Benchmarking is as easy as 1, 2, 3

Interface saves provider hours each month

Nothing worthwhile is ever easy, but it seems data collection is often much harder than it has to be.

The National Managed Health Care Congress had good reason to award Strategic Health- Care Programs (SHP) of Santa Barbara, CA, its "Healthcare Innovations in Technology Systems Partnership in Technology Award for Home Care Systems." SHP, an outcomes and disease management program developer, collaborated with several technology partners to create a seamless interface between SHP outcomes software and operational pharmacy software systems.

Providence Home Infusion of Seattle is now reaping the benefits of the technological advancement that landed SHP the award. There’s no more double data entry, and the provider is saving hours of manpower every month while producing more complete and payer-specific data.

The way it was

As recently as September 1997, the combined staff at Providence were spending nearly a full work week each month in compiling data for use with SHP’s outcomes program.

When Providence first began using SHP’s program in 1995, there was no automated format. So for every patient, Providence had to complete a lengthy form.

"We were collecting the data as part of our day-to-day operations, and then we had to transfer 35 data elements on to a three-page form using dot coding and a number two lead pencil," says Rick LaFrance, PharmD, director of Providence Home Infusion.

Even though much of the data from nursing, pharmacy, and reimbursement had already been entered into Providence’s information system, staff had to manually code the information onto the sheets, which were then sent to SHP. Every six months, Providence would then receive benchmarking and outcomes reports.

"The problem was that it was incredibly labor intensive," says LaFrance. "We were committing 30 to 40 hours a month just in data collection and coding, spread out through various individuals within each department. At the same time we were seeing decreasing reimbursement rates, and it’s difficult to justify that labor cost when you’re trying to gain efficiencies."

Barbara Rosenblum, SHP’s president, admits the process had its flaws.

"It was labor intensive in that they had already entered the patient’s name, date of birth, ICD-9 code, the drugs, and then they would have to take a bubble format and do it again," she says. "We also link an ICD-9 code to every drug, so for every drug, they had to have a separate page, and it isn’t that common for a patient to be on five different infusion therapy drugs."

Even when SHP automated its program, technology didn’t do away with the data entry dilemma.

"When we completely automated our system, they still had to enter all the data a second time," she says.

After automating its program, SHP looked to make things even easier on its clients.

"We wanted to bring in a piece of technology that could link our outcomes program to the home infusion provider’s pharmacy management software so there wouldn’t have to be double data entry," says Rosenblum. "The data could be drawn from existing files and transmitted to us. We could then generate quarterly reports and mail those back to the providers, giving them benchmarking with a Joint-Commission approved system."

The first interface was created for use between SHP and Management by Information of Little Rock, AR, whose Home IV Manager product was being used by Providence.

"The interface allowed us to link two disparate computer applications, so once the provider opens the outcome software, it’s already populated with all the patient information, including drug information and ICD-9 codes," says Rosenblum. "They don’t have to do anything but open the application and answer the questions that are not in the [pharmacy] software and transmit the data."

Once the interface was up and running, LaFrance says his staff’s work was dramatically cut down.

"About 90% of the data elements [required by SHP] are already in our system," he says. "We have not time-studied it yet, but it’s fairly obvious that if we can download 90% of our data elements instead of doing it manually, we’re going to save considerable time."

Providence will receive a data set from the fourth quarter of 1997, but LaFrance anticipates numerous benefits other than the time savings and improved efficiency in future quarters.

"We would get the old reports every six months, and it was pretty much a canned report that took all of your payers and separated them out into commercial payers or Medicare," says LaFrance. However, there was no way to compile in-house reports on patients from individual payer sources.

"If I got a call from Blue Cross of Washington/ Alaska, and they wanted to look at their patients and how they compare with other commercial payers in the Northwest, I would have had to pay SHP to compile a special report," he says. "Now, we have the ability to customize payer- or physician-specific reports, which we could not do previously."

This is possible because rather than filling in the data sheets and shipping them off to SHP, the data remains in a database at Providence, ready for retrieval at any time.

"With the flexibility of reports, outcomes, and financial data, this allows us to take a look at ourselves and get a better understanding of our business," he says.

Home Health Care Under Reduced Reimbursement, Feb. 25-27, The Houston (TX) Plaza Hilton. For more information, call (312) 540-3010.

INS Annual Meeting and Industrial Exhibition, May 2-7, 1998, George R. Brown Convention Center, Houston. For more information, call (617) 441-3008.

American Society of Health-System Pharmacist’s Future of Pharmacy in Managed Care Conference, Feb. 27 - March 1, 1998, Dallas. For more information, call (301) 657-3000, Ext. 1337.

American Society of Health-System Pharmacist Home Care ‘98, Aug. 22-24, 1998, Chicago. For more information, call (301) 657-3000, Ext. 1337.