1430 panel discussion - day 2

National E-Health Transition Authority

www.nehta.gov.au

0

Examining the

Outcomes of Differing

Operational Efficiency

Options – Panel

4th National Hospital Procurement Conference

Sydney, 25th July 2014

Mary Thompson, GS1 Senior Advisor – Healthcare, GS1 Australia

Anne Petterd, Partner, Baker & McKenzie

Val Usatoff, Deputy Medical Director, Cabrini Health

1 National E-Health Transition Authority

www.nehta.gov.au

Examining the Outcomes of Differing

Operational Efficiency Options

1. Panelists State Their Case

2. Questions – Open Forum

3. Panelists Summary Statement

Agenda

2 National E-Health Transition Authority

www.nehta.gov.au

• Mary Thompson, GS1 Senior Advisor –

Healthcare, GS1 Australia

• Anne Petterd, Partner, Baker & McKenzie

• Val Usatoff, Deputy Medical Director,

Cabrini Health

Your Panelists

3 National E-Health Transition Authority

www.nehta.gov.au

The Discussion

The relative benefits of:

• Medical coding and billing

• Bring Your Own Device (BYOD)

• Document scanning and data warehousing

• Electronic medical records

• Enterprise scheduling

• Inventory management

1. What is feasible?

2. What are the ROI’s?

3. Examples of real-life implementations

Australia Operational efficiencies

driven by standards

Mary Thompson

Senior Advisor – Healthcare, GS1 Australia

mary.thompson@gs1au.org

2014 National Hospital Procurement Conference

© GS1 Australia 2014 5

Electronic Medical Records &

Inventory management benefits

Considerations

• global standards complement internal identification

systems

• appropriate technology is sourced to support data

identification / capture

• Hospital Information Systems (HIS) and Enterprise

Resource Planning (ERP) systems ability to hold

identification keys & related data

• develop clinical and technology strategies in tandem

• trading partners collaborate & share data

• change management underpins implementation

© GS1 Australia 2014 6

Benefits to be realised…

Electronic Medical Record (EMR)

• organisation of information

• patient safety: identification / infections

• cost based tracking

• AEs &recalls

• continuity of patient care

Inventory Control • process & data quality

• logistic partnerships

• efficiencies: procurement / stock levels / time / asset tracking /

resource allocation

• visibility

Baker & McKenzie, an Australian Partnership, is a member firm of Baker & McKenzie International, a Swiss Verein with member law firms around the world. In accordance

with the common terminology used in professional service organisations, reference to a "partner" means a person who is a partner, or equivalent, in such a law firm. Similarly,

reference to an "office" means an office of any such law firm.

© 2014 Baker & McKenzie

Operational efficiency options - legal

considerations

Anne Petterd, Partner

Baker & McKenzie, Sydney

anne.petterd@bakermckenzie.com

2014 National Hospital Procurement Conference

© 2014 Baker & McKenzie 8

Contract to realise benefits + address risks

Conduct planning and risk assessment to work out

viable options and what to address

Choose wisely to realise efficiency

Examples

BYOD – support and compatibility commitments

E-records – regulatory compliance

Data warehousing – control and access terms

Enterprise scheduling – who needs to participate?

Inventory management – web of reliance

© 2014 Baker & McKenzie 9

Contract / commercial issues

Committed purchases vs options

Bespoke vs off-the-shelf

Outsourcing vs ability to self-help

1 throat to choke vs vendor choice

Ensuring information management / accessibility

Regulatory responsibility

Transition-in issues

Mandatory vs optional business take-up

Panel Discussion. A clinical perspective.

• A/Prof Val Usatoff

• Working Surgeon • Private and Public Sector

• Head of UGI/HPB surgery

• Masters HSM

• Deputy Medical Director

• Cabrini Health

• 2 campuses

• 500 and 100 beds

• 20 op theatres

• 2 Rehab sites

• Pall. care and Aged care

• Emergency Dept

• HITH

• Linen and Technology

Doctors and e-Medical Records

Engaging Doctors in the Health Care Revolution

• Doctors are deeply anxious and angry about transformation, fearing loss of autonomy, respect, and income.

• Any strategy that they do not embrace is doomed.

• Stages of grief; from denial to anger

• Suggest focusing on what can be gained, positives.

Lee T, Cosgrove T. Harvard Business Review. Engaging Doctors in the Health Care Revolution. June 2014

….products that are functionally decades behind those they use in their “civilian” life. (NEJM 2012)

Is it the Doctor’s fault?

Clinical Viewer

Clinical Viewer

Clinical Viewer

BYOD - iPads

• Cost of device and service pushed to clinicians • Capacity costs

• Bandwidth overloading • Slow down of other services • Controlling number of devices

• No ability to control version updates • Android vs Mac

• Extra cost to support all platforms or limit to one

• ROI • Increased engagement • Efficient ordering of path requests • Early notification of results and early intervention • Less phone calls to pathology

Incentives – do they work?

• Yes!

• What’s in it for me? • Tickets, dinners, trips – short term, trivial

• Sustained improvements to productivity – meaningful, win-win • Increased theatre efficiency improvement

• Unit/division secretarial support

• Data manager, IT support

• New equipment

• Healthcare Financial Management Association • physicians more interested in efficiency gains than direct rewards

https://www.ecri.org/Documents/MDPT/Implant%20roundtable.pdf

Medical coding and billing

• Fully automated (and accurate) billing directly from e-MR is a long way away

• Current low tech solution • Medical staff manually auditing select records

• Excellent ROI but not comprehensive

• Future • Electronic discharge summary WITH diagnosis specific prompts

• Gallstones - ?gram negative sepsis

• Prolonged ileus - ?TPN, ?Hypokalaemia, ?malnutrition

• Major surgery - ?acute renal impairment

Enterprise Scheduling - example

• Oncology day ward scheduling system

• Coordinating patient arrival and CTx preparation

• Reduced wait for CTx and reduced stay in day ward • More patients treated

• Patients requiring O/N stay having CTx in day ward

• Admitted later in day

• Reduced burden on ward staff

• Reduced need for inpatient beds

• Excellent ROI

22 National E-Health Transition Authority

www.nehta.gov.au

Summary

The relative benefits of:

• Medical coding and billing

• Bring Your Own Device (BYOD)

• Document scanning and data warehousing

• Electronic medical records

• Enterprise scheduling

• Inventory management

1. What is feasible?

2. What are the ROI’s?

3. Examples of real-life implementations

23 National E-Health Transition Authority

www.nehta.gov.au

• Mary Thompson, GS1 Senior Advisor –

Healthcare, GS1 Australia:

mary.thompson@gs1au.org

• Anne Petterd, Partner, Baker & McKenzie:

anne.petterd@bakermckenzie.com

• Val Usatoff, Deputy Medical Director,

Cabrini Health: usatoff@bigpond.net.au

Contacts