Today as part of my normal Friday routine I visited my favorite breakfast spot. I enjoyed my eggs and pork roll sandwich, coffee and freshly squeezed orange juice. The atmosphere here is very mom & pop. I can sit by the counter and have conversations with other patrons and workers about politics, entertainment and world events. By all accounts this is much like any other little cafe across the country.
When I was finished the waiter handed me a small tablet where I swiped my credit card, applied a tip and signed for my meal. The application even asked if I would like my receipt emailed. A clever use of technology, and I know they make good use of my email address by notifying me of daily specials.
The process is simple and my little café has been doing it this way for the past year.
My experience at my local pharmacy was much the same. I picked up medications and electronically signed for my transaction. I also electronically acknowledged I was counseled by the pharmacist and understood my rights. As a consumer, we all expect these kinds of transactions in our daily lives. Anything less seems old fashioned, and out of pace with regular life.
My experience visiting an emergency room over vacation was much different.
I was handed a Consent for Treatment form.
I was handed a Financial Responsibility form.
I was asked for my driver’s license and proof of insurance, which was photocopied and placed into a paper chart affixed with a label containing my information.
Like most medical forms there were boxes for narrative answers and of course the signature line. With forms bundled and attached to a clipboard, the registrar handed them over with a pen with instructions to complete them before she returned. Of course she didn’t know the pen was dry, but one of the nurses had one to spare. Eventually, I completed and understood all of the forms. During my many years in healthcare I have helped design similar forms, so I easily understood the questions being asked, but I can guarantee you that many are completing these forms without a good understanding of their meaning.
Eventually all the forms were stuffed into my chart.
How odd I thought. Healthcare is a service wrapped in high-tech, yet these archaic paper processes still exist as they have my entire adult life.
Where is my electronic signature?
Where is my access to documents via email or website?
Fortunately my regular hospital utilizes electronic forms, and I think of them as more high-tech, more in line with the way I typically do business. If I am honest I have a better impression of a hospital using electronic forms than I do with one using paper forms. It might not be fair, but this is all about perception.
But is it just perception, or are there real hard-costs to doing business the old fashioned way?
Being an analytical fellow I wanted to understand the hard-costs behind this paper-based process.
Paper forms are cheap, unless you are using an external printing agency to create them, and I know one customer who paid $1 per form for a multi-part color form. But for the purposes of this analysis let’s say the hospital is using plain white paper. The costs include paper and toner, not to mention printer maintenance and electricity, but we won’t count that here. So I estimated the cost of paper at around a penny a form. That is a conservative number considering that most people consider five cents reasonable.
What about paper handling which includes physically printing the form, affixing a patient label and scanning that form? Remember, just because you scan a form doesn’t make it an efficient process. The person scanning still has to prepare these forms and make certain they are indexed properly. How much time does that take? Well, by all industry accounts that is roughly 90 seconds. Still doesn’t sound bad, but with an hourly wage of $15 per hour, a single registration will cost $1.13.
Then I remembered a Gartner study indicating 1% of all forms are lost and 3% are misplaced. Recovery time is anywhere from 15 minutes to an hour…to never. These lost or misplaced documents can increase AR days and slow down reimbursements. How many complaints has your hospital received when a patient had to complete a form more than once? This is not the mark of an efficient and modern business, and can damage your image. Everything that negatively impacts your image can potentially alter your HCAHPS scores, but that is a conversation for another time.
Based on this logic the cost to handle paper forms for 1000 patients totals $1,506. Doesn’t sound bad does it?
How about this? The annual cost for an average hospital to use paper forms is $200,000 and 10,000 man hours.
This is significant, but there are solutions.
Signature pads, electronic forms and portable tablets can replace paper. Platforms from dbtech can analyze the registration process and ensure quality collection.
This is a win/win, and dbtech provides this technology with an ROI of less than a year.
I fully expect that all hospitals will rid themselves of paper-laden registration processes, and it’s my hope that I can help many of you through this process.
Best of luck, and happy holidays!