Data reporting system saves $500,000 for center
Improvements speed turnaround time 11.8%
After instituting a data reporting system in the spring of 1996, the medical transcription and word processing department at Geisinger Medical Center improved turnaround time 11.8% and cut operating costs by a half million dollars a year, reports Cynthia Taylor, department manager of the Danville, PA, hospital.
The department also has experienced greater collaboration with other hospital departments and proved that it could be cost-competitive against external medical transcription services, Taylor adds.
The environment at Geisinger is one familiar to many hospitals. Hospital leadership has been looking at ways to reduce costs without sacrificing quality. Staff cuts were instituted in the medical transcription department some as a result of cost-cutting efforts, and others through attrition after the data measurement program Taylor instituted identified ways to increase productivity. As a result, the department is operating with a 71-member staff compared to 106 one year ago, yet turnaround time to generate reports has declined.
Taylor instituted the data reporting program shortly after returning from a workshop in March 1996 conducted by Kathy Cameron, director of education for Modesto, CA-based Health Professions Institute. She admittedly had several factors working to her advantage. Geisinger had implemented a management document support system in January 1995 to run data on, so the systems were already in place to provide the data needed. In addition, Taylor had the full backing of hospital administrators to institute the program.
Geisinger’s goals for the data measurement program included:
• Identifying how and where transcription staff time was being spent.
• Identifying tasks that were not value-added.
Transcriptionists were key in identifying some of these tasks. Where possible, Taylor eliminated the task or transferred the work to another department. For example, the department calculated that transcriptionists were hand-addressing 400 interoffice envelopes a day to send out copies of reports. Taylor transferred the work to secretaries to free up the transcriptionists’ time.
• Working with divisional leadership to identify and institute improvements.
• Benchmarking productivity against industry standards to show Geisinger’s transcription unit was competitive with outside vendors.
Taylor began generating quarterly reports for each hospital department to measure utilization based on output of transcribed lines by department and by report. Only one department wanted a physician-by-physician breakdown. She also instituted meetings with department heads every six months to discuss changes in productivity and output, and opportunities for improvement.
Taylor used the reports to identify ways to improve, and also encouraged transcriptionists to come up with their own ideas. Department meetings were held on an as-needed basis to discuss trends.
Results to date have confirmed the program’s success to Taylor. The department’s direct cost for the 1996 fiscal year decreased 20.9%, a $494,000 cost savings. In addition, direct costs per line the department’s direct costs divided by the total number of transcription lines produced dropped 13.8% during the same period. Taylor recommends benchmarking transcription line production based on the national standard of 65 characters per line, as set by the American Association for Medical Transcription.
Other improvements included:
• Identifying template suggestions for physicians to use on commonly used reports to cut down on transcription time.
• Identifying portions of reports that could be automated. This eliminated manual calculation of financial reports used in some documents.
• Holding frequent meetings with transcriptionists and asking them to identify improvement ideas. Taylor gave individual transcriptionists recognition for ideas by inviting them along to meetings with the appropriate department head to present their ideas.
• Creating a benchmark cost per unit of service, then identifying what is needed to get there. For example, Geisinger’s average cost per line of transcription was 0.1655 cents for fiscal year 1994, compared to the current average of 0.129 cents per line.
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