Alamance Regional Medical Center (ARMC)
Burlington, North Carolina (238-bed medical complex)
Centralized Scheduling Combined with Online Order Processing
Integrated Solution Provides ‘Power Access’ ROI
The Challenges
At ARMC, physician dissatisfaction with scheduling into the Radiology department was the initial catalyst for access improvements. There was an abundance of frustration (both at ARMC and with its referring providers) with having to call multiple contact numbers (seven) and long phone wait times. Coordination across Scheduling and Registration departments was disjointed. Workflow and communication links between departments were often repetitive. Patients often “blamed the hospital” for their incomplete, unsigned and missing orders, which would result in long wait times and appointment delays. Revenue was often lost when complex (high dollar) procedures were compromised by a mismanaged schedule. A manual and cumbersome orders checking process further compounded the access frustrations. And, ARMC was also facing strong competition by a new radiology facility that had opened across the street.
Another challenge faced by ARMC was the fact that their Order Management processes were in a state of disarray. When paper orders were received before the date of service, they were manually logged onto a spreadsheet and filed in date order in filing cabinets. Not only was this very time consuming, but it also took up a lot of storage space. There was an FTE dedicated to looking at the orders to make sure they were complete and contained a valid diagnosis. If any pertinent information was missing, she would contact the physician’s office to obtain a corrected order—a very cumbersome process!
The Goals
Because patient and provider satisfaction outcomes and revenue cycles are directly impacted by the pre-registration process, ARMC knew they needed to make improvements in order to operate with maximum efficiency and stay ahead of the competition. ARMC had a vision of providing “One Stop Shopping” for its patients and providers to order and schedule into the facility as well as to stay ahead of its competition by making the facility as easy-to-access as possible.
The Solutions
Sophisticated, Centralized Scheduling
On June 24, 2003, ARMC rolled out Schedule Maximizer® in a newly formed Centralized Scheduling Office. Staffed with 6 schedulers, ARMC began scheduling the following procedures for Radiology Department: mammography, CT, MRI, Diagnostics, Nuclear med, and Ultrasound. The 1-Way Registration Interface with Med-Series 4 was expanded to a 2-Way Registration Interface with Account Management*. (The Account Management* module can either prompt schedulers to pre-register patients during the scheduling process, if the patient is on the phone, or in other instances like at ARMC, they assign a dedicated registration team to perform the pre-registrations and have accounts created for scheduled appointments.)
Based on the rules set up by ARMC, Schedule Maximizer populates entries onto a “Worklist” for the pre-registration (pre-reg) team to call the patient and complete the task. This online “Worklist” enables the team to prioritize the patients that need to be contacted and provides a link to enter the pre-registration details that require additional follow-up such as insurance verification, authorization and precertification details. All of this ensures that the patient is fully preregistered prior to their visit. If all of the preregistration measures are complete and accurate, the patient is able to “Fast Lane” through ARMC’s check-in desk and move swiftly to their scheduled appointment.
Additionally, an outbound Schedule Interface was added to automatically send appointment information from Schedule Maximizer to the Siemens Novius Radiology System upon scheduling, rescheduling and canceling.
The Schedule Maximizer Account Management, Medical Necessity, Insurance Verification and Worklist modules, are enabling ARMC to complete pre-registrations more efficiently and to improve patient satisfaction by eliminating the discovery of insurance issues on the date of service. The following “front door” activities are now completed before the patient arrives:
- Pre-registration (Patient Account Creation)
- Medical Necessity Checks
- Insurance Verification
- Financial Counseling
Additionally, in an effort to maximize efficiencies while maintaining the staff’s scheduling preferences, ARMC’s Mammography department has:
- opened an additional room for mammography screening exams
- shortened the duration of the mammo screens
- created an "emergency" slot for diagnostic mammograms 4 days a week
- built sophisticated templates and rules into the scheduling system
Online Order Processing
Following the Centralized Scheduling success with Schedule Maximizer, ARMC implemented Order Facilitator® in September 2007. Currently, approximately 40 practices (representing 140 physicians) are benefiting from an improved orders process.
In this process, ARMC’s schedulers have the ability to check CPT codes and verify orders in Order Facilitator, without having to search for the test or having to know complex medical terminology—scheduling errors have been greatly eliminated.
