A recent webinar, "EHR in the ASC: How to Drive Cost Savings with Point-of-Care Charting," discussed the financial savings achieved through point-of-care case costing. The presenters, Todd Logan, MBA, regional vice president of sales at SourceMedical's Surgery Division, and Bill Hazen, RN, CHT, administrator at the Surgery Center at Pelham in Greer, S.C., explained how using electronic health records to capture cost data at the point-of-care can help ambulatory surgery centers save money by providing accurate information on use of resources and by educating nurses and physicians.
Buy-in
The first step to successful case costing is gaining the buy-in of physicians and employees. "If no physicians are on board, there will be no sustainable changes," Mr. Logan says. Mr. Hazen offered several strategies for getting the support of employees:
1. Make the center "the best place to work." Mr. Hazen says the employees at the Surgery Center at Pelham truly love where they work, evident in how they act, what they say and in positive employee satisfaction reports. Because of their satisfaction with where they work, they are invested in the success of the center. Once they understand how charting with EHRs can help improve the center, they are likely to lend their support.
2. Encourage employee engagement. Mr. Hazen says involving the employees in decisions for the center is critical for successfully operating an ASC. Employee engagement in decision-making can facilitate changes in the center, for instance. Creating "a culture to get employees to have ownership is crucial," Mr. Hazen says. "It's not a monopoly from the top. My whole philosophy is to work myself out of the job. The [fewer] decisions I have to make for employees, the better the system is going to run." Furthermore, engaging employees in different aspects of the company educates them about the business and financial implications of decisions. When they learn the potential savings through immediate case costing, employees will be more apt to support its implementation.
3. Develop loyalty. Mr. Hazen says the Surgery Center at Pelham highly values loyalty between the center's leaders, employees and physicians. The orientation for new employees and the code of conduct emphasize the importance of being loyal to the center. This reciprocal relationship helps build trust and understanding between the management and employees.
4. Education. Educating physicians and employees helps them make better decisions, Mr. Hazen says. He suggests showing physicians the EHR case costing report that clearly shows the amount each case costs, and how changes in the choice of materials or implants can save money. "Physicians don't understand what things cost," he says. "Physicians are not normally businessmen. Like nurses, they don't take business classes, which I think is a big mistake." Through education about itemized prices, however, physicians and employees can more easily understand the benefit of charting in an EHR system. In addition to educating physicians and staff on cost, Mr. Hazen says ASC leaders should educate physicians about the time savings achieved by identifying opportunities to eliminate inefficiencies in EHR cost reports. He suggests, "Tell [physicians] how it will make their lives faster, how they will have a higher quality of life at home." For example, Mr. Hazen says the average length of a colonoscopy is one hour, 48 minutes.
Case costing
They key to achieving savings with case costing is including accurate costs for each item and service as they occur, according to Mr. Hazen. The report should include fixed costs, up-to-date salaries for staff, implants and other materials. "You cannot go into this halfway," Mr. Hazen explains. For instance, the Surgery Center at Pelham includes the price of crayons (nine cents) and coloring books (60 cents) the center provides children. Through this level of detail, Mr. Hazen knows exactly how long each case takes in each area of the center and its exact cost.
Mr. Hazen uses the case costing report to identify opportunities for savings and areas of waste. He says, "I'm in my doctors' faces a lot. If they're using a lot of implants, I'm seeing it." To increase physicians' awareness of the cost of different parts of a case, Mr. Hazen posts anonymous reports of physicians' cases in the break room. He says this level of competition helps drive physicians to be more conscious of how the tools and supplies they choose affect the cost to the center, and thus to themselves. When this form of education does not effectively change the behavior of physicians with high-cost cases, however, Mr. Hazen suggests using peer pressure to influence physicians' decisions about their choice of tools and equipment.
To emphasize the financial benefits of EHR charting to physicians and staff, the Surgery Center at Pelham has instituted a quarterly bonus system that rewards employees with an equal division of 5 percent of all profits. "For every dollar they save, they are truly [getting] five cents into their pocket," he says.
In addition to direct monetary gains, case costing can benefit ASCs by allowing for greater control over vendors. Mr. Hazen explains that his center receives reimbursement for implants because he provided the insurance company with the actual invoice of implants from the EHR system without any mark-ups. After about a year of providing accurate implant prices, the insurance company agreed to pay for implants.
"The bottom line is [case costing] is simple, easy and nurses and physicians will appreciate you doing it," Mr. Hazen says.
Download the Webinar presentation by clicking here (pdf).
View the Webinar by clicking here (wmv). We suggest you download the video to your computer before viewing to ensure better quality. If you have problems viewing the video, which is in Windows Media Video format, you can use a program like VLC media player, free for download here.
Learn more about SourceMedical.
