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Cio Summit 2008


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Presentation for CIO Summit in New Jersey

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Cio Summit 2008

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