Using Tools to Improve Workflow, Reduce Data Entry Costs, and Standardize Data for Reporting:

A Case Study of INTEGRIS Health’s Use of PatientLink®

PatientLink Removing the Barriers to Enter and Access Patient Information

INTEGRIS Health is an Oklahoma owned, not-for-profit health system that operates nine hospitals and care facilities in the Oklahoma City metropolitan area, led by INTEGRIS Baptist Medical Center and INTEGRIS Southwest Medical Center. INTEGRIS Health also maintains five regional hospitals across the state and is in a joint venture with five others. The organization has affiliated mental health providers in 50 Oklahoma towns and cities and offers hospice services through Hospice of Oklahoma County.

Approximately six out of every 10 Oklahomans live within 30 miles of a facility or physician included in the INTEGRIS Health organization. Collectively, the entities within INTEGRIS Health maintain more than 1,900 licensed beds and have medical staffs that number more than 2,500 physicians. INTEGRIS Physician Services (IPS) manages the physician practices owned by INTEGRIS Health in the metropolitan Oklahoma City area.

Client Profile:

  • 9 hospitals and care facilities in Oklahoma
  • 9,000 employees
  • 2,500 physicians

Outcomes:

  • Reduced transcription costs
  • Saving up to 15 minutes of data entry time per patient
  • Successfully attesting for Meaningful Use
  • Improving care quality measurement

Opportunities

 

Quality Reporting Requirements Drive Search for Solution to Augment EHR

When an organization clears one business hurdle in today’s rapidly changing healthcare climate, it often means that another hurdle is soon approaching — sometimes unexpectedly. Such was the case at IPS, which implemented an EHR solution throughout its network of physicians in 2004, long before the industry’s widespread adoption of the technology to meet Meaningful Use requirements.

 

Solutions

 

PatientLink Helps INTEGRIS Overcome Initial Hurdles

Although the EHR helped the organization overcome some substantial business hurdles, additional hurdles remained.

“One of the ‘side effects’ of the electronic health record revolution is that there are more metrics and documentation needs than ever before,” said Tanya Livingston, M.D., of INTEGRIS Family Clinic.

The majority of physicians and nurses in the ambulatory clinics are now entering patient information directly into the EHR, bypassing the need for transcription services. Even with its EHR, IPS found that the physicians, nurses and staff were spending a tremendous amount of time collecting and entering patient data due to increasing federal and state care quality reporting requirements, as well as INTEGRIS’ internal care quality measurement programs. To augment its EHR, INTEGRIS began searching for a solution that would reduce its data collection and entry demands. The organization’s efforts, which started with the implementation of its EHR, soon turned into a multi-phased journey.

PatientLink Solution Found

INTEGRIS discovered the solution to its data collection and entry needs in 2011. “That’s where I first saw PatientLink,” said Sunnie Glover, Administrative Director of Physician Business Services. “It only took them about 30 seconds to demonstrate the solution, and I knew it was a solution we needed.” Livingston, who was also at the demonstration, agreed. “I can remember thinking it was miraculous,” she said. “Our staff was so overworked with data entry, and I can remember thinking that PatientLink would change our lives.”

Reducing Data Entry with PatientLink Scanning

The PatientLink Scanning solution provides coded forms for patients to fill out. The forms look similar to the “fill-in-the-bubble” forms that are used for standardized tests, such as the ACT or SAT. Once patients complete the forms, they are scanned in as discrete data that is used to populate specific fields within the EHR. Scanning the front and back of the form takes less than two seconds, and eliminates 10 to 15 minutes of manual data entry time.”

PatientLink Implementation

INTEGRIS licensed the solution in early 2012. The PatientLink implementation started with the creation of a committee to standardize the type of information that would be collected across all practices. A general patient intake form was designed, and additional forms were developed to accommodate the needs of specialties. “We wanted to include everything we needed for all of the different metrics that we monitored for PQRI, HEDIS and other quality initiatives,” Glover said. Five practices served as the initial pilot sites for the program, which went live on the solution in early 2012. “Everything was up live in 90 days,” Glover said. “I’m not sure any other vendor could have done it that quickly.” Following the success of its initial pilot sites, INTEGRIS implemented PatientLink Scanning at 20 practices in the fall of 2012.

