— Ken Flagg, MIS Manager
Electronic forms at Florida Hospital, Fish Memorial integrate seamlessly with the hospital’s Meditech™ enterprise operations software. The result is more productive users, major savings – and most of all – faster turnaround which means improved patient care.
Florida Hospital, Fish Memorial is a virtually new 97-bed acute care hospital in suburban Orlando, Florida. It was built in 1994 by Florida Hospitals, a subsidiary of Adventist Health System, and has a staff of about 600.Patient census has grown steadily since it was built, and will likely continue to expand with the rapidly-growing Orlando metropolitan area
The result is more productive users,major savings – and most of all – faster turnaround which meansimproved patient care.
The Computing Environment
Fish Memorial’s highly automated data system is based on the popular hospital operations software from Meditech, hosted on four Data General Avion servers running Meditech’s proprietary operating system. Meditech comprises a suite of integrated clinical and administrative services including applications such as inpatient and outpatient admission ,utilization review, billing and accounting, discharge, nursing, radiology, emergency/trauma, medical records, pathology, and rehabilitation, all running on a dedicated network. Additional productivity applications, including transcription, are hosted on six NT servers connected to PC clients with a 10 Mb Ethernet LAN. The two networks are connected and most users have controlled access to both systems.
Health care providers sometimes feel inundated by large numbers of forms required not only for administrative activities such as Medicare and insurance companies, but for clinical practice, such as treatment plans, physicians’ orders, nursing records, laboratory reports, medical records, and more. Ameritech’s default forms printing capability uses preprinted multi-part forms on impact line printers. At Fish Memorial, this system caused low user productivity due to the frequent maintenance and continued downtime required by the impact printers, and the need to coordinate form runs with loading the correct preprinted form stock. The form printing process, itself, was also a significant operational cost. Strategically, using traditional line printing processes would have made it more difficult to realize the new hospital’s growth potential. The MIS department was aware of productivity increases and cost savings achieved in other industries with electronic forms printed on laser printers. The department conducted an informal study which documented the benefits electronic forms could achieve at Fish Memorial, and received the go-ahead to find a solution.
At medical computing trade shows, MIS staff found FormFast, Inc., a software developer which has partnered with Meditech to develop forms printing applications using Hewlett-Packard LaserJet printers. The hospital particularly liked the fact that FormFast’s electronic forms solution could be implemented form-by-form, allowing the transition to be invisible to users and not interrupt the flow of information or alter business processes. FormFast forms could also use the HP LaserJet printers visible to the Meditech network in conjunction with existing Meditech print services. A competing solution was rejected because it required all electronic forms to be cut over at once, and needed dedicated network nodes and forms printers. Fish Memorial Hospital first installed FormFast forms technology to use with requisition forms in the Radiology Department, where line printer support was a critical problem because of weekend and after-hours use. With the new system, users of Meditech’s radiology application can input form data exactly the same way as previously done; however, the FormFast application now merges this data, using plain paper stock, with the appropriate legal-sized forms stored in memory of a HP LaserJet printer. The printer is virtually maintenance-free, available at all hours of the weekend, and prints from multiple applications without changing paper stock. Based on this initial success, the hospital’s MIS department has since converted the multipage, multi-part HCFA 1500 and UP92 Medicare claim form and both inpatient and outpatient registration forms to the FormFast system as well. Forms are developed by FormFast at their offices with proofs and revisions exchanged electronically for rapid turnaround. When a form is completed, FormFast downloads it to the required printers. To control costs and overhead, the hospital does not plan to develop forms in-house until the form creation and revision volume reaches higher levels.
Three features of the FormFast system have pleased form users very much: First, that they don’t experience unscheduled downtime for printer maintenance; second, they don’t have to load preprinted form stock, giving them the flexibility to print forms singly or in batches; and third, the new work process is exactly like the old one and does not require additional training. Not counting the reduced cost of technical support, initial figures showed that after a 6-month pay-back period, the radiology electronic form will save about $2,000 – $3,000 per year, the HCFA 1500 and UB92 electronic forms will save about $10,000 per year, and inpatient/outpatient admission electronic forms will save on the order of $12,000 per year.