As out patient services increased dramatically, Rice Memorial Hospital in Willmar, MN, found itself under more pressure than ever to deliver high-quality medical care, remain competitive and accurately bill patients and third-party providers under emergency circumstances.

Rice Memorial has faced these challenges head-on.  A multi-specialty regional referral center built in 1937 as a 35-bed hospital with a trust from Colonel Cushman Rice, it now has 136 beds and 830 employees.

It has seen a lot of changes, but by staying innovative and caring, Rice Memorial has successfully responded to the changes in managed care in health services in the nineties.

Previously, Rice had a totally manual time card system with old time-clocks that had to be figured by hand.  Today, a computerized system using bar-coded ID cards automatically generates information for all paychecks.

The automated system processes labor data for three locations, including a nursing home.  "Administrators now get easier breakdowns of data and a wealth of information," says Donna Behrends, payroll manager at Rice Memorial.

Wish List

The system worked so well, Rice hospital decided to add 30 paramedics and emergency medical technicians (EMTs) to it in 1995 when the Willmar Ambulance Service became an actual part of Rice Memorial Hospital.  While the inclusion of the service allowed paramedics and EMTs to provide more medical interventions in pre-hospital settings, it also complicated payroll and third-party billings.

The EMTs come in to respond to an emergency and don't have time for any complicated paperwork.  "They do this on the side, nights and weekends," says Aaron Reinert, ambulance manager.

These technicians needed a flexible, workable system, so ID America, worked with the ambulance drivers and hospital payroll staff to develop a system using automatic data capture.

Installation of the system means EMTs can go right back to work or home after completing their medical duties and don't have time to spend time doing paperwork.

Fast, efficient, and uncomplicated

Two AXIOME Alpha portable BARman scanning terminals are used.  One scanner is used to download information into the payroll department of the hospital, and one is kept in the garage (functioning as a time-clock) to be used by the drivers.

When EMTs or drivers arrive at the ambulance garage in response to a call, they scan a barcoded photo ID badge with the BARman terminal or key enters the badge number.  Access into the garage is only gained through a card scan or keypad entry.  The scanner automatically stamps the date, time, and run number with each swipe.

The various barcodes which are scanned are kept at the garage in a binder along with the terminal.  The binder is locked in a closet to which only the drivers have keys.

In all, there are 13 types of ambulance runs.  Drivers scan the barcode when leaving for a call.  They must scan or enter the information with the keypad during the run, scan when they get back into the station, and scan once more when they're finished.

Billing

There are barcodes for each and every runtime.  This is important for two reasons:

• It's a way of verifying that the time spent on the run actually matches pre-set time parameters (e.g., 6.5 hours has been established as the time it takes to get to Metro Minneapolis/St. Paul) otherwise, explanations are given for exceptions.

• The hospital gets paid different rates depending on the type of run.  When the driver enters a time that's beyond the set parameters, an exception report is generated, thereby allowing for accurate billing.

Transferring data from the portable terminals to the time/attendance system is the next step in the process.  It provides the hospital with a completely automated solution.  The AXIOME program data is simply reformatted and imported into the Timekeeper Central software database.

Each week, drivers bring the portable scanning terminal and its charger/cradle back to the hospital to download their payroll information.  The charger/cradle acts like a poling device and communicates with the time/attendance system through an RS-232 port.  Then the custom program reformats and transfers the data.

The new program has a 99.6% accuracy rate while still providing information in a much more complex environment.  Behrends doesn't know how the hospital would have handled the ambulance drivers' time card system any other way.

© Reprinted from Automatic I.D. News, August 1998