Background: Olean General Hospital, based in Olean, N.Y., is a 186-bed hospital committed to providing the highest quality care to its local residents and surrounding communities. As the area’s main healthcare facility, residents rely heavily on the hospital and its emergency department (ED) for treatment. Because of this, Timothy J. Finan set out to improve hospitalwide efficiency and communication when he became president and CEO to ensure that the community received the best care possible. Olean leaders began evaluating departmental processes to determine needed changes and found that technological advancements would greatly improve ED operations and patient care.

The Challenge: Like other EDs with paper-based processes, Olean’s nurses were spending nearly half of their time searching for charts, staff, patients or other information. With 70 percent of admissions coming from the ED, Olean knew that ED inefficiencies and unnecessary steps during admission were affecting the rest of the hospital both operationally and financially. The leadership team decided that transitioning to an electronic system was the first step to enhancing communication, information availability and patient satisfaction. Olean began its search for an Emergency Department Information System (EDIS) that would meet its needs and become a valuable investment.

 

The Solution: A selection committee was formed to conduct onsite demos of several ED systems, which were evaluated based on feedback received from ED physicians and nurse managers. Ultimately, only MEDHOST met Olean’s requirements, largely because of the system’s intuitive documentation and robust patient tracking modules. After a unanimous decision, MEDHOST was deployed, and its impact became clear soon after go-live. 

 

Early results included streamlined workflows because clinicians could easily document care and access patient information. Clinicians reference the icons and alerts with the Patient Tracking module and have a real-time view of the ED and each patient’s status. ED staff can simultaneously keep track of charts, check order results and identify backlogs from any computer screen. Patients are moved to their inpatient rooms faster, freeing up ED beds for those waiting to be seen. Olean’s ED staff is now prepared to manage patient flow even during peak times.

 

“MEDHOST’s proven track record and its intuitive, touch screen system are so easy to use that even those weary of technology immediately loved it,” said Gail Bagazzoli, ED manager at Olean General Hospital. “It became clear very early on that we made the right decision. Adoption is the element required to succeed with any technology, and because MEDHOST is designed to support the way clinicians work, our clinicians quickly adopted the system. MEDHOST has actually become a great recruiting tool.”

 

With MEDHOST’s one-touch, template-driven charting, inputting patient information and documenting care is quick and easy. MEDHOST also prompts clinicians to complete required fields with visual indicators and unobtrusive reminders, so documentation is more complete and fully compliant with Joint Commission standards.

 

Order entry immediately became more efficient with MEDHOST. Prior to MEDHOST, physicians hand wrote their orders and gave them to clerks, who transcribed each individual order into the hospital’s order entry system. Now Olean’s physicians enter orders directly into MEDHOST, and ancillary departments receive the orders instantly. Ninety-eight percent of orders are entered by the ED physicians, and the remaining 2 percent are verbal orders to a nurse. These process improvement changes were apparent to the patients, as satisfaction with ancillary services such as lab and radiology jumped to the 90^th percentile after implementation.

 

“Since implementing MEDHOST, patient satisfaction scores have soared, increasing by 50 percent and boosting the ED’s scores from one of the lowest, to at one point the highest in the hospital,” said Grace Mosher, Olean General Hospital’s process improvement manager. “Besides helping us achieve our process and communication goals, MEDHOST played a major role in changing how happy our patients are with their experience and care, and that is the most important accomplishment of all.”

 

To further improve throughput, eliminate bottlenecks and ensure that ED resources are used in the most efficient way possible, Olean administrators review MEDHOST’s robust Reports to gather data and make operational decisions.

 

“Instead of manually going through daily logs, now we can easily pull a number of reports to trend peak times, adjust staffing and pinpoint unique breakdowns. This allows us to more proactively and effectively manage the ED and enables us to make changes based on hard data,” said Bagazzoli. “Because the ED is essentially the front door of the hospital, ED process improvements positively affect the entire facility. MEDHOST gave us everything we needed to revolutionize our entire facility.”

 

In addition to improving ED processes, MEDHOST turned the ED into a profit center. Olean’s manual coding process was tedious and delayed billing reimbursement because coders had to manually review paper charts and assign E&M Levels. MEDHOST’s automatic, behind-the-scenes Charge Capture is a byproduct of documentation that generates charges without any additional steps.  Prior to MEDHOST, Olean had a two-week-long billing cycle which is now down to one day. The new bill is much cleaner and is fully supported by clinical documentation, which has translated to an eight-day decrease in receiving payment.

 

“Automated Charge Capture has expedited the entire billing process because coders simply review charges rather than calculate and apply them. Because MEDHOST drives more complete documentation, we’ve recognized a significant increase in Level 4 and Level 5 charges, and per patient revenue is up more than 32 percent,” said John Eichner, vice president of finance at Olean General Hospital. “The gross revenue improvements were so significant after implementing MEDHOST that I ordered two audits to ensure accuracy. The audits proved the charges were right on the money, which means we are now accurately charging for the care we provide. MEDHOST is hands down the best vendor we do business with.”

 

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Emergency Department Information System