Whitepaper INTEGRATING SYSTEMS FOR EQUAL ACCESS CLINIC WHY INTEGRATED SYSTEM IS NEEDED. Gaurav Jangid

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1 Whitepaper INTEGRATING SYSTEMS FOR EQUAL ACCESS CLINIC WHY INTEGRATED SYSTEM IS NEEDED Akash Jain Gaurav Jangid Sanya Gulati Zhijun Huang

2 Executive Summary As quick-developing organizations achieve greater market share, attract more customers, they regularly run into a hinder where interior procedures battle to match increased demands. (NetSuite, 2013). The main challenge to support the development is to prepare well for the effective and efficient expand of the business while maintaining highlevel customer service. At the beginning, most organizations deal with problems in the quickest, most economic ways possible, which as the time going, leads to one of the biggest troubles for growing organizations: using disparate business systems for different groups of users among different departments. With the development of the business, these standalone systems bring out more and more questions on inefficiencies, low customer experience and below-average employee satisfactions, which hinder the organization to reach a higher level. Equal Access Clinic (EAC), as the organizations mentioned above, is now getting into the mire of growth. Due to the high demand of treatment, the organization is considering opening a new branch in Jacksonville. However, there are many legacy problems remaining. With the integration of current disparate systems, the organization could increase the process efficiency, create real-time visibility and generate enormous cost savings, achieving the full potential in the near future. The paper covers the business challenges caused by having multiple systems for different groups of users and how an integrated system that unify the data format as well as the processes could help organizations to move forward and keep growing rapidly. To address the challenges outlined above and support Equal Access Clinic s operations, we propose to use OpenEMR, a new age cross-functional open-source application. 1 Executive Summary 2 Introduction 2 Siloed Systems 2 Trend Impacting System Integration 3 Equal Access Clinic Environment 4 Business Challenges Caused by Having Siloed Systems 5 Benefits of Integrated Systems 6 The Solution: Integrated System OpenEMR 6 Benefits of Customizing and Implementing OpenEMR * Implementation of OpenEMR *Cost Analysis *Data Migration *Change Management 7 Conclusions 8 References 2 1

3 Introduction Siloed Systems A silo describes any management system that is unable to work with any other system. It's separated with other systems, creating an environment of individual and disparate systems within an organization. (Vangie, 2013) Silos regularly do not share same priorities, objectives or even the same tools, so department or units operate as individual business entities within the company. (Vangie, 2013) Because of the structure of an organization, many small to middle sized companies are Silo users. Within an organization, each of the departments or groups has distinctive needs and visions. Most of the upper-level managers are not conscious about the needs and goals of other department. Therefore, there is a big gap between these business units, causing problems in communication and collaboration, which arouse the urgent need for System Integration. Trend impacting System Integration Systems integration is now becoming a part of every major industrial operation, computing industry, marketing segments, consulting firms, automobile industry and military systems. Usage of Systems integration is not only in the ground levels of any company but also in upper levels of hierarchy like managerial decision making. The main work of a system integrator is to bring various different kinds of subsystems together by means of various techniques and tools. It Figure 1 is a culmination of data, process management, business ideas, skills, hardware, software and knowledge. (Ed Sullivan., 2003) Over the past decades, system integration (mainly ERP and CRM) continues to accelerate. The Gartner predicted that by 2016, midsize to large companies will spend 33% more on application integrations than in 2013 (Benoit et al, 2012). IT relevant and System integration takes a more and more important part in todays business world ($256 billion) (K. Piskorski., 2013), as indicated in Figure 1. To meet today s system integration requirements and be ready for future initiatives, EAC need faster, more efficient tools for collecting data and measuring outcomes. 2

4 Equal Access Clinic Environment Equal Access is a network of student-run free healthcare clinics established by the University of Florida, College of Medicine in Gainesville, Florida. Pre-medical and health professional student volunteers along with the University of Florida faculty and staff provide care for the underserved in the community. The clinic vision is to improve the physical, mental and social well-being of all, by enhancing access to high-quality, comprehensive, patient-centered care and by facilitating community-level action. (Equal Access Clinic, 2014) Right now, there are four different clinics in run. (Mobile West Clinic, Gainesville Community Clinic, Mobile East Clinic and Main Street Clinic) Currently the clinic is using 3 disparate systems that share lots of same functions and overlaps, as indicated in Form 1. The use of these siloed systems generates a complicated working environment for employees. Working in such a complicated environment causes several business challenges that hinder the growth of the organization. Form 1 Three Systems Used in EAC System Main Use Main Users Overlaps and Drawbacks Electrical Health Records and Clinical Practice Management Doctors Analysis, research and patient follow-up records management Employee Management Analysts Staffs (Receptionists) Managers Intakes Duplication, Repetition of Inputting Records, Different Data Formats, Non-unified Standards, Complicated Processes 3

