Case Study: Washington Square Endoscopy Center/PHGI Associates Reduces Costs in a Paperless Environment
Located in Philadelphia, Washington Square Endoscopy Center (WSEC) is dedicated to the delivery of high-quality gastrointestinal (GI) care in an efficient, cost-effective and compassionate atmosphere. WSEC is a physician-owned ambulatory surgery center (ASC) that is home to nine endoscopists who perform more than 8,000 procedures annually at the facility. Named by the American Society for Gastrointestinal Endoscopy (ASGE) to its national Endoscopy Unit Recognition Program, WSEC is Joint Commission accredited and has earned the "Gold Seal of Approval" designation. It is licensed by the Pennsylvania Department of Health to participate in the Pennsylvania Patient Safety Authority Reporting System.
ProVation® MD and ProVation® MultiCaregiver software users since 2003, WSEC transitioned to a more electronic environment over time, adding functionality like document management and enhancing their overall IT systems. By 2009, they were almost completely paper-free.
"What we hoped to achieve in the transition was modest in comparison to the actuality," said Stephanie Diem, RN, BS, WSEC's Clinical Director. "Initially we were focused on compliant documentation, reporting to referring physicians, shortened billing cycles, lower transcription and printing costs and increased availability of data and reports. While that may seem like a comprehensive list, ProVation software has allowed us to achieve much more."
Eliminating dictation and transcription, ProVation MD allows physicians to efficiently document procedures at the point of care. It then produces complete, coding-ready and image-enhanced documentation that results in greater efficiency, as well as increased profitability and clinician satisfaction.
The first true electronic health record designed for busy, cost conscious ASCs, ProVation MultiCaregiver offers robust electronic documentation and document imaging for all elements of the patient encounter, from past records to procedure documentation to follow-up care. With ProVation MultiCaregiver, ASCs have affordable access to a single, patient-centric documentation system that eliminates printing and chart storage costs and streamlines workflow. Further, ProVation MultiCaregiver provides an affordable solution with low monthly operating costs that interfaces seamlessly with vitals monitors, information systems and ProVation MD.
Currently, the WSEC utilizes ProVation software to:
- Document physician, nurse, anesthesia and technical staff notes
- Label specimens
- Report pathology results
- Produce coding reports
- Fax information to referring physicians
"Also important is the ease with which ProVation software integrates with our practice management applications," said Diem. "This has been huge since these applications are used to manage scheduling, patient tracking, billing, charts, demographics and patient correspondence. Compliance between systems has made operations run much smoother."
"Combined with our GE Centricity System, these capabilities allow us to operate in an almost completely paperless environment," said Diem. "Patients come in with paper, but we make it go away pretty quickly."
Approaching Implementation to Achieve Success
Key to the success of WSEC was its approach to software implementation, which leveraged the facility's intranet for continuous project communications.
"Our first step was announcing to our staff the upcoming changes via our facility's internal home page," said Diem. "We also included links to professional societies, reference materials and any other documents that would assist in overcoming the learning curve."
Staff education is key and should be repeated annually. For WSEC, this is most attainable by utilizing online resources. Further, management developed training materials that are available from the home page, including films and DVDs to supplement mandatory training.
The establishment of a project manager also ensured a smooth transition. In particular, the project manager worked closely with IT support to ensure that hardware, firewalls, antivirus and web filtering were up to date and that the network and application infrastructures were capable of handling the software - ongoing responsibilities that help ensure the systems continue to operate at peak efficiency and capacity.
"Setting clear objectives is extremely important," said Diem. "If you don't know where you are headed, it will be very hard to get there. Determine your goals and how you will achieve them, and from there get the rest of your team on board to help."
Since going paperless in 2009, WSEC has realized an annual savings of $20,750 in charts costs alone, including $1,500 in paper expenses, $450 in storage costs and $18,800 in retrieval and delivery charges. Further, it has decreased medical records staff by one fulltime equivalent (FTE) and transcription staff by 1.4 FTE, resulting in a total annual savings in salaries and benefits of $80,092.
Reporting capabilities within the facility have also been enhanced. Most notably, it now takes less time to run more comprehensive procedure time, medication use and scope use reports, as well as recredentialing information, audits and other administrative reports.
Increased patient throughput has also been realized, as have other efficiencies, such as the availability of patient assessment information at subsequent visits, pathology tracking and reconciliation, and increased coding and billing accuracy.
WSEC has been so impressed with the benefits of working in a paperless environment that plans are in place to expand electronic functionality to include e-prescribing, secure messaging and an advanced patient portal to drive improved outcomes and satisfaction.
"What we are realizing is far beyond what we expected," said Diem. "We're thrilled with what the ProVation software has allowed us to accomplish and are currently looking to enhance functionality with a number of tools in the future."