Friday, April 24, 2009

Cool Technology of the Week

The New England Health EDI Network (NEHEN) and MA-Share are completing their merger over the next month into a new non-profit LLC called the New England Healthcare Exchange Network. The resulting merged organization will provide a single appliance for exchange of benefits/eligibility, referral/authorization, claims/remittance, the full suite of e-prescribing functionality (eligibility, formulary, history, routing, refills), and clinical summary exchange of continuity of care documents.

Many recent articles in the popular press have questioned the cost savings of health information exchange. Here's more data from our experience in Massachusetts.

The quantifiable savings are different for each provider organization depending on what their starting point is, however here are some example of significant savings:

*For Brigham & Women's and Mass General their 'Total Denial Write Off
Rates as a Percent of Net Revenue' has reduced from 3.78% to 0.88% and
from 4.17% to 1.28% respectively.
* For Brigham & Women's and Mass General their 'A/R Days' have reduced from
81 days to 55.6 days and from 99 days to 54 days respectively.
*Since Baystate's go live with NEHEN in January 2007, they have saved over
$1.5M by avoiding per transaction fees.

In general, NEHEN users have experienced the following clinical and administrative benefits

*Reduction of ambulatory medication errors
*Enhanced communication among providers
*Improvement in the Patient Experience
*Reduction in claim denials due to lack of good information
–Correcting insufficient or inaccurate eligibility or referral information
–Correcting invalid PCP, DOB
*Reduction in write-offs due to eligibility and exceeding the filing limit
*Improved collection of Copays
*Labor savings
_Reduction in ambulatory care staff needed to manage medications.
–Reduction in time spent on manual transactions: eligibility, claim
status inquiry
–Focusing on the exception processing
*Reduction in “Days in A/R” & claims rework
–Focus on front-end weighted, clinically driven revenue cycle
*Reduction in bad-debt

A single healthcare information interchange platform that pays for itself via cost avoidance. That's cool!


Donald Green MD said...

Dr. Halamka, To make the comparison properly on this new application at the Brigham and MGH could you explain what was replaced? Sometimes what is attributed to the technology alone misses whatever changes at the user level was made to improve efficiency. What steps were taken to bring this new system about? It can be problematic to proclaim advances when important changes are not also brought out.

John Halamka said...

I agree that before and after comparisons are tricky because of confounding variables - a changing environment or workflow that occurs at the same time as the software change. In this case, we're comparing a manual process using email/fax/phone calls with an automated process using the web.