Tracking solutions improve patient care and bottom line
The future looks bright for for-profit hospitals, which are likely to see a 2.5 percent to 3 percent growth rate in 2018.1 But for not-for-profit and public healthcare facilities, the horizon looks a little dimmer as they continue to grapple with the same fiscal challenges as last year.2 Despite good inpatient volume, for these facilities, revenue growth is likely to plummet in the months ahead as spending continues to climb. This is according to a 2018 outlook report by Moody’s Investor Service which says low government reimbursement rates — which accounted for 61 percent of gross patient revenue in 2016 — clinical staff shortages, labor costs, bad debt, escalating insurance deductibles and co-pays, and increased spending on essential technology all play a role. However, it’s essential technology that could also play a role in leading healthcare providers closer to the light.
Big data is the big focus
Hospitals that provide quality care, greater efficiency and patient safety are likely to be using data analytics and other information gathering technologies to achieve their goals. Omnipresent connectivity — interoperability — is the target most facilities are aiming for. Compliance deadlines for GS1 standards are also approaching and while nearly all non-federal acute care hospitals have an electronic health record (EHR) system in place,3 not everyone see it as the seamless, communication dynamo it was meant to be — not without the right technology in place.
Capturing data at the point-of-care is one way that healthcare facilities are tying all of their once disparate data systems together in real-time — a practice that is likely to be as common as it is for clinicians to don personal protective equipment before starting a surgical procedure.
“We wanted to change the need for each system to utilize its own numbering and nomenclature methodologies, which force the providers to expend significant time trying to manually manipulate and maintain data that really isn’t ours,” explained Mosser. “We needed total system-to-system interoperability.”Franciscan Missionaries of Our Lady Health System (FMOLHS) is an admirable example of how perceptive planning and smart product selection can lead to success. The organization recognized a need to synthesize the varying content they generated and stored in multiple data systems. The goal, said William Mosser, Vice President, Materials Management, FMOLHS and LogisticsOne, was to connect the Supply Chain, Clinical and Financial departments so that they could immediately share and access each other’s information in a joint effort to improve care, eliminate waste, and cut unnecessary spending.
Implementing a system that would allow clinicians to scan medical supplies at the point of use was part of the build. “Since we are very active in promoting and using GS1 Data Standards, we saw the opportunity to utilize manufacturers’ data, based on our contracts, to directly feed our Clinical Information System (EPIC) automatically,” explained Mosser. “The data required by EPIC (item number, description, UNSPSC Codes, HCPCS codes, dimensions, price and so one) are all known and driven by the manufacturer of the products we use. For us to take that data and translate it into other system-driven naming conventions simply makes no sense. The GS1 data standards that the manufacturers feed into the required data pools meet all of our expectations. The challenge was to find someone who would be willing to work with us to connect the dots … and make this all interoperable.”
FMOLHS was satisfied with the various supply chain management technologies they were already using from GHX so they decided to enlist another application from the vendor to help make their vision a reality. “They are a trusted partner and one who already had the wherewithal to understand the need and help drive the change,” Mosser said. They adopted GHX’s ClinicalConnexion solution and point-of-care barcode scanning which increased OR efficiency significantly since clinicians no longer had to manually key in surgical supplies to patient EHRs. Charge capture also increased dramatically from 40 percent to 95 percent, along with other benefits that prompted the organization to implement EPIC and ClinicalConnexion across FMOLHS’s entire healthcare system.
“Our clinical teams simply capture what is used via EPIC tools and bar coding and the ClinicalConnexion feeds the required data to allow us a clearer picture of cost per episode of care, including highlighting financial variation in similar procedures and care plans,” said Mosser. “We have immediate access to information that was previously maintained in different systems, with different keys that required manual intervention to align the data points. Plus we don’t need to maintain our item master with staff manually updating elements that are all owned and maintained by the manufacturers.
“In the end, the investment is minimal compared to the benefit of seeing first hand, what devices and supplies are used by physician for each episode of care,” he continued. “The level of data we have available for identifying costs and revenue improvement opportunities are fantastic. And providing this level of data to our physicians and clinical leaders allows us to have more evidence-driven decisions to achieve best practice clinical outcomes.”
“The introduction of the Universal Device Identifier (UDI) initiative created broader mandates surrounding the tracking and tracing, and chain of custody, of these critical products. With the current Class 2 and Class 3 UDI requirements in place, it is federally required that patient identification is tied to the use of these products,” added Robert Sobie, Senior Worldwide Director & Business Leader at BD.”With a POU tracking system in place inside the procedural/OR rooms it’s easier for the circulating nurse to document patient specific usage of these items while allowing interoperability between systems to reduce clinical documentation time and increasing accuracy. This can also be accomplished with systems outside of the procedural/OR rooms but would require the circulating nurse to leave the room during the case potentially increasing the possibility of nosocomial and surgical site infection rates with repeated exits and reentry.
“A correctly deployed tracking system allows inventory tracking and data confirmation in real time eliminating the need to wait until the conclusion of the procedure to do this,” continued Sobie. “Postponing this documentation until the end of the procedure can increase the turnover time thereby decreasing efficiency and causing costly delays. Lastly, the digital integration reduces the time spent with inventory reconciliation, order entry, order tracking, audit and recall management, all things that ultimately increase labor costs and the risk of a stock-out event.”
Sobie discussed the success that the multi-site Memorial Hermann Healthcare System has after implementing the BD Pyxis system in an effort to eliminate the time-consuming task of manually loading and locating products, improve accuracy of inventory information, address duplicate data entry and other issues. “With concerns over increasing labor and supply costs, regulatory compliance and patient and caregiver satisfaction, the Supply Chain team at Memorial Hermann worked in conjunction with their OR clinical counterparts to implement the connected, end-to-end supply solution from BD Pyxis,” Sobie said. “By deploying this advanced tracking system Memorial Hermann has also successfully implemented the GS1 standards and have been tracking Universal Device Identification (UDI) information for over five years.”
Also, recall management labor decreased 95 percent and staff now spends less than one hour a day managing implantables, physician-specific and trunk stock inventory. “By working together with BD Pyxis we’ve created a truly end-to-end patient care focus from the point-of-order through the point-of-use by the entire Hermann team” said Chris Toomes, Regional Director of Operations, Memorial Hermann Healthcare System. “We now digitally track the use of medical devices from the time the order is placed until they time they are used on a specific patient. We integrate the data usage and product disposition information into other systems and processes to increase accuracy and create new efficiencies. By using medical device consumption data to drive clinical and supply chain decisions, Memorial Hermann has been able to substantially reduce costs, the number of suppliers used and our business operations.”
Perfecting physician preference cards
As the cost of labor and medical products increases, facilities must find proven ways to bolster productivity and savings in all departments, including the central sterile/sterile processing department where outdated physician preference cards are filled, causing a lot of wasted time and money.
“The key to doing this effectively is streamlining process and the supplies and equipment used during a procedure; if hospitals are not documenting that information, they may be picking and sterilizing extra items that are rarely used,” said Suzanne Alexander-Vaughn, Senior Product Manager, Omnicell. “This causes unnecessary activity in purchasing, central sterile supply, case pick operations, operating room setup, and room turnover times. Reducing these inefficiencies also allows the organization to refocus clinical staff time to patient care instead of administrative tasks.”
The article in it’s entirety may be found at: Keeping Track Pays You Back