget continuously. It’s a 24-7 high-volume environment.”