Slow and Steady Wins the Revenue Cycle: Lessons From Nemours' Six-Year HIM Automation Journey
A conversation with Cathy Murphy and Sally Van Blarcom of Nemours Children’s Health
and Prithvi Jayachandran from Vyne Medical.
When something’s broken, there’s an impulse to rip out what’s rotten and start over. Take out the old system, rebuild everything in six months, and put out a press release about it. That’s not what happened at Nemours Children’s Health. Their story spans six years, one module at a time, and a set of numbers that many revenue cycle leaders would trade for.
Nemours Children’s Health runs two freestanding children’s hospitals, in Orlando and Wilmington, plus more than 70 care locations across six states. Its HIM department is the hub for every document that doesn’t arrive through a direct system interface: referrals, lab reports, imaging, correspondence, new patient records. With such a high volume of fax, mail, and PDF traffic to manage well, it’s where the team focused first.
Six Years, One Module at a Time
Nemours didn’t automate all at once. Each addition solved one specific problem, on its own timeline:
- November 2020: HealthyData took clerical documents off manual entry.
- August 2021: LabDE pulled discrete data out of scanned lab reports instead of relying on scans alone.
- April 2022: Google Cloud Vision added handwriting recognition.
- December 2022: A custom referral workflow routed specialty referrals to the right scheduling queue while holding a 24-hour turnaround.
- Most recent: Auto-indexing across 11+ document types, a patient label barcode reader, and a redaction tool built into the verification queue.
None of it required a system-wide rebuild. Each module stayed solved.
What Six Years of Small Wins Add Up To
Here’s where the small wins add up to something bigger.
Nemours’ HIM verification team went from 62 associates across three siloed teams in 2021 down to 48 today, even as document volume kept climbing. Total documents processed grew from 1.6 million in 2024 to more than 2 million in 2025, with similar growth in pages and batches. The team placed 217,495 specialty referral consult orders in 2025 alone, up 10.74% over the year before.
Between 2021 and 2025, output documents rose 24% while the hours required to process them fell 37%.
The custom referral workflow alone roughly tripled throughput, from about 15 referrals an hour under the old manual process to 45 an hour once the new data entry panel was in place. Across all document types today, the team holds a 95% productivity rate and a 99% accuracy rate.
Why Steady Beats Sweeping
These results are based on strategic moves instead of sweeping changes. A department that adds one well-scoped module a year doesn’t have to pause operations to retrain everyone at once, doesn’t bet its budget on a single go-live, and doesn’t risk becoming the kind of “six months later, it didn’t work” headline that’s becoming common.
For revenue cycle and HIM leaders weighing an automation investment, that steadiness is itself a data point. Lower cost per document processed. Fewer hours spent on manual entry that could go toward verification and quality instead. A referral workflow fast enough to keep scheduling queues moving, which matters well beyond HIM’s four walls. None of it required a single leap of faith, just six years of small ones adding up.
Nemours’ team is excited to keep improving the system. Handwriting capture still depends on how legibly something was written, large batches can slow processing, and the team holds a standing monthly meeting just to tune recognition thresholds. That candor is part of what makes the makes the story attainable. Cathy Murphy points to the team’s auto-indexing rollout as the moment that candor paid off:
Want the full story, including the dashboards Nemours built to track all of this?
Watch the full webinar, “From Scanning to Scalable: How Nemours Children’s Health Built a Smarter HIM Operation,” featuring Cathy Murphy and Sally Van Blarcom, HIM Operations Managers at Nemours Children’s Health, and Prithvi Jayachandran, Technical Implementation Lead at Vyne Medical. And stay tuned: we’ll be back with a closer look at the workforce side of this story, how Nemours turned three siloed teams into one cross-trained group, which shaped the numbers above just as much as the technology did.