The July/August 2014 Issue of Administrative Eyecare Magazine includes three articles focused on Key-Whitman Eye Center, and how their two practices in Dallas and Plano, Texas, use Versus Advantages™ Clinic to improve patient flow, reduce patient wait times, and automatically collect data for process improvement.
Excerpts from each article appear below. The full text is available to members of the American Society of Ophthalmic Administrators (ASOA) and subscribers of Administrative Eyecare at asoa.com.
Information Advantage: Using Data to Improve Your Practice
By Amy Souza, excerpted from the July/August 2014 issue of Administrative Eyecare Magazine
Dan Chambers, practice manager of Key-Whitman Eye Center, has an MBA in operations management, with a background in optimization and logistics. So it’s no surprise that when his practice faced increased patient complaints regarding wait times, Chambers turned to a solution often used to increase efficiency on a manufacturing floor—a real-time locating service that tracks patients, staff, and doctors. The system, currently installed at two of Key-Whitman’s locations and on its way to installation at a third, utilizes radio frequency identification (RFID) chips embedded in small badges about half the size of a credit card. Infrared scanners read badge data and provide a real-time picture of where any badge holder is with- in the clinic, while also storing that data for future reference.
“Our goal was to reduce wait times to less than 15 minutes,” Chambers says. “Plus, looking to the future, we saw an avalanche of Baby Boomers coming our way, as well as lower reimbursements from providers, making efficiency that much more important.”
With all of this data on hand, Chambers and his staff can now easily analyze and track wait times and overall visit times. They can look at which procedures and which doctors are more efficient and identify bottlenecks. The system provides helpful monitoring, such as pop-up messages that alert staff if a patient has been waiting too long. Additionally, computer-aided design (CAD) software provides a computer model of the building—reception, pretesting, examination, and surgery rooms—so Chambers and his staff can simulate patient movements and workflow processes to try out new procedures on a computer rather than in the clinic.
“Initially our staff was hesitant,” Chambers admits, “because it looked like Big Brother was watching.” But the results won over naysayers. “We’ve been able to lower wait times, increase our production capacity by 15%, and keep a pace of work that is comfortable. The practice is less feast or famine, and we have better patient satisfaction scores, as well as happier staff dealing with a more consistent pattern of work.”
It took Chambers several years to put together the best technological solution, one he notes would have been economically infeasible just a decade ago. And though the initial expense was still significant, Chambers’ initial analysis showed that adding one more patient per day would cover the start-up costs.
“This system is now constantly gathering data. We can get tens of thousands of samples with virtually no effort.”
Reducing Patient Wait Times
By Susan Thomas, COE, excerpted from the July/August 2014 issue of Administrative Eyecare Magazine
Reducing patient wait time is often the primary goal for most clinics and usually the most difficult to achieve. Patient wait time and decreased patient cycle time are key indicators in measuring patient satisfaction. In these days of declining reimbursement and emphasis on patient satisfaction, increasing wait times for patients can be detrimental to any practice. Each workday can be filled with surprises: challenges to patient scheduling, variable patient arrival times, and available staff to work with the patients. If only there were a way to minimize these factors that affect patient wait time and increase patient satisfaction.
Enter patient tracking and simulation.
With readily available patient/staff tracking software along with simulation software, we are able to passively obtain a tremendous amount of data in order to account for these variables and schedule patients accordingly.
VALUE AND COMPETITIVE ADVANTAGE
The power of the technology allows us to evaluate business processes by taking hundreds and even thousands of data points to create a customized workflow for each operating environment. The advantage to putting systems such as RTLS in place is the ability to measure before, during, and after changes. This differs from a traditional time study where measurements are taken from a specific point in time and under specific conditions. Once you make a change, you should be conducting a second time study to measure results. RTLS is adaptive and has allowed us to measure the results of our changes. The specialized consulting techniques such as predictive modeling, queuing theory, capacity planning, and cluster analysis have allowed us to discover unique patterns and trends within our own clinics.
For example, we were able to measure the time difference between our exam lanes with traditional equipment compared to our lanes with newer technology. We were also able to compare the amount of time each individual technician took to work up patients as well as the amount of time it took for specific types of exams (our system is interfaced with our practice management system). The benefit of having real data compared to staff perception is immeasurable.
The changes we have been able to implement are not subtle. We were able to successfully increase the number of patients each day to our schedule by 8–12% without adding additional wait time to the patient. The staff and pace of work is more manageable, decisions are based on facts, and decisions are facilitated quickly. The technology has provided us a more strategic view and competitive advantage in providing the best care to patients with less wait time.
HOW TO EVALUATE A VENDOR
Once the practice has decided this is something it would be beneficial, it is best to evaluate those companies that can best understand a clinical setting. Many hospitals and ERs have implemented RTLS systems; however, as we all know, ophthalmology practices are different. Taking into consideration the diagnostics, work-up interval, and scribe and physician interval, it is imperative that any business selling you this type of equipment understand the dynamics of your clinic.
Key-Whitman Eye Center on Data-Driven Decision Making
Interview with Key-Whitman Eye Center Practice Administrator Dan Chambers, excerpted from the July/August 2014 issue of Administrative Eyecare Magazine
AE: You said you “can get tens of thousands of samples.” Are there other uses for this data beyond how you’re using it now?
DC: YES! Besides being an excellent method of tracking waiting times at various stages in the patient’s visit, we find the data especially accurate and reliable, and can monitor total cycle times, work-up times by technicians, and doctor, room, and equipment utilization patterns. We can use this data to simulate better Doctor-Patient Templates.
These scheduling templates have already demonstrated the ability to “compact” the schedule with better wait times, higher staff utilization, and more capacity without making the workday longer.
We have also used this data to simulate “what if scenarios,” where we demonstrate the impact of adding exam rooms, techs, or equipment to determine if we can improve overall operational performance.