Losing Revenue from Surgery, ED Operations? There’s an App for That

When planned surgeries are delayed or cancelled because of no shows or low-acuity patients are clogging EDs, the financial burden can be significant for health systems.

For a hospital with $600 million annual revenue, 60 cents of every hospital revenue dollar is generated through surgeries, with another 30 percent coming from the ED. So incremental improvement in either area can result in significant additional revenue or cost avoidance—an important consideration when the median operating margin for hospitals is 2.7%.

The use of hospital-specific mobile apps can reduce no shows for surgical procedures and lower the incidence of complications following surgery due to non-compliance. Prescribing mobile apps to frequent flyers and others who abuse the ED can help a hospital right-size its ED operations while encouraging patients to utilize the appropriate care facility. Finally, the return on investment (ROI) is as high as 10x, with development costs covered within months.

Increase surgical throughput with timely reminders

While surgeries represent a majority of hospital revenue, they also are a huge cost if patients aren’t showing up on time for their procedures. Hospitals don’t just stand to lose revenue for each no show, there also are carrying costs for administrative, pre-op, post-op and surgical staff who are on the clock but not working.

Just 82% of patients show up at the right time for their procedures. And among those who do arrive on time and are prepared, the complication rate is 13%, mostly due to faulty follow-up of post-op instructions.

Moving the needle by improving the arrival rate and/or reducing the complication rate can reap big rewards—and quickly. A performance improvement of just 1% on either measure can generate an additional $2 million in hospital revenue.

Surgeries are the focal point of a patient journey that starts with scheduling and ends 30 days post-op after potential readmission penalties expire. For patients facing surgery or in-hospital procedures, there often are pre-op labs and other instructions such as special bathing, cessation of certain medications and other preparations. Post-op comes with wound care instructions, special medications, healing complications to monitor and follow-up clinic visits.

Hospitals, however, tend to remain laser-focused on the day-of procedures and to downplay the importance of the pre-op and post-op processes. A mobile app can guide patients through the surgical process from start to end, with push reminders of what needs to occur when.

Depending on the procedure(s) covered, a hospital-branded mobile app does not need to exchange protected health information (PHI). Exchanging PHI would open up an app to greater scrutiny from a HIPAA standpoint.

Take a colonoscopy, for example. A patient can input the day of the procedure and receive day-specific instructions on next steps to pick up colon cleansing supplies, pre-op preparations, directions to the surgical center and post-op instructions. Mobile push notifications can remind patients what should happen on each day.

Encourage appropriate ED use

The cost of urgent care is 10 times cheaper than emergency care, which is why hospitals have been taking steps to guide patients to the most-appropriate medical setting.

About 60,000 patients will pass through a typical hospital emergency department in a year. Of that number, 80% don’t really need the ED. Half of them would be better served by urgent care, and the rest are frequent flyers who need support or counseling instead of emergency care.

Tanner Health system is a non-profit that serves nine counties in western Georgia and eastern Alabama. A mobile app is “prescribed” to those who would be better served by urgent care or with community resources. Users can find current wait times, tap to call and turn-by-turn navigation to the health system’s urgent care facilities. It also has a physician-finder feature and such community resources as counseling facilities and gyms. Patients can get immediate transportation to multiple referrals using direct access to Uber or Lyft directing from the app.

Especially during busy times such as flu season, diverting patients to urgent care allows ED personnel to concentrate on those who truly need emergent care. Patients who use urgent care also can save significant money, spending $250 for urgent care versus $2,500 or more for care in the ED. When deployed properly, a mobile app can generate as much as $3 million annually in increased revenues and cost avoidances.

Apps don’t have to break the bank

Although health systems use a surprising amount of technology, it enables care but isn’t a core competency. So it makes more sense to work with an established app developer that has specific experience in the healthcare industry, rather than trying to develop apps in-house.

Costs will also be considerably less. Do-it-yourself app development can run into the millions and take years. Those costs don’t include lost revenue that app use can partially recoup if the app had been deployed earlier.

Templates can be customized with health system-specific branding, rolled out within 90 days and tweaked on the fly generally without developer assistance. With ROI approaching 10x and costs recouped within months, health systems should explore mobile apps to streamline hospital operations.

The time to consider mobile is now. More than three-quarters of Americans own a smartphone, up from just 35% in 20111. Those under 40 (Millennials and Generation Z) account for one-half of all citizens, and they are accustomed to working, playing and communicating on their mobile devices.

A 2015 survey showed that 71% of Millennials want their providers to offer mobile apps to do everything from schedule appointments to sharing healthcare data and managing preventive care.

There’s no question that going mobile can bring efficiencies to the surgery suite and the ED while generating additional funds for the health system. But mobile apps also can help set a health system apart from competitors and help patients communicate the way they want.

Randy Tomlin is CEO and Chairman of the Board for MobileSmith Health. In his position, Randy directs the company’s strategic growth and operational excellence, and is responsible for the successful proliferation of the company’s mobile app technologies throughout the healthcare spectrum.



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