Modern conveniences of the 21st century have touched most areas of our lives. As an example, think about how the supply for the day has changed. You can use an app to send your order to Dunkin’ Donuts or Starbucks, so everything is prepared just the way you like it, and pay in one click. Then, when you arrive at the store, you bypass the long line out front and head straight to the mobile ordering section, picking up your items without having to speak to anyone.
And consider the changes on the other side of the counter, too. Employees can transmit your digital order directly to their screens to prepare it exactly right and on time. No more scribbling a misheard version of your name on a mug, or Handwrite your preferences (half a coffee? sweetener instead of sugar?) on a piece of paper that is given to the barista who might not be able to read it clearly. When customers order in advance, the employee doesn’t need to spend time taking their money and counting change, which speeds up the whole experience, which is a good thing for everyone involved at the transaction (and for other people waiting in line).
But for some reason, such conveniences have yet to make their mark in the healthcare environment.
Why can’t healthcare be like so many other aspects of life: easy, convenient and effective? At Penn Medicine, efforts to rethink and simplify the care process are doing just that.
“Penn is really focused on thinking about the effectiveness of health care workers in all areas,” from clinicians to front-line staff to those working behind the scenes, UPHS vice president said . Marchand Raina, MD, MSHP, Penn Medicine Chief Transformation Officer, Associate Vice President and Director of the Center for Health Care Transformation and Innovation. “We try to reduce repetitive tasks to give meaning to the work employees do, allowing them to perform at the top of their license. »
Eliminate hidden obstacles
Take the example of paperwork. Before a new patient visit, care coordinators are responsible for gathering their health records from various sources, an effort that can take more than six days, between obtaining patient consent and interfacing with other care providers. Until recently, part of this process might also involve processing faxes (from healthcare providers with different medical records systems); each fax would have to be processed manually and the information it contained entered by hand. “Across the system, which processes nearly 24,000 faxes per day, processing faxed documents consumes a significant amount of time and valuable staff time,” said Jency Daniel, DNP, MSN, RN, senior innovation manager at the Penn Medicine Center for Health Care Transformation and Innovation.
Such an inefficient system deserved to be improved. Penn Medicine has introduced several, driven by the Heart and Vascular Center, the Abramson Cancer Center and many other departments and divisions. Enhancements include a SmartForm in Epic and eConsent, a new document management system to electronically collect patient consents and carefully assemble records, easily accessible from our electronic health records system, PennChart. These programs have reduced the time needed to collect patient signatures for records collection to less than a day, with approximately 60 percent of signatures obtained within an hour, according to Daniel.
A similar process has been put in place to handle faxes: internal software called “coordn8,” which uses optical character recognition and natural language processing to speed up the processing of faxes received from outside Penn Medicine. It has reduced the time it takes to enter each fax from an average of three minutes to around half a minute, reducing staff workload and, therefore, processing costs.. Softwares is expected to save the health system about $5 million annually, “about five times the savings compared to an external vendor with fewer features,” said Emeka AnyanwuMD, MSc, manager of clinical informatics at the Center for Healthcare Transformation and Innovation and associate director of the Center for Cardiovascular Informatics. It also gives staff time in their day to spend on other things, like providing patient care.
No more clipboards
Although these process changes have occurred in the background, others are immediately obvious to patients. This summer, vswithout act vsdevil– the ability to pre-complete outpatient questionnaires and privacy and payment forms, enter insurance information and pre-pay for visits – expanded beyond just registered users of myPennMedicine and MyLGHealth. Now, even patients who don’t have accounts on these platforms can complete all their paperwork before arriving for their appointment, eliminating the need for clipboards full of forms that were traditionally part of the check-in process in some offices. (Patients whose forms are not completed in advance can still complete this step of the process in person, but with a paperless digital signature system.)
The one-click login option further enhances the experience for both patients and staff. Patients who are within a certain range of their appointment location receive a text prompt click on “I’m here” in the digital portal. When they do, they are asked to walk around the front desk and sit down. During this time, staff receive a message that the patient is present, allowing them to know who is in the waiting room and to be able to greet them by name.
“It allows staff to look up from the computer and make a warm connection with a patient,” instead of bombarding them with questions, said Heather Landis, practice manager at Lancaster General Health Physicians Family Practice Manheim. She added that not spending a lot of time checking in patients frees up staff to take care of other tasks, like reminding patients of their upcoming appointments.
At the same time, most Penn Medicine offices have also become “cashless,” meaning they do not accept cash or checks as payment. (Those that sell products, like optical stores and some dermatology practices, are an exception; and hospitals will still have cashiers for patients who use cash.) Patients are now encouraged to pay extra advance online, but they can still pay in person with credit or credit. debit card or choose to receive a bill by mail.
Rather than performing all the tasks associated with accepting cash (keeping track of cash and checks, setting up at the end of each day, and physically transporting them to a drop-off location), staff can spend more time helping patients with other recording needs or questions. “I really like the cashless and paperless initiative so much as it allows me to focus on other priorities,” said Zhang ThaiPatient Services Associate at Penn Medicine Radnor.
Danielle Werner, MHA, The Director of Clinical Practice Operations at the University of Pennsylvania (CPUP), said that through these projects, “we hope to be able to enable staff to focus on patients with more complex needs, or to reach patients and confirm that they are So we can make an appointment, so if they can’t make it, we can reschedule them and make sure their spot is taken by someone else.
Doctors without burdens
A first “victory” in efforts to make care delivery easier for healthcare teams – and more transparent for patients – is a recent agreement between Penn Medicine and Independence Blue Cross remove pre-approvals and prior authorizations for tests ordered by certain doctors. This means that more than 1,200 doctors with a proven track record of following insurer guidelines will face fewer barriers to getting their patients approved for CT, PET and ultrasound scans, and patients will be able to access radiology appointments more quickly.
Innovation continues all the way to the exam room. In outpatient practices, Penn Medicine is testing “ambient listening” – essentially using software on the doctor’s phone or computer to “listen” to the visit. In this case, the program replaces a human scribe to record the conversation between the doctor and the patient, including remarks made by the doctor during his examination and about the laboratories and analyzes in the patient’s file. This saves the doctor from having to complete their notes after the patient’s visit – a practice that often leads to using “pajama time” to catch up after the work day ends, according to Merchant – and allows them to spend the visit more closely focused on the patient in front of them.
“The physician’s daily workload is increasingly cluttered with “low-value” activities that serve regulatory, billing, administrative, and other purposes and that compete with or detract from actual patient care.“said Penn Medicine’s chief medical information officer, vs. William Hanson, III, MD. “Ambient listening will significantly reduce the documentation burden that contributes to provider burnout.”
Staff can expect more innovation efforts along these lines, without skimping where quality matters, Merchant said: “Not only do we want to be the easiest place to work, but also maintain our excellence by providing the highest quality and most evidence. care based on them. »
