Many of you know the fairly tale tilted, "Goldilocks and the Three Bears." Upon entering the home of the Three Bears, Goldilocks sits in their chairs, eats their porridge, and falls asleep in their beds. Upon sampling each of the Bear's chairs, porridge, and beds she exclaims that one is too much, the other is not enough, but the last option is just right. What does this fairy tale have to do with Healthcare data and performing one's job, you may ask?
Here is the Three Bears Question: When it comes to performing your job well, which do you feel you must have?
a. too much data
b. not enough data
c. just the right amount of data
Before you answer, read this statement by Becker’s Hospital Review…
“Operational inefficiency is a difficult challenge to solve. Data and analytics were expected to help; instead, it’s made things worse as hospitals are awash in data without context or actionability.”
Now, let’s revisit the three bears question.
Your answer should be neither A or B but both A and B. I too think healthcare is awash in data and that much of it is not actionable.
How is this possible?
Let’s focus first on the most difficult data and documents. Papers, faxes, and images are the most likely data and documents that your organization will stumble over. Integrating this information into the EMR or other downstream decision making tools is usually relegated to manual processing. There are four reasons why this is so difficult:
Big volumes
Determining one document type from another
Knowing whom each document should be routed to
Finding the bits of data that will make a big difference for patient care or for revenue cycle issues
Next, we’re going to discuss each of these four reasons in depth.
Big Volumes
For many organizations, the first step is to print the documents. One Extract customer (size = one hospital + 100 clinics) prints approximately 17 million pages per year (that’s 68,000 pages per day!). Becker’s used the word awash for good reason.
Determining one document type from another
Multiple people (read expensive manual labor) print and read through these documents to decide what they are and who might be most interested in the information contained in the document. Extract’s customer, mentioned above, has identified a list of 409 document types in their EMR. Most organizations have many locations (clinics and hospitals) and inside each of those physical locations, there may be many fax machines. The numbers are staggering. Becker’s Review said, again, for good reason, the data is “without context or actionability”.
Knowing whom each document should be routed to
Some fax machines are assigned to a department which means most of the documents that come into that fax machine are related to that department. However, they still receive documents that come to their fax machine that belong to HIM and they need to be scanned, indexed and saved to the document management system (DMS). Before that can happen, these documents must be routed to HIM for further processing which equals more manual labor.
Finding the bits of data that will make a big difference for patient care or for revenue cycle issues
Finding the bits of data that are worth acting upon is incredibly difficult. It is highly unlikely that the person printing and sorting the fax documents has the clinical knowledge to do this work. This means printed documents are routed, in a paper format, throughout the organization which means the possibility of lost documents or HIPAA breaches increases. Once the documents reach their end location, it is possible someone will do manual data entry to get discrete data into the EMR. Or, the document may be scanned, indexed, and saved to the Media Tab (as known in the Epic world). The Media Tab means clinicians will spend valuable minutes every day (very expensive) sorting through the Media Tab to find patient information. Hate is a strong word but it is a word used by physicians to describe how they feel about the Media Tab. If the hospital’s management team understood how much money is spent searching for data, they would dislike the Media Tab too (please continue reading to the conclusion for some additional thoughts).
Modest sized healthcare organizations receive extraordinary numbers of documents every day, and as a rule, handle these documents very inefficiently. Time and money is wasted. In the end, critical data can still be lost to the organization. Sadly, neither the physician or the patient can take full advantage of the data.
Extract has done the math. If an organization has 200 physicians and 450 nurses and both are interrupted 3 times a day at 10 minutes each time, to find documents and data, the direct cost is over $5M. This doesn’t include opportunity cost or staff fatigue or any other soft cost associated with lost documents or data breaches. Your numbers could be higher or they could be lower, but the point is that a great deal of money is wasted that doesn’t need to be wasted.
Do you agree or disagree? You may need to re-answer the Three Bears Question.
Extract can help your organization reduce lost data and data breaches.
ABOUT THE AUTHOR: David Rasmussen
David Rasmussen is the President of Extract. With 30 years’ experience leading software companies, David is driven by the challenge to consistently find groundbreaking ways to solve customer problems. David finds it rewarding to hit the customer’s target and create a great team, build a solid infrastructure, and emerge with a strong value proposition.