Jacksonville Center for Endoscopy Goes Paperless with ProVation® MultiCaregiver, ProVation® MD


Jacksonville Center for EndoscopyFounded in 1998, Jacksonville Center for Endoscopy (JCE) is committed to the delivery of high-quality gastrointestinal care in an efficient, cost effective and compassionate atmosphere. The Jacksonville, Fla.-based ambulatory surgery center (ASC) is Joint Commission accredited, certified by the American Health Care Association and has surpassed the standards required by Medicare for licensure. More than 32,000 procedures are performed annually at JCE's two locations, which are owned and operated by the Borland-Groover Clinic. Specialists in liver and digestive diseases, the clinic started in Jacksonville in the 1940s with the practice of clinical gastroenterology pioneer Dr. James L. Borland, Sr. Borland-Groover now includes 50 physicians caring for patients across North Florida and Southeast Georgia in eight office and seven hospital locations. Borland-Groover physicians are also actively involved in clinical research, with hepatitis, therapeutic endoscopy and "outcomes" treatment studies currently underway.


From its inception, JCE was determined to leverage health information technology (HIT) to achieve its primary goal of providing care at the highest levels of quality and safety. The ASC was also determined to utilize HIT to streamline workflow, increase patient throughput, maximize revenues and minimize overhead costs by eliminating paper from the care process. Specifically, JCE wanted a point-of-care procedure documentation solution that allowed for immediate post-procedure documentation and imaging. They also sought an electronic health record (EHR) system that would, among other things, provide real-time history and physical information, capture nursing notes, track anesthesia, enable electronic patient consent and manage scheduling.

"Our goal was to ensure that our physicians had access to patient information that was up-to-date to the minute," said JCE Administrator Cindy Hall. "It was our belief that real-time information would reduce adverse events and streamline the pre-procedure process by automatically including certain checks into our workflow. "For example, an up-to-the-minute patient history might reveal new airway
problems that would necessitate the presence of an anesthesiologist during a procedure – information physicians need, but might not have access to unless it's automatically documented as part of the pre-procedure assessment," she added. It was equally important to leverage technology in a way that allowed JCE to maximize its staff resources by eliminating the need for nurses or receptionists to pull or copy charts, or enter data.


JCE ultimately selected a combined solution from ProVation® Medical, part of Wolters Kluwer Health: ProVation® MultiCaregiver, a patient charting and electronic record system designed specifically for ASCs, and ProVation® MD, which replaces the dictation/transcription process for physician procedure notes and automatically generates reimbursement codes based on a physician's documentation.

"We chose ProVation® for a number of reasons, including its ability to integrate seamlessly with our existing NextGen system and the fact that the company offered high-quality customer service and support," said Hall. ProVation® MD eliminates dictation and transcription and allows physicians to
efficiently document procedures at the point of care. It then produces complete, coding-ready and image-enhanced documentation, resulting in greater efficiency, as well as increased profitability and clinician satisfaction. ProVation® MultiCaregiver offers patient-centric electronic documentation and document imaging for all elements of the patient encounter, from past records and procedure documentation to follow-up care. It enables ASCs to increase patient throughput and streamline
workflow, while eliminating costs associated with creating, maintaining and storing paper charts. Both also drive quality indicators and pay-for-performance metrics through a robust set of turnkey data reports and data query options.


Today, JCE is paperless. The elimination of paper and printing costs associated with paper charts alone has netted an annual cost savings of more than $26,000, while a reduction in off-site storage fees creates an additional, ongoing annual savings of $12,000. Further, JCE was able to convert space previously used for on-site storage to offices. A paperless environment has also allowed JCE to refocus staff resources. The ASC saves up to two hours per day previously lost to pulling, copying and managing

patient charts. Because ProVation® MultiCaregiver is integrated with JCE's NextGen system, the ASC saves an additional three hours per day previously spent entering registration information, translating into faster patient throughput and room turn-over.

"We have seen an increase in the accuracy of information entered into our systems because fewer individuals are involved with data entry," said Hall. "Eliminating the need to scan patient consents into the system has also resulted in savings of both time and the costs associated with shredding paper copies." In addition, deployment of ProVation® MultiCaregiver and ProVation® MD has accelerated JCE's revenue cycle and shaved as many as five days off the billing cycle by eliminating wait times for the various reports necessary to complete billing. Because physician documentation and coding is automated, the overall coding and billing process is faster and more accurate, ensuring that JCE is reimbursed for all services provided and at the highest allowable level.

"Now, billing reports are generated and submitted daily," said Hall. "Billing for facility fees in particular is accelerated because physician charges are captured automatically. We no longer have to wait for them to be entered and then passed along to another department for facility charges to be added."

JCE has also realized significant benefits from the software's robust reporting features, which allow staff to track key performance measures and prepare for audits and reviews with the click of a mouse. But, perhaps the greatest benefits JCE has realized from its transition to a paperless environment are the improvements in both physician and patient satisfaction.

JCE's patients respond well to the instructions and images they are provided upon discharge. "They leave with instructions and a personalized report in hand that includes the detail and images from their procedure," said Hall. "This helps ensure that patients follow through with their post-operative care and, in the unlikely event of complications, any clinician who comes in contact with them will know the exact
procedure and treatment they have received."

Because ProVation® MultiCaregiver and ProVation® MD were designed by clinicians, they are highly intuitive and integrate seamlessly into the care process. As such, Hall says, "We were confident our physicians would adopt them quickly and easily. This was very important to us, because we knew that having all of our physicians use the software was key to getting a return on our investment.

"And in the end, we were right," she concluded. "Our physicians love that it simplifies their workflow, our staff spends less time on administrative work, and our cost savings have been extensive. We're extremely satisfied with the ProVation solution."