A Holistic Approach
Not one to rest on there laurels, Bronson Healthcare Group (BHG) has adopted a system- wide platform for enterprise content management (ECM).
The ECM complements clinical applications in multiple departments with dozens of automated workflows to improve business operations and patient service. With KeyMark, Inc., they have accomplished this at a significantly lower cost than niche healthcare applications or other ECM solutions. In fact, the solution provided by KeyMark was cost justified in about a year and provides the perfect platform for ongoing process improvements.
Bronson was initially just looking for a Finance Department solution after the payroll manager saw a presentation at a trade show.
“When Matt (Molise, Senior IT Analyst at Bronson) and I got involved we realized how it could be used in multiple departments and move away from niche solutions. The modular design of the KeyMark solution allowed us to spread the cost of the system over several high-profile projects,while expanding upon the same core application infrastructure,” said Mike Moore, Systems Analyst at Bronson.
When compared with competing systems, the KeyMark solution was selected because it could be rapidly deployed, has strong imaging and document import functionality, robust workflow capability and the ability to consolidate data from disparate systems.
“OnBase is our core system and all the other systems feed into it,” said Moore.
A More Efficient AP Department
The first project implemented at Bronson was automating the processing of 120,000 multi-page invoices a year in Accounts Payable. KeyMark’s solution accommodates both paper and Electronic Data Interchange (EDI) invoices for posting to McKesson Pathways Financial Management (PFM). Workflow has significantly reduced handling of non-exception, PO-driven invoices and significantly improved exception processing and other activities. The EDI feed is imported into the system and paper-based invoices are scanned.
Using Application Enabler, indexing values are automatically populated with data from PFM. If an invoice is PO-driven and the amount matches the entry in the General Ledger, the payment can be automatically posted. Based on pre-configured business rules, exceptions are routed to the appropriate person. Workflow manages the entire process for reconciling and approving exception invoices. The solution has reduced AP staffing costs while improving the ability to collect early- pay discounts and avoid late payment penalties. “But the biggest benefit is the reduction of phone calls to the Finance Department,” asserts Moore. “The ability for managers to access documents themselves has been a positive for both managers andfinance.”
“AppEnabling” PFM also makes it possible for users to retrieve documents in the repository directly from the PFM interface. Using point-and- click configuration, a user simply double-clicks on a field (e.g. an invoice number) and the documents appear on their desktop. Application Enabler was a huge factor in our decision,” says Moore. “No one else had that integration capability as an integrated module.”
KeyMark’s solution has also provided an opportunity to evaluate and improve business processes.
“Workflow designed for the budget process reduces Finance’s research time in half or more,” claims Moore. “Staff can immediately answer questions about budget variances. Overall, greater structure to the budget process allows us to budget more accurately, saving tens of thousands of dollars.”
Adding Agility in Patient Accounting
Workflow has also been used to improve efficiency in Patient Accounting to prevent write- offs/denials and improve financial compliance and cash flow. For instance, because of the nature of the care, a physician name may not have been associated with the patient record upon admission to the ER; preventing payment. With KeyMark’s system, now a patient record not associated with a physician will kick off an electronic form which is routed appropriately.
“Abilities like this allow for faster and more accurate billing for reimbursement gains of tens of thousands of dollars per year,” says Moore.
Improving the Admitting Experience
Workflow has also been used to improve efficiency in the Admitting Process. Now workflow manages the collection of documents from admission through EOB processing and links them to the patient record in a McKesson Star HIS. Though KeyMark’s solution is rapidly deployable, its modular design also supports a more gradual approach to minimize the disruption of a cultural shift. When a patient registers at one of 50 registration stations around the Bronson campus, documents such as proof of identity, insurance verification and consent agreements are captured via scanning. An admitting clerk completes the required data and documents are indexed and routed to appropriate destination.
“We’re probably capturing about ten different document types for each patient admitted,” estimates Moore.
The KeyMark system in place also manages physician orders for outpatients. In the past, several physician practices with which Bronson is affiliated would fax orders and clerks would have to try to locate them when a patient arrived. Using RightFax integration, orders are captured and stored in alphabetized queues. When a patient calls to schedule an appointment, the clerk accesses the appropriate queue and acquires the pertinent information needed.
Pharmacy Response Times Cut By Half
One of the most recent major projects at Bronson has been the deployment of workflow in the Inpatient Pharmacy. This solution was implemented at a fraction of the cost of a niche specialty solution — automating the processing of 200-230 orders a day. In the past, pharmacy orders were completed by hand using three-part No Carbon Required (NCR) paper and the yellow bottom copy was sent through a pneumatic tube or placed in bins in the nursing units. Stray marks would affect the quality of the orders, which were collected by personnel from the decentralized pharmacy units.
“We did a time study on how long the copies sat in the bin,” say Cherie Woodhams, Pharmacy Educator at Bronson. “Some were there as long as 38 to 40 minutes. Faxing and scanning reduces that time to 12-15 minutes.”
KeyMark’s solution also supports better allocation and prioritization of tasks. STAT orders, for example, are faxed to a different line and placed in a high-priority queue.
Leveraging Their Investment
Molise and Moore have developed and are in the process of developing a multitude of new solutions. These include: an Incident Report System and other HR applications, credentialing, leave of absence reporting, mailroom, radiology, auditing, medication and allergy reconciliation forms and insurance.
“In the past, we would have done each of these projects individually, and that would have required too many people to support,” says Molise. “With the scalability of the KeyMark system we’ve been able to accomplish all this in a relatively short time with a mid-range investment – and there’s a lot more to come.”
About Bronson Healthcare Group
Bronson Healthcare Group (BHG) located in Kalamazoo, MI is a not-for-profit healthcare system provider. Founded in 1900, BHG employs more than 4,000 people and generates more than $473 million in revenue. Not only is Bronson one of the largest employers in Kalamazoo, it consistently garners awards for employee satisfaction and patient care.