April 16, 2007

Automation in Motion
By Laura Gater
For The Record
Vol. 19 No. 8 P. 8

Saint Clare’s Health System, a four-hospital operation in New Jersey, serves 23,000 inpatients and 250,000 outpatients annually. The task of keeping up with patient information, accounts payable, accounts receivable, regulations, and claim denials falls to Chief Information Officer Rich Temple.

Temple believed there was a better way to keep up with the daily flow of patient information, track accounts and regulations, and reduce claim denials. Employees in the accounting office had to manually discharge patient accounts, and he knew this process could be more efficient. He also knew there were many other system wide tasks that could be automated, thus further reducing costs and streamlining operations. He turned to Boston Software Systems’ Boston WorkStation, which he had used at a previous job.

“I found Boston WorkStation very useful for synthesizing mass amounts of data. It’s labor-saving and accurate, a very powerful and valuable tool. When I came to Saint Clare’s, I wanted to utilize it here as well,” explains Temple.

The ability to automate time-consuming, repetitive work is an important benefit that Boston Software Systems was able to offer Saint Clare’s, notes Thom Blackwell, the company’s product manager. “We are automating Saint Clare’s workflow, not changing it,” he says. “We’re taking their drudgery work and automating it. This doesn’t require any retraining; it just makes employees’ work more efficient.”

Perhaps the greatest benefit of Boston WorkStation, according to Temple, is its ability to be used in various settings. Temple has scripted many of Saint Clare’s departmental tasks with the help of WorkStation, automating repetitive and time-consuming tasks. Often, the same data needed to be entered into two or three different systems. WorkStation has eliminated that need through its scripting function. Workflow changes since the implementation have also eliminated the need for multiple sign-off steps on various documents or transactions.

WorkStation also creates registration records and automates pre-registrations, saving staff time and effort in a job previously done manually. The program pulls a feed from the scheduling department, where information about those patients has already been collected and saved. Pulling data that the hospital already has automates the registration of those patients, and the feed can generate registrations before the person comes in. Then, when the patient arrives, he or she just has to be checked for insurance verification. So the benefit trickles down to the patient, who doesn’t have to spend as much time at the registration desk.

Temple is a strong proponent of using scripting to automate any processes that can be automated, from the business office and human resources to clinical applications.

Hospital departments are utilizing WorkStation in many different ways. Human resources built a script to automate and track personnel pay raises in its PeopleSoft software system, which is linked to WorkStation. The business office uses WorkStation in all aspects of its revenue cycle—many revenue cycle functions have been scripted, making them more efficient and less time-consuming. Now, accounts payable expedites its invoice loads without manual information entry.

“The implementation of Boston WorkStation provides an opportunity to examine the current workflow and ask ‘where can we move information faster and more accurately?’” explains Boston Software Systems marketing director Margaret Mayer. “WorkStation can smooth out the rough spots in your workflow process and streamline information. It’s a scripting tool that is very helpful to hospitals with a limited IT staff because it’s easy to use and other staff members can learn it as well.”

Mayer compares WorkStation with a container of Legos, the small plastic bricks that children use to build almost anything. WorkStation, too, can be used to build any type of application to automation.

At some time or another, most hospitals are faced with the task of rebilling accounts for various reasons. Mass billing is time-consuming, but it can be automated through WorkStation. Once a script is written to automate mass rebilling, it can be used again with few changes. “You have the power to do mass amounts of work with a single tool,” says Temple.

Mayer says many of the company’s largest customers use WorkStation in their business department because it helps accelerate the revenue cycle. The software can also be used to write simple applications to overlay a sometimes complicated process. For example, it’s possible to create a WorkStation script that overlays a registration application at a hospital’s front desk. The script will send a pop-up note if a field is skipped during the application process or if information is entered incorrectly. It will also connect to an address verification site to confirm that the address the patient has provided is deliverable or valid.

The refunding process has also been scripted; Saint Clare’s can now tell when the refund was received by the patient or payer and when it was cashed. WorkStation has also enabled the health system to keep track of all its patient accounts, a valuable tool when dealing with patients with similar names. Besides helping to ensure account accuracy, the technology eliminates old and/or invalid patient accounts by automatically discharging those that have shown no activity over a certain period of time.

“Once you have this valuable tool and have used it, you tend to think of many other ways it can be used to streamline tasks and improve efficiency,” says Temple. “Predictability is also a big factor in using WorkStation because you know what it can do and how things will be done.”

A number of patients come to Saint Clare’s via external physicians, many of whom are not listed in the system’s medical directory, so their names are not recognized by the computer system. The registration clerks had to look up the physician’s address, telephone number, and other information and key it in manually when a patient registered. The health system used WorkStation to load the physician information into its medical directory, and physician names are now recognized and acknowledged by the system.

“All the physicians now know that, all of a sudden, we recognize them when a patient of theirs is admitted. Anything we can do to improve relations with our physicians is welcome,” says Temple.

WorkStation can also work behind the scenes in conjunction with electronic medical records (EMRs) to pull up patient information as needed. Saint Clare’s has not yet utilized it in this capacity because its EMR is relatively new, but Temple is thinking of ways the two programs can work together to improve the health system’s efficiency.
Laboratory test results can be scripted to be automatically entered into a patient’s EMR as well as be delivered to his or her physician, which eliminates the waiting period and also speeds patient care.

— Laura Gater’s medical and business trade articles have been published in Healthcare Traveler, Radiology Today, Corrections Forum, Credit Union BUSINESS, and other national and online publications.