Power Headaches? Take One UPS, and Call Engineering
UIHC Sees Net Revenue Gain with Single-Statement Billing Solution
Staffing Tips for Hospital Administrators

Power Headaches? Take One UPS, and Call Engineering

By Renee DiIulio

From left, members of the UPS installation team at Saint Vincent Hospital stand by their project: Dave Woodford, director of radiology; Paul Strniste, associate administrator for facilities; Chris Valkus, electrical foreman for Coghlin Electrical Contractors; and Bill Fox, project manager.

Saint Vincent Hospital installs one uninterruptible power supply for 12 modalities to save time, money, and hassles

Saint Vincent Hospital is a 368-bed, acute care facility in Worcester, Mass, that doesn’t worry much about earthquakes, hurricanes, or other natural disasters. David Woodford, the hospital’s director of diagnostic imaging, has never encountered any unplanned downtime in power supply during his tenure. However, this does not mean that power outages do not happen. In fact, Woodford has encountered inconveniences from planned power interruptions.

As more modalities have transitioned to digital, an uninterruptible power supply (UPS) has become more important to avoid downtime. When Saint Vincent purchased new imaging equipment, the hospital decided to evaluate its power supply and opted to install one central 750 kilovolt-ampere (kVA) UPS system from CPN Power, Somerville, Mass, to support multiple modalities rather than maintain several smaller systems, as the facility had been doing.

“Basically, we were using hospital power with several of our key pieces of equipment also connected to the hospital emergency generator,” Woodford explains. “Our PACS computers and MRI system were on their own separate, large UPS systems—the only two on a UPS system previous to the installation.”

When the hospital ran tests of the backup system, which it did at least twice a month, the imaging department had to shut down equipment beforehand to avoid interrupting the power supply and risk damaging the systems. “When the hospital switches to backup, it causes a momentary interruption in power, about 8 to 10 seconds, which would shut down our equipment. It was an inconvenience to the staff, who had to reboot the equipment,” Woodford recalls.

Although the department never lost data as a result of the power interruptions, the possibility existed. What it did experience, however, was the introduction of software errors that, in one instance, required servicing to repair. “Because we are completely digital, with the exception of mammography—which will transition soon—we are very software- and computer-dependent. So it is a big deal when the testing was so frequent,” Woodford says.

Despite the inconvenience, the department might have continued with the hospital backup system if it were not for two big purchases: the installation of a new digital angiography system and an upgrade of the MRI system. Both required new power supplies; the digital angiography system needed a UPS, and the MRI unit needed a larger one.

“The UPS for the angiography system was close to $50,000. The MRI upgrade was $60,000. So with just those two systems, it was more than $100,000. So we began to reevaluate,” Woodford explains.

The maintenance costs for the existing UPS systems ran roughly $5,000 to $6,000 a year, in addition to batteries and preventive maintenance expenses. Cost comparisons suggested that one large system, costing roughly $200,000, would incorporate all of these costs along with the expense for the two new systems. The hospital could also connect the existing cardiac catheterization laboratories as well as the new one being installed and for which a UPS was under consideration.

“One large system would be cheaper, take up less space, and could run essentially all of radiology and the three cardiac cath labs,” Woodford says.

Working with facilities engineering, the department decided to install one central 750-kVA UPS to support a total of 12 modalities, including MRI, CT, the electrophysiology laboratory, the catheterization laboratories, special procedure rooms (angiography, digital fluoroscopy), x-ray rooms, and R&F applications. The unit is stored in a basement electrical room, freeing up the space in radiology that previously had been devoted to the UPS systems for MRI and PACS.

In addition, the system is now the responsibility of the hospital’s engineering department. “The original UPS systems fell under my responsibility, and I am not an electrical engineering expert,” Woodford admits. “Now the UPS and electrical issues are overseen by the facilities engineers, which has eliminated some headaches from my point of view.”

UIHC Sees Net Revenue Gain with Single-Statement Billing Solution

Within the past 3 years, The University of Iowa Health Care (UIHC), Iowa City, has leveraged the power of its business software to consolidate patient management while gaining a net revenue of $317.7 million.

