How Virginia Streamlined Its Hospital Patient Pre-Admission Screening Process
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The Old Dominion’s creation of a Medicaid portal complicated procedures for facilities with data automation, so it had Curaspan create a workaround.
When Virginia developed its own pre-admission screenings tool, ePAS, last spring for submitting patient information, the state inadvertently made more work for hospital employees.
Pre-admission screenings are federally required of acute care hospitals to ensure patients aren’t improperly discharged to nursing homes.
Pre-existing hospital tools automating data entry weren’t automatically integrated with the new Virginia Medicaid Web Portal tool, forcing staff to input information into both systems separately—double the workload.
“As everyone is aware, the regulatory environment and demands on these types of employees is increasing dramatically, and that means a lot of documentation and administrative demand on caregivers,” said Tom Ferry, CEO of the Newton, Massachusetts-based Curaspan Health Group. “Without technology, the more time is spent on data entry versus working with patients.”
Historically, pre-admission screening paperwork—more than 15 pages’ worth—took more than an hour to fill out by hand and was mailed or faxed to the state Department of Medical Assistance Services to await approval. In 2003, Curaspan partnered with Norfolk, Virginia-based nonprofit Sentara Healthcare, which manages more than 100 hospitals, nursing homes and hospice care operations, to streamline the process.
With Curaspan’s DischargeCentral tool, a patient’s name, birthdate, contact information, demographics, insurance, Social Security number and admitting diagnosis are pre-populated on screening forms, which can be easily amended if conditions change or a mistake is made. Databases make it easier for hospital employees to refer back to information if the state has questions about a submission.
“I liked going electronic,” said Brenda Parker, nephrology case manager at Sentara RMH Medical Center in Harrisonburg, Virginia. “I was the person who sent all that stuff via mail, and it left me with uncomfortable feelings.”
Problem was, when Virginia introduced ePAS, it proved difficult for staff at the 238-bed community hospital to toggle between the portal and DischargeCentral to input information in both at the same time. Parker kept a sticky note with basic patient information off to the side for convenience, because names and Social Security numbers go on every screening page.
Recognizing the complication to workflow, the Virginia Department of Health reached out to Curaspan in June and asked the company to integrate its tool—eliminating the redundancy of filling out forms via the portal. Development began in August and beta testing in September, and four Sentara test hospitals began electronic submissions before the state’s Dec. 1 deadline, a four-month process.
Submissions to the state portal are made with the click of a button, and Curaspan announced earlier this month it would partner with Virginia to complete the Sentara rollout—the only other state-sanctioned pre-admission screening solution.
Parker wasn’t sure of her hospital’s exact cost savings, but the pre-admission screenings of patients she knows well now take 15 minutes, a huge boost to her productivity elsewhere.
Employees are averaging 30 to 45 minutes in time savings, Ferry said, most sites submitting 30 forms per month for a total of 6,000 per year statewide. Now medical practitioners can focus on what they were professionally developed to do, rather than the secretarial demands of the job.
“Communication can definitely be a bottleneck in the timely discharge of a patient,” Ferry said. “If that process isn’t streamlined, and external resources aren’t arranged for, that can delay a patient’s discharge so there’s a financial burden.”
Dave Nyczepir is a News Editor at Government Executive’s Route Fifty.
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