According to ARMC's Supervisor Centralized Scheduling and Insurance Verification, “Order Facilitator’s online order transmission has dramatically improved our efficiency as well as our paper overload.” She continued, “All of the physician’s offices that are using Order Facilitator are so pleased with the system and they cannot imagine going back to the way things were before.”
Power Access – Combines Online Orders and Scheduling in a few quick steps
In the winter of 2009, (live Dec 8) through the integration of Schedule Maximizer and Order Facilitator, ARMC’s Order Management process became dramatically improved. This 'Power Access' workflow saves ARMC twelve manual steps and approximately 3.7 hours of work per day.
The New Workflow
1. Appointment is booked first in Schedule Maximizer
2. Appointment goes to the Order Request tab in Order Facilitator
3. The office user picks up the appointment from the Order Request tab and builds the order.
- Order is automatically linked to the Schedule Maximizer appointment
- “Appointment Requiring Order” worklist item is automatically closed in Schedule Maximizer.
- Order is automatically in the “scheduled” status in Order Facilitator with the appointment details
- Order is auto-archived off the scheduler’s Order Facilitator dashboard.
The Results
Since implementing SCI’s suite of advanced Access Management products, ARMC has realized the following results:
- Reduced decentralized Radiology phone numbers from 7 to 1.
- With FTE reallocation, technicians were saved approximately $44,449 per year in time no longer spent on scheduling activities
- Reduced FTEs due to centralization, saving the Radiology department $42,931 in annual salaries
- Reduced Radiology scheduling resources from 15 to 6
- ARMC has realized over $300,000 benefit in salary, time and FTE savings by centralizing scheduling with Schedule Maximizer
- Now that Radiology's access problems have been resolved, ARMC has solved the same issues in additional departments. They built upon their success in Radiology and shared the solution enterprise-wide to include:
- Centralized Radiology, Cardio Pulmonary, Pre-Admit Testing scheduling, MRI, CT (3 locations), Nuclear Medicine, Pre-Op Classes, Bone Densitometry, Ultrasound (3 locations), Mammography (3 locations), Diagnostic (2 locations), PET Scans, Perinatal Clinic, X-ray (3 locations)
- Decentralized Rehab and Pain Mgt Clinic, Cardiac Cath Lab and BCCCP (Breast and Cervical Cancer Control Program) Clinic, Massage Therapy (3 locations), Human Movement Lab
- 500 appointments per day
- Sophisticated Integration
- Pre-registration/account management with Siemens MedSeries4
- Outbound schedules/orders with Novius Radiology
Conclusion
ARMC has fulfilled its “One Stop Shopping” vision by implementing both Central Scheduling and Online Order processing solutions that enable “ease of access” for both patients and providers. With Schedule Maximixer, physician offices appreciate the fact that they can opt to call for patient appointments one at a time or they can make one phone call to schedule multiple exams for multiple patients. In the past, a call to the radiology department may have meant leaving a voice mail to schedule an appointment. With Centralized Scheduling, voice mails are a thing of the past. With Order Facilitator, ARMC staff and customers appreciate the ease of online order automation that all but eliminates missing, illegible and incomplete orders as well as the manual order checking process. ARMC patients are benefitting from reduced wait times on the day of their exam because their orders arrive accurately and the scheduling and pre-registration process has taken care of demographic and insurance verification before they even walk into the building.
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About Alamance Regional Medical Center (ARMC)
ARMC has combined state-of-the-art technology with a care philosophy of respect and compassion for every single patient. This unwavering pursuit of excellence has earned them recognition, awards, and most importantly, satisfied patients.
- 238-bed medical complex
- Committed to core value of excellence, striving to provide services in a superior fashion and with the highest integrity, continuously making improvements to these services and exceeding the highest expectations of those we serve.
- ARMC has been successfully using Schedule Maximizer for Decentralized Scheduling for five Outpatient Rehabilitation Clinics with a 1-Way Registration Interface since January 2001.
- ARMC has been successfully using Order Facilitator since September 2007 in approximately 30 practices (representing 54 physicians)
- ARMC is an SCI Customer Development Partner and was the first customer to roll out the fully integrated Schedule Maximizer/Order Facilitator product (Winter 2009).
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“SCI Order Facilitator has streamlined our orders workflow, increased provider and patient satisfaction and reduced operational delays.”
Mary G.
Manager Centralized Scheduling
Baptist Health Care
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