AlertMD® has given me a unique 10-year window into a day in the life of a clinician and all the administrative overhead that they have to undergo before they get paid for their hard work. Being an engineer, I could not but help applying the principles of industrial engineering to the process. What is the overhead and what is the processing time? Those were fundamental questions for me.
On numerous occasions, I had to do a walk through and got to see the amount of time a clinician spent with the patient (value-added time) and everything else (overhead). Here is what I found:
- Patient contact - 25%
- Family discussions - 10%
- Hospital support staff, orders - 10%
- Documentation in the hospital - 25%
- Documentation back for the practice - 10%
- Handoffs, communication within their own group and other groups - 20%
To be clear, all 100% is necessary for the system to function. However, the sheer amount of overhead for the 25% of patient contact seemed stunning to me. I set out asking the question “why?” to each step other than patient contact. If the provider would stop and write down something, I would ask Why. If they then stopped and repeated what they just entered into the chart to another party, I would ask Why. When they would go to the staff lounge and effectively redo the same work they did in a chart, but only slightly differently, I would ask Why.
The lessons were painful. After spending billions on allegedly interconnected systems that are in an information highway, the provider on the front line is saddled with repetition of the same information again and again in multiple software. The provider then has to call and relay that information to a different party all over again. While this is going on, reimbursement drops by a couple of percentage points each year. In other words, the provider has to work 2% harder to make the exact amount as last year.
Dejected from the reality, I assembled a smart team of people and asked a few questions…
What can we do to slash the time spent on overhead by a factor of 7? In other words, handoffs and communication should take 3% of the provider’s time and not 21%, as an example. What can we automate? How can we reduce/eliminate repetition?
Before I discuss more of what we ended up doing, perhaps you can share your thoughts. Do you agree with the premise? How is your $30,000,000 system working? Saving you time? Are you repeating the same thing again and again, only changing it a bit just to get by?
Contact Badri Narasimhan email@example.com to discuss more...