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Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events...

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SCA RHIO/NHIN June 2006 Smart Cards In The Smart Cards In The RHIO / NHIN Application RHIO / NHIN Application
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Page 1: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Smart Cards In The Smart Cards In The RHIO / NHIN ApplicationRHIO / NHIN Application

Page 2: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

New Medicare Rules Take New Medicare Rules Take Effect Today!Effect Today!

Page 3: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Patient ID New Initiative in Patient ID New Initiative in Most Health Systems Most Health Systems Around the USAround the US

Page 4: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Challenges and IssuesChallenges and IssuesLittle standardization in processes.Multiple tools being utilized to access needed data.Turnover rate high for front-end employees.Hospitals/Physician offices beginning to look for new technologies to enhance revenue cycle.Significant need to increase cash collections at front-end.

Little standardization in processes.Little standardization in processes.Multiple tools being utilized to access Multiple tools being utilized to access needed data.needed data.Turnover rate high for frontTurnover rate high for front--end end employees.employees.Hospitals/Physician offices beginning to Hospitals/Physician offices beginning to look for new technologies to enhance look for new technologies to enhance revenue cycle.revenue cycle.Significant need to increase cash Significant need to increase cash collections at frontcollections at front--end.end.

Page 5: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

How Important is RC and How Important is RC and The RHIOThe RHIO

70% of All Errors

Page 6: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Page 7: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

EMR is SOOOO Secure We Do Not Need EMR is SOOOO Secure We Do Not Need Smart Cards. We Have a RHIO!Smart Cards. We Have a RHIO!

Page 8: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Some SolutionsSome Solutions Smart CardsSmart Cards

Page 9: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Page 10: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Page 11: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Page 12: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Smart CardSmart Card

Host Host System System

DataDataPractice Practice

ManagementManagement HIS HIS EMR/EHR/PHREMR/EHR/PHR

MCSMCS

Integration Integration LayerLayer

HL7 HIEHL7 HIE

WSS/ODBCWSS/ODBC……Data MappingData Mapping

Data TransformationData TransformationContinuity of Care RecordContinuity of Care Record

Page 13: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Smart TechnologySmart Technology

Page 14: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

I Told You We Should Go To The Health I Told You We Should Go To The Health System That Had Smart Cards and System That Had Smart Cards and Kiosks!Kiosks!

Page 15: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Page 16: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Extended Wait Time For Registration Extended Wait Time For Registration

PrePre--registered registered

WalkWalk--ins ins

Point of Service (POS) areas per a prior process Point of Service (POS) areas per a prior process

Hope that overflow handled by Outpatient Hope that overflow handled by Outpatient Registration Registration

Wait TimeWait Time––PrePre--Registered (% < 10 minutes)Registered (% < 10 minutes) 50.0%50.0%

Wait TimeWait Time--WalkWalk--Ins Ins (% < 30 minutes)(% < 30 minutes) 34.5%34.5%

Page 17: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Smart Card CheckSmart Card Check--In / Check OutIn / Check Out

Wait TimeWait Time––PrePre--Registered (% < 10 minutes)Registered (% < 10 minutes) 90.0%90.0%

Wait TimeWait Time--WalkWalk--Ins Ins (% < 30 minutes)(% < 30 minutes) 95.0%95.0%

Page 18: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Poor Registration Data QualityPoor Registration Data Quality

Front end quality control process Front end quality control process

Training Training

Formal documentation Formal documentation

Current System dictionaries/tables Current System dictionaries/tables

Accuracy Accuracy --Demographic Demographic (% Error free)(% Error free) 0.0%0.0%

Accuracy Accuracy --Billing Billing (% Error free) (% Error free) 4.3%4.3%

Accuracy Accuracy --OVERALL OVERALL (% Error free) (% Error free) 2.2% 2.2%

Page 19: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Smart Card Rapid RegistrationSmart Card Rapid Registration

Accuracy Accuracy --Demographic Demographic (% Error free)(% Error free) 90.0%90.0%

Accuracy Accuracy --Billing Billing (% Error free) (% Error free) 90.0%90.0%

Accuracy Accuracy --OVERALL OVERALL (% Error free) (% Error free) 90.0%90.0%

Page 20: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

National Association of National Association of Healthcare Access Healthcare Access

Management (NAHAM) modelManagement (NAHAM) model

The NAHAM model recommends a The NAHAM model recommends a continuum of services that should be continuum of services that should be provided by a comprehensive access provided by a comprehensive access management system. Core management system. Core competencies are required in the areas competencies are required in the areas of preof pre--encounter activities, encounter encounter activities, encounter activities, and post encounter and staff activities, and post encounter and staff development activities.development activities.

Page 21: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

PrePre--EncounterEncounter••Patient PortalPatient Portal

••PersonalPersonal

••InsuranceInsurance

••Med Med HxHx

••Soc Soc HxHx

••MedsMeds

••AllergiesAllergies

••CCRCCR

Page 22: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

ImpactImpactAdverse drug events alone cost U.S. hospitals billions Adverse drug events alone cost U.S. hospitals billions

annually, while errors lead to an increase in hospital annually, while errors lead to an increase in hospital stays of 4.6 days and an incremental cost of $4,700 stays of 4.6 days and an incremental cost of $4,700 per admission. Medication errors may occur at any per admission. Medication errors may occur at any point in the medication process but the vast majority point in the medication process but the vast majority occur during the ordering and administration stages. occur during the ordering and administration stages. According to the Institute of Medicine and other According to the Institute of Medicine and other experts, thousands of deaths result from medication experts, thousands of deaths result from medication errors. The total possible annual benefit from errors. The total possible annual benefit from preventing adverse events due to medical errors is preventing adverse events due to medical errors is $2 billion.$2 billion.

Page 23: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

OpportunityOpportunity

Page 24: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

The The FutureFuture

Page 25: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Bush Administration Bush Administration Announces New HIPAA Announces New HIPAA Police ProgramPolice Program……They Are They Are Watching!Watching!

Page 26: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

What do You Mean You What do You Mean You WonWon’’t Sign Int Sign In……ThatThat’’s The s The Way We have Always Done ItWay We have Always Done It

Page 27: Smart Cards In The RHIO / NHIN Application...SCA RHIO/NHIN June 2006 Impact Adverse drug events alone cost U.S. hospitals billions annually, while errors lead to an increase in hospital

SCA RHIO/NHIN June 2006

Final AnalysisFinal Analysis


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