Mediware User Review:
Casa Colina Centers for Rehabilitation
Casa Colina Hospital has an outpatient services department that was seeing roughly 300 patients per week. At the time, the hospital placed more emphasis on acute care services than outpatient services. As a result, many of the patients discharged from the hospital sought their continuing outpatient treatment at competing facilities.
A CEO-level initiative was undertaken that same year to improve the performance and visibility of the outpatient services department. This initiative included new marketing efforts, additional hiring and internal process improvements.
The Problem: Long Wait Times and Errors
Almost immediately, patient scheduling was identified as an obstacle to both customer service and departmental workflow in outpatient services. Typical patient visits consist of staggered appointments across multiple disciplines such as physical, occupational and speech therapy. Our textbased legacy system required that the user essentially make an individual appointment for each discipline included in the appointment.
Because of this, errors were common and appointments took an average of 15 minutes to schedule. I saw the human impact of this one day as I watched a close friend with a degenerative bone disease stand at the front desk for 15 painful minutes while her appointment was being scheduled.
The complicated scheduling routine also meant that it was difficult to schedule or change appointments over the phone without making several calls back and forth to the patient. This situation led to frequent bottlenecks at the front desk and long wait times for patients. We had three full-time staff people dedicated to scheduling fewer than 300 appointments a week. In addition, new office staff members required a full week of training to learn the scheduling system.
Our scheduling system also had a negative impact on our clinical staff. Therapists were responsible for using the same time-consuming system to schedule follow-up appointments for their patients. This meant that clinicians were losing valuable time each day simply scheduling appointments. Reporting was another problem area. Our legacy system had very few reports, making it difficult to perform simple administrative tasks and monitor departmental performance. The legacy system also used a proprietary database which made it time-consuming and difficult to produce custom reports. The IT staff had to be involved to create every report needed by outpatient services.
Choosing a Software Partner
After we identified the obstacles that were created by our legacy scheduling system, we placed a high priority on finding a solution. The IT department worked with outpatient services staff to evaluate possible solutions. We identified five vendors with suitable scheduling solutions. Over a period of three weeks, we compared features and conducted online demonstrations of each product.
At the end of our evaluation period, we felt that Mediware AppointmentsPRO offered the best solution. There were three main reasons for our selection. First, the product presented us with an easy-to-use visual interface that could accommodate our staggered, multiprovider appointments. Secondly, the application was priced very competitively. Finally, one of our administrators had been involved in a successful implementation of the application at another facility.
We purchased a 10-user license of AppointmentsPRO and after a successful initial implementation, we purchased an additional 10-user license and the latest product upgrade. Because AppointmentsPRO uses a licensing model based on concurrent users, this gave us enough licenses to serve the needs of all the employees in the outpatient services department.
Smooth Implementation and Training Process
We implemented the application within 30 days of receiving the software. AppointmentsPRO is a client/server application and runs entirely on a secure hospital LAN. The installation was handled by our internal IT staff. The AppointmentsPRO server application and database were installed on an existing server with dual PIII 550Mhz processors. A separate client application was also installed on each computer in the outpatient services department.
“After three months, the time to schedule an appointment dropped 80%”
When we purchased the solution, we also wanted to add an HL7 interface to link it to our legacy system. However, the vendor of our legacy system made such an interface cost-prohibitive. Therefore, we installed the software as a stand-alone application. Even with the double data entry that is required, AppointmentsPRO was still preferable to our existing solution. The majority of the implementation period was spent customizing the system for our needs. The IT staff worked with the clinicians to customize support files such as provider descriptions and availability, appointment types, hours of operation and color-coding. Instructions for the setup were thoroughly documented in the user’s guide that accompanied the software. Any minor problems we encountered were solved through a call to Mediware’s technical support desk.
End-user training on the system was also handled internally. The IT staff provided a one-day session for all end-users.
The Benefits Were Dramatic
Once we went live with the system, the time required to schedule appointments dropped dramatically. The application allows our staff to easily book appointments with multiple providers on a visual scheduling grid, or it automatically finds opening for them. After just three months, the time to schedule an appointment dropped from 15 minutes to three minutes.
Scheduling accuracy has also improved. With our legacy system, it was common for patients to be unintentionally scheduled with long wait times between various segments of their appointments.
These customer service and efficiency gains were critical to the success of our efforts to improve the performance and visibility of our outpatient services department. Since those efforts began in 1999, we have gone from seeing 300 patients per week to seeing between 800 and 1,000 patients per week. We have been able to concentrate on hiring clinicians to meet the new demand without dramatically increasing the size of the office staff.
Fewer Staff Hours Required for Scheduling
The increased efficiency we have experienced has allowed us to add only one additional scheduling position while we have nearly tripled the number of appointments scheduled. The user-friendliness of the system also has enabled us to cut training time for new employees from one week to two or three hours.
Our clinicians are no longer spending 15 minutes between each appointment to schedule follow-ups for their patients. This has freed up time for them to complete their patient documentation and move on to other patients.
Another benefit of the system is its ability to track insurance authorizations. We are now able to track how many visits a patient has authorized and how many remaining visits they have. Before, we could only do this by manually locating a patient’s chart and looking up the information. This allows us to efficiently ensure that a patient has visits available before we even schedule another appointment.
AppointmentsPRO also included more than 30 scheduling-specific reports. The reports allow us to review departmental statistics, print provider schedules and provide our customers with customized appointment reminder letters. This has allowed us to manage the department more efficiently, and, as an added benefit, the IT department has not had to create any customs reports.