Using PatientLink

IPS uses PatientLink Scanning to collect information on patients’ medical, surgical, social and family histories. Patients are also given the opportunity to write in information that doesn’t fit the format of the forms. IPS recently added a new section on the forms to collect information about the status of preventive screenings, such as colonoscopies, mammograms, eye examination, bone density tests, and more. Additional information can be gathered on the forms, such as medications, allergies, Review of Systems, History of Present Illness, and Chief Complaint and INTEGRIS plans to expand its use of these other capabilities in the near future. Once the forms are scanned, a nurse reviews the information before meeting with the patient, clicks to accept the information, and the data is then sent into the proper fields within the EHR. The scan of the completed document can also be stored as an image within the EHR.

Outcomes

EHR and PatientLink Reduce Transcription Costs

“When we implemented the EHR in 2004, we went from 20 transcriptionists down to two to support our 55 providers. Over the years we’ve added more providers, but only one additional transcriptionist,” Livingston said. “Since we virtually have real-time documentation using PatientLink, it greatly improves document conversion, since there is no more time spent listening to the transcription or hovering over the transcriptionist to complete a dictation so you know what happened to the patient.”

Improved Documentation and Data Access

“There’s no question that PatientLink helps us document patient visits much better to support coding. I think the use of the EHR has enabled our physicians to look at our patients more closely, look at our patterns of care and gaps in care, and take better care of patients,” Livingston said. “Using PatientLink with our EHR, our providers now process a great deal more information about a patient with just a few clicks of the mouse from a number of settings, whether it’s from a PC in the clinic, a personal laptop, a home PC or a mobile device. They’re no longer tied to the office to get to patient information.”

Meaningful Use Reporting

The combination of our EHR and PatientLink solutions has helped IPS meet Meaningful Use requirements. “In terms of attesting for Meaningful Use, PatientLink is a real game changer,” Livingston said. “Before, we were running scripts and looking in four or five places to find the information that we need,” Livingston said. “Now, it’s much simpler to get the information out. I know we’re much more accurate with our documentation and it’s easier to find the information we need.” IPS practices attested for Meaningful Use in early 2013, and earned a substantial incentive payment.

Standardized Terminology

A byproduct of using the PatientLink forms is that it allowed IPS to standardize clinical terminology among all of its practices, which has helped with quality reporting. “We have a common, standard vocabulary for the chart across our enterprise and we can put exactly the right term in exactly the right place in order to data mine,” Livingston said.

Higher Clinician Satisfaction

“Providers and staff have been thrilled with PatientLink. It speeds their rooming of a patient and allows the nurse to focus on the clinical questions and interacting with the patients that sometimes gets missed when she has to enter reams of information,” Livingston said. “It has allowed the nurses to ‘visit’ with the patients, get to know them personally, and look them in the eye – instead of turning their back to them to face a computer.”

 

Looking Ahead

 

Adding Functionality

By the end of 2013, IPS plans to expand the use of PatientLink among its practices, and increase the types of patient information collected to include History of Present Illness, and Review of Systems. Additionally, IPS plans to implement PatientLink Online, which will enable patients to securely enter their information online before their office visit. “Our goals are to have a fully integrated patient portal, more mobile devices for physicians, engage patients in their own health strategies, offer more types of services via web or mobile devices for our patients, reach out into patient homes through the use of our electronic record and care for patients in a more collaborative way as a member of a care team,” Livingston said.

Working with PatientLink

“Our experience with PatientLink has been nothing but stellar. Their commitment to IPS as an organization and their commitment to understand the processes and needs of the care providers is impressive. They truly keep an open dialogue with providers and staff and come onsite frequently in the clinics so they can better design their product. I think I can honestly say that no vendor has been so open to our feedback, suggestions and then been nimble enough to execute those visions in a matter of days. That’s the norm for PatientLink,” Livingston said.