5 Business Challenges Caused by Having Siloed Systems The potential challenges aroused by disparate siloed systems can become so severe that they cripple growth. The following lists four problems the general business as well as EAC mainly faces. Wasted Productivity: The efficiency of the staff goes down because of the inefficient and disjointed processes. It leads to increase in errors and most of their time is wasted in redundant manual tasks rather than focusing on the important core duties. For example, right now 70% of inclinic staffs time is spent in retyping the patient data into different systems, instead of focusing on clinical procedures, as indicated in Figure 2 Figure 2 Time in Work Time Spent in repetition of data inputting Clinical Procdedures (Diagnoses, Prescriptions, Appointments ) Research and Marketing Accounting Management Lacking of real time visibility: Due to the unintegrated software systems, there are multiple overlapping databases which lack the view of business performance. The reports which show the performance across various departments are crucial for getting an integrated view of the organization s operations. In our practice, the weekly generated statistics reports usually contain a huge number of errors (duplication, redundant info, and irrelevant data) due to the confliction between different databases. Consequently, it leads to taking a lot of time in making critical decisions which are quite risky. Integration complexity and cost: IT staffs spend significant time and effort to migrate, integrate and maintain the different applications. Moreover, even more money and time need to be consumed in installing the new versions of the various applications and integrating it. Consequently, the valuable time which could have used for focusing on the main business is simply wasted because of the redundant processes. EAC cost over $10,000 this summer to just maintain the mobile systems, not even mentioned how much it will cost when other three main systems need to be tuned. Lesser Patient Satisfaction: A good customer experience is the most important thing for a service organization. So here come the needs of an integrated system which gives the right information at the right time to the organization staffs and provide the customer a great experience. Right now, the patients in clinics as well as the employees are not satisfied with the current systems because of the time taking service and the complex operations between different applications. For example, a patient needs to wait when the staff members are busy finding out her or his specific diagnoses information from different sources located in the three disparate systems each of which has a unique interface and user rights requirements. 4

6 Benefits of Integrated Systems Process Efficiency: The new integrated system can automate invoicing, prescription approval, enabling us to avoid new hires and redeploy employees to higher-value activities such as medical research. Nucleus, the world leading integrated cloud company, found that, with such system, most of the companies accelerated their financial close time by up to 50%, increase productivity by 12.5%, which means 20 more patient visits per night for local each clinic. (NetSuite, 2013) Real-time visibility: When info can be accessed immediately from almost anywhere without wasting resources on data extraction and joining together, our volunteers and employees are better informed and make more accurate better decisions. The unified storage of data also offers a way to obviously shorten the time proceeded for research and marketing. IT Cost Savings: As the result of integration, IT staffs will no longer need to spend great amount of energy and time in maintaining three separate systems as well as the frequent extraction and inputting of different data sources. A significant reduction in operation cost can be realized. In addition, we can shorten the training cycle. A similar company like EAC, Kardia System saved $75,000 annually after system integration. (NetSuite, 2013) 3 5

7 Benefits of Customizing and Implementing OpenEMR Freely Available: Unlike most of Electronic Medical Records software, Open EMR is freely available and easy to implement. Thus clinics won t need any monetary investment from shifting from one system to another. Also Open EMR is an open-source application, i.e. anyone with knowledge of coding can modify the software accordingly to meet its need. Clinics with minimal one time investment can modify the software with all the features and functionalities it needs. Patient Information / Electronic Medical Records: Different departments of the clinics will have same basic information about the patient stored in their system. This creates redundancy. Also if the same patient is being treated for multiple illnesses by different departments then it becomes crucial for both the departments to work in synchronization and share medical records. Open EMR keeps all the records related to patients at one place. Information such as Primary Information, Marital status, Insurance coverage, Language and Ethnicity, Medicals Reports, Medical Problems, Medications, Allergies, Appointments etc. Thus any and every department which is part of the system can access the latest patient related medical information and work accordingly from there. It is way easier not only for the metrics to extract data and do statistics but also more visible for managers to manage employees. Flexible Scheduling: In traditional ways, the patients were supposed to make appointments by either walking in into the hospital or by calling up. Many times this creates confusion when the shift of receptionist changes or two patients are given same appointment time by mistake. (Shifting Schedule is stored in SharePoint.) Or there is no one to pick up calls or patient have to wait for the receptionist to get free. Thus one of the benefits of Open EMR Making appointments becomes very easy and convenient for both the employees and the patients. Patients can scan through the appointment calendar, find the appropriate doctor, find open slots and schedule an appointment. Both patients and available staffs are then notified via and cellular messages regarding confirmation or any other important updates, thus increasing the productivity by treating more number of patients with efficiency. 6

8 Conclusions Nowadays, organizations with rapid growth have to adapt to the world trend, raising the importance of having a fully integrated system to support the entire business operations including managing capabilities and continually increasing efficiency and effectiveness. A well-integrated system provides visibility in real-time, supports gradual and continual growth of the organization in accordance with business needs and gives additional benefits as the system capability develops simultaneously with the business. (Steve Downton, 2012) It s transforming how our clinic runs, and enabling it to the next level of growth and improvement. With the help of OpenEMR, we can get rid of the complicated use of the current three systems and come into a new page. 7 9

9 Equal Access Clinic References Benoit J. Lheureux, Massimo Pezzini, Jess Thompson, Ross Altman, Daniel Sholler, W. Roy Schulte, Paolo Malinverno, Eric Knipp. (2012). Predicts 2013: Application Integration. Gartner. ID: G Ed Sullivan. (2003). System Integration. Facilitiesnet. Retrieved from Equal Access Clinic. (2014). About Us. Author JP Medved. (2014). The Top 7 Free and Open Source EMR Software Products. Capterra. Retrieved from K. Piskorski. (2013). Forrester, Gartner Paint a Mediocre Scenario For IT Markets, Excluding IT Outsourcing. PGS Software. Retrieved from Netsuite. (2013). The Great Debate: One Integrated Business System VS. Siloed Applications. Author. Netsuite. (2013). Benefits of an Integrated Business Software System. Author. Retrieved from Steve Downton. (2012). Why fully integrated solutions are the way forward. Eagle Field Service. Vangie Beal. (2013). Information Silo. Webopedia. Retrieved from 8