Situation

For more than 100 years, Mercy Medical Center has championed excellence and healing for those they serve. Staying true to its mission of providing quality and compassionate care, the hospital sought state-of-the-art technology to streamline scheduling workflow and improve service to its patients and physicians.

Mercy Medical Center sought to accomplish the following:

• Boost service levels to patients and physician practices.
• Streamline management of faxed physician orders.
• Improve collaboration between scheduling and ancillary departments.
• Increase scheduling workflow and efficiency.

Approach

Mercy Medical partnered with Vyne Medical to conduct an assessment of departmental processes. Best practices were identified to address the following initiatives:

• Streamline workflow with paperless approach to physician order management.
• Improve patient and physician satisfaction by eliminating lost orders.
• Boost collaboration and efficiency with centralized access to needed records.
• Enhance financial performance with documentation of insurance authorization.

Best practices were implemented and hardwired through supporting technology solutions.

Solution

Mercy Medical implemented the following best practices using supporting solutions available through Vyne Medical’s Trace platform:

Automation of faxed physician orders

Mercy Medical’s Central Scheduling department receives an extremely high volume of orders, approximately 600 per day. The hospital previously used a paper process to receive, store and route these documents. File cabinets were filled with orders, filed alphabetically and by date to assist in retrieval. Because the orders are only eligible for a year, staff members were constantly filing and replacing outdated orders.

“It felt like we were eating orders,” said Tamara Arney, Manager of Central Scheduling. “We would constantly get complaints from physicians that we had lost orders.”

Vyne Medical collaborated with Mercy Medical’s departmental leadership and IT group to identify and map an electronic workflow for order management. The goals were to improve workflow and patient and physician satisfaction by going paperless and eliminating lost orders.

Electronic workflow for order management

Mercy Medical began by implementing Trace FaxCert® for electronic management of faxed physician orders. According to Arney, identifying and mapping the workflow was the step most critical to the project’s success. “The workflow helps ensure that orders are complete and accurate prior to the date of service, eliminating the need to delay or cancel procedures as a result of missing or incomplete orders,” said Arney. With FaxCert, physicians fax orders to one number. Scheduling receives the order electronically through Trace. The staff person responsible for reconciling incoming orders indexes the order by date of service. A second staff person works upcoming scheduled days by searching Trace for orders by date of service. Scheduling ensures that each order has a signature, that the diagnosis matches the order and correlates with the test scheduled and that the diagnosis meets medical necessity. If any of these criteria are missing or inaccurate, scheduling faxes the order back to the physician office for completion and/or correction. If an order is completely missing for a scheduled procedure, Mercy faxes the physician office to request the needed order. All faxes are date and time stamped in Trace for auditing purposes.After implementing Trace in Central Scheduling, Mercy expanded implementation to Radiology, Admitting and the Laboratory so ancillary areas could gain access to orders through the system. When a medical record number is entered for the patient, scheduling indexes the order to the patient account through an HL7 interface between Trace and the hospital’s registration system. The order is then accessible to all areas and searchable by patient name or medical record number.

Central scheduling process

When a patient calls Mercy Medical to schedule a procedure, Central Scheduling pulls up the patient’s order through Trace and schedules the appointment. Once the appointment is scheduled, scheduling notifies order reconciliation. The order is then accessible to ancillary departments, which are able to quickly locate the order when the patient presents at Check-In.

Recording and scoring of verbal communication through Trace Voice and Quality Scoring

Mercy Medical’s Central Scheduling department will soon be implementing Trace Voice to record phone calls with patients. Monitoring and scoring these encounters through Trace Quality Manager will help scheduling teams continue to pursue communication performance excellence with patients.

Recording of phone calls and faxes with insurance companies.

Mercy Medical’s Insurance Verification team uses Trace Voice to record phone calls with insurance companies when authorization is given for service. Staff also use Trace FaxCert to capture faxes sent for insurance notification. The hospital is able to use these records as proof to prevent and overturn denials for lack of authorization and notification.

Referencing recordings for patient advocacy

Mercy Medical’s Patient Advocate uses Trace to investigate patient issues such as complaints and misunderstandings. Because phone calls and faxes are documented and tied to the patient account, leadership can use the information to conduct root cause analysis and pursue service recovery when needed.

The workflow helps ensure that orders are complete and accurate prior to the date of service, eliminating the need to delay or cancel procedures as a result of missing or incomplete orders.
— Tamara Arney, Manager of Central Scheduling

Results

Through its partnership with Vyne Medical, Mercy Medical has realized significant improvements in patient experience, collaboration, workflow and physician and staff alignment. The benefits to Central Scheduling and ancillary departments include the following:

Improved collaboration and workflow

Collaboration has greatly improved between scheduling and ancillary areas as a result of other departments now having a “window” into Central Scheduling. Rather than searching through file cabinets or making multiple phone calls in search of an order, ancillary staff are able to quickly locate needed information through Trace. In the Sleep Lab, for example, the time needed to complete patient charts has decreased from approximately 4 hours down to 30 minutes as a result of implementing Trace. Trace also provides an electronic audit trail to track information such as when an order was faxed to another department, when it was received and who has viewed the order.

Reduced hold time and phone abandonment rates

With immediate access to needed information, scheduling has significantly reduced hold time and phone abandonment rates, boosting service to both patients and physicians. As a result of Trace and other coinciding projects, Central Scheduling reduced its phone abandon percentage from 15-18% to 6-9% over a 2½-year period. (Figure 1.)

Fewer delays and cancellations

By working scheduled days in advance, scheduling staff are able to better prioritize workflow and ensure that orders are complete and accurate prior to the date of service. This has reduced service delays and cancellations previously resulting from lost orders.

Because orders are centrally stored through Trace, ancillary areas are able to quickly locate orders upon patient arrival, ensuring an efficient check-in at the time of service.

Enhanced service levels to physicians

Improved access to needed information has resulted in faster response times to physicians and office personnel. This has resulted in better working relationships with physician offices, improved credibility for the hospital and increased loyalty among physicians.

Improved financial performance

Documentation of insurance authorization has given Mercy Medical proof to prevent and overturn a significant number of denials, improving financial performance for the hospital.

Conclusion

Mercy Medical has achieved excellent results in the quest to improve key performance indicators such as patient experience, workflow and physician & staff alignment. Real-time access to critical fax records has created an efficient work environment, fostered collaboration among teams and improved service levels to both patients and physicians. (Figure 2.) Scheduling will soon add voice recording and quality scoring as another best practice to further these performance improvements.

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