Pamela Tallman, director of cardiology at Southern Regional Medical Center in Riverdale, Georgia, saw a harbinger of future challenges in 1983, when the hospital purchased a new computerized billing system, "We spent 40 hours each month trying to reconcile our ECG records with those of the accounting department," she said. "It was a real challenge to read the hand-written log sheets, eliminate double entries, and make the two records match. It became clear that we had to improve our system."

Refining the manual procedures over several years and eventually purchasing a personal computer for a departmental database helped increase efficiencies, but were not long-term solutions. As the cardiology department expanded, it was faced with a lack of space and increasing record-keeping demands. In 1989, the department purchased a MUSE^® CV Information System . The system promised to put an end to ECG record problems, as well as provide electronic filing of other cardiology exams, such as stress tests.

No more lost records

Upon installing the system, the department immediately realized efficiencies that led to time savings. "One advantage was that we no longer lost ECG results," Tallman said. "In the past, each time an ECG was ordered, we had to find the results of previous exams. An average of four patient ECG records per week were filed incorrectly due to human error. Also, if the exam had taken place recently, the results might be in the doctor's box, the transcription box, or the copying box. Or it might be in a stack of exams waiting to be re-filed. Searching for exams took a lot of time."

By preventing lost records, the MUSE CV system also increased revenue, because under the old system, when exams could not be found the account had to be credited for the price of the ECG.

Cash flow improvement

Managing higher volume with less staff

Less storage, material usage also generates savings

"We also anticipated savings on materials," Tallman said. "I had determined the materials cost per procedure - things such as file folders, copies, and labels - to be 74 cents. With the MUSE CV system , it was only 15 cents. We save over $18,600 each year on filing supplies alone."

The MUSE CV system also required less storage space. "Our storage room was not capable of handling the records we had already, and we knew that the plans to open the cath lab to other physicians would increase our storage needs," Tallman said. "The MUSE CV system decreased our filing space from280 square feet in 1988 to 12 square feet in 1995. When we added a second nuclear medicine camera and additional thallium stress testing equipment in 1992, we installed them in a space formerly occupied by filing cabinets."

7,077 hours of paper processing per year saved

Long hours spent processing paperwork were also significantly reduced. According to Tallman's analysis, the system reduced paper processing time for each of 28,310 ECG, stress, Holter and echo tests performed in 1996 from 19 to four minutes per procedure, resulting in a savings of over 7,077 hours per year. Because the system offers automatic management reports and database search features, time spent reconciling information was also reduced, to only one-half hour each month.
   

Financial Summary Southern Regional Medical Center achieved the following savings through the use of the MUSE CV Information System : Supplies:  $18,600 per year  Storage space:    reduced from 280 square feet to  12 square feet  ECG procedures/FTE: increased from 2,778 to over 4,780  ECG billing:  reduced misfiled ECGs from four percent to nearly zero  Report turnaround time:  reduced by one day or more  Accounting time:  eliminated 39.5 hours per month

 

More data added to create single electronic patient record

As impressive as the immediate results were, Tallman had high hopes that the system would meet future, as well as present, demands. She was not disappointed. In 1989, the MUSE system was extended to handle stress test and Holter results, in addition to ECGs. The system was also expanded to include two additional terminals in the department for transcription and information retrieval, and a third terminal in the emergency department for quick access to previous ECGs. In 1991, Holter monitoring and signal averaging records were added, and echocardiology results were added in 1993.

Networking capability was also added in 1993. The cardiology department is now networked to nine off-campus clinics, a psychiatric hospital, and the emergency medical technicians' pre-hospital ECG program.

As the department's data management needs changed, so did the MUSE CV system , and in 1996, both cath lab and pacemaker reports were added, resulting in the complete elimination of paper files. The MUSE CV system 's one point of entry feature allows users to log onto a single database for all exam results, and to use a common format that allows results to be correlated.

System has data analysis features for outcomes reports

With the growing importance of cost containment and cost tracking, Tallman has found that the MUSE CV system is also an excellent management tool. The system allows for sorting of records by name, date and time, referring physician, order number or test type. It also enables outcomes and cost analysis by procedure or physician. "We've used the system to provide accurate documentation for quality control and staff proficiency," she said. "We've been able to evaluate the percent of computer-read ECGs that are overread by cardiologists, and track the percentage of normal tests. We've also been able to document baseline artifacts, limb lead reversal, and other problems."