Entrada

How a Rapidly-Expanding Surgical Group Overcame Its Biggest Obstacle to Growth, While Quickly Reducing Medical Records and Transcription Costs by $230,000 Annually and Improving Revenue.

The Surgical Clinic (TSC) of Nashville, TN consists of 25 highly skilled surgeons specializing in general, vascular, and thoracic surgery as well as surgical oncology. The practice has grown dramatically with increased patient demand in recent years, to which TSC responded by adding new physicians and increasing its geographic reach with new locations.

Three years ago, the practice CEO initiated a thorough review of the clinic’s operations with the objective of identifying any factors that threatened to curb ongoing growth. His goal was to not only add new surgeons to the practice but also to increase operational efficiency. He quickly identified clinical documentation as a growth-limiting factor requiring immediate attention.

The Challenge

The practice was using a traditional outsourced transcription service costing $250,000 annually. TSC battled high error rates, lost work, long turnaround times, and multiple reviews of each report. This had significant impact on the practice’s documentation workflow. Each delayed report postponed billing, increasing the revenue cycle and impeding communication with referring physicians.

Additionally, there was no integration with the clinic’s other systems so transcribed reports had to be handled manually upon return from the transcription company. The clinic had five staff tasked with tracking down physician notes and manually filing them in patient charts.

The process was riddled with inefficiencies and opportunities for human error which was regularly the case causing further delays and additional mistakes.

Immediate Savings and Process Improvements

TSC implemented the Entrada platform, eager for a highly integrated solution with end-to-end automation. The Entrada team worked closely with the clinic’s physician leader, William Edwards, M.D., to customize the technology to meet the very specific needs of the surgical practice.

Complete integration enables TSC to cut the Medical Records Department at every location
Entrada is fully integrated into the clinic’s existing systems. The front-end integration enables Entrada to automatically import patient demographics from the clinic’s GE Centricity Practice Management system, generating a work list for each provider listing all patients with scheduled appointments in a day, along with jobs for any letters or other related tasks. At check-in, complete patient information is automatically added to the provider’s work list allowing the physician to click on a job and begin dictating without having to provide patient demographics or any personal identifying information.

This front-end integration saves time for the physician on each dictation and guarantees finished jobs are never returned unidentified. Completed jobs are automatically routed to the correct patient file via full back-end integration with the clinic’s Allscripts TouchChart Electronic Medical Record (EMR) system. This end-to-end integration has drastically reduced the need for human intervention, dramatically cutting personnel needs and the risk of errors.

“In the past, each report was passed from person to person,” Edwards recalls. “The chances of error were increased with each pass. Misfiling was always a problem. Now, there is no longer a need for a person to intercept the process. This has drastically reduced errors.”

As a result of this complete integration, the practice was able to completely cut the Medical Records Department at each of its five locations, keeping only one part-time position to oversee clinical documentation for their entire practice. This reduced the clinic’s annual personnel expense by $160,000.

Entrada saves TSC over $230,000 annually
Also, the clinic experienced a 30 percent drop in medical records documentation costs for each physician bringing the total savings in service costs to over $230,000 annually. In addition, the clinic was amazed by the effortless deployment, how quickly each physician learned the new system, and the dramatically improved turnaround time.

Increases physician productivity, boosting practice revenue by as much as $325,000
The end-to-end integration coupled with the intuitive design and ease of use saves each surgeon approximately 1.5 hours per week on documentation, which is time they can now spend with patients. Clinic CEO Bob McCorkle says this translates into the potential for an additional $325,000 of annual revenue.

Drastically reduces turnaround time
“Even more than the cost savings and productivity boost, the drastically reduced turnaround time is the biggest advantage,” says Edwards. “We get completed reports returned either the same day or the next morning. This allows for prompt communication with treating doctors and guarantees proper care coordination.”

Ideal Solution for Surgeons

“Surgeons want to be in the O.R. seeing patients, not stuck in their office doing paperwork,” says McCorkle. “They want one effort to document their work, sign it, and move on. Any time surgeons spend time not seeing a patient is nonproductive time. Entrada recognizes the complex and diverse needs of surgeons.”