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Real-World Solutions with Adobe Technology: Health Care e-Form

Feb 24, 2010

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Paperless: Real-World Solutions with Adobe Technology

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The Results

The following are some of the results that doctors have achieved with the Janus OS:

Reduced paperwork by using the data provided by the facesheet to automatically complete various other documents
Reduced support staff because more of the documentation and ordering is automated
Faster and easier pharmacy and lab ordering through process automation

By improving the capabilities of mobile doctors, other savings can be realized for the overall medical system. Dr. Bayne notes that, “67 percent of new house-call patients would have called 911 or gone to the ER if we had not come, suggesting a huge cost savings to the system.” A house-call clinician can replace a $1,200 ambulance ride and a $6,000 emergency room visit with a $150 paperless visit. Also, various studies have shown that house calls can reduce Medicare program administration costs by substantial margins.

Paperless Patient Registration at St. Vincent’s Hospital

Have you ever been handed a clipboard and told to “fill out a few forms” in a doctor’s office or during patient registration at a hospital? How would you feel if the forms were already prefilled with relevant information? What would you think if the entire registration process was completed in less than three minutes? That is what happens at St. Vincent’s Health System with Adobe LiveCycle technology.

St. Vincent’s launched a pilot paperless patient registration system at its downtown Birmingham hospital in the summer of 2009. The system uses LiveCycle Forms ES, Process Management ES, PDF Generator ES, and Reader Extensions ES to automate consent and HIPAA (Health Insurance Portability and Accountability Act) forms. According to IT Manager, Mike Totty, “The feedback from patients, staff, and management has been very positive, and we are planning to roll it out to all 75 of our registration points within the year.” St. Vincent’s is part of Ascension Health, the nation’s largest nonprofit health care system, with five facilities in and around the Birmingham, Alabama, metropolitan area.

The process begins when a patient enters the hospital and meets with a registration clerk. If the patient has been to the hospital before, the clerk calls up the patient’s record from the hospital’s patient information system. If the patient is new, the clerk creates a record for the patient in the system. St. Vincent’s uses a combination of the McKesson STAR 2000 system and a Vignette-based physicians portal. These systems are integrated with the LiveCycle ES solution components mentioned previously.

After the registration clerk has updated the patient’s information, XML data is sent from the patient information system to two different LiveCycle processes. The first process uses LiveCycle Forms ES to render a prefilled consent and HIPAA form based on an XDP template and an XML data file. The second process uses LiveCycle PDF Generator to create and print other patient materials, including armbands, labels, and facesheets. The forms are presented to the patient in Reader on a PC. After the patient reviews the form, the patient signs it using a third-party hardware device: the ePad-ink electronic signature by Interlink Electronics. This tool, like other third-party signature input devices, is integrated with Acrobat/Reader, and the patient’s signature appears in the PDF.

The hospital has already seen some specific cost savings: Previously, the staff needed to pre-print patient admissions forms and keep an adequate supply of these forms at each of the 75 registration points. Also, staff needed to scan all the registration forms for the patient’s EMR. According to Steve Anderson, St. Vincent’s Director of IT, “This scanning costs six to seven cents a page, so over a year we expect a savings of $25,000 on scanning and printing costs for the registration forms.”

However, the more significant benefit is the improved patient service the hospital is providing. In addition to making registration easier and quicker, the new system also enhances information privacy for the patient. Previously, paper forms could be misplaced or filed in the wrong patient’s folder. This is no longer the case with paperless forms.

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