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Engaging Patients Through Self Service Technologies
April 13, 2015 Theresa Z. Meadows, RN, MS, CHCIO, FHIMSS,
FACHE
Company logo may be placed on this slide
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
Conflict of Interest Theresa Z. Meadows, RN, MS, CHCIO, FHIMSS, FACHE Has no real or apparent conflicts of interest to report.
© HIMSS 2015
Learning Objectives • Create an automated check-in environment that is patient-centric and
efficient, allowing registration staff to focus more on patient service and satisfaction.
• Design a patient-friendly check-in process that collects and posts co-payments and outstanding balances in real time.
• Initiate discussions with patients to identify ways to make the check-in experience easier, more convenient and pleasant.
• Demonstrate technology’s role in providing a better patient experience.
• Apply lessons learned from other industries to expand check-in functionality and enhance customer satisfaction.
Benefits Realized for the Value of Health IT • The value steps impacted
were: – Savings – Satisfaction
• Over $1m collected at beginning of revenue cycle
• 70% of patients using self service technology
• Patient and staff satisfaction improved
http://www.himss.org/ValueSuite
About Cook Children’s
• Founded in 1918 – Fort Worth Free Baby Hospital
– Cook Children’s Hospital – Fort Worth Children’s
Hospital • 1984 Merger: Cook-Fort Worth
Children’s Medical Center • Private, not-for-profit corporation
held in the public trust by a board of community and physician leaders
• 2013 Nationally recognized Integrated Delivery System
Cook Children’s Health Care System
• Nine Companies – CC Health Care System – CC Medical Center – CC Physician Network – CC Home Health – CC Health Plan – CC Health Foundation – CC Northeast Hospital – CC Pediatric Surgery Center – CC Health Services
Service Area Defined
6-County Service Area Outlying Referral Area
Tarrant, Parker, Hood, Johnson, Wise, Denton (47% of state)
Our Promise Knowing that every child’s
life is sacred, it is the promise of Cook Children’s to improve the health of every child in our region through the prevention and treatment of illness, disease and injury.
Fast Facts
2014 Annual Statistics • 429 licensed beds • >60 primary care and specialty clinics • 600 (315 employed) active medical staff • 6000 employees • 15,000 Surgical procedures • 128,000 emergency room/UCC visits • 103,000 Health Plan Members • 9700 Home care visits • > 1 million patient encounters each
year • ~$ 1 billion revenue • ~$ 100 million in community benefit • Best of Breed IT shop
Awards and Recognition • 2012 SDI’s Top 100 Integrated Healthcare
Networks • 2012 Modern Healthcare’s Best Places to Work
(# 61) • 2012 Magnet re-designation (only 3% of
hospitals achieve) • 2012 Texas Award for Performance
Excellence from Quality Texas Foundation • 2014 US News and World Report Best
Children’s Hospitals ( 6 out of 10 specialties) • 2014 Dallas Morning News Top 100 places to
work • 2012 Leapfrog Group’s Top Hospital List • 2013 Information Week 500 • 2014 Most Wired Hospital • 2013 Best Hospital IT Department to Work
Our Problem
Challenges • Manage the changing
dynamics of children's healthcare systems
• Opening new outpatient specialty clinic, diagnostic & ambulatory surgery facility
• Decentralized registration with many entry points
• Improve patient experience
Solution • Automate the check in
process • Reduced patients time in the
waiting room • Increase co-pay collection • Validate Insurance
Information • Paperless consent process • Streamlined the workflow
Our Goal
• To create a more customer service-oriented culture; help parents check-in with ease; and implement one-point registration, where information entered at a kiosk could be shared instantly across the system.
The Vision
Patient Engagement - Access to Care
Pre Register (web/mobile)
Check –in (kiosk)
Visit Occurs
Check-out (Kiosk/Mobile/
Web)
Return for next
visit
Our Process
• Select the appropriate partner • Take the time to document workflow – Story Board
• Think about customer needs in design • Understand compliance issues • Integration with Revenue Cycle Systems is critical to success
Choose the right Partner
• Find a partner with similar vision • Commitment to delivery • Multiple form factors • Ability to meet regulatory
requirements
Story Boards
• Kiosk eligibility • Check-in logic • Consent logic • Scanning Driver’s licenses, insurance cards, and credit cards
• Posting cash
Kiosk Eligibility
• Determine the patient types who could use kiosk
• Demographic Changes • Pre-Authorization • Insurance verification • Daily eligibility list – Used
to greet and educate patients
Check-in Logic
• Language Preference – English and Spanish
• Pre-registration and scheduling integration
• Scheduled appointment choices
• Bar code/QR code check-in
• Driver’s License and Insurance card scanning
Consent Logic
• HIPAA Privacy Statement
• Financial Consent • Consent to Treatment • Patient Rights • Billing Instructions • Rules definition • Signature capability
Payment Logic • Cash, Credit, Checks • Co-pays • Prior Balances • Multi-revenue cycle vendor
environment • Real time updates to patient
accounts • Integration to 2 Revenue
Cycle Systems • PCI Compliance
Customer Driven Design
• Patient and family focus groups
• Patient friendly design • Multiple form factors • Staff available for first time users
• Guide patients toward kiosk
Directions and Next Steps
• Registration staff escorts patient and family to appointment location
• Clinic aware of patient’s arrival
• Clinic is able to greet patient on arrival
• Decreased wait time
Patient Engagement - Access to Care
Pre Register (web/mobile)
Check –in (kiosk)
Visit Occurs
Check-out (Kiosk/Mobile/
Web)
Return for next
visit
What’s Next - Web?
• Patient portal integration
• Improved pre-registration integrated to kiosk check-in
• Scheduling appointments on Web or Mobile
• Improved consolidated bill pay
What’s Next - Mobile?
• Cook Children’s app • Mobile versions of web capabilities
• Kiosk Check out – Follow-up
appointment scheduling
Benefits Realized for the Value of Health IT • Savings
– Fully centralized patient registration – > 100,000 check-ins have occurred
at kiosk – 80% of patients are kiosk eligible
– Reduced paper by 7 – 10 sheets
per patient (700,000 pages) >$150,000/year
– 70% of patients paid their co-pay at kiosk
– Year 1 Collections = $800,000 – Year 2 Collections >$1,000,000 – Able to maintain low AR days
http://www.himss.org/ValueSuite
Benefits Realized for the Value of Health IT
http://www.himss.org/ValueSuite
• Satisfaction – Technology empowered the
staff - Able to use registration clerks to escort patients
– Increased physician satisfaction
– Increased patient satisfaction around registration process and wait times for Ambulatory services
– 2 minutes at kiosk vs 5 – 7 minutes with registration clerk
– Improved practice efficiency. Patients directly to exam room
Questions?
Theresa Z. Meadows, RN, MS, CHCIO, FHIMSS, FACHE Senior Vice President and CIO Cook Children’s Health Care System [email protected] 682-885-6275 (O) Twitter: @tzmeadows