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eHealth Global Technologies Case Study
Penn State Milton S. Hershey Medical Center, Hershey, PA |
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| Medical Record Retrieval Using eHealthConnect Leads to Increased Efficiency, Cost Savings and Better Patient Care at Hershey Medical Center’s Transplant Program |
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As with any kidney or pancreas transplant program, motivated donors and recipients can often help drive process from the evaluation to listing by keeping their scheduled testing appointments or notifying their coordinators when testing is done at an outside facility. However, obtaining a comprehensive evaluation of all appropriate external medical records for both donor candidates and transplant recipients can be one of the biggest impediments to the process. |
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 Rachel Thomas, MBA, BSN, RN, CNN, Transplant Program Administrator for the abdominal transplant program at Penn State Milton S. Hershey Medical Center has seen this impact from both sides. "Four years ago, I was able to donate my kidney to my husband in Philadelphia. Despite the fact that I knew the proper procedures for medical records releases and proactively scheduled all of my own donor evaluation testing in one facility on one day, it still took over three months for the transplant coordinator to receive all of my records."
At Hershey Medical Center, Thomas attributed evaluation inefficiencies to the delay in getting outside records. "Initiating, tracking and ultimately acquiring medical records for patients over time from one or more providers can significantly impede progress for patient presentation at selection committee meetings," Thomas said.
At Hershey Medical Center, Thomas attributed evaluation inefficiencies to the delay in getting outside records. "Initiating, tracking and ultimately acquiring medical records for patients over time from one or more providers can significantly impede progress for patient presentation at selection committee meetings," Thomas said.
Once a patient is initially referred to Hershey for transplant, they will undergo roughly 15 to 20 different tests. In theory, Thomas sees great potential to reduce the number tests based upon the program's ability to quickly access prior records. "If the patient recently had an EKG or routine chest X-ray, that's two less tests they'll undergo, saving time, provider expense, and unnecessary duplicate testing."
Thomas and her team decided to explore outsourcing the process for medical records retrieval. "We believed that outsourcing would expedite the process from record request to candidate presentation in a cost-effective manner." Plus, she also thought resolving this key bottleneck would enable her staff to become more efficient, leading to a reduction in the number of candidates "in the queue."
That's when Thomas discovered eHealth Global Technologies (eHealth Global), a leading medical record services provider in North America. Her interest was piqued when she discovered the company offered a thirty-day pilot program to demonstrate benefit to healthcare organizations. In February 2007, Hershey's transplant program began to use eHealth Global's eHealthConnect service for a six-week trial period.
Results
During this initial period, Hershey outsourced record retrieval to eHealth Global for twenty-two patients. Dates and times for requests and results were tracked and response times analyzed. Thomas also looked at the time from receipt of all results to presenting the candidate to the selection committee and compared the traditional method against eHealth Global's service. Specifically, she looked at her staff time and total expense.
With eHealth Global, Thomas measured staff time to initiate medical record requests as well as patient time to testing, time to the follow-up exam at Hershey and time to placement on the transplant waiting list.
"Initial results of the pilot demonstrated benefits and also great opportunities to improve the quality of care and patient satisfaction while reducing staff time," she said. With eHealth Global, the transplant program was able to present patients to the selection committee in as few as six days, compared to the traditional 13-20 days from pre-kidney evaluation clinic once all tests were completed. Nearly 70 percent of medical record requests were filled within 24 hours while expedited requests were filled within two hours. The average time it took a coordinator to complete a requisition to outsource record retrieval took just five minutes versus 60 minutes for the traditional approach.
Assuming an average of 200 patient evaluations per year, the program would save three hours per week of staff time. Thomas noted the value of this time is nearly $8,000 per year.
Thomas estimates that her staff will save 156 hours of coordinator time each year. "This can only positively impact patient care. Coordinators now have the time and capacity to focus their efforts on community outreach, nursing education and other quality initiatives that are imperative for our thriving program." This ability can further distinguish Hershey's transplant center as a patient care and customer service leader.
However, cost is not necessarily the critical factor. "Even the providers with whom we have the best experience for obtaining medical records accurately and quickly could not provide the same level of response as eHealth Global. Plus, there is no question that the consolidated, online view of written reports and images organized by patient from eHealth Global is superior to the fragmented, illegible faxes and piecemeal mailings obtained through the traditional method." |
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 In fact, Mary Ann Smith transplant coordinator cites a recent example of superior patient care. Two hours before a meeting with the selection committee, Smith was still waiting for test results. Without these results, the patient's expected listing approval would entail further delay. She faxed eHealth Global with an urgent request to obtain the patient's missing records that day.
"Thirty minutes later, I had the report and the patient was listed that same day," she said. "They are absolutely efficient and productive. For whatever reason, they can get information for us in situations that I simply can't!"
Thomas continues to measure and track results and outcomes to further document the benefits of this service. This includes further exploration of physician time searching for missing records, cost of canceling patient appointments due to missing records, and cost of duplicate testing.
As Thomas reflects on next steps for her program, she stated "Since one obstacle to efficiency has been solved by using eHealth Global, I have been able to focus on more distinct metrics within the evaluation process. Measuring referral to evaluation, or evaluation to listing, was too broad making it seem that problems were solely due to the records delay. Eliminating that problem helps me focus on other quality improvement measures with my team and our processes."
Plus, with new regulations from the Centers for Medicare and Medicaid (CMS) requiring longer and more thorough documentation of follow-up on living donors, Thomas sees the service as a method for increasing compliance.
Certainly, costs savings are not the real motivation for Thomas. "The increase in efficiency and reduction in retrieval time from two weeks to 24 hours translates to the patient getting listed for organ transplant that much sooner. Although the patient will still wait an average of three years for a kidney, if a perfect match becomes available, timely listing can be the difference between life and death." |
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About Penn State Milton S. Hershey Medical Center
Founded in 1963 through a gift from The Milton S. Hershey Foundation, Penn State Milton S. Hershey Medical Center is one of the leading teaching and research hospitals in the country. The 500-bed Medical Center is a provider of high-level, patient-focused medical care. Annually the Medical Center admits more than 26,000 patients, accepts more than 766,000 outpatient visits, receives nearly 48,000 patients for emergency room visits and performs more than 23,000 surgical procedures. The Medical Center campus also includes Penn State College of Medicine (Penn State University's medical school), Penn State Cancer Institute, and Penn State Children's Hospital-the region's only children's hospital.
The transplant program at Penn State Milton S. Hershey Medical Center offers kidney, liver, pancreas and heart transplants. It is currently the only liver transplant program certified by Medicare in central Pennsylvania. |
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About eHealth Global Technologies, Inc.
eHealth Global Technologies, Inc. is an industry-leading medical record service provider. The company combines advanced information technology with its world-class clinical customer support team to retrieve, digitize, organize, store and secure patient medical records that reside beyond the 'digital reach' of its customers. eHealth Global's eRetrieverT, eHealthConnectT and eHealthShareT services help patients, tertiary medical departments, community hospitals, and private healthcare institutions improve productivity, reduce repeat exams, and enhance patient care through better, faster access to patient records. For more information about eHealth Global, please visit the web site at www.ehgt.com. |
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