Executive Thought Leadership

Mobility Solutions for SMB

An Interview with Jamie R. Steck of the Central Utah Clinic

Central Utah Clinic is the largest group of independent physicians in the state of Utah. They practice in 15 specialties and currently have nine locations in Utah County, eight clinics in rural communities, and 500 employees. In April 2002, Jamie R. Steck, Director of IT for Central Utah Clinic, began implementing a "paperless" electronic medical records system, a process that is now nearly complete.

Peter Alexander, vice president of small and medium-sized business marketing for Cisco Systems, spoke to Jamie about this process.

Q: Peter: It my understanding that Central Utah Clinic was quite a different place several years ago. What made you realize that it was time for a change?

A: Jamie: Central Utah Clinic was growing about 50 to 70 percent per year, which was great on many levels, but it also created significant difficulties with regard to business management. Our biggest challenge was the massive amount of paperwork. We had to hire 15 to 16 people just to keep patient records in order and even then it still took up to two weeks for specific documents to be filed. This was problematic for patients and doctors alike. If a patient needed to know about insurance coverage for a particular procedure, they'd have to wait 72 to 96 hours for the records staff to find their file in one of the records rooms and then look up the information. If a doctor needed something from a file in another building, someone had to search for that file and look up the necessary information; the wait was even longer if the doctor needed to have the file in hand. It was a waste of precious time, particularly in cases where patient information was critical to making a diagnosis or prescribing a medication. Also, the paperwork kept doctors tied up in the office during the week and made it difficult for them to get important patient information in off-hours or on weekends. Paperwork, files, records rooms, an entire records stafft just wasn't an efficient way to manage the business. We knew that we would continue to grow, but that we couldn meet the needs of our doctors, employees, and patients if we continued to work this way. So we started looking into technology solutions that could help us get rid of the paperwork.

Q: Peter: What differences have "paperless" technology solutions made to your business?

A: Jamie: Efficiency has increased dramatically. We did an "in motion" study in our records room, which showed that filing electronically is 80 percent more efficient than filing manually, and wee seen proof of that on a daily basis. Documents that once took two weeks to be added to a patient's record are now filed electronically in less than 12 hours. Wee also seen a 30 percent reduction in patient calls-and a corresponding increase in staff productivity-because our staff has instant access to information and can handle many tasks electronically. For example, instead of waiting 72 to 96 hours for benefits details, we can retrieve patient benefits in 30 seconds while the patient is on the phone. The return on investment has also been significant. We saved $400,000 on transcription costs in the first year alone because doctors can now take notes right in the exam room rather than dictating them later and then sending them off for transcription. With about 22,000 new patients per year, we spent more than $176,000 a year just on new charts. Now that charts are created and managed electronically, wee eliminated that cost. By cutting the paperwork, wee also been able to reduce our records staff and wee saved $250,000 on space that would have been allocated to records but can now be used in other ways. In addition to the cost savings, revenue has increased as a result of an 18 percent improvement in the accuracy of the reimbursement documentation that we provide to insurance companies.

Q: Peter: Those are some impressive quantifiable improvements, but what about benefits that can easily be measured?

A: Jamie: The soft benefits are as important to us as the measurable improvements, which is why wee so pleased with this solution. One of the greatest benefits has been the freedom that it has allowed our doctors. Almost all patient records have been consolidated electronically, and doctors now have instant access to those records wherever they aret the hospital, in the office, or at homesing mobile PC pads and remote network access. It used to be that if a patient was admitted to the hospital, doctors would have to go back to the office to get pertinent information about that patient. If there was no time to do so, then doctors had to rely on their memoryr on information provided by attending physicians who had no historical data about the patiento make a diagnosis. Now, doctors always have comprehensive patient information at their fingertips so they can make clear, educated decisions and provide better care. Since they don have to deal with piles of paperwork, doctors can also spend more time with each patient they treat. This interaction, along with some the quantifiable improvements just discussed, results in patients that are better informed and happier with the care they receive through Central Utah Clinic. The doctors, nurses, and administrative staff are also happier because theye more productive. Now they can come in every day and do what they were trained to do and what they love to do: care for patients.

Q: Peter: Given the sensitive nature of patient data, do you have concerns about information privacy?

A: Jamie: The privacy of sensitive information is critical for any business, but it particularly important at Central Utah Clinic where we deal with personal health issues. As a healthcare provider, we are required to comply with the Health Insurance Portability and Accountability Act (HIPAA), a federal set of standards that are designed to protect the confidentiality of personal health information. The Cisco products and technologies wee implemented have actually made it easier and less expensive for us to comply with those standards. Before, we had no way of knowing if a file on a desk in an office had been seen by someone other than the patient doctor. But now we can track everything. We can audit our system to find out who has accessed every single lab result or physician note. The network itself provides an added level of protection for our patients. The Cisco security measures are leading-edge, and they ensure that access to patient information is limited to authorized users only. For these reasons, patient data is more secure with our system than it would be with a traditional paper-based system. We definitely feel more comfortable now than we did before. Our patients do too.

Q: Peter: How difficult was it to implement these mobile technology solutions?

A: Jamie: It wouldn have been an easy task had we tried to do it on our own, but we were fortunate to develop a solid partnership with Intermountain IT, a Cisco partner. We selected Intermountain IT because they had experience in the medical field and expertise with the specific products and technologies that could help us customize a solution to meet our needs. Intermountain IT is also very familiar with HIPAA regulations and they help us ensure that we remain in full compliance as we continue to move forward. Theye made the implementation process go smoothly and quickly.

Q: Peter: Do you have any advice for other companies that are thinking of implementing a similar solution?

A: Jamie: I suggest starting slow. Even the best technology solution is useless if no one uses it. With this in mind, we developed a modular approach to introducing new mobile tools and capabilities into the Central Utah Clinic workplace. We took things slowly and in stages so that our doctors, nurses, and staff could become comfortable with the changes; but it didn take too long before they saw the benefitsncreased productivity, better customer care, and the likef the mobile PC pads, remote network access, and other tools. Since then, wee been able introduce things more quickly. Even though they have the flexibility to choose which mobility tools they take advantage of, some of our doctors now say that if we took these capabilities away they have to retire early because they wouldn want to give up their freedom and go back to the paper-based way of working. In addition to starting slow, I also suggest choosing a technology partner with experience in your field. Intermountain IT has that experience and it made a big difference for us. It was their expert recommendations that led us to purchase Cisco equipment for our network. We could have gone with a cheaper solution initially, but it definitely would have cost us more in the long run in terms of security, reliability, and scalability, which is critical to what wee doing. The Cisco equipment is the basis of our entire mobile technology solution and without it this whole project would never have gotten off the ground. Wee been extremely happy with it. Without the team effort between us, Intermountain IT, and Cisco, we wouldn be where we are today.