Doctor, Doctor, Give Me the Cure
March 2004 - By Craig Settles

As physicians feel the painful squeeze of increased patient loads, the uncertainties of Medicare and constant insurance industry pressure on reimbursable expenses, mobile technology can prove to be just what the doctor ordered. Or more specifically, just what should be ordered for doctors.

Want to build a strong ROI case for mobile technology in medicine? The physician ranks are a good starting point. This focuses on much more than just PDAs as prescription pads; it’s about incorporating technology into many aspects of how doctors operate, as it were.

As with any business, an effective mobile strategy for a medical team requires a systematic analysis and planning process. Let’s start by defining the need for mobility in two categories of potential benefits: 1) those quantifiable in dollars; and 2) those that are elusively quantifiable but vitally important to the physician’s mission of mercy.

Quantifiable Costs

Begin building your ROI case by identifying all of the areas where you can either spare doctors from time-consuming tasks not directly related to healing, or speed up those tasks that are related to patient care.

1. Determine if you can cut the paperwork load. Do you have six-figure salaried MDs filling out forms, surveys or other paperwork required for insurance or government payments, reporting and research? Calculate how many hours each doctor spends on this paper trail, multiply the hours by their hourly cost to the hospital (salary, benefits, taxes), and then add up how many docs you have on staff.

Assuming these numbers don’t send you into cardiac arrest, estimate the cost savings if you can trim 30 to 50 percent of that time by digitizing this paper onto PDAs so doctors just need to tap, type and click. Docs can then sync their PDAs with a workstation at convenient times to automatically dump the data into appropriate backend software.

2. Can you cut the paperwork load that physicians generate? Besides the time and trees sacrificed sending information to outside entities, MDs often handwrite reports on patient visits and treatment recommendations. These are usually rekeyed into computers by nurses or other staff.

Along with reducing errors that occur trying to decipher doctors’ handwriting, how much can you save in staff costs by having this information captured on mobile devices and sent directly to your databases? Holston Medical Group in Tennessee expects to save $24,000 annually per physician in costs associated with transcribing reports.

3. Capture more revenue and improve cost accounting. Some medical facilities may be losing 20 to 30 percent of potential revenues from routine medical procedures because they aren’t being recorded on paper, particularly in high-intensity emergency rooms. If this is true in your facility, you have another possible case for using mobile devices.

Some PDAs can record voices as .WAV files. When activity is fast and furious, it is possible for ER docs to capture key data this way during brief intervals between patients and type in information at times when the pace is calmer. What is the potential financial impact? Someone will still have to transcribe the .WAV files, but at least you have billing data that you might otherwise not capture.

Sometimes value is found in not only recovering missed revenues, but shortening billing cycles or more accurately allocating costs incurred. Look at what business decisions depend on knowing the amount each department is earning based on procedures performed. Is there a case to be made for improved cost and revenue alignment?

4. Explore the possibility of cutting malpractice insurance costs. Have a chat with your finance people about the amount of your facility’s insurance bill, then talk to an insurance rep about the potential savings if you can prove increased reliability in the accuracy of treatment your patients receive.

There are products and services available that allow doctors with PDAs to access up-to-date data on medications, including recommended dosages and potentially harmful interactions with other drugs.
Philadelphia’s Temple University Health Systems used such a service to negotiate a $130,000 reduction in insurance costs, as well as significantly increase the use of generic drugs, which is another major saving.

Elusive Quantifiables

Because medical care is ideally about more than dollars and cents, your definition of ROI (and the subsequent case you’re building for it) has to stretch to include the intangibles.

5. Determine when time is literally life or death. If I’ve learned anything from watching ER, it’s that confusion often reigns. Decision-making is immediate. And many patients are showing up these days who aren’t that sick but have nowhere else to go, thus compounding the time crunch.

So the ROI question is: If you give ER docs mobile devices to access records, receive test results immediately and review notes on incoming patients, will it really save time? It doesn’t have to save much time, but when a patient’s condition can go from stable to code blue in a heartbeat, that time savings can matter significantly.

The ER at Singapore’s National University Hospital set up an 802.11b wireless LAN and gave doctors HP iPAQ Pocket PC devices. It’s estimated that MDs save 20 minutes each shift just by eliminating the time
to manually retrieve patient records. In a department that can see 300 patients on a busy day, 20 minutes per doc per shift makes a big difference.

6. In how many areas can you improve customer service? Such a profit-oriented commercial term as “customer service” might not be used often in dialogs about patient health. But if you observe how mobile technology is used in traditional businesses, it spurs new thinking about how this can help improve patient care.

Calculate how much doctors can improve the speed and accuracy of healthcare if you deploy Wi-Fi, PCs with Wi-Fi cards on portable carts and PDAs. Instant access to medical records, test results, diagnoses from specialists treating the patient and medication history all lead to better care and even happier patients.

And let’s not ignore the underlying “profit” motive. Faster, better healthcare delivery translates into increased revenue, quicker payment cycles, enhanced opportunities for research grants and a strong incentive to entice the best doctors to work at your facility. The resulting reduction in medical errors reduces the number of people taking you to court; that alone can ease a hefty financial burden.

While there are many issues to take into consideration when planning a mobile strategy, this should help you make a healthy diagnosis of the potential impact on your business. If in doubt, take two PDAs and call me in the morning. •

Craig Settles is president of and the author of Wireless, Inc. He can be reached at [email protected]


Leisure Publications