“How much did this procedure cost?” While this might seem like a straightforward request, it’s often difficult, if not impossible, for healthcare providers to accurately pinpoint. But with the move to value-based care, the issue is becoming increasingly critical to understand.
Value-based care requires providers to understand the true cost of a procedure, from start to finish. To calculate the total cost of care, providers must be able to answer key questions:
- Care episode. What was done? Who was involved? What was the outcome?
- Location costs. Where was the procedure or test performed?
- Labor costs. Which surgeons, nurses, and technicians performed specific procedures and tests?
- Supply costs. What was used? What was the total cost of these items?
The first three categories are typically slam-dunks for providers. It’s fairly straightforward to identify a procedure, staff involved, the results and where the procedure took place. That data is recorded and stored in the electronic health record (EHR). However, accounting for the supply chain costs associated with an episode of care has proven to be a much more challenging task. More often than not, bedside and procedural documentation for supplies remains a time-consuming, largely manual process.
It’s not uncommon for a clinician to add a product by name or even scan a product barcode only to discover the system doesn’t recognize the data. The clinician then must find the information and manually enter the data into the EHR, an occurrence that takes place about 50 percent of the time.
Not only is this inefficient, but it’s also error prone. Clinicians often use their own terms to identify a product. The result is incorrect, incomplete or missing information that makes it nearly impossible for supply chain and revenue cycle teams to accurately identify every product involved in a procedure.
This has implications for reimbursement, not to mention the wasted clinical time spent in the EHR find supply data versus providing more valuable patient care.
If the industry wants to accurately account for the products used in the course of care, prepare for recalls and capture a greater percentage of case charges, it must ensure the systems supporting every aspect of care are connected and able to share timely and accurate data.
When a hospital implements an EHR system, it is integrated with the item master to enable clinicians to look up and record products in the course of patient care. The catch is that most item masters only contain products that are routinely purchased, and this is where bedside supply documentation becomes problematic.
The item master may be missing many of the supplies clinicians need to log in the patient record. That’s because clinicians must account for all procedure that occur during a given day. This represents from 300,000 to 400,000 items for an average hospital.
Including these items as part of a typical item master would more than double its size and make it unwieldy. Ensuring that the data is continuously updated for accuracy and completeness is a monumental task, requiring an exorbitant amount of time, effort and labor. Finally, data needed for supply chain, clinical and revenue cycle processes differs in many ways. In short, adding everything to the item master doesn’t make practical sense, nor is it best practice.
Supply data doesn’t have to be a stumbling block to understanding total cost of care. What the industry needs is a clinical item master that can serve as the single source of truth for item information to support clinical documentation and patient billing. This makes it easier and faster for clinicians to document product use.
Barcoding for clinicians can become as easy and effective as it is in retail stores. The data will help ensure that providers have complete and accurate information on chargeable items. And, the industry can improve patient safety through better recall management and adverse event reporting.
Data is the lynchpin to understanding the total cost of care. The industry must do everything possible to maximize existing investments in EHR, ERP and supply chain systems to ensure that clean, accurate data can be accessed and shared across these systems to help improve efficiency and enhance patient care.
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