Case Study: The Cardiovascular Group

TCG Automates New Patient Registration to Save Time, Money, and Improve Patient and Physician Relations

April 2006

Registration is often a new patient's first experience with a medical practice.

Bottlenecks in this process can result in physician delays; frustrated patients; missing, inaccurate, or illegible data; delays in insurance verification; and rejected claims. On the other hand, an efficient registration process can translate into a more timely and positive patient and physician experience.

“Getting patients through the registration process in a timely manner with accurate and complete data is an ongoing challenge for those of us running a medical practice,” explains Dr. Warren Levy, President of The Cardiovascular Group (TCG). To address this challenge, TCG, a 40-physician cardiovascular group in northern Virginia, decided to automate all of its new patient paperwork through its practice website.

When new patients call to schedule their first appointment, they are directed to the website to complete their registration data, medical history, and "sign" their authorization and privacy notices. TCG receives approximately 800 messages per month through its Secure Messaging Center, representing nearly 50 percent of all new patients.

Practice and Patient Benefits

Collecting registration information in advance has improved patient throughput and benefited the practice in numerous ways:

1. Improves accuracy, completeness, and legibility of forms. Patients are likely to fill out the forms more accurately and completely from the comfort of their own homes when they are not rushed and have access to their medications and personal records.
2. Increases likelihood of receiving forms. TCG has discovered that patients are more likely to enter their data on the website than they are to return the hardcopy forms sent to them by mail. When forms were sent in advance, patients often forgot to bring them to their appointment.
3. Eliminates cost of pre-visit mailings. Prior to implementing online patient registration, TCG mailed pre-visit forms to new patients. However, with an average of 40 new patients per day, direct mail cost an estimated $16,560 a year for labor (10 to 15 minutes per mailing), materials, and postage. The web-based process has allowed the practice to realize these savings.
4. Allows for pre-visit data validation and insurance verification. When patients provide information in advance, the practice can verify insurance and check eligibility before the patient visit. In addition, the staff can use the data entered online by the patient to validate the demographic data collected by the scheduler when the appointment was made, and to ensure that all the necessary information is collected before the appointment.
5. Reduces patient in-office time. Patients appreciate not having to come to the office early to complete paperwork. Reducing inoffice time becomes increasingly important as practices try to capture market-share from working consumers.
6. Reduces waiting room bottlenecks caused by late-arriving patients Despite their best efforts, patients are often delayed due to traffic, parking, and other logistical obstacles.
7. Reduces physician wait time for patients Prior to implementing the online registration, TCG administrators received weekly complaints from physicians because patients were not ready to be seen promptly. The new process has eliminated this problem.
8. Allows for more productive use of physician and patient inoffice time. Prior to the patient's arrival, TCG routes the patient's medical history from the web to the appropriate medical assistants and clinical staff in each office who, in turn, enter the data into their EMR. The nurses and physicians can then make better use of their time with the patient to validate the pre-entered data rather than collect it from scratch.

Addressing Workflow Challenges

Despite the many benefits of online pre-registration, it can create an additional burden for the already over-worked front office staff. TCG addressed this challenge by shifting some of the preregistration data entry responsibilities from the front office to “back office” staff, specifically transcriptionists. “Transferring this responsibility has helped take some of the pressure off our front desk staff who already must multi-task throughout the day,” according to TCG administrators. It allows them to be more patient-focused, dedicating more time to the patients who are in the office and on the phone.

In addition, it has provided more flexibility in staffing. Currently TCG employs data entry staff that work remotely and are less expensive than their front office counterparts. The new process has not only saved in overall labor costs but has also improved their ability to process new patients in a timely manner while providing better service.

Implementing new procedures within their registration workflow practice wide required changes in behavior for many of the staff. The key to success, according to Dr. Levy, was “the development of well-written protocols and training for who was responsible for what within the new process backed by positive reinforcement from leadership. Once people realized the reasons for the change and discovered that they really could be more efficient, the change management process became much easier.”

TCG has also benefitted from a 25 percent increase in visitors to their website since the system was implemented. This program has been so successful that they are now investigating a second phase of the program — automating the transfer of data collected on their practice website directly into their EMRs.

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