POTENTIAL CURE FOR WHAT AILS HEALTHCARE

by Steve Mackes

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What with the huge legislative battle in 2010 over reform of the healthcare industry and the continuing attempts to repeal or cripple the law that was passed, one has to ask: What really ails healthcare in this country? In the heat of the battle that continues to rage, fingers of blame have been pointed in many different directions. Depending on who is pointing, the guilty parties can range from bloated bureaucracies and wasteful/ fraudulent providers to greedy insurance companies and a fundamentally sick society.
This much, however, is certain: the healthcare industry, as a whole, continues in an upward spiral of greater cost and a downward spiral of lower patient care quality. Rather than searching for scapegoats, we all might be better served if our attention focused on finding solutions to this colossal problem.

THE HEART OF THE MATTER

Though there are certainly plenty of axes to grind and agendas to further when it comes to healthcare, what seems to be at the very core of the industry’s systemic malady is a lack of cohesive information management. This is evidenced by the high percentage of patient histories that are incomplete or scattered, the huge number of medical records that are lost or misplaced and the persistence of disparate systems that have difficulty communicating and sharing data. All of these realities, it could be argued, are merely symptoms of a greater illness, the illness of failing to effectively manage medical records and patient data and so many other healthcare and healthcare-related documents and communications throughout the information lifecycle.

The culpability of poor information management has been suspected for some time, fueled, in the U.S. especially, by horror tales of misdiagnoses, inappropriate treatments, mix ups regarding coverage and catastrophic billing errors, initiated or at the very least exacerbated by the mishandling of information. In each and every instance, time and money are wasted, medical care is delayed or denied and professionals, patients and the healthcare industry itself all suffer.

LESS THAN EFFECTIVE TREATMENTS

There have been well-meaning, if ineffective, attempts to treat this problem. They have come largely in the form of regulations meant to coerce better information handling through the threat of non-compliance fines and penalties. But as much as these regulations mandate corrective changes, they frequently create fresh obstacles (new bureaucratic layers to navigate, increased volumes of information to manage) that hinder the very issues they seek to address. A recent example is the much heralded drive to transition healthcare organizations and their information from physical, hard copy environments to Electronic Medical Records. Given the convenience, accessibility and share-ability of digital files, there is much commending such a transition. But while medium and large-sized organizations are embracing this change, smaller medical centers and practices are finding it extremely expensive if not impossible to implement. For these smaller concerns, the added costs in software, hardware, training, and the loss of productivity associated with implementing change do not justify whatever benefits might be gained.

LESS THAN EFFECTIVE TREATMENTS

There have been well-meaning, if ineffective, attempts to treat this problem. They have come largely in the form of regulations meant to coerce better information handling through the threat of non-compliance fines and penalties. But as much as these regulations mandate corrective changes, they frequently create fresh obstacles (new bureaucratic layers to navigate, increased volumes of information to manage) that hinder the very issues they seek to address. A recent example is the much heralded drive to transition healthcare organizations and their information from physical, hard copy environments to Electronic Medical Records. Given the convenience, accessibility and share-ability of digital files, there is much commending such a transition. But while medium and large-sized organizations are embracing this change, smaller medical centers and practices are finding it extremely expensive if not impossible to implement. For these smaller concerns, the added costs in software, hardware, training, and the loss of productivity associated with implementing change do not justify whatever benefits might be gained.

PRESCRIPTION FOR SUCESS

What improved information management can provide, whether it’s the handling of physical documents, digital records or a combination of the two, is better security, easier accessibility, improved workflow processes, greater information accountability and ultimately savings in time and dollars, all of which can translate into better outcomes for both patients and healthcare organizations.

So, the 64 trillion dollar question (that’s what U.S. healthcare could eventually cost on our current course) is really this: How can medical and medical-related organizations cost-effectively improve their control and utilization of information?

The answer lies in a whole range of innovative solutions that are out there and readily available, and in partnering with a knowledgeable information management provider, capable of implementing those solutions to the best possible effect.

A HOLISTIC APPROACH

First and foremost, healthcare organizations need to adopt a “big picture” perspective of their overall operations, including their internal and external information needs. The next step is to get expert advice from an information management specialist.

One of the worst mistakes organizations make is to think they can devise and handle their information management program all by themselves. That mindset is an invitation to problems in the form of siloed, piecemeal solutions that may fix one department’s need, but, in the process, causes difficulties in other areas. Also, without information management expertise, an organization primarily focused on healthcare may employ products and services that are not the most efficient in cost and productivity, or fail to factor in long-term needs.

Just as there are many good health reasons for patients to consult a specialist, healthcare organizations are well-advised to do the same regarding information management. This analogy is especially appropriate because information management, like specialty medicine, has become an extremely complex field. It’s no longer a matter of sticking some papers in a filing cabinet and calling it a day.

