Executive Summary
Patient access departments can achieve significant cost savings with electronic signatures, due to less paper use and no need for offsite storage. Registrars at Ann & Robert H. Lurie Children’s Hospital of Chicago no longer have to scan in 30,000 consent forms each month.
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Providers have immediate access to signed consents for admitted patients.
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Consents are stored electronically.
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Forms are no longer printed.
Paper costs are now ‘minimal’ for patient access department
More than 60,000 pieces of paper each month no longer need to be printed, copied, and stored in offsite record storage locations, due to electronic signatures being implemented in registration areas at Ann & Robert H. Lurie Children’s Hospital of Chicago.
“We are anticipating a great deal of cost savings as a result of this project,” says Brian M. Stahulak, MBA, BSN, RN, NEA-BC, administrator of new patient referral.
Registrars no longer need to scan in 30,000 consents each month to the medical record. “This will save a great deal of time for our medical records team,” says Stahulak.
Paper costs are now minimal. “Costs for FTEs dedicated to scanning these documents can now be redirected to more value-added projects,” adds Stahulak. There are also decreased storage costs. Previously, paper consents needed to be stored offsite in a secure location for several years. “E-signature will allow consents to be stored electronically, safely within the patient record,” explains Stahulak.
Patient access leaders at Fairfield, CA-based NorthBay Healthcare are looking at several vendors for electronic verification software. “When you think about a five-page consent form alone, you can easily do the math and figure out that in a year, you’ve made your money back,” says Lori Eichenberger, interim senior director of revenue cycle management.
Immediate access
Ambulatory areas recently implemented electronic signatures at Ann & Robert H. Lurie Children’s Hospital, but patient access leaders are not stopping there.
“Patient safety, patient engagement, improved workflows, and cost savings are key drivers,” says Stahulak. “We are continuously looking for ways we can use it for process innovation.” Here are some examples:
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Electronic signatures in the emergency department give providers immediate access to signed consents and other forms for patients admitted to acute care inpatient floors.
“We have also been able to move a manual process to an electronic one, reducing or eliminating the risk for potential errors,” adds Stahulak.
Widespread training
Training was provided to the admitting department, point-of-service staff, and the hospital’s transport team.
“There was additional training with nursing teams as well,” says Stahulak. “We created a new process for work lists. The admitting team utilizes this to confirm a consent was signed for all admitted patients.”
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Electronic signatures are used for consent documents for all hospital-based outpatient centers.
This process allows parents to sign annual consent documents electronically. “Our previous process was that all consent documents had to be signed on paper, labeled with the patient information, and manually sent to medical records for scanning,” says Stahulak.
Patient consent documents are now automatically saved and stored within the electronic medical record. “This ensures that all patient consent forms are protected and can be utilized by providers immediately,” says Stahulak.
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Electronic signatures are available for families using self-check-in kiosks at registration areas.
“This gives families the opportunity to skip the queue while checking in,” says Stahulak.
Hundreds of forms
Patient access leaders at Memorial Hermann Health System in Houston, TX, have used an internally developed electronic signature tool for years. The department is converting to a revenue cycle system from North Kansas City, MO-based Cerner that includes an electronic signature tool.
“We will be going off our ‘homegrown’ tool in 2016. But we have taken a lot of what we have learned from our existing tool and asked them to build some of that in,” says Tonie Bayman, director of revenue and recovery for patient business services.
The “homegrown” tool automatically prints the right forms for each patient. Previously, patient access scanned paper forms and then uploaded those to the patient’s account.
“We have hundreds of forms. There is a lot of risk in counting on a patient access person to remember which one is needed, and a lot of potential for somebody to forget,” says Bayman. Some important forms aren’t used often, such as a form enabling self-pay patients to obtain funds for pharmaceuticals.
Patients appreciate not having to sign the same consents multiple times, since the tool flags which forms already were obtained by patient access. “It is a permanent part of the financial and medical records,” says Bayman. “And if a visually impaired patient has a hard time reading a form, we can zoom in to enlarge it.”
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Tonie Bayman, Director, Revenue and Recovery, Patient Business Services, Memorial Hermann Health System, Houston, TX. Email: [email protected].
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Lori Eichenberger, Revenue Cycle Management, NorthBay Healthcare, Fairfield, CA. Email: [email protected].
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Brian M. Stahulak, MBA, BSN, RN, NEA-BC, Administrator, New Patient Referral, Ann & Robert H. Lurie Children’s Hospital of Chicago. Phone: (312) 227-4622. Fax: (312) 227-9645. Email: [email protected].
