Tracking cost and info: An affordable solution
50-bed unit gets big program at small price
Knowledge is power, and to succeed, information is key. But for a small hospital, affording the kinds of systems that provide the best data often is overly expensive and close to impossible. But one small facility in rural Washington state has found the critical operational and quality information it needs. Samaritan Healthcare, a 50-bed acute care hospital in Moses Lake, located between Seattle and Spokane, knew that with lower Medicare and private reimbursement rates, understanding where money went and how to reduce costs without sacrificing quality of care was vital.
The facility had been using PACE, a product of the Computer Sciences Corporation (CSC) of El Segundo, CA. But CSC dropped the PACE system and after a year of trying to function on its own, Samaritan executives decided to seek out a new system.
It didn’t help that the region between Spokane and Seattle has experienced some of the fastest growth in the nation, leading Samaritan to start a $20 million construction project to keep pace. Money was tight, says Glen Stambaugh, RRT, director of quality at the hospital, and the typical six-figure intelligence software offerings were completely unaffordable.
"They had wonderful capabilities, but required high front-end investment in licensing, hardware, and dedicated employees to maintain and operate the infrastructure," he explains. He did some research and asked others what products they used. There were two companies — which Stambaugh declines to name — that offered great products, but that would have required between $60,000 and $100,000 to start for the capabilities the hospital needed. That was beyond what Samaritan could afford, and more than three times what they paid for the defunct but highly capable CSC product. "It would have been out of the question even in a good year," he says.
New company is like old reliable
Lucky for Stambaugh, the old PACE sales representative he used was working for a start-up company called Net-Fast based in Billerica, MA. "He offered a newly developed solution with capabilities similar to more expensive packages, but at a price we could afford." The price was a relatively mere $25,000 per year.
Not that Stambaugh wasn’t concerned about using a product from a new company. "But then again, CSC was established and they quit offering a service, so the risk is inherent in the industry whether a company is new or old," he says.
Net-Fast takes routinely generated transaction data and puts it in a form that is readily available to hospital decision makers. The system is designed to be simple to understand and use, but allows for thorough analysis of the factors impacting profitability and clinical effectiveness. All of the data and the required software reside on Net-Fast’s secure web site, enabling hospitals to easily access their information without additional infrastructure, software, or hardware costs.
The source data used in the system is extracted by the user hospital and uploaded to Net-Fast on a regular basis. In the case of Samaritan, Stambaugh says, "Our source data is maintained by a consortium of regional hospitals using a shared information system. We alert them when our quarter is completed and they forward it to Net-Fast. Net-Fast works with them to make it a smooth and simple process."
The reporting module Samaritan uses, Net-Fast (NF) Blue, supports a number of clinical and financial applications, says Stambaugh. "We can get information on any procedure, diagnosis, or charge master population. We can analyze for utilization, revenue, and outcomes." The data isn’t real time, but it is available within a couple of weeks of transferring it to Net-Fast — something faster than many products that are out there. "It’s as close to real-time data without going day-to-day as we can get," he says. "We could have gone for cheaper options that use state and other public databases, but the data is old and limited by the time you get it."
Stambaugh found NF Blue extremely easy to learn and used it right away to explore revenue-challenged laparoscopic procedure service lines. "We knew changes in Medicare reimbursement had resulted in lost revenue, and it was important to identify waste and potential variances in care which could be addressed to restore viability." Stambaugh used the wide range of data elements available in NF Blue to comb through the procedures and break out charge categories where utilization varied by physician. NF Blue again was applied to rank variances by average value and to compare clinical outcomes.
"We were able to validate that our laparoscopic service line was efficient and safe, with physician practice-related variations in some charge items and missed charges in others," he said. "We shared the variations with the physicians for their consideration, and the missed charges with the surgery department to improve the charging process and eliminate, for example, over $3,000 in a single category of lost laparoscopic surgery charges."
In another project, Samaritan tracked pneumonia readmission rates as a quality-of-care measure. NF Blue made the task easy. "We found that re-admissions were primarily associated with one physician, and that a change in the formulary using a newly available drug was very effective at eliminating the high rate of re-admissions," says Stambaugh. "If we had had to use chart reviews and manual methods for tracking, it just wouldn’t have happened for lack of time and resources. But with access to our data through a powerful application to find the outcome information, it leaves time for the chart reviews when they are occasionally needed."
Samaritan Healthcare sees this approach as necessary to survive and improve while some other smaller hospital systems may be folding for lack of information. Says Stambaugh, "We are excited about having the same capability as larger systems and are ready to focus it on the next area of need." That area: looking across major DRGs for utilization outliers and working with medical staff to update clinical outcomes indicators. "This system allows us to look into any question that comes up immediately."
The system still is evolving, with Net-Fast actively seeking input from users on how to improve the system. "PACE had excellent drill down, but this is more flexible," Stambaugh says.
[For more information, contact:
- Glen Stambaugh, RRT, director of quality, Samaritan Healthcare, 801 East Wheeler Road, Moses Lake, WA 98837. Telephone: (509) 765-5606. E-mail: [email protected]
- Net-Fast, Billerica, MA. Telephone (978) 436-9100. Web: www.net-fast.com.]
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content