A Patient esignature Case Study
St. Elizabeth Hospital
Physicians can view forms from anywhere, anytime
St. Elizabeth Hospital, based in Enumclaw, Wash., provides 24-hour emergency care, a spacious family birth center, leading-edge surgery suites, simple to sophisticated diagnostic imaging exams, the latest in gastrointestinal lab screenings and procedures, and a full range of specialty services.The hospital earned a HIMSS Analytics EMR Adoption Model Stage 7 award and the prestigious LEED Silver certification by the United States Green Building Council.
PATIENT ESIGNATURE Case Study Highlights
- ABN forms available immediately and electronically, speeding the revenue cycle and eliminating chance of document loss.
- Electronic patient signatures and eForms create paperless processes.
- Prefilling demographic information and providing eSignatures boosts patient satisfaction.
- Physicians can view forms from anywhere, anytime—improving patient care and safety.
Location: Enumclaw, WA
Focus: HIMSS Level 7 attestation, paperless environment, CMS Advance Beneficiary Notice of Noncoverage (ABN) forms
Departments: Registration, admissions, billing and clinical floors
Access solutions: Intelligent eForms, Electronic Signatures and Enterprise Integration
Reaching the Peak of EMR Excellence
St. Elizabeth Hospital is committed to improving patient care, safety and satisfaction through the use of technology. It is this dedication that propelled the facility to Stage 6 of the HIMSS Analytics EMR Adoption Model. When St. Elizabeth began planning for how to advance to the next and final level, Stage 7, the hospital’s leadership team worked with Spokane-based Inland Northwest Health Services (INHS) to determine which new solutions were needed.
One of the areas for improvement was managing patient forms. Staff members typically pulled preprinted forms for patients to complete and sign, and then affixed labels to them. The forms were sent to the HIM department, where staff members scanned and indexed them — a time-consuming, paper-intensive, manual process. With the help of INHS, St. Elizabeth evaluated several electronic forms management vendors, and chose Access to help them go paperless.
“We have a long and successful partnership with INHS, so when they recommended Access, we had confidence that their solutions would meet our needs,” says Shelly Pricco, Associate Vice President of Patient Care Services at St. Elizabeth.
Boosting Care With Anywhere, Anytime Data Access
When a patient completes their registration packet, the forms data is needed immediately across the hospital. This wasn’t possible with preprinted forms, as it took time to send the documents to HIM for scanning, and forms could be mislabeled or data entered incorrectly. The Access system has eliminated these barriers to rapid information availability.
“Many people need to view patient forms — registration, billing, clinical, HIM,” Oster says. “Having one central forms repository makes this quick and convenient, and people aren’t calling registration to ask them to send copies of advanced directives, motor vehicle accident reports or other forms they need.”
The instant, secure data provided by the Access solution also is benefiting physicians, including those who need to view forms when they’re off-site. Surgery documents are scanned before a patient leaves the unit and are then available from anywhere, at any time.
“Physicians working remotely don’t have to ask questions about what treatment has been given or where chart documents are, because all the information is right there — there are no duplicates and the forms are in the correct chart,” Pricco says. “The Access system is making a big difference in patient care and safety.”
St. Elizabeth’s billing office is located off-site in Tacoma, Wash. Previously, hospital staff mailed the ABN forms required to bill Medicare-eligible patients for services that do not qualify for Medicare reimbursement. It could take two days for these documents to arrive, delaying the revenue cycle. This has all changed with e-forms.
“Our ABN documents are available electronically in real time now, so the billing office isn’t waiting for information anymore and the forms don’t get lost,” Oster says.
Now that the hospital has been awarded Stage 7 status (the first hospital using MEDITECH Magic to achieve this), St. Elizabeth’s registration department is finding other innovative ways to apply Access’s electronic patient signatures product.
Questions for federally mandated race and ethnicity forms are presented on signature tablets. When the patient completes their selections, the registrar sees these and quickly enters the data into MEDITECH.
“In addition to helping us meet HIMSS Stage 7 requirements for going paperless, Access e-Signature also is enabling us to capture more information for government-required race and ethnicity forms,” Pricco says. “We’ll keep finding new ways to use the system across the hospital.
“Wherever we can remove steps, we eliminate errors and so improve patient safety. That’s exactly what Access solutions are doing.”
St. Elizabeth Hospital Associate Vice President Care Services
Rapid Deployment and a Thumbs-Up From Patients
One of St. Elizabeth’s goals as it moved toward HIMSS Stage 7 was to deploy electronic patient signatures and e-forms quickly. The hosted option offered by INHS and Access eliminated the need for dedicated on-site hardware and enabled the hospital to meet its aggressive deadline. Managing the e- forms project in INHS’s data center also provides continuous uptime and data security.
“We were up and running with our e-forms and electronic patient signature solution in two weeks,” Pricco says. “This was one of the fastest implementations I’ve ever seen, and everything worked seamlessly with our MEDITECH system.”
The Access system soon made its mark on patients in the admissions department. Instead of waiting for a staff member to retrieve and label preprinted forms, they’re now quickly presented with a complete registration packet, which the registrar launches from
MEDITECH with a single click. Some data is already prefilled, and the patient rapidly completes the remaining fields. They then apply secure electronic signatures.
“Patients never liked filling in the same information over and over on a stack of paperwork,” says Jody Oster, Patient Access Manager at St. Elizabeth. “They like the electronic signature setup a lot more, and because registration is faster with the Access system, they’re getting care without delay. It has really enhanced the patient experience.”
Electronic patient signatures and e-forms are not only making patients more satisfied with their experience at St. Elizabeth, but also safer.
“Wherever we can remove steps, we eliminate errors and so improve patient safety,” Oster says. “That’s exactly what Access solutions are doing.”
The Access solution also has proved to be a hit with admissions staff, as they have been able to eliminate manually retrieving, labeling and photocopying documents and patient cards.
“Our admissions team loves how fast and streamlined registration is with the Access system,” Oster says. “It’s not just saving time with the admissions packet but also with patient ID and insurance cards, as we’re now scanning these instead of walking to a
photocopier to copy them.”
Nurses also are taking full advantage of the speed of e-forms on clinical floors. They simply select a patient in Access’s e-forms repository, click a button to generate a cover sheet with the patient’s unique information, and then scan this with any clinical documents
to send them into the correct EHR.
“The ability to get clinical documents into EHRs is another way that Access helped us satisfy a huge component of getting to HIMSS Stage 7,” Pricco says.