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Efficiency as a means to improve healthcare outcomes

Improving processes


It seems almost a tautology to say that improving efficiency is best done through improving organizational processes. A more useful way to look at process improvement, Tyler said, was to see it as the product of many efforts, which includes better use of technology, instituting cost control measures and outsourcing.


There are processes around how we bring patients into a clinic, how we take them back to an exam room, how we take them to the to the operating room, Summerlin said. There also are processes that are broken around how bill collection services are rendered. Efficiency in healthcare is really about improving these processes, whether they are business or clinical processes, and making sure that they’re optimized to minimize harm and to maximize value.


Many healthcare organizations routinely use automation, including robotic process automation, to improve financial and operational tasks like payment processing and insurance claim statusing, and providing accessibility to authorized people so that adjustments can be made quickly without bottlenecks. 


“We could check on a claim that we submitted last week every single day, and if a human’s doing that, then we’re waiting every single day for them to check,” Summerlin said, “and that’s just man-hours that are being consumed.”


Automation also significantly improves the ability to schedule personnel more efficiently, a process that until fairly recently was still done manually. Automating process allows healthcare systems to determine the staffing mix of nurses, nurse assistants, custodial and other staff to maintain the highest quality of onsite care while reducing unnecessary overtime or the use of expensive contract labor.




Managing physician preference


Tyler said barriers to instituting quality efficiency measures in healthcare aren’t always a matter of implementing new technology, but investing time in easy-to-understand but difficult-to-implement tasks such as managing physician preference items (PPI). The variety of choices and the human nature of medical care is such that the tools physicians use to perform both routine and specialized treatments may vary widely from person to person. These items can range from advanced surgical tools to in-office blood pressure monitors to disposable rubber gloves.


While all professionals will develop preferences over time of the materials they use, that sort of individuality can be difficult for healthcare organizations to satisfy at times, as it conflicts sometimes with the ability to, say, purchase in bulk to take advantage of economies of scale.


“We’re dealing with physicians who are highly trained, highly skilled, and have a perspective about what their preferred tools are,” Tyler said. “Sometimes, those tools make a clinical difference and improve quality and are worth the cost—and sometimes they don’t.” Getting PPI choices done correctly can make an organization more efficient and more cost-effective, but it’s not easy to do. Better analytics can identify choices, but it doesn’t make the solution any easier to execute, Tyler added. Sometimes there are not measurable differences between items, so it becomes at times a difficult conversation with a physician to refuse to purchase a preferred item.


Often physicians, and healthcare organizations, can have relationships with particular equipment suppliers that have been profitable for both, and it’s sometimes difficult to advocate purchasing supplies elsewhere. Ultimately, healthcare is an industry where you are employing highly specialized people where responding to their supply preferences is a way to ensure efficiencies in care without always using the cheapest acceptable alternative. 

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