As the U.S. shifts further into the era of accountable care, hitting quality benchmarks becomes ever more important. Reimbursement is increasingly tied to the value generated by providers, and data about who is making the grade is becoming more transparent.
Knowing this, it’s a powerful capability to recognize an issue before it arises, rather than retroactively during a meeting weeks later.
That’s the capability staff at Nyack Hospital, a 375-bed community acute care medical and surgical institution in Rockland County, N.Y., have realized since they launched a pilot program with the Conserus Workflow Intelligence, from McKesson this past spring. Mark Geller, MD, radiologist-turned-CEO at Nyack Hospital, notes that prior to implementing the workflow intelligence software, the hospital was only aware of issues after they arose through a retrospective analysis of difficult-to-mine data.
“We needed a system that helps manage data on a prospective basis to prevent quality or a value issue before it arises.” says Geller. “As the CEO, having a real-time snapshot of potential issues, made possible with the robust rules engine within Conserus, is vital to our success.”
Previous models of workflow management would involve the hospital going through its processes and reflecting on turnaround times at the end of the month. Only if staff had fallen out of compliance would issues be dealt with.
Intelligent enterprise worklists, essentially help stop these situations from occurring, says Geller. The rules engine used at Nyack is capable of automating prioritization and assignment of studies to those that need urgent attention, priority studies bubble to the top of a worklist, with an escalation process to notify staff it needs to be read with increasing urgency.
“Now there’s little chance of that patient falling outside of accepted benchmarks and parameters,” says Geller.
This same thinking can be applied to any type of imaging study and any type of benchmark, whether it be Joint Commission requirements or service level agreements with a hospital. Administrators will be able to ensure their staff is providing higher quality and better value.
Enterprise Worklists Helps Drive Collaboration
Not all imaging is read by a radiologist, of course, but Nyack found they could use Conserus Workflow Intelligence to incorporate non-radiologists into the same workflow cycles.
Cardiologists who read cardiac-specific studies, including echocardiography and nuclear cardiology, had variable compliance with turnaround time goals depending on the physician and their workload. By looping them into to a standardized, enterprise-wide worklist, communication improved and along with it so did operational efficiency.
Standardized workflows across an enterprise improve care through the utilization of shared resources and decreasing report turnaround time. They ensure that the most qualified person will interpret a study by facilitating sub-specialty reading and reassignment of studies to specific users or groups as needed.
Gellers says that while the hospital doesn’t yet have hard numbers on how Conserus has improved turnaround times, anecdotal evidence is strong that workflows are now much more efficient.
This is particularly true for radiologists who don’t read studies at the hospital every day and couldn’t get into the flow of how studies were prioritized under the old system. Rather than try to get caught up on new, constantly evolving protocols around worklist priorities, they can now simply read what’s in front of them. The system itself handles study priority without manual intervention, and the radiologists can focus on interpretation.
“In today’s healthcare environment, hospitals need to be increasingly compliant and radiologists better aligned with their peers. I think a tool like this will help facilitate that, certainly from a data reporting perspective,” says Geller.
With increasing scrutiny on quality metrics, data is becoming more transparent. Benchmarks from programs like HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems), will need to be met, and this provides an opportunity for radiology to show its value.
Length-of-stay is a focus area at Nyack, for example. Using the rules engine in the workflow intelligence software, pre-discharge studies now more quickly bubble to the top of the worklist. Instead of a discharge study being read at 4 p.m. and delaying a discharge that could have been done at Noon, those studies are being interpreted earlier, allowing the hospital to decrease average length of stay, according to Geller.
“It allows our diagnostic imaging department to provide a valuable service, one that can be tailored specifically to the hospital’s needs and to the community’s needs,” says Geller. "That’s good for both radiologists and the hospital. The more aligned the two entities become, the better for each.”