Road to automation is sometimes rocky

Road to automation is sometimes rocky

data processing

case study

Maine Data Processor Learns Quickly from Tough Experience

PROCESSING HEALTHCARE FORMS, HANDLING HIGH-VOLUME DATA ENTRY, AVOIDING WORKPLACE INJURY AND MEETING TIGHT DEADLINES, WERE THE EASY PARTS. OVERCOMING “IMPROVEMENTS” IN TECHNOLOGY WAS THE GREATEST HURDLE FOR GHS.

GHS Data Management (GHS), on the bank of the Kennebec River in Augusta, Maine, is one of the largest data capture facilities in New England, serving state and local agencies, pharmacies, various medical associations, HMOs, hospitals and private corporations. GHS is also a Pharmacy Services Administration Organization providing on-line prescription processing for pharmacy benefits.

In addition to its work with the healthcare industry, the service bureau has managed the flow of data from surveys, proxy and claim forms during its 25 year history. The company also provides data processing and analysis as well as image archival services. What began as a heads down, data entry service bureau has evolved into a leader in government and healthcare data processing, thanks in part, to the implementation of advanced technologies.

THE PROBLEM

Unfortunately, keeping up with changing technologies has not always been a pleasant experience for GHS. Several years ago GHS was advised that the “heads down” data entry system they’d been using would no longer be supported by the vendor’s technical staff. For GHS, this news appeared to be a mixed blessing. While the system was old and outmoded, the GHS staff had become quite proficient on the GEN 5 system and produced some of the highest keystroke-per-hour averages in the industry (as many as 16,500 characters per hour, with some stellar performers doing even better).

GHS saw the change as a chance to implement a scanning/ OCR system that the vendor would design and then train GHS staff to run. Along with moving to a more technologically sophisticated system, GHS was told they would be able to achieve production numbers in the 200 document-per-operator hour range. With assurances on production numbers nailed down, GHS and the vendor inked the deal.

Unfortunately, despite an extended effort on both the vendor’s and GHS’ part, results fell short of expectations. Not only was the system unreliable, but production numbers were actually less than the manual system. In the meantime, GHS had a workload that included thousands of daily HCFAs that by contract, required processing within 48 hours of receipt. Because the new OCR/scanning system was unreliable, operators resorted to keying from image to meet the 48-hour deadline. Still, a backlog of work mounted while the vendor tried to bring the system up to speed.

In an effort to keep up with the client workload, GHS added a second shift of 24 key operators. Many of these keyers were hired as temporary workers and required considerable training. As in many rapid keying environments, injuries were prevalent. Repetitive stress injuries and physical therapy appointments took one to two employees off the work floor per week.

After two years of false starts and dozens of system Band-Aids, GHS data entry staff still only processed 64 documents per operator hour. Instead of improved work conditions using state– of-the-art technology, the technical staff found themselves nursing an ill-designed system. The addition of mandatory over– time, cancellation of holidays and interrupted vacation schedules further eroded already waning morale.

During this time, the claims processing division’s top account voiced their concern over the new system. GHS’s ability to turn documents in 48 hours lengthened by days and at one point by weeks. The service bureau’s top account was getting nervous. Without consistent performance on turnaround, the client would cancel their contract. Determined to get their production numbers back on track and keep their longtime client happy, a group of technical and business managers met to discuss the problem. GHS realized that a change was needed. After several lengthy meetings a consensus was reached, the service bureau had no other option but to scrap the system and start again from scratch.

THE SOLUTION

While the episode was a painful and costly period in the company’s history, it did provide invaluable lessons for the future. A small procurement team comprised of a data services manager, a systems expert and the company’s top brass met to review bids and critique vendor demonstrations.

“We called three vendors to the table initially,” said Jeanne Smith, data capture manager. “But that number was whittled down to two fairly quickly.” After researching competitive solutions and hearing from former clients, GHS selected software from Recognition Research, Inc. (RRI).

Recognition Research is developer of the data-capture solution, FormWorks. RRI bundled its presentation with an additional benefit. Knowing that the service bureau had already taken on a significant expenditure in their previous procurement, RRI’s Manu Uppal suggested a unique financing option. Rather than asking for an investment commitment from the already gun-shy GHS team, Uppal suggested a “per click” fee structure. GHS would still need to finance the purchase of a new scanner and five new servers to upgrade the hardware for the project, but the software and services expenses would be billed only as claims were actually processed.

“It was very difficult; we had already been burnt, but this time we knew what questions to ask,” said Jeanne Smith, a 25-year veteran with GHS. “We traveled to an RRI site in Atlanta and spoke to many of their customers on the phone. RRI was willing to give us the software with no up-front costs. Their willingness to stand behind their product is what finally swayed us.”

During the early weeks of system development, RRI systems engineer Luis Chalmeta, GHS project leader Darren Hartford and Smith held numerous conference calls to flush out critical business rules and logic requirements-a six– week process that would make or break the success of the system. During the design stage, GHS’s document process was examined and graphed to set the groundwork for customization of the FormWorks system.

To ease any needed customization RRI has established an exact replica of the GHS system at the RRI headquarters in Blacksburg, Virginia. There, Chalmeta monitors the back-up system and tests new code and rules before they are implemented live at GHS.

“Once we were live, one of our main goals was to get rid of our backlog which we had struggled with since our first manual system,” said Smith. After a week-and-a-half with FormWorks, our backlog was gone.”

A large part of GHS’ work continues to be related to healthcare form processing. This includes work for the State of Maine in handling “Prior Authorization” forms sent by fax from hundreds of different healthcare providers throughout the state. Similarly, home health workers file Community Assessment Program (GAP) forms, which must be captured and made available online.

This state work involved the usual healthcare forms-UB92s and HCFAs. While accepting these forms electronically has reduced the volume of paper that must be converted through scanning, still GHS is handling as many as 10,000 documents daiLy

Today, GHS processes approximately 150,000 claim forms a month. Scanning is handled by a combination of Fujitsu flatbeds, and a Kodak 7520.Contractual obligations, which spell-out processing deadlines of 48 hours with a one percent reject rate, no longer keep employees working overtime. Now Smith’s department has exceeded its goal of processing over 200 HCFA documents per operator hour and has added a second industry claim form to the mix. The UB-92-previously keyed from paper by a half-dozen employees-is now automated for the first time in the company’s history using FormWorks and two employees.

As for the two rocky years GHS spent weathering the storm of a costly technology misfit, these are now behind them. Today the company is on an even keel. GHS finds itself in an enviable leading edge position when new business comes calling. For employees, repetitive stress injuries and mounting deadlines have given way to flex time and improved work conditions. Both management and data capture employees are enjoying weekends and holidays again.

NAME

Darren Hartford

TITLE

Project Leader, GHS Data Management

AREAS OF EXPERTISE

System Integration, Workflow, Software Development

YEARS TAWPI MEMBER

Darren continues a 10-year tradition of TAWPI Membership at GHS

CURRENT PROJECT

Capturing Account Payable Invoices with CheckStub for Archival Retrieval * Using OCR, Database, and programmed rules, expect

BENEFIT OF MEMBERSHIP

Meet, talk, and share knowledge with people who have similar challenges and accomplishments

PET PEEVE

Staples, post-it notes, dog-ears, and staples! Oh, and staples if I did not already mention them

Copyright Association for Work Process Improvement Jun 2002

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