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Title Emergency Room Information Technology Re-Design
Year 2010
Contributor/Contact James Godbold
CTSA MT Sinai
Success Topic Collaboration
Description of Success With the support of the CTSA, BERD consultations are now more complex and far-reaching than traditional statistical analysis. At Mount Sinai Medical Center we found that our BERD consultations were able to assist the Emergency Department Information System to implement a process redesign that resulted in rapid financial enhancement.

The adoption of comprehensive information systems in Emergency Departments has been slow despite perceived advantages in efficiency and safety for health information technology in other areas of the hospital. Although there has been recognition that there are likely benefits in terms of patient safety and patient throughput times, there has been reluctance to implement such systems due to concerns about start-up costs, unclear financial rewards, and potential work flow disruptions associated with implementation of such systems.

Mount Sinai Medical Center, is a designated heart hospital and primary stroke center with 45 licensed ED beds. Beginning in 2003 Mount Sinai implemented a comprehensive ED information system. This system was implemented in stages over a number of years, and recently, Dr. Jason Shapiro, a faculty member in the ED undertook the task of evaluating the effects of this information system in terms of financial costs and revenues. facility services. The implementation of the system involved redesign of clinical and administrative work flow in order to maximize efficiency of the new system, including the way that lab orders and results are processed, the way that radiology orders are processed, and the way that facility charges are captured for nursing procedures, with electronic methods being introduced in each instance.

Dr. Shapiro came to the BERD unit of Mount Sinaiís CTSA to seek expertise in the analysis of the financial data that had been collected over 5 years. James Godbold, Ph.D., and Fen Ye, M.S., biostatisticians in the BERD, began working with Dr. Shapiro to see how the financial data correlated with the implementation of the new system. The 5-year period was divided into four 15-month phases: pre-implementation, peri-implementation, post-implementation, and long-term post-implementation. Time-series models were developed for monthly receipts for facility charges and for monthly receipts for professional charges. These models compared the rates of change in charges and receipts among the four study phases, and found that that the rate of increase in professional receipts in the long-term post-implementation period was significantly greater than the rate of increase in the pre-implementation phase. Considering all costs and revenues, the new system resulted in a break-even status in eight months from implementation, with total revenue enhancement at the end of 5 years.

Links to the publication:
Shapiro, JS, Baumlin, KM, Chawla, N, Genes, N, Godbold, J, Ye, F, Richardson, LD (2010). Emergency Department Information System Implementation and Process Redesign Result in Rapid and Sustained Financial Enhancement at a Large Academic Center, Vol 17, No 5, pp 527-535.

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Topic revision: r9 - 10 Apr 2012 - 15:51:00 - MaryBanach
 

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