Today, information management comprises the 4 critical areas of Capture, Workflow, Management and Compliance. Within these 4 categories, there is a wide range of potential products and services such as scanning, imaging, indexing, off-site storage, web-hosted systems, automated workflow processes, chain-of-custody tracking, mirrored repositories, retention scheduling and much more.

GETTING EXPERT HELP

Working in partnership with a knowledgeable information management specialist is essential to achieving success and the cost-reducing, productivity-enhancing results that go with it. While there are many companies and individuals offering services, only a few provide truly top-notch expertise. To better the chances of aligning with a provider that will meet or exceed expectations, there are a couple things to look for and keep in mind.

  • An information management provider that delivers end-to-end solutions is able to offer recommendations and deliver products or services that benefit the overall enterprise (not just one part of it) and leverage information from its creation to destruction. With providers offering less than comprehensive services, it requires more of them as well as multiple contracts to enact a complete program. This can become complicated and counter-productive if vendors don’t communicate well with each other.
  • A pay-as-you-go SaaS (Service as a Software) Hosted Web-based Platform not only provides a secure, digital information management environment, but can save an organization significantly on upfront expenditures by eliminating the costs of internal hosting, purchasing hardware/software and maintenance. Compliance is a huge issue within healthcare. Failure to comply with regulatory mandates found in HIPAA and HIPAA Hi-Tech can cost an organization dearly in fines, penalties and reputation. So, it’s vital to work with a provider that is on top of the latest compliance issues and can provide products and services certified to meet all the stipulations of EMR migration, privacy, insurance access and physician sharing of patient information.

LOWER COSTS / GREATER PRODUCTIVITY / BETTER OUTCOMES

Physicians for a National Health Program estimate that over 30% of our national healthcare expenses go to processing claims and meeting administration overhead. And none of that enormous expense contributes in any way to the actual treatment patients receive. Today’s advanced information management solutions can change all that by making day-to-day healthcare processes fully automated and error-free. This is especially beneficial in areas such as Patient Records, Accounts Payable, Human Resources and Explanation of Benefits.

The most common cause of excessive costs for medical centers is maintaining inventory long past disposal dates. Though such records are no longer needed, organizations, in many instances, continue to pay for their storage and preservation. With an effective information management program in place, such inventory can be quickly identified and disposed of, providing an organization with substantial savings.

Another problem hindering healthcare facilities is the prevalence of multiple systems that are not integrated with one another. That inefficiency, alone causes significant waste in labor and time and dramatically increases the instances where lost or misplaced information never reaches the appropriate administrator or department or healthcare provider. Well-directed information management, however, can help healthcare organizations literally get on the same page by enabling these formerly incompatible systems to communicate and exchange data.

KEY HEALTHCARE APPLICATIONS

Better information management can answer a wide range of specific needs for healthcare departments such as Administration, Accounts Payables, Accounts Receivables, Contracts, Human Resources and Credentialing. By automating workflow processes, information can be leveraged to improve productivity and outcomes in numerous ways.
For Human Resources, information management solutions can help an organization:

  • Monitor workforce skill sets, licenses, certifications and training
  • Manage labor costs, risk and employee productivity
  • Meet OSHA, EEO, ERISA and HIPAA compliance
  • Realize hiring goals with fewer resources
  • Protect the confidentiality of employee information

In the area of Healthcare Payables, an information management program can provide:

  • Faster workflow cycle times in preparing/submitting invoices
  • Reduced costs in transaction processing
  • Fully automated data extraction
  • Greater accessibility to payables information
  • Lower call center and storage costs

For physician practices seeking to seamlessly transition from physical information to a more electronic and automated environment, a quality information management provider can implement integrated services that deliver:

  • On-demand and standardized access to documents from remote, multiple physician locations
  • More efficient A/R processing
  • Improved information accuracy
  • Complete record accountability (no more lost/misplaced information)
  • Reduced need for physical storage
  • Increased personnel productivity
  • More overall operations efficiency for less cost

Information management solutions are also available to help healthcare organizations solve their most pressing mail-related issues by customizing and automating document workflow parameters to meet unique needs. Processing is streamlined by electronically routing documents to preset data-entry programs that simultaneously initiate the running of integrated compliance and productivity reports. In addition to many of the benefits realized in the previously mentioned applications, this digital mail solution ensures a reduction in costs associated with audit/oversight issues and less potential damage to documents from repeated handling.

CONCLUSION

In summary, what the healthcare industry needs more than anything—more than powerful new drugs, cutting-edge medical devices, or state-of-the-art facilities—is the ability to store, access, share and retain information in more efficient ways, across the board. To get there, organizations should look to partner with an experienced information management specialist that can provide proven, enterprise-wide solutions.

The stakes are incredibly high as it’s not just profits, but lives that hang in the balance. In both instances, there is much to be gained by taking prompt and positive actions now. From insurance processing to accounts payable, from handling admissions to distributing lab test results, improving information management holds the key to reducing the overall cost of healthcare while improving the quality of patient care.

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