This month’s edition of Harvard Business Review features an article on service driven innovation at Kaiser Permanente. Kaiser is well known in the healthcare industry as a leader in applying IT to improve quality of care and producing better business results. The organization routinely outspends its peers on IT as a percent of revenue and has always rejected the fee for service model that is often blamed for excessive healthcare costs across the industry.

What struck me as interesting about this article is that innovation initiatives are typically associated with expensive, top down endeavors aimed at producing new product categories. The approach at Kaiser is different in that the focus on service driven processes means that innovation can be done rapidly and economically. One example that is cited examines the process that nurses follow to exchange information between shifts. The status quo process took 45 minutes or more and delayed the arriving nurses first contact with their patients. This not only wasted time, but also often resulted in inaccurate information exchange, as well as unhappy patients. After analyzing the process and engaging the nursing teams, a simple breakthrough was identified that called for information exchange to take place with the patient’s at bedside rather than at the nurse’s station. This new process, coupled with supporting software to compile information in standard format throughout the nursing shift, led to much improved quality, staff satisfaction and increased quality of care.

To ensure that the service innovation process takes hold throughout the KP organization every project includes a “change package”. The package consists of a concise set of guidebooks describing the innovation, the process by which it was developed, the benefits for staff and patients and the metrics used to evaluate performance over time. Several versions of the package are targeted at line of business leaders, project managers and frontline staff.

I think this process of service driven innovation can be applied successfully in the information security domain. Incident response is one area that comes to mind. The process calls for coordination with many groups within the organization and the quality of results are driven as much by the thoroughness of the process preparation as the technical methods employed. Another area calling for process innovation is application security. The risk to the organization is acute, but often IT and information security teams get bogged down in reacting to the latest vulnerabilities rather than following a process to reduce risk and liability to the business.

The process of medical transcription has evolved a lot since the beginning to accommodate changing demands of the healthcare sector, by providing innovative solutions to make life easier for healthcare professionals and other members of healthcare facilities. 

How does outsourcing medical transcription provide innovative solutions?

The word “Innovative” has been described as a new way of doing something, making the old method more useful, incremental, revolutionary changes in thinking, increasing value and overall bringing about positive change. Let us see how this service fits into this definition of innovation.

• New way of doing something-These services have been constantly adapting technology to add features to services, which can benefit healthcare professionals and other staff enormously. A good example of this point would be remote printing and faxing of reports. This results in cutting short a lot of steps in the process of document delivery.
• Making the old method more useful-Use of Internet has quickened the entire process eliminating the need for the physical presence of the transcriptionist to provide these services. Adding features like archiving has made life much easier for healthcare professionals and support staff enabling them to locate medical records instantaneously
• Revolutionary changes in thinking-Outsourced services have brought about revolutionary changes in the way a healthcare professional is able to manage his/her limited time by allowing them to use familiar modes of dictation, instead of forcing them to adhere to any particular method as prescribed by the transcription vendor
• Increasing value-The service of creating patient medical records has added value to the basic service of listening to the audio recordings of healthcare professional and converting them into text format, by having transcriptionists trained in specialties. This has added value to these services by ensuring the team working on the dictation understands the nuances of the service required and provides transcripts with maximum accuracy and minimum turnaround time
• Bringing positive change-By use of technology, positive changes have been bought about in the process by securing confidential patient data at all stages

If you have ever received treatment at a hospital in the US you have probably been exposed to some of the admin complexity that this entails. Such are the innefficiencies in the administration processes that according to the American Hospital Association sixty percent of hospitals lose money providing patient care.

To be precise, Healthcare Providers lose $60bn per year because of administrative errors. To put this into perspective this equates to the 2007 cost of providing universal healthcare through the National Health Service to 25 million people in the United Kingdom.

Problems begin right at the registration point. It always amazes me just how much information must be gathered and processed at patient registration time; information such as insurance plan code, insurance eligibility, demographics, credit risk, charity availability, deductible amount and much more. Patient registration not only involves the creation of the patient’s medical record, which must be accurate in order to provide appropriate treatment and care, but, in addition, a healthcare provider’s ability to collect payments directly correlates to an efficient and accurate registration process.

An innovative approach to improving the registration process is to enable hospitals to not only access the information needed, but to customize the information to fit the required process, and then intelligently and automatically guide the patient-facing employees to use the information effectively through on-screen interactive guides.

To understand what I mean by the patient-facing employees being ”intelligently guided”, let’s examine one of the many registration processes that are key to the hospital’s overall revenue cycle: the insurance verification process. When a registrar has gathered enough information for the insurance verification process to be carried out, a message is sent to the appropriate data source to validate that the patient does have that particular insurance plan and it is in force at that point. The system then validates the terms of the plan and what the copay amounts are. During the registration, it sends that information back to the registrar, who would be automatically prompted to use that information, and then be guided to the next set of relevant questions.

With other methods, the information received from the different sources is not readily available in an easy-to-use format. The registrar has to interpret the information and glean whatever information is relevant. On the other hand, with a system like the one described here, the data is automatically interpreted and the appropriate set of prompts is shown to the registrar to seamlessly continue to the next step in the registration process.

An additional requirement for such a system is that it seamlessly integrates with a healthcare provider’s existing patient registration system, thus allowing the hospital to have a patient registration system that determines who is going to pay for the treatment and in what shares it is going to be paid – part insurance, part Medicare, part Medicaid or part co-pay- or if it is the growing number of people who are self-paid or self-insured. And when there are multiple insurance companies, the claim needs to be submitted in the right order.