Chris Klitgaard

The UIHC implemented Flowcast from IDX Systems Corp, Burlington, Vt, in 2003 as an enterprise-wide business solution. (GE Healthcare acquired IDX earlier this year and renamed the solution from Flowcast to Centricity Business Advantage.) However, Chris Klitgaard, director of the patient financial services department, says that UIHC has been using a portion of Centricity—Combined Business Office—since the mid-1980s across its entire enterprise for patient access, authorizations, scheduling, clinic operations, billing to third parties, and producing a common statement that bills for both hospital and professional services.

“We were an alpha site and the development partner for a portion of the Centricity Business System that is called Combined Business Office for all the patient accounting activity for both the hospital and the practice plan,” Klitgaard says. “The hospital and the physician activity occur, which ultimately generates a single patient statement. That type of product did not exist in the marketplace, and IDX was willing to create a product to basically adhere to our needs and business desires.”

That single patient statement means that a patient receives just one statement showing both the hospital charges and the physician’s professional charges. Klitgaard says this part helps provide better customer service when a patient calls with a question because the patient needs to call only one phone number for answers about both sides of his or her account.

“Frequently, you need information from one side or the other to bill appropriately, and having all of that information allows us to make sure that we’re submitting claims in a compliant manner,” he says.

Radiologists with UIHC are employed through the College of Medicine, but Klitgaard’s department does the billing and follow-up for all employees, regardless of affiliation. “From the moment a department enters in the charges for the physician side into the system, our office takes control of it and handles the A/R until it’s brought to resolution, whether it’s hospital or college side,” he says.

Klitgaard says that some of the true financial benefits his organization has seen come from the online workflow. The automation of work files has helped save time, especially because the system alerts the user if a patient needs preauthorization, a step that makes all the difference when it comes time for billing.

He says it took about 1 year after implementing Centricity for UIHC to recover its initial investment. “Since we went live with Business Centricity, we are $317.7 million better off than if we had stayed on our legacy system,” Klitgaard says. “On the hospital side, it breaks down to $282.1 million; on the physician side, it is $35.6 million. That’s a lot of money.”

—M. Saffari

Staffing Tips for Hospital Administrators

An article published in the April 2006 issue of Trustee Magazine provides hospital administrators with food for thought when looking ahead to staff their facilities.

According to Jeffrey C. Bauer, PhD, a partner in the Management Consulting Practice of ACS Healthcare Solutions, Dearborn, Mich, and Thomas P. Flannery, PhD, a principal with Buck Consultants, Boston, hospital boards and senior executives will be facing workforce challenges posed by shifts in medical science, technology, demographics, and economics. Those employees who do not keep up with the changing environment by learning new skills will not be very effective. The authors claim that several factors will play into the coming changes: retirements, immigration limitations, not enough faculty at training programs, and a shorter workweek by younger professionals.

Bauer and Flannery also noted in the article that the board’s leadership plays a crucial part in retention as well as making sure employees keep up with their continuing education. The authors offered several tips for retention strategies that board members can help implement at their hospitals:

  • Modernize Employee-Training Programs. Bauer and Flannery advise that new approaches should be taken when training employees so that the education is interesting, and the information is retained. They suggest experiential learning in team environments, Web-based instruction, and simulation-training technologies. In addition, the authors note that offering tuition reimbursement and salary adjustments are other ways to promote education.
  • Emphasize Retention Over Recruitment. By individualizing employee training, more employees will stay where they are because it is creating more opportunity for career development and professional growth, according to the authors. Bauer and Flannery add that employees are more likely to leave a job not because of money but because they can learn new skills and use advanced technologies elsewhere. Having top-notch training programs is key to keeping employees.
  • Create a Culture of Organizational Creativity. Trustees need to formalize policies that authorize and encourage work-related creativity. Bauer and Flannery suggest initiating programs to empower and reward employees who help bolster the organization’s value.
  • Respond to Significant Differences Between Employees. Instead of thinking of the work group as singular, Bauer and Flannery note that employers need to allow employees to develop through an individualized approach. Those employees who already have certain skills should be allowed to opt out of that particular teaching; instead, they should be encouraged to work on developing weaker skills. Additionally, integrating older and younger employees with different experience levels can create a culture that will bridge gaps between what they do and do not know.
  • Prepare Workers Who Are Adept at Adapting. Although Bauer and Flannery do not think boards should get involved in the everyday management of employee adaptability, the authors do believe that boards should endorse and practice adaptability—and expect their CEO to set the example.