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  • 1. Self-Service Opportunities in Healthcare Tom Gregorio, VP & CIO Saint Barnabas Health Care System Newark Beth Israel Medical Center Children’s Hospital of New Jersey
  • 2. Self-Service is Everywhere Airline Hotel Healthcare Bill Pay / Food Order Retail Financial
  • 3. The Self-Service Movement Continues to Expand Are you more likely to do business with companies that offer self-service?
  • 4. Consumers Choose Self-Service for speed, Convenience and Ease-of-use Across Industries Faster More Convenient Easier
  • 5. Self-Service is Growing
    • Self-service will account for 58% of all customer service interactions by 2010
    • Consumers will spend $1 trillion through self-service by 2011
    • Retailers show a 6-8% increase in incremental sales when kiosks are placed in the store
    • By the end of 2007, 800,000 customer kiosks will be installed in North America increasing to 1.2 million by 2009
  • 6. Cross Industry Results
    • Over $111B in sales through self-checkout in 2005 – up 35%
    • 11% of customers select retailer because of self-checkout
    • 37% of customers believe self-service improves their patient experience
    • 38% of customers more likely to dine at Quick Service Restaurant
    • 41% of customers more likely to stay at hotel with self-service
    • ATMs generate $2.5B in fees
    • Airline drives $8M+ per month with self-service kiosks
    • Labor optimization benefits:
      • ATMs cost $0.27 vs. $2.93 per transaction
      • Airlines save $3.52 per passenger with self-service kiosks
      • Retailers eliminate up to 150 cashier labor hours a week with SCO
    • 75% reduction in registration times on second use with self-service
  • 7. The Wait We Hate the Most Results from Opinion Research Corporation – Commissioned Study by NCR
  • 8. Key Findings Q: Why would you choose self-service over personal assistance ?
  • 9. Key Findings - Healthcare Q: Why was “I trust myself and the self-service technology more” one of your top choices?
  • 10. NCR Multi-Channel Approach to Self-Service
    • Pre-registration
    • Bill Payment
    • Secure Messaging
    • Self Scheduling
    • Personal Health Record
    • Patient Check-In
    • Paperless Workflow
    • WayFinding
    • eSignature
    • Co-Payment / Account Payment
    • Remote Check-In / Authentication
    • Scheduling Notification
    • Lab Results Delivery
    • Physician/Staff Activity Monitoring
    CVM Enterprise Server – Platform for Healthcare Self-Service
  • 11. DOCUMENT IMAGING EHR / EMR SCHEDULING ADT / EPM BILLING Applications Layer Connect. Interact. Transact.
  • 12. Newark Beth Israel Medical Center Newark, New Jersey, USA
  • 13. Nationally recognized services
    • World-class cardiac surgery services for adults and pediatrics
    • Heart transplant program ranked in top 10 by volume nationally
    • New Jersey’s only lung transplant program
    • Kidney Transplant Program with over 35 years of experience
    • Certified chest pain center by American Society of Chest Pain Centers
    • The most comprehensive robotic surgery service in the region including cardiothoracic surgery, general surgery, adult and pediatric urology, gynecology, and gynecologic oncology.
    • East Coast DaVinci Robotics Training Center
  • 14. About Newark Beth Israel (NBI)
    • 673-bed regional care teaching hospital
    • Approximately 3,800 employees
    • 1.2 million square feet
    • $380 million operating budget
    • 25,558 admissions
    • 300,000 outpatient visits
    • 3,000 deliveries per year
    • 7 miles away from Newark Liberty International Airport
    • Full service transfer center for international patients
  • 15. NBI’s Self Service Journey
    • April 2005 -Initial MediKiosk Implementation in Same Day Surgery and Pre-admission testing
    • September 2006 – September 2007- Hospital-wide with MediKiosk application
      • Self-Service Check-In
      • Insurance card, ID card and prescription scanning
      • eSignature
      • Activity Monitoring / CVM
    • November 2007 - ED Triage Workflow Implementation
    • 2008 – 28 locations live throughout the facility with 20 Desktops, 75 eClipboards and 35 desktop scanners deployed. Continuing new location rollouts.
