Focusing on Infrastructure

The focus of planning for a new ambulatory surgery center’s (ASC) core information technology (IT) infrastructure is understandably the PCs, servers, telecommunications and related components that form the backbone for business operations and today’s sophisticated array of medical devices. Another element is frequently overlooked or given incomplete consideration until near facility opening, although it is every bit as crucial to the ASC’s “central nervous system.”

This key need is the software that will manage all the administrative and clinical information of the organization from patient registration through final billing.

An opening presents one of the best opportunities to create an optimal long-run information management direction and even to “change the game” with its decisions. The central question comes down to this: Should we replicate the largely paper-based practices found in most existing facilities, or can we from the start move to a fully electronic approach?

Today, it is possible to acquire integrated management and electronic medical record (EMR) systems designed for the outpatient surgery environment. These systems automate scheduling, inventory management, preference cards, insurance management, and other administrative functions. At the same time, the EMR tools permit clinical automation: electronic documentation at all stages of the case, alerts that promote patient safety, order entry and other features. The ideal systems seamlessly share data and automatically populate the relevant administrative and clinical fields. As a result, information capture is “once and done” and a hidden cost of an ASC — personnel time on data entry — can be dramatically reduced.

While the traditional workflow path may seem most comfortable and even least expensive, adopting the electronic model from the outset may offer significant upside for the new ASC. Return on the investment in a comprehensive information management system comes from savings generated in several categories:

Construction: New ASCs have paid for EMR systems with the considerable savings that accrue from avoiding building rooms dedicated to paper chart storage.

Operations: In addition to the reduced data entry time mentioned earlier, personnel costs associated with chart handling drop when data is available electronically throughout the facility. EMR charting lowers or eliminates transcription costs, while the improved documentation that usually results leads to more accurate and better billing.

Analytics: The old adage that “you can’t manage what you can’t measure” is as true in an ASC as anywhere. Whether for reporting to external authorities or for internal business analysis, more granular information needs to be captured. Electronic systems offer opportunities to collect and manage data that simply do not exist in paper-based systems.

A few additional considerations for the new ASC evaluating comprehensive information management software are as follows.

1. Legacy or Contemporary?

Many of the management systems on the market today were developed years ago and face obsolescence. Acquiring one of these can lead to an expensive migration.

2. True EMR or “Electronic Filing Cabinet”?

Some options that are labeled EMR are really scanning or document management utilities that capture images but do not produce structured data for reuse.

3. Comprehensive or Limited?

Whether immediately or in the future, will your affiliated physicians want to share data between the ASC and their offices for added efficiency and convenience? Some systems promote this capability; others avoid it.

There are other aspects of the decision and rationale for EMR systems. The new ASC will do well to make this analysis as much a priority as its basic IT infrastructure.

Don Fallati is the senior vice president of marketing at Amkai. He can be reached at Donald.Fallati@amkai.com.