More Articles Featuring SourceMedical:
SourceMedical's Vision EHR Receives ONC-ATCB Certification by Drummond Group
6 Ambulatory Surgery Center Reimbursement Trends for 2011
SourceMedical Announces Partnership With ExitCare for Patient Education Resources
Buy-in
The first step to successful case costing is gaining the buy-in of physicians and employees. "If no physicians are on board, there will be no sustainable changes," Mr. Logan says. Mr. Hazen offered several strategies for getting the support of employees:
1. Make the center "the best place to work." Mr. Hazen says the employees at the Surgery Center at Pelham truly love where they work, evident in how they act, what they say and in positive employee satisfaction reports. Because of their satisfaction with where they work, they are invested in the success of the center. Once they understand how charting with EHRs can help improve the center, they are likely to lend their support.
2. Encourage employee engagement. Mr. Hazen says involving the employees in decisions for the center is critical for successfully operating an ASC. Employee engagement in decision-making can facilitate changes in the center, for instance. Creating "a culture to get employees to have ownership is crucial," Mr. Hazen says. "It's not a monopoly from the top. My whole philosophy is to work myself out of the job. The [fewer] decisions I have to make for employees, the better the system is going to run." Furthermore, engaging employees in different aspects of the company educates them about the business and financial implications of decisions. When they learn the potential savings through immediate case costing, employees will be more apt to support its implementation.
3. Develop loyalty. Mr. Hazen says the Surgery Center at Pelham highly values loyalty between the center's leaders, employees and physicians. The orientation for new employees and the code of conduct emphasize the importance of being loyal to the center. This reciprocal relationship helps build trust and understanding between the management and employees.
4. Education. Educating physicians and employees helps them make better decisions, Mr. Hazen says. He suggests showing physicians the EHR case costing report that clearly shows the amount each case costs, and how changes in the choice of materials or implants can save money. "Physicians don't understand what things cost," he says. "Physicians are not normally businessmen. Like nurses, they don't take business classes, which I think is a big mistake." Through education about itemized prices, however, physicians and employees can more easily understand the benefit of charting in an EHR system. In addition to educating physicians and staff on cost, Mr. Hazen says ASC leaders should educate physicians about the time savings achieved by identifying opportunities to eliminate inefficiencies in EHR cost reports. He suggests, "Tell [physicians] how it will make their lives faster, how they will have a higher quality of life at home." For example, Mr. Hazen says the average length of a colonoscopy is one hour, 48 minutes.
Case costing
They key to achieving savings with case costing is including accurate costs for each item and service as they occur, according to Mr. Hazen. The report should include fixed costs, up-to-date salaries for staff, implants and other materials. "You cannot go into this halfway," Mr. Hazen explains. For instance, the Surgery Center at Pelham includes the price of crayons (nine cents) and coloring books (60 cents) the center provides children. Through this level of detail, Mr. Hazen knows exactly how long each case takes in each area of the center and its exact cost.
Mr. Hazen uses the case costing report to identify opportunities for savings and areas of waste. He says, "I'm in my doctors' faces a lot. If they're using a lot of implants, I'm seeing it." To increase physicians' awareness of the cost of different parts of a case, Mr. Hazen posts anonymous reports of physicians' cases in the break room. He says this level of competition helps drive physicians to be more conscious of how the tools and supplies they choose affect the cost to the center, and thus to themselves. When this form of education does not effectively change the behavior of physicians with high-cost cases, however, Mr. Hazen suggests using peer pressure to influence physicians' decisions about their choice of tools and equipment.
To emphasize the financial benefits of EHR charting to physicians and staff, the Surgery Center at Pelham has instituted a quarterly bonus system that rewards employees with an equal division of 5 percent of all profits. "For every dollar they save, they are truly [getting] five cents into their pocket," he says.
In addition to direct monetary gains, case costing can benefit ASCs by allowing for greater control over vendors. Mr. Hazen explains that his center receives reimbursement for implants because he provided the insurance company with the actual invoice of implants from the EHR system without any mark-ups. After about a year of providing accurate implant prices, the insurance company agreed to pay for implants.
"The bottom line is [case costing] is simple, easy and nurses and physicians will appreciate you doing it," Mr. Hazen says.
Download the Webinar presentation by clicking here (pdf).
View the Webinar by clicking here (wmv). We suggest you download the video to your computer before viewing to ensure better quality. If you have problems viewing the video, which is in Windows Media Video format, you can use a program like VLC media player, free for download here.
Learn more about SourceMedical.
More Articles Featuring SourceMedical:
SourceMedical's Vision EHR Receives ONC-ATCB Certification by Drummond Group
6 Ambulatory Surgery Center Reimbursement Trends for 2011
SourceMedical Announces Partnership With ExitCare for Patient Education Resources