2004 OPEN FORUM Abstracts
COST SAVINGS ASSOCIATED WITH CONVERSION FROM PORTABLE COMPUTERS TO DESKTOP COMPUTERS FOR ELECTRONIC CHARTING
Susan
Rinaldo-Gallo, RRT, MEd, Janice J. Thalman, RRT, MHS, FAARC, Duke
University Health System (DUHS), Durham, North Carolina
Background: Electronic patient care charting can be accomplished
using a variety
of devices such as: tablets, personal digital assistants (PDAs),
laptop computers, or desktop computers. User acceptance of the
charting device is crucial to success of the system. In October 2002,
the RC Department converted from a RC Information System (RCIS),
which had been used since 1995, to a different RCIS. At this time the
method of electronic charting used by the Respiratory Care
Practitioners (RCPs) changed from portable charting devices (Symbol
3000) on a wireless network to stationary desktop computers.
Method: A
variety of portable charting devices were demonstrated and evaluated
by the staff. The following problems were identified: battery issues,
difficulty viewing display screens, too large or too heavy to carry,
not robust enough to hold the entire hospital census, and download
and synchronizing delays. Management identified the cost and
maintenance of mobile computers as a disadvantage. As a result, the
decision was made to use desktop computers.
Results: Cost
was significantly less. When using portable computers each RCP has a
computer to chart in wherever they travel within the hospital. At
DUHS this would require 23 mobile computers (maximum staff) plus 2
for back up. Each computer cost approximately $3,000. PDAs cost much
less, but were unable to hold the entire hospital census and
downloading or manual entry of new patient information would be
necessary. Eight desktop computers were purchased for $2,000 each.
One desktop computer was located on each floor of the hospital. The
cost saving was $59,000. The initial training for the system was
reduced by 50% since it was not necessary to learn a new computing
device. We estimate that the training was reduced from 4 hours per
staff member to 2 hours. With a staff of 80, that represents a
reduction of 160 hours for our staff of 80 RCPs. This resulted in a
saving of $3,360 (average rate of pay =$21.00 per hour). System
maintenance time was reduced by five hours per week. There were no
broken mobile devices, battery issues, data transmission problems and
fewer trouble calls. These were previously the responsibility of a
computer clerk. This resulted in a clerical staff saving of $3,900
per year. We experienced an increase in accuracy using desktop
computers.This was due to quick and easy access to every patient in
the hospital and immediate availability of newly admitted patients.
As a result, patient billing records required fewer corrections and
patient care revenue increased by approximately 25%. This also
decreased the clerical time previously required to audit and correct
patient billing records, which resulted in an additional clerical
savings of 3 hours per week saving of $2,340 per year. Staff
satisfaction also increased because the computers were quicker and
more accurate and downloading or synchronizing was no longer
necessary. An added benefit was the multiple uses of the desktop
computers.The staff has easy access to hospital applications such as
e- mail, policies, annual competencies, and the electronic medical
record. When surveyed, 85% of the staff indicated they were more
satisfied using the desktop computers.
| Increases in the following: | Reductions in the following: |
| Accuracy of data | Training time |
| Billing and productivity capture | Clerical time and cost |
| Staff satisfaction | Capital expenditure |
| Access to multiple applications | Supplies (i.e. Batteries) |
Figure 1.
Advantages realized by using desktop computers
Conclusion:Converting from portable computers to desktop computers for
electronic documentation resulted in significant cost savings,
improved accuracy and billing and an increase employee satisfaction.
The estimated cost saving for the first year was $130,960. In
addition, we experienced a 25% increase in billing, which resulted in
increased revenue.