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ON-LINE FOR EFFICIENCY

MARY NEMETH July 31 1995
COVER

ON-LINE FOR EFFICIENCY

MARY NEMETH July 31 1995

ON-LINE FOR EFFICIENCY

Computers are everywhere at the Wetaskiwin Hospital—at the nursing stations, in the pharmacy, in the radiology department, in the laboratory, even in the supply room. In fact, the 105-bed facility in Wetaskiwin, Alta., 90 km southeast of Edmonton, is one of the most highly automated hospitals in Canada. Its computers keep track of the drugs and bandages administered to each patient, the syringes dispatched to each nursing station, and tally the cost of lab tests and X-rays. At the end of the day, they can collate all that information and calculate to the last penny—including everything from nursing to housekeeping charges—how much it costs to treat any given patient.

The Wetaskiwin Hospital has been a test site for the past decade for a federal-provincial project to improve efficiency in health-care facilities by using better management information systems. And now

staff at the hospital have begun implementing a compatible computer system throughout the entire Crossroads health region in central Alberta. (The Alberta government established regional health authorities last year as part of a restructuring of the health system.) Crossroads Regional Health Authority CEO Peter Langelle says the computers have already helped the hospital to make significant savings: although factors other than automation also played a part, its annual budget has fallen from $20 million in the late 1980s to $13 million this year. And it has been able to close 28 acute-care beds.

Savings have come in part through simple efficiencies. Based on medical information typed in each day by nurses, the computers can calculate how many minutes of nursing care each patient on a ward will need in a 24-hour period. That allows administrators to fine-tune their staffing levels each morning.

But according to Langelle, the computers are most effective in enabling administrators to compare how much of the hospital’s resources various doctors are using. Even among doctors treating similar kinds of patients, he says, “we were able to identify great differences.” Some physicians were admitting patients for relatively minor illnesses, while others ordered a higher-than-average number of lab tests. Langelle is quick to point out that medical necessity accounted for some discrepancies. But others seemed inexplicable.

The hospital began sending physicians an accounting of the resources they had been using compared with the hospital average. “We’ve found that the mere fact that these kinds of reports and comparisons were produced and reviewed was enough,” says Langelle. “The physicians themselves took an interest and usually adjusted their practices accordingly.” It has all been voluntary. But Langelle warns that will change. One day soon, he predicts, physicians will be awarded or denied hospital privileges based, at least in part, on how efficiently they use hospital resources.

MARY NEMETH in Wetaskiwin