Improving efficiency and decreasing medical paper waste secondary to the implementation of MĪNA® Health

Project Overview:

The medical health history is a standard set of information that is required by health care providers to provide high level individualized care to patients. The personal health record guides medical decision making based on previous vital encounters with healthcare personnel. This information is required for every health care provider, including but not limited to dentists, chiropractors, specialty physicians, emergency room providers and general practitioners. Even though a particular individual’s health history may not always be extensive, it includes information that is relevant to each patient encounter.

From the provider’s perspective, this information is always required yet the methods of acquiring this data are not standardized. In 2015, surveys estimated that nearly 20% of physicians’ offices were using paper forms exclusively for all health-related information.1 Even with the advent of the electronic health record, the estimates for those using paper health history forms would be even greater. These forms range from comprehensive to problem-directed/focused questionnaires. Comprehensive forms may seem irrelevant to the current visit, yet will provide a more thorough understanding of a patient’s history. Focused questionnaires may be useful, but tend to omit vital information that may be pertinent to the current visit. A broad foundation of the health history assures that the appropriate data is obtained so that proper measures can be taken.

Expenses related to the obtainment of patient health histories are multifaceted. Staff work hours may include time spent in the preparation and distribution of this information, as well as reconciliation of illegible responses and conversion into the electronic health record or paper chart. Additional costs are created if postal delivery of these forms is the method of delivery used prior to visits. Furthermore, reproduction of forms for those that were not completed prior to the visit add additional expense. After completion of these forms, safe disposal of patient protected information is required and while compliant disposal services are available, they too add to the overall cost. These tasks build up to a significant expenditure.

Smartphone use continues to grow over time, from 35% in 2011 to an astounding 64% of US adults owning a smartphone in 2015.2 This percentage is even higher for adults between the ages of 18 and 29 at 85%.2 MĪNA Health was developed as an untethered, standardized method for paperless communication between patients and providers with the use of QR codes. We propose an improvement of cost due to the use of our untethered paperless method, thus decreasing expenses related to dedicated form production, staff work hours, postage, and disposal.

Key Insights

1. Even in the age of electronic health records, paper forms often continue to be utilized for obtaining new patient information and changes in health history since the previous visit. This occurs both when visiting current or new providers, when visiting specialty providers, when visiting providers outside of current networks, or when changing providers, just to name a few.
2. Information acquired in these forms is standard though no universal standardization has been established. This information is required to prevent repeat allergic reactions, provide treatment options that previously were shown to be ineffective, to help determine the cause of a specific disease presentation, etc.
3. Health history information is universal across the majority of healthcare provider practices.
4. Costs accrued from this process are measured in work hours, production and disposal..

Method

WonderHealth®, LLC and MĪNA Health generated a comprehensive survey developed to understand the costs associated with obtaining the health history of patients. This survey was completed by a variety of health care providers. Each survey was completed as a snapshot representation of the routine practice for each provider. The results were generated from the self-reporting of practice managers. Surveys were sent to greater than 25 different practices. The breadth of the practices surveyed included academic to private practices. Responses included dental practices, specialty physician practices as well as surgeons and general medicine-based practices. Completed surveys were returned to WonderHealth, LLC staff for review. Survey questions were centered around production and disposal costs for health history forms and staff work hour expenses required for preparation and disposal. Twelve completed surveys were returned to our staff for analysis. Note that the size of the practice was not specifically queried (for example, number of sites or number of physicians in each practice were not specifically addressed).

Results

Survey results demonstrated a wide range in cost associated with obtaining health history information. Three practices reported a zero-dollar cost for production/disposal and work hours in obtaining this health history information, however, the remaining survey respondents articulated monthly and quarterly budgeting costs for this process. Excluding the practices with the zero-dollar costs, the range for expenditures in production and disposal was conservatively $3.50 to $500/month with a mean of $130.17/month spent of this process. In addition, staff work hour expenditure per month, excluding the zero-dollar practices, ranged from $26 to $360/month with a mean of $109.98/month. It can be concluded that the mean cost expenditure per month for this process (INCLUDING the zero-dollar/month practices) is $152.58/month with an average of $203.44 spent per month in all offices that use paper forms for their health history.

Discussion

Health care providers understand that an accurate health history is the foundation of nearly every intervention, diagnosis and treatment plan. The information required for this health history is standard, yet not standardized across practices and healthcare systems. Because of this, new health history forms are provided to patients to complete at each visit which causes an unnecessary expense. The survey presented here begins to place a cost to this process. We surveyed a wide variety of practices, as the methods used by each practice to obtain this information may vary. This is not a comprehensive understanding of cost, but an early snapshot of the cost burden for obtaining this standard information. With the current data presented, MĪNA Health would allow for an average monthly savings for each health care provider site.

MĪNA Health

MĪNA is the first and only patented untethered personal health record that allows a patient to communicate with their healthcare provider using QR codes. This highly secure, efficient and FREE smartphone application will allow for easy communication of health history information to providers with the scan of a QR code. Providers also benefit from the implementation of MĪNA Health technology with improved efficiency of communication at a cost savings to the average practice site.

Find out more at: MINAapp.com

References:

1. Office of the National Coordinator for Health Information Technology. ‘Office-based Physician Electronic Health Record Adoption,’ Health IT Quick-Stat #50. dashboard.healthit.gov/quickstats/pages/physician-ehr-adoption-trends.php. December 2016.
2. http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/