For hospitals and health systems navigating today’s challenging operating environment, workflow efficiency and cost control are more important than ever. At the University of Maryland Medical System (UMMS), one area ripe for transformation was the bill-only workflow – a process that directly affects circulating RNs, billers, supply chain teams, and vendor representatives. Historically dependent on handwritten forms and manual reconciliation, this workflow was time-consuming, error-prone, and burdensome for staff.
We knew improvements were needed. That’s where iHarbor, the UMMS center for innovation, stepped in. Leveraging access to UMMS hospitals, staff, systems, and real-world needs, iHarbor reimagined the bill-only process from the ground up. The result was Gallion, a purpose-built solution that dramatically improved accuracy, compliance, and efficiency across UMMS.
iHarbor: Solutions Made by a Health System, for Health Systems
iHarbor innovates with a unique advantage: direct access to UMMS’s 11 hospitals and more than 150 care locations, as well as continuous collaboration with clinical and operational leaders across the system. This proximity allows iHarbor to bridge visionary ideas with practical, real-world applications and rapidly test, refine, and validate solutions that address systemic healthcare challenges.
Within this environment, iHarbor’s multidisciplinary team of software engineers, data scientists, designers, and strategists work alongside UMMS clinicians, supply chain teams, financial leaders, and IT organizations. This alignment ensures every solution is deeply informed by the day-to-day realities of hospital operations, resulting in tools that are innovative, usable, and impactful.
Transforming Bill-Only Management Through Purpose-Built Innovation
Before Gallion’s introduction in 2021, UMMS relied on a manual, paper-based bill-only process. Bill sheets were handwritten, discrepancies were common, and matching consumption to charges and contract terms required significant staff time. As bill-only and physician preference items represent 40–60% of supply chain costs, the inefficiencies created risks for both financial performance and care delivery.
The vision behind Gallion was to create a standardized, automated workflow that addressed these challenges at every stage of the process. iHarbor worked closely with stakeholders across UMMS to get to the heart of the issues and create a purpose-built solution with measurable results. As Warren D’Souza, PhD, MBA, Senior Vice President and Chief Innovation Officer at UMMS, described:
“We developed Gallion to disrupt the manual bill-only process and improve upon existing market solutions. Our goal was to create a seamless, standard workflow that enhances cost insight and vendor price compliance.”
Gallion’s implementation provided immediate, meaningful improvements:
- Vendors can now generate electronic, real-time bill sheets, eliminating handwritten forms.
- Perioperative staff receive instant EHR validation to reconcile discrepancies before the case ends.
- Supply chain teams have visibility into contract compliance and receive alerts when billed amounts do not match contracted pricing.
- Leaders access robust reporting and analytics to strengthen future vendor negotiations and cost management.
The platform also has fostered unprecedented collaboration. Clinical staff, administrative teams, and vendor representatives now operate within a unified, transparent workflow, reducing burdens for everyone involved while improving accuracy and turnaround times systemwide.
The Results: Millions Saved, Hours Returned, and a Spinout Born
The impact of the UMMS-developed Gallion platform has been substantial throughout the system. Since implementation, UMMS has experienced:
- $1.5 million reduction in discrepant invoices and remediation
- $550,000 in operational efficiency savings
- 70% decrease in bill sheet processing time
- 50% faster movement from bill sheet submission to purchase order
- 17,500–30,000 hours saved annually
- Invoice error rates reduced from 20% to 3%
- Completion time improvements of 75% across workflows
These results validated not only the power of Gallion, but the strength of iHarbor’s innovation model. In July 2025, Gallion officially spun out of UMMS as Gallion Health Inc., becoming a standalone company and making the software platform available to health systems nationwide. For UMMS, the spinout represented a major milestone and is evidence that innovation developed internally can scale far beyond the system and create industrywide impact.
Innovation from Within Drives Impact Beyond the System
Gallion’s success highlights a powerful lesson: some of the most impactful healthcare innovations are born inside the health systems that understand the challenges firsthand. Because iHarbor is embedded within UMMS, we were able to closely collaborate with clinical, operational, and supply chain leaders to identify pain points, root causes, pressure test prototypes, and refine a solution that would meaningfully transform the bill-only workflow.
Our position as a large, diverse health system gives us unique insight into the daily hurdles faced by care providers and administrators. As we continue to scale our work, iHarbor aims to develop additional solutions that improve efficiency, elevate care quality, and maximize revenue cycle for UMMS and health systems nationwide.
