Smartphones save money and stave off staffing shortages, study finds

May 17, 2010 Topic: Outcomes in the News 

Outdated hospital communications systems — based on blaring PAs and multiple, often incompatible mobile devices –  are causing confusion, reducing efficiency, wasting money, and helping contribute to serious staffing shortages.

So say the findings of a white paper published today by Voalté, a Sarasota, Fla.-based developer of point-of-care communications software for iPhones and BlackBerry devices. “Smart Hospitals – Embracing Smartphones at the Point of Care” highlights communication inefficiencies within hospitals that cause confusion and reduce effectiveness. It concludes that smartphones offer a comprehensive and easy-to-adopt solution.

Researchers have found that ineffective communication wastes as much as $12 billion nationwide each year, and that frustrations with outmoded systems can lead to nurse dissatisfaction and, ultimately, exacerbate the hospital staffing shortage.

But “smartphones offer a solution to many of today’s healthcare communication issues,” the study finds. “With PC-like functionality and advanced capabilities, smartphones provide a single interface to make calls, send texts, manage schedules, organize tasks, view online literature, and receive alerts. Most clinicians are already familiar with smartphones and the devices easily integrate with hospital networks, providing a solid platform for application developers. Mobile healthcare applications allow physicians and nurses easy access to medical information, bringing faster, more informed decision-making to the point of care.”

For a typical, 500 bed, acute-care hospital, communication problems between physicians and nurses create an annual $4 million economic burden, the white paper reports, and often needlessly increase the length of hospital stays.

Worse, poor communications can adversely impact care. Noisy overhead paging systems can cause nurses to miss calls – particularly when working within patients’ rooms. In addition, most point-of-care staff are saddled with multiple devices – a nurse may carry a pager, PDA and a mobile phone, with each device providing specific functionality and generating its own alarms. The nurse can’t prioritize alarms according to criticality, so a pager buzzes the same tone when a patient wants ice or for a code blue alert.

Due in part to these inefficiency and communication problems, nursing dissatisfaction is on the rise. According to a recent study of 43,000 nurses from 700 hospitals, more than 40 percent of U.S. nurses reported being dissatisfied with their jobs – three to four times higher than the average worker.

The problem can be self-perpetuating, the study finds. “Nursing shortages and communication problems negatively impact patient safety and increase patient dissatisfaction.This in turn can affect a hospital’s overall rating and reputation, which can drive down HCAHPS and Press Ganey scores and directly impact a hospital’s ability to stay profitable and recruit talented staff.”

As smartphones grow increasingly feature-rich and easy-to-use, the devices offer a solution to many of these serious communication shortfalls.  Their functionality make them tantamount to “a miniature computer that combines phone, e-mail, texting, and Internet service.” And since they’re already in common use, the learning curve that usually occurs when new equipment is introduced to a workplace would prove minimal. (According to a study by Manhattan Research, 64 percent of U.S. physicians own smartphones and analysts predict penetration will increase to 81 percent by 2012).

[Smart Hospitals: Embracing Smartphones at the Point of Care] via Voalté

Integrated Wireless Telephone

Healthcare Outcomes

How Quality Will Pay for Hospitals Under New Reform Measures

May 13, 2010 Topic: Outcomes in the News 

A recent article in HealthLeaders Media outlines how new reform measures will affect hospitals.

While most hospitals have focused on promoting quality care at their facilities to help decrease costs, quality care will take on a somewhat different meaning under the new healthcare reform law: Hospitals will feel the pressure to maintain continuous quality improvement or risk being penalized under reform incentives scheduled over the next several years, according to a PricewaterhouseCoopers’ Health Research Institute report titled “Health Reform: Prospering in a Post-Reform World.”

According to the report, the new law can be expected to impact hospitals in three main areas:

  • Hospital readmissions. Starting in October 2012, hospitals will be financially penalized by Medicare if they demonstrate “excess” readmissions within a 30-day period when compared to the “expected” risk-adjusted levels of readmissions. The readmissions are based on the measures for acute myocardial infarction, heart failure, and pneumonia.
  • Hospital payments based on value based purchasing (VBP). Starting in 2013, hospitals will be paid according to a Medicare VBP program schedule, in which payments will be made based on hospitals’ quality measure outcomes. VBP will measure hospital efficiency, patient satisfaction, and quality of care. These outcomes will be collected beginning October 2012.
  • Penalties for hospital acquired conditions (HACs).Beginning in 2015, 1% of payments will be subtracted from hospitals with the highest rates of HACs—essentially those falling into the bottom quartile of hospitals when compared to the national average. This could result in a nationwide reduction of $1.5 billion in payments over the next 10 years.

The message hospitals need to pay attention to is “don’t get stuck in the bottom quartile, and work towards continuous quality improvement,” according to the report. The bottom quartile will change from year to year as the quality performance of hospitals change. However, at least 1,000 hospitals will end up in the bottom quartile—regardless of the quality provided.

Beginning in 2013, high scoring hospitals under VBP will receive a higher payment of 1%—which rises to 2% in 2017 and beyond. In addition to the direct financial impact, the reform law will require that an organization’s quality metrics be publicly available and accessible.

In addition to the direct financial impact, hospitals also could feel the impact of consumerism. For years, healthcare has lagged behind in making information easily accessible to consumers, but this has been changing.

According to a 2009 PricewaterhouseCoopers consumer survey, individuals are using the Internet as a source for making decisions. Online content was found to edge out physicians as an information source: For instance, 48% of consumers said they use health websites to find information to make decisions about their healthcare.

Within this consumer realm, hospital quality information will move “beyond the organization and government websites” to health websites and consumer advocacy sites, the researchers note.

In addition, making more quality information available to consumers could impact a system’s perception in the community and payers’ contracting strategies with them. More informed decisions by patients could lead them away from organizations listed as “poor performers”—or those in the bottom quartile of hospitals.

For the typical hospital, being on the bottom quartile in terms of quality could mean millions of dollars lost annually. For instance, for a 300-bed community hospital with $50 million in Medicare inpatient net revenue, failure to improve on hospital readmissions (a loss of about $96,780), failure with VBP (a loss of $750,000), and ending up in the lowest quartile for HAC ($500,000), would create a drop of $1.35 million in income.

In addition to Medicare, hospitals also will have to learn to live with cuts in Medicaid. Hospitals that care for high numbers of uninsured and Medicaid patients currently receive extra funding from Medicare and Medicaid under the disproportionate share program. But in 2014, Medicare DSH will be reduced 75%—the same year that the insurance exchanges and individual and employer mandates go into effect.

[How Quality Will Pay for Hospitals Under New Reform Measures] via HealthLeaders