      • 3 Desktops, 3 eClipboards in Emergency Department
      • Remainder of hardware is in Clinical & Diagnostic areas
  • 16. Patient Check-in
    • Examined the business case for self check-in
      • Desire to improve patient throughput
    • Deployed in outpatient settings throughout the hospital
      • Shorter lines and wait times improve the patient experience and help build a long-term customer base
      • Staff no longer re-enter patient data, print or file paper registration forms
      • Patients behavior is changing to arrive closer to appointment schedule times
    • Wanted to expand check-in process to ED
  • 17. Why the ED?
    • 48% of emergency departments are at or over capacity, according to the American Hospital Association
    • Half of all ED patients wait 30 minutes or more before seeing a doctor, according to a recent study in Health Affairs
    • The National Hospital Ambulatory Medical Care Survey shows an increase of 5.1 million ED visits in 2005, representing an average of 219 visits to U.S. emergency rooms every minute
  • 18. ED Patient Check-in
    • Patients enter name, date of birth, gender
    • Questions asked about diabetes and pregnancy, if applicable
    • Capture chief complaint using body diagram
  • 19. The Staff View – ED Check-in
    • Monitor
    • Arrival time
    • Chief Complaint
    • Criticality
    • Diabetes or pregnancy
    • Triage throughput
    • Date & Time Stamps each process step
  • 20. Using the KIOSK – Outpatient Arrival Day
    • At desktop KIOSK patient is presented with scheduled appointments for that day only
      • Choice of 2 languages: English or Spanish
      • Current appointment/s listed and patient is asked to validate or to see registrar
    • Registrar presents patient with an eClipboard
      • Choice of 2 languages: English or Spanish
      • Patient is presented with a maximum of 4 forms for signature
    • Pt ID, Insurance and Prescriptions forms are scanned into Galvanon and sent to document imaging system.
    • Signed forms are sent to document imaging system.
  • 21. Device Options
  • 22. Patient Desktop Check-in Outpatient
    • Patients touch screen name and DOB or swipe a Hospital issued “Patient Access Card” to begin authentication process.
  • 23. Patient Desktop View – Outpatient
    • Patient validates appointment time and is directed to be seated
  • 24. Outpatient Check-In Staff View
    • Monitor
    • Schedule time
    • Arrival time
    • Registration Throughput
    • Who is completed and “To Be Seen”
    • Comments
    • Date & Time Stamps each process step
  • 25. Patient eClipboard Signature - Outpatient
    • Patients read, complete and sign General Consent, Patient Rights, HIPAA Notice of Privacy Practices and Medicare Utilization form.
  • 26. Results: Patient Satisfaction
    • Shorter wait times
      • On average, self-service leads to a 40% reduction in check-in times on the first visit and a 50% reduction for follow up visits (approximately 3 min / registration)
      • Overall reductions in wait times
    • Less paperwork
      • No more sign-in sheets
      • Fewer forms to complete
      • Less printing
    • More personalized experience
      • More clinical time available for the patient
  • 27. Results: Enhanced Data Quality
    • Kiosks assist in determining positive patient ID
      • Patient typing into system and take ownership of information entered
    • Patients are empowered to take control of their own health information
      • Patient identifies the reason for the encounter to the emergency department in advance of seeing a practitioner
      • Patient self identifies criticality of the visit
  • 28. Results : Reduced Administrative Costs
    • Reduced paper and printing costs
      • On average, self-service reduces 90-99% of registration paper forms at check-in
      • Space previously used for filing now available for other revenue generating opportunities
    • FTEs can be redeployed to more productive tasks
      • No need to copy, file and manage paperwork
      • More time to focus on patient concerns
      • Ability to handle more patient volume with existing resources
  • 29. Looking Ahead
    • NBI’s vision for self-service
      • Patient Access Cards
        • Authentication for desktop and eclipboard
        • Walk-in authentication and encounter creation
      • Consumer On-line Portal
        • Form completion prior to visit
        • Appt Reservation for Outpatient Lab Visits
        • Community access to Health Information
      • CVM Mobile for Blackberry, Windows Mobile Devices
        • Notify Patients and Physicians of scheduled appts
      • ED Receipt Processing
        • Co-Pay Collection and Receipts