Utilization Management FY 05
For FY 05, the Utilization Management Program is focusing on bringing greater
value to the high quality care offered at BWH. This year’s focus is on improving
lab, radiology, pharmacy and other operating costs. Led by a multidisciplinary
team, the program is instituting a number of technological and process changes,
as outlined here:
Pharmacy
The Pharmacy team is developing guidelines for use of medications such as Neseritide
and several others, with the goal of providing excellent care at least cost. With
the help of the computerized order entry system, the ordering process for certain
medications such as Erythropoetin is becoming more guideline-based.
Operating Rooms
The OR is investigating ways to reduce its use of specific supplies and seeking
opportunities for product standardization and better supply management.
Blood Bank
The blood bank has implemented a new policy to decrease the purchase of blood
from outside blood banks, saving BWH an estimated $50,000 per year.
Radiology
Radiology has the goal of expanding film-less imaging to Neurology, the Center
for Chest Diseases and Oncology this year. In addition to saving film costs, digital
images are bringing a number of operating benefits to departments using them.
Images can now be archived, offering great convenience for surgery and follow-up
patient care whether on campus or at a satellite clinic. The availability of digital
images also enables quicker report turnaround, which will be greatly aided with
the addition of speech recognition capabilities, anticipated later this fiscal
year.
Another goal is to perform imaging in the most appropriate location for patients
and BWH, which means shifting more imaging to an out-patient basis. This program
is designed to reduce patient waiting times, increase revenue and decrease expenses,
and lead to shorter length of stay and earlier discharges.
The team is encouraging physicians to reduce radiology leakage by ordering
all images from BWH facilities, instead of outside providers, and to capture all
imaging charges by ensuring appropriate documentation for any tests ordered. Improved
payer contracts are also being negotiated for BWH and BWPO. Lastly, Precipio,
the computerized image ordering and viewing system is enabling BWH to provide
better documentation and information for the radiologist and ordering clinician.
Lab Utilization
The Lab Utilization team is encouraging physicians to order only tests that are
appropriate and needed and to avoid standing orders. It is also considering ways
to improve direct communication between physicians and the lab, as well as looking
at ways to improve the efficiency of overnight phlebotomy.
Utilization teams are arranging meetings with physicians in various departments
to encourage their support for these initiatives. Last year, the program saved
over $1 million in hospital operating expenses. Robert Goldszer, MD, MBA, associate
chief medical officer said, “With the support of our colleagues for these
utilization initiatives, BWH has the potential to increase those savings substantially.”
Please direct comments and questions on utilization to Goldszer (rgoldszer@partners.org),
Anthony Whittemore, MD, chief medical officer (awhittemore@partners.org)
or Deb Leven, director, special projects (dleven@partners.org).