Data Quality And The Hospital Revenue Cycle
The issue of capturing and maintaining the consistency and validity of patients'
personal and financial information is quickly becoming a major headache for hospital administrators. For Healthcare providers in the US and Europe keeping a consistent view of the patient is a critical aspect of the entire hospital revenue cycle.
The problem usually begins at the point of registration. To understand why this happens let's consider the following factors:
- Patients access hospital services through multiple entry points (inpatients, outpatients, emergency room, etc).
- The access points to these services do not always follow a consistent registration process.
- It is extremely difficult to ensure that all hospital personnel conducting registrations follow best-practices. Particularly where the registration processes is de-centralized and clinical personnel conduct some of the registrations.
-In general hospital information systems are not designed to help patient-facing employees through the data capture process at registration.
These factors result in duplicate patient records, incorrect patient information being captured, inaccurate insurance details entered in the system, and so on. Hospitals are then faced with having to re-work all this data in the back office and footing the bill for delayed payments and loss of revenue due to unpaid services.
Ideally, everyone registering a patient should be aware of what to do to avoid these problems. However, the reality is that achieving this level of expertise across the board and ensuring that best practices are always followed becomes a management utopia.
Hospital staff report to different departments, their 'main' job may not be patient registration, they don't fully understand the system, or simply, they want to get the patient registered in the shortest possible time with as little hassle as possible.
So what can hospital administrators do to reduce this problem?
Traditionally auditing has been the answer; which in a way becomes a game of cat and mouse of catching errors and correcting them before they get too far. The only preventive measures are besed on reporting on most common errors and trying to train all personnel involved so they can be avoided in the future. The high staff turnover at hospitals and the difficulty in getting everyone trained to the same standards means errors continue to happen.
But increasingly, the attention is turning to error prevention. Some healthcare providers are already using systems that integrate with their Hospital Information Systems to provide guidance through these processes. Such systems take the hospital employee through a process of questions and answers and check the validity of the data being entered. Using the hospital best-practices as the starting point they ensure that errors are virtually eliminated before they are entered into the system.
Using this approach even the most inexperience hospital staff can perform flawless registrations. The amount of re-work needed decreases dramatically, the registration process becomes stress-free for those involved and hospitals see their revenues increased and their AR days reduced.
by: Oscar Gonzalez
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