Web Log


Holistic Healthcare Solutions: Integration is Dumb

9/19/2016 10:24 AM

Many of you opened your email this morning, trying to figure out what the current state of affairs is.  In your inbox, you found requests for information, instructions on what needs to be done or maybe a fire or two to put out.  Email isn't your problem, but it is a symptom of the larger illness.

Your practice/hospital/office has departments that do various things: reception, billing, human resources, maybe a lab.  You may even have a way for a couple of these departments to communicate with each other.  Sure, when a practitioner orders a test, the lab is probably notified, the test run and the results entered somewhere.  That is only one question out of dozens, or maybe hundreds that need to be answered.  Yes, we now know that Patient X has a total cholesterol measurement of 247.  Who administered the draw? What kit was used for testing and who was the tester? What equipment was used and how old was it?  What is the average lifespan of that particular piece of equipment?  Where was the draw done? Where was the test done? How much power was consumed and rent paid on the facilities the tests were conducted in and how do they compare with other facilities?  How does all that affect the accuracy of the test itself?

I don't know the answers to these questions any more than you do.  I don't even know how the total cholesterol test is conducted or on what equipment.  That isn't the point.  The point is that we don't know.  If you walk into your local watering hole, ask the owner/manager what his or her food and labor costs are as percentage of sales revenue.  That manager will be able to tell you off the top if his or her head, without sending an email, calling anyone or any other action.  Labor cost will be between 30 and 35% of sales and food will be 28-35% of sales.  That bar owner knows the cost of every head of lettuce, loaf of bread and bottle of beer.  If he or she doesn't, the venue will go out of business.  Sure, running a bar restaurant isn't nearly as complicated as running a hospital.  ...or is it?

A bar or restaurant has raw materials coming in the back door.  A bar or restaurant has technicians that make the products and provide the services.  A bar or restaurant has patients, er, patrons who walk in the front door looking to consume the products and be provided the services.  I am completely unclear on how that is different from what your practice or hospital does.  I am also completely unclear on why we can't have a simple point of sale system, like a bar or restaurant that tracks every bottle of beer and head of lettuce.  

This reminds me of the classic psychology test given to groups of youngsters.  One group is given two ropes and two boards and the instructions to cross a room without touching the floor.  Predictably, they either tied the boards to their feet or tied the ends of the ropes to the ends of the boards and 'skied' across.  A second group was given one board and one rope.  Just as predictably, the tied the rope to the board but then walked across the room, one foot on each end of the board using the one rope to hold the one board to the bottoms of their feet.  The second group solved the same problem in half the time and consumed half the physical resources.  The moral of that story is that the solution to any problem will expand to consume all available resources.

Back to bars and practices, we don't have children and rope we have administrators who don't understand what is going on or how the processes and materials all fit together to produce the product, making decisions on what the best ways to get things accomplished are.  Thinking is hard, researching that particular question is beyond probably most of us, so we buy a bunch of expensive equipment and hire a bunch of expensive people to run it and we get some result, right, wrong or indifferent.  We don't know and we don't care.  We had a job to do and we got it done.  When we need some of the other dozens or hundreds of questions answered, we call Accenture or Deloitte and pay them $200 per hour to 'integrate' our systems.  Sometimes, and yes I've seen this happen, the 'integration' is a bunch of offshore resources copying and pasting data from one system to another.  Forever.  At $200 per hour.  Literally.

Flash forward (or not) to 2016 and healthcare is consuming about 20 cents of every dollar produced by the United States economy.  The juggernaut of healthcare has expanded to consume all available resources.  Like the first group of children, administrators just throw resources at a problem until it is overshadowed by a larger problem.  If the hospital or practice isn't making money, jack up the prices.  Nobody is minding the store.  ...or restaurant.  

The solution is to run your practice like a restaurant.  Mom and pop do it with paper or with Excel (There really is a restaurant across the street from my office named Mom's).  Smart owners and chains use a Point of Sale (POS) system that can literally track everything that goes into or comes out of the restaurant and how much is used for each dish or drink.  When we are getting eight shots out of a bottle of J├Ągermeister, we have a problem and we KNOW it.  

So how does your proactice manage all this data?  Do you know all the inputs and outputs?  Do you know the total cost for that cholesterol test? Can you track the work output of any given employee over any given period?  Do you have one system that does everything like a bar's POS or do you have hundreds or thousands of boards and ropes laying around for your practice to strap to their collective feet?   So you didn't do the due diligence, and don't worry nobody else did either, demonstrably, and you went and bought some accounting system because a guy you play golf with likes it.  You bought some human resource management system that may or may not track time cards for hourly employees, you bought this and you bought that and none of it works together, so you can't tell what the cholesterol test costs.  Joe Bar Owner knows EXACTLY how many shots are in a bottle of J├Ągermeister and how many s/he is getting and what percentage of his sales go into buying the bottle, pouring and serving and all the other little details of running a restaurant. 

Running a large hospital is no different from running a bar except in scale.  You can't run a hospital (or maybe any practice) on paper or Excel.  Worse, you shouldn't try.  People are not meant to sit around and fill out spreadsheets all day.  As doctors, you should know that better than anyone.  At Sentia, we have been designing and building software in a holistic environment for decades.  Ok, its only TWO decades but that is still decades,  We have automated entire businesses to the point that the owner just clicks the "Send Bills" button at the end of the month.  Not just once, not just twice, but many times.  So what we have is basically the POS system for your practice.  Soon, we will have automated the entire health insurance industry and if your patient has our coverage, simply documenting your patient encounter with our software will submit the claim and pay it automatically.  Sentia's EMR is completely free to your practice, has no installation and requires no servers for you to buy.  No moving parts.  No medical coding, no fighting with the insurance over coverage (you will know what procedures are covered and for how much, before they are performed), no billing, nothing but the things you need to do to take care of your patients and eliminating the things the insurance company forces you to.  For your patients, it eliminates almost the entire cost of providing the service of insurance.

Sound nice?  CALL US and let's set up a demonstration.

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