Parkview Episcopal Medical Center in Pueblo, Colo., had a rapidly expanding home healthcare business but also a rapidly expanding paperwork load that was cutting into the time of visiting nurses.
An internal study showed that about 50% of a nurse's time was spent on paperwork. And even then the documentation was afflicted by inconsistent reporting on care delivery, lack of timeliness that delayed reimbursement, multiple write-ups of the same care plan for different payers, and difficulty providing referring physicians with timely and legible updates.
To increase the home-care department's efficiency, Parkview set out to automate the documentation of care on handheld computer tablets, link it to the central information system and tie it to a billing process that used the same entered data to capture charges, said Mike Gogola, the hospital's vice president and chief information officer.
A joint project with healthcare software vendor Patient Care Technologies has resulted in a 20% increase in nurse productivity, an 83% reduction in billing errors and the potential to increase revenue nearly $900,000 a year at the same staffing level, said Mr. Gogola.
For that, Parkview earned the second-place Honors Award for Excellence in Healthcare Information Technology.
A prime consideration in designing the system was to put current patient information in caregivers' hands in the home, and get progress notes and other new data back to a central storage point.
Under the old paper-based system, charts had to stay in the home-care office, Mr. Gogola said. Nurses had to familiarize themselves with the day's patients before going out, either by making copies or scribbling crib sheets. Once back, all the new data had to be banged out and transferred to specific forms. "It took longer to prepare and document than to actually visit," he said.
Now the nurses load information on patients into their computer tablets before starting on their rounds, and enter new data in the home using methods that require little actual entering of text. Then they load their chart revisions into the main computer at the end of the day.
The software automatically produces both a traditional care plan and the one required by HCFA for Medicare reimbursement, which by itself saves an average of 105 minutes per patient in paperwork time, Mr. Gogola said.
Nurses now log an average of five visits a day instead of four, which allows Parkview to expand its case load 20% without adding staffers.
Mr. Gogola said the hospital is targeting home-care business throughout southeastern Colorado. Without its simplified system of care and billing, however, Parkview would not be considering such an expansion, he said.