March 19th, 2013 by David E. Williams of the Health business blog
This is the transcript of my recent podcast with J.P. Fingado of API Healthcare.
What problem does API address?
J.P. Fingado: We’re trying to solve several problems. The first is around quality of care, so we seek to put the right people at the right place at the right time to achieve the best possible outcome for the patient.
The second piece is helping hospitals control their cost and optimize the use of labor. So if we actually optimize across everybody in the hospital, across all their facilities through the continuum of care, we’re saving the hospitals millions of dollars through the deployment of their staff on an annual basis.
There’s a third piece that’s also very important, which is improving that satisfaction of their entire workforce. Allowing them to have more control over their schedules, over their interaction with their human resource system leads to happier employees, which in return, increases productivity.
Williams: Here at HIMSS there’s certainly a lot of discussion about electronic health records and health information exchange. Meanwhile you have a couple of things that sound like variants on those. You’ve got not an EHR but an EER and not a health information exchange but a healthcare workforce information exchange. Can you describe what those concepts are and how they fit in to the goals that you’re trying to achieve?
Fingado: The electronic employee record is a single repository of everything about every single health worker in an institution. We’re actually tracking before they even come on board. We’ll start the data collection at the recruiting phase to understanding the competencies and the scenarios and the environments that workers have been in prior to joining an organization.
Once they come then we’re tracking all their growth inside of an organization. We’re tracking where they work inside of a hospital, the time that’s being tracked, all their HR information, all their training, all their performance reviews. We ultimately go to full succession planning.
Putting these millions of data points into a single record allows the hospital to effectively deploy those people and put the best people on the field at any point in time.
The other piece that we brought to market from an innovation standpoint is the healthcare workforce information exchange. We take all these records –imagine in a hospital two or three thousand people and the millions of data points– and we optimize that across the continuum of care and share the information across every facility inside of a hospital.
We’ve got a hospital customer, for example, Advocate Health Care, which over 200 locations in their network with tens of thousands of people that we help them optimize.
Williams: Interestingly, you seem to be combining clinical information about patients in the hospital with this EER concept. If a client is using your system, how much of a difference can it make for the patients that are in the hospital? Is it just a minor or incremental improvement or do you see something that’s more dramatic. And if so, how could you measure that?
Fingado: So scheduling a nurse is not like scheduling a waitress. You can not just give every nurse three patients and call it a day. There’s a huge benefit when you can match up the needs of the patient to the expertise of the nurse. So think about it. If you are in the ICU and there was one nurse that had treated 50 patients with the exact ailment and another nurse that treated one, which nurse do you want?
It’s pretty obvious. So when you start to do that you really drive higher quality across the board, a better outcome for the patient. Now you’re talking about huge results for the organization. With reform, reimbursements are going to get tied to quality. Poor quality will drop reimbursements.
So now we’re not only saving the money on the expense side, we’re actually increasing the revenue of the organization, now making it a healthier environment, which in turn helps patients as well.
Williams: You’ve been describing the tracking of nurses and others from the time they are hired into the organization and maybe even beforehand. But a lot of these health care organizations are a little more complex than that. A lot of them use agencies or other sorts of outside resources. So how do you address that situation where you have many personnel that are not actually employees of the hospital?
Fingado: That’s a unique thing that we do that nobody else in the industry does. We don’t think in terms of employees. When you look at a hospital you’ve got the full-time employees and part-time employees, but you have volunteers, you have contractors and you have contingent workers.
When we put in the system we’re putting in the system for all the health care workers in an institution. If somebody calls in sick a nurse manager or a manager of any department can look at all the available resources in their department, they could look in the float pools, they could across the entire organization.
But with our systems they can also look at any contingent staffing companies that are in their preferred network and it will show them just the resources that fit the need based on licenses, competencies, performance ratings, as well as cost. And for the first time, a manager can make an instantaneous decision about picking the right resource, not just their full-time employees but anybody that can provide the highest level of care to the patient.
Williams: I want to ask a broader policy question that relates to what you’re doing. We hear about the shortage of nurses and in particular about baby boomer nurses that are going to retire, but at the same time we also hear that nurses graduating from nursing school are actually having a hard time getting started in the profession.
So you could see a situation where you’ve got a lot of inexperienced nurses who don’t get experience and then a lot of nurses that eventually retire. You also have some people who will come in and out of the workforce. It all seems very dysfunctional. Does what you’re doing contribute to getting nurses into the funnel and helping them to get experience?
Help me understand this combination of a nursing shortage overall coupled with the difficulty a new nurse has getting hired.
Fingado: A very astute observation. So that’s actually a big reason why we’re seeing a lot of demand for the systems. Hospitals are bringing a lot of the nurses in who don’t have a lot of experience and what they can do as part of the system is match those nurses with the experienced nurses, put them in scenarios where they can really learn and get up to speed quicker, and then over time starting to move them to more independent roles where they’re learning and training on different types of patients going forward.
It’s a huge issue and one reason why hospital administrations are starting to make a big technology investment in workforce management. They recognize that there’s going to be a big shift in the workforce over the next decade.
Williams: I’ve been speaking today with J.P. Fingado, President and CEO of API Healthcare. We’re at HIMSS in New Orleans. J.P., thank you very much for your time.
Fingado: David, thank you and I hope you have a great rest of the show.