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Reducing Bottlenecks with Health IT

March 27, 2013
by Gabriel Perna
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Bottleneck. It’s a word that is sure to give any hospital administrator, especially the ones who manage patient flow, a headache.

From hospitals to small medical practices, healthcare providers across the country are investing in systems designed to reduce bottlenecks at the point of check-in. In hospitals especially, these systems not only aim to get patients into a bed (or in front of a clinician) quicker, but they can improve quality of care measures such as readmission rates while reducing costs at the same time.

At Hugh Chatham Memorial Hospital, an 81-bed, acute facility in Elkin, N.C., 60 percent of the patients are admitted through the emergency department (ED). With this kind of volume, it’s easy to see why the hospital might suffer from long wait lines, dissatisfied patients, and a decrease in quality.  Thus, the hospital looked at the various components which cause long waits in the ED. It then decided to invest in enterprise-wide patient throughput software from MedHost, a Plano, Texas-based provider of process management software solutions.

The software gives administrators many views, including a virtual map of the various beds in the hospital. From a pure patient flow standpoint, Hugh Chatham CIO Lee Powe says the system can improve throughput significantly. It gives nursing managers three beds to choose from for the next patient.

“On the first day, we improved our [throughput] time by 25 minutes. That was the first day,” Powe says. In addition, he adds, the system can reveal real-time metrics on quality measures such as length-of-stay and 30-day readmission, information that can help hospital administrators determine what patients are costing them money. “You know what you’re getting paid. You know what it’s costing you. It’s right in your face.”

The information can be taken back to nurse managers that are dealing with the throughput. The transparency of the system has helped reduce length-of-stay and readmission rates, while raising the accountability of everyone within the hospital.

“For us and small hospitals we’re struggling financially, so we have to figure out ways to reduce our costs and maximize our reimbursement. With the knowledge this brings us, this is a huge help,” says Don Trippel, Hugh Chatham’s CFO.

Reducing Registration Headaches

For some providers, like Elaine Montano, CNP, founder, CEO, and one-half of the Santa Fe, N.M.-based primary care and diabetes management family practice Life Care Health Services, patient flow improvement didn’t come through a broad-based system. Instead, for her practice, it came through a mobile health (mHealth) application.

As Montano tells it, with a poorly educated and low-income patient population, the organization found that it was taking patients a long time to go through registration paperwork. This was the case even after the organization had switched to an electronic medical record (EMR).

Within the city confines of Santa Fe was a patient engagement vendor by the name of Seamless Medical Systems, which basically told Life Care that they in fact had an app for that. The app, called SNAP, puts registration paperwork onto an Apple iPad app, which Montano says, is easier to maneuver through since they’re often just simply clicking on information. The app thus far, she says, has shaved off 15-20 minutes of waiting time for her patients.

Furthermore, Montano notes, the app, which is touted as HIPAA-compliant, can integrate the data with other systems within her practice, such as her athenahealth patient portal and the practice’s EMR. She says this helps shave down the time she spends with new patients from an hour to about a half-hour.

Overall, the app is part of a wider trend that Montano sees is necessary for the industry to adopt. “I think, as time goes on, even other practitioners, other healthcare providers, other facilities are going to see what the rapid flow is for their patients and for themselves. We’ve got to go electronic. We have to go with what the future is bringing. It’s not going to get easier for us, as far as continuing to do paper,” she says.

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Great article Gabriel, it's good to see healthcare utilizing health IT tech to establish innovative ways to promote efficiency, reduce costs and streamline patient registration.

One question about the Life Health Care Services, it is mentioned that the patient demographic is low income and poorly educated, yet are taking advantage of an iPad app. Are these iPads being provided by the hospital to the patients for registration or do a majority of the patients actually have tablets?

Just curious to know since some hospitals are indeed providing smart devices for patients to register and also as a way to check their identities through a series of questions from a credit rating agency to ensure the accuracy of the information they provide and protect against healthcare fraud.


Software from a proven vendor, such as MedHost mentioned in this article is absolutely the way for Health Organizations to go. Trying to reinvent the wheel is not an effective use of a provider's scarce IT resources.

Companies such as these will already have a proven methodology to get providers up and running as quickly as possible and also provide software updates at a very low cost, since the cost is shared by many providers.

A word of warning in selecting a vendor. Look for reputable vendors such as MedHost or PointClickCare to name two, who will take care of your precious PHI and ensure that not only is it protected from hackers, but that it is secured and de-identified in their own testing and development environments.

Has your company experienced the same type of results when automating HIEs and ACOs?