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Surgery centers should look beyond the sticker price before selecting an information technology solution.
For instance, surgery centers could create a checklist of the product qualities needed for their facilities, says Caryl Serbin, RN, BSN, president of Serbin Medical Billing in Fort Myers, FL.
“Some priorities would be the same, but what’s important to a GI center would be different from what’s important to an orthopedic center,” she explains. “Identify what you’re looking for before you buy software.” The surgery center should drive the conversation, not salespeople. Serbin has received calls from surgery centers that want to switch to a new product and are concerned about how the switch will affect billing. These leaders found they were unhappy with their product, partly because they did not know exactly what they needed before making the software decision. One of the areas that dominates the forward-thinking interests of surgery centers is benchmarking data and trending related to benchmarking, says Tom Hui, CEO and president of HST Pathways of Lafayette, CA.
Benchmarking data and information can be made available on a dashboard, giving surgery center administrators the type of easily accessible analytics they need to make informed decisions, says Michael Orseno, president and owner of Acuet RCM in Chicago.
Orseno, Hui, and Serbin suggest surgery centers follow these steps when upgrading their software solutions:
• Hold a roundtable, form a team. Surgery centers should form a team to assess various software solutions. The team could include a physician, an administrator, a purchasing person, and a clinical nurse, Serbin offers.
The key is to ask stakeholders to list what they need from an information technology system, including details such as producing reports that outline problem areas. “They can rank what’s important to their particular surgery center and make a checklist of questions,” Serbin says.
Each team member can complete a checklist of what is needed from a software system, although administrators could focus on technology solutions that will work long term and decrease workload in various areas.
• Prioritize goals. Surgery centers can assign a timeline to software selection, ensuring it is reasonable and works well with their overall goals and plans, Serbin suggests.
“The first thing is to make a list of what’s important to your surgery center and your physicians,” she says. “Do a roundtable, and rank what’s important. Don’t forget billing.”
A surgery center might prioritize making billing and collections easier. Another surgery center might be more concerned about organizing inventory. Still others might desire easily accessible analytics and metrics, providing them with the analytics to make informed decisions, Orseno says.
“Data can be available on a dashboard,” Orseno adds. “Say they want to look at a new specialty — orthopedics; if they’re not having a great case mix, it might not be as profitable as they think, so software can give them the data to make informed decisions.”
Good analytics provide information that can be used to make a surgery center more profitable and efficient. “With analytics, they can negotiate better rates from insurers, and they can attract better doctors — higher-revenue-producing docs,” Orseno says.
Another information technology goal might be to reduce errors and improve patient safety. “One thing we focus on is [minimizing] medical errors. One of the more common and serious medical errors comes from allergic reactions,” Hui says. “We designed software to look at that and to place alerts to the nurse, anesthesiologist, surgeon, or medical director when there’s a potential allergic reaction.”
In the usual practice of directing preop nurses to confirm medical history and medication allergies, some patients might recall a problem that had not been noted in the medical chart. The nurse might make a note of it, but medication errors can occur when the update does not reach the anesthesiologist, Hui explains. In an information technology system with concurrent charting, the update is pushed to the front of the screen automatically for anyone who accesses the patient’s chart electronically, he adds. “We felt that if this one thing saves one life, then it’s worth it,” he explains.
This prioritization process is just as important for new surgery centers, although they have many competing project goals, Serbin notes. “If you’re a brand-new surgery center, you have so many things going on in terms of buying equipment, building issues, and accreditation that it seems like software may not get the attention it deserves in the decision-making process. That’s where I see bad fits happening,” Serbin says.
• Consider all costs and scrutinize contracts. “When you’ve made a decision that this is the company I want to go with and this is the software I want, read that contract carefully, particularly if it happens to be a newer or less-proven software,” Serbin cautions. “What are your options if you find out it’s not a good fit for you?”
When calculating the full cost of new technology, there are important questions to consider, including: Will you own the data, or does the vendor own the data? How difficult would it be to unwind the project, if that proves necessary? What are the best- and worst-case scenarios? What does the price include? What is the package price, and what do add-ons cost?
Surgery center administrators also need to weigh the benefits and risks of outsourcing their information technology needs to companies that take over part of the operations, such as revenue cycle management, Orseno says.
If facilities can reduce staff costs by outsourcing and also collect more revenue because of the benefits of information technology, then they could become more efficient. This, even after deducting the extra cost of the outsourced service, Orseno adds.
“A lot of emphasis is on the bottom dollar price instead of what that price includes,” Serbin notes. “Often, there are add-ons that you can’t do without, so you think you got this great deal. Then, you find out there are four or five functions that you absolutely have to have, and that adds on to the price, making it harder to budget.”
Before purchasing any add-ons, a surgery center should ensure the extra features are pertinent to their own needs and operation. But they also should not pass on additions that are important, Serbin says.
People might think they are buying a complete software package that gives monthly reporting. But then they find out that their package does not include reporting. This leads to purchasing an analytics add-on, which might double the price, Serbin warns.
• Perform due diligence. Create a list of what needs to be completed to answer all questions about any particular vendor or software, Serbin suggests. This includes checking references, calling other surgery centers about particular companies and asking for advice.
“There are a lot of people out there who have the right software and are very happy about it,” Serbin says. “Talk to those people as well, and see what makes it such a good fit.” Vendors will provide references of current customers. Call the centers already using the software, and ask them about the customer service they have received, Serbin says. This includes asking about response times to problems and how quickly companies solved those problems.
Someone could even call the software company’s customer service line to see how quickly they answer the phone and provide help. “Ask to talk to the customer service department as if you have a problem with the software that you haven’t bought yet,” Serbin suggests.
Even if the call does not go far, it can hint at how well the customer service is and how quickly callbacks occur. “Do you have to wait 15 minutes on the phone before talking to an actual person?” Serbin asks.
This might not provide all the customer service information an ASC needs, but it paints a picture of what one might experience. “I also like to look at company structure, leadership, and stability,” Serbin adds. “If you think about buying a system that will run your center, think of it as a long-term investment. The last thing any administrator wants is to switch out software; switching is very disruptive to the surgery center.”
Financial Disclosure: Consulting Editor Mark Mayo, CASC, MS, reports he is a consultant for ASD Management. Nurse Planner Kay Ball, PhD, RN, CNOR, FAAN, reports she is a consultant for Ethicon USA and Mobile Instrument Service and Repair. Editor Jonathan Springston, Editor Jill Drachenberg, Author Melinda Young, Author Stephen W. Earnhart, RN, CRNA, MA, Physician Editor Steven A. Gunderson, DO, FACA, DABA, CASC, RN, CRNA, MA, Editorial Group Manager Leslie Coplin, and Accreditations Manager Amy M. Johnson, MSN, RN, CPN, report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.