Engaging Patients Through Self Service Technologies

April 13, 2015 Theresa Z. Meadows, RN, MS, CHCIO, FHIMSS,

FACHE

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DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

Conflict of Interest Theresa Z. Meadows, RN, MS, CHCIO, FHIMSS, FACHE Has no real or apparent conflicts of interest to report.

© HIMSS 2015

Learning Objectives • Create an automated check-in environment that is patient-centric and

efficient, allowing registration staff to focus more on patient service and satisfaction.

• Design a patient-friendly check-in process that collects and posts co-payments and outstanding balances in real time.

• Initiate discussions with patients to identify ways to make the check-in experience easier, more convenient and pleasant.

• Demonstrate technology’s role in providing a better patient experience.

• Apply lessons learned from other industries to expand check-in functionality and enhance customer satisfaction.

Benefits Realized for the Value of Health IT • The value steps impacted

were: – Savings – Satisfaction

• Over $1m collected at beginning of revenue cycle

• 70% of patients using self service technology

• Patient and staff satisfaction improved

http://www.himss.org/ValueSuite

About Cook Children’s

• Founded in 1918 – Fort Worth Free Baby Hospital

– Cook Children’s Hospital – Fort Worth Children’s

Hospital • 1984 Merger: Cook-Fort Worth

Children’s Medical Center • Private, not-for-profit corporation

held in the public trust by a board of community and physician leaders

• 2013 Nationally recognized Integrated Delivery System

Cook Children’s Health Care System

• Nine Companies – CC Health Care System – CC Medical Center – CC Physician Network – CC Home Health – CC Health Plan – CC Health Foundation – CC Northeast Hospital – CC Pediatric Surgery Center – CC Health Services

Service Area Defined

6-County Service Area Outlying Referral Area

Tarrant, Parker, Hood, Johnson, Wise, Denton (47% of state)

Our Promise Knowing that every child’s

life is sacred, it is the promise of Cook Children’s to improve the health of every child in our region through the prevention and treatment of illness, disease and injury.

Fast Facts

2014 Annual Statistics • 429 licensed beds • >60 primary care and specialty clinics • 600 (315 employed) active medical staff • 6000 employees • 15,000 Surgical procedures • 128,000 emergency room/UCC visits • 103,000 Health Plan Members • 9700 Home care visits • > 1 million patient encounters each

year • ~$ 1 billion revenue • ~$ 100 million in community benefit • Best of Breed IT shop

Awards and Recognition • 2012 SDI’s Top 100 Integrated Healthcare

Networks • 2012 Modern Healthcare’s Best Places to Work

(# 61) • 2012 Magnet re-designation (only 3% of

hospitals achieve) • 2012 Texas Award for Performance

Excellence from Quality Texas Foundation • 2014 US News and World Report Best

Children’s Hospitals ( 6 out of 10 specialties) • 2014 Dallas Morning News Top 100 places to

work • 2012 Leapfrog Group’s Top Hospital List • 2013 Information Week 500 • 2014 Most Wired Hospital • 2013 Best Hospital IT Department to Work

Our Problem

Challenges • Manage the changing

dynamics of children's healthcare systems

• Opening new outpatient specialty clinic, diagnostic & ambulatory surgery facility

• Decentralized registration with many entry points

• Improve patient experience

Solution • Automate the check in

process • Reduced patients time in the

waiting room • Increase co-pay collection • Validate Insurance

Information • Paperless consent process • Streamlined the workflow

Our Goal

• To create a more customer service-oriented culture; help parents check-in with ease; and implement one-point registration, where information entered at a kiosk could be shared instantly across the system.

The Vision

Patient Engagement - Access to Care

Pre Register (web/mobile)

Check –in (kiosk)

Visit Occurs

Check-out (Kiosk/Mobile/

Web)

Return for next

visit

Our Process

• Select the appropriate partner • Take the time to document workflow – Story Board

• Think about customer needs in design • Understand compliance issues • Integration with Revenue Cycle Systems is critical to success

Choose the right Partner

• Find a partner with similar vision • Commitment to delivery • Multiple form factors • Ability to meet regulatory

requirements

Story Boards

• Kiosk eligibility • Check-in logic • Consent logic • Scanning Driver’s licenses, insurance cards, and credit cards

• Posting cash

Kiosk Eligibility

• Determine the patient types who could use kiosk

• Demographic Changes • Pre-Authorization • Insurance verification • Daily eligibility list – Used

to greet and educate patients

Check-in Logic

• Language Preference – English and Spanish

• Pre-registration and scheduling integration

• Scheduled appointment choices

• Bar code/QR code check-in

• Driver’s License and Insurance card scanning

Consent Logic

• HIPAA Privacy Statement

• Financial Consent • Consent to Treatment • Patient Rights • Billing Instructions • Rules definition • Signature capability

Payment Logic • Cash, Credit, Checks • Co-pays • Prior Balances • Multi-revenue cycle vendor

environment • Real time updates to patient

accounts • Integration to 2 Revenue

Cycle Systems • PCI Compliance

Customer Driven Design

• Patient and family focus groups

• Patient friendly design • Multiple form factors • Staff available for first time users

• Guide patients toward kiosk

Directions and Next Steps

• Registration staff escorts patient and family to appointment location

• Clinic aware of patient’s arrival

• Clinic is able to greet patient on arrival

• Decreased wait time

Patient Engagement - Access to Care

Pre Register (web/mobile)

Check –in (kiosk)

Visit Occurs

Check-out (Kiosk/Mobile/

Web)

Return for next

visit

What’s Next - Web?

• Patient portal integration

• Improved pre-registration integrated to kiosk check-in

• Scheduling appointments on Web or Mobile

• Improved consolidated bill pay

What’s Next - Mobile?

• Cook Children’s app • Mobile versions of web capabilities

• Kiosk Check out – Follow-up

appointment scheduling

Benefits Realized for the Value of Health IT • Savings

– Fully centralized patient registration – > 100,000 check-ins have occurred

at kiosk – 80% of patients are kiosk eligible

– Reduced paper by 7 – 10 sheets

per patient (700,000 pages) >$150,000/year

– 70% of patients paid their co-pay at kiosk

– Year 1 Collections = $800,000 – Year 2 Collections >$1,000,000 – Able to maintain low AR days

http://www.himss.org/ValueSuite

Benefits Realized for the Value of Health IT

http://www.himss.org/ValueSuite

• Satisfaction – Technology empowered the

staff - Able to use registration clerks to escort patients

– Increased physician satisfaction

– Increased patient satisfaction around registration process and wait times for Ambulatory services

– 2 minutes at kiosk vs 5 – 7 minutes with registration clerk

– Improved practice efficiency. Patients directly to exam room

Questions?

Theresa Z. Meadows, RN, MS, CHCIO, FHIMSS, FACHE Senior Vice President and CIO Cook Children’s Health Care System Theresa.meadows@cookchildrens.org 682-885-6275 (O) Twitter: @tzmeadows