A Enterprising Answer

Nov. 1, 2006

Midwest academic medical center streamlines patient transport with IVR technology.

For healthcare providers, capacity management means more than just managing patients in beds; it can also mean managing patients in transit. For large healthcare organizations with substantial campuses and multiple buildings, the efficient moving of patients from one site to another is an opportunity to apply information technology to a challenging frontier that, for years, has depended on paper documentation at worst and live voices on phones at best.

Midwest academic medical center streamlines patient transport with IVR technology.

For healthcare providers, capacity management means more than just managing patients in beds; it can also mean managing patients in transit. For large healthcare organizations with substantial campuses and multiple buildings, the efficient moving of patients from one site to another is an opportunity to apply information technology to a challenging frontier that, for years, has depended on paper documentation at worst and live voices on phones at best.

The Ohio State University Medical Center (OSUMC), which is enjoying its 14th straight year on U.S. News & World Report’s list of “America’s Best Hospitals,” fits that large healthcare organization description: It includes about 25 buildings within a five block area, employs about 14,000 employees and consists of about 800 patient beds. Every day, between 500 and 550 patients require transport services from patient rooms to departments including X-ray, surgery, lab and MRI. To handle these transports, OSUMC had been employing four dispatchers and about 80 transporters who transported patients in courtesy vans over a two-shift period.

Matching Technology to Need
Assigning the transports was cumbersome. An authorized person would place his transport request with a dispatcher. The dispatcher would page a transporter, who would then call and speak with a live dispatcher to accept the assignment. When the transporter completed the assignment, he or she would let the dispatcher know by calling and speaking directly with them again. If there was any delay, either at the transport end or in reaching a live dispatcher, the transporter had to make yet another call. In short, each assignment required at least two phone calls and sometimes three.

With 1,000 or more phone calls in the air every day to accept transport assignments or report delays, the medical center was wasting precious time and wanted to economize on it. OSUMC Director of Technology Chad Neal says that managing all those calls was, “one of our biggest bottlenecks” and a situation they were determined to streamline with automation.

Neal believed that Interactive Voice Response (IVR) technology was an appropriate fit. He was no stranger to IVR, having worked with it internally for several years. But OSUMC’s experience with an IVR outsourcing vendor was less than satisfactory to Neal, even after a healthy financial investment. He wanted better, more measurable results from applying the technology to patient transport.

Meanwhile, one of Neal’s colleagues at the medical center was working with a demonstration version of the Brooktrout TR1000 for Microsoft Speech Server (TR1000 for MSS) from Cantata Technology, Needham, Mass. Neal decided to buy a version of the product suitable as a test platform. Because the TR1000 for MSS was comparatively inexpensive, he hadn’t planned to use it in a live network. But he was surprised at the product’s power and realized it could be the basis for streamlining OSUMC’s patient transport system.

Neal also liked the price, the fact that it is designed specifically for the Microsoft Speech Server, and that it was certified by Microsoft’s Windows Hardware Quality Labs. Finally, because he was already using six of Cantata’s Brooktrout fax boards in his fax server, he trusted the vendor.

Smooth Sailing for Installation
Neal already had an appropriate server, the Hewlett-Packard ML370, so he needed to buy only the software licenses and decided on the multiprocessor T1 enterprise version of the Brooktrout TR1000 for Microsoft Speech Server. Including the cost of the HP server that OSUMC already owned, total costs came in below $50,000. After Neal had the new system racked and installed, it took three people just four months to bring the system online. About one-third of that time was spent on writing the application; another third went to telephony integration; the final third was dedicated to testing and customizing.

The solution is composed of two main components: Microsoft Speech Server and the TR1000 for MSS. The Microsoft Speech Server performs the actual speech recognition and speech synthesis. The TR1000 for MSS includes a processing board, Telephony Interface Manager, drivers, configuration tools and a suite of management utilities. It provides an interface layer that abstracts the underlying telephony protocols, and it manages telephony resources and communication with the telephone network. It also streams media for speech recognition and speech output, performs DTMF detection and processes call control.

When he started the project, Neal found much of his support for the Microsoft Speech Server via newsgroups and user forums. But when Microsoft learned about what Neal and OSUMC were doing, they stepped up to the plate and named OSUMC a member of their Rapid Deployment program, making Microsoft resources available to the organization and visiting the OSUMC in person.

According to Neal, Cantata worked very closely with the medical center even before the organization made a major financial commitment. “They were very knowledgeable, helpful, informative and willing to get into it with us, as well as highly interested in making it work. Lots of times we might demo hardware like a telephony board, but unless we buy it, support is limited.”

Creating Results That Count
Using the new IVR system, an employee uses a Web-based form to request patient transportation. The request automatically appears in the transportation database. The dispatcher sees the request and pages a transporter.

Instead of calling to speak with a dispatcher, the transporter calls into the new IVR application and is given a transport assignment through text-to-speech technology. The transporter then presses 1 to accept the assignment. Later, the transporter calls into the application again and presses 2 to indicate the transport assignment is complete or presses 3 if there will be a delay. Transporters are no longer subjected to hold times; transport status is automatically updated in the department’s database in real time, and the requesting employee can view the status of his request on the Web-based system.

When a transporter calls to indicate that a transport is complete, a new job can be assigned at that time automatically through text-to-speech technology, eliminating the need for another page. Without the use of IVR, OSUMC’s old transport system easily required 1,000 calls per day simply to accommodate a routine volume of transport traffic. Today, just about all of those 1,000 calls have been eliminated.

Nothing points to the domino effect faster than a challenged transport system. A simple 10- or 20-minute delay can ricochet among multiple departments and medical disciplines, causing unintentional backlogs and inconvenience within the enterprise. But OSUMC is using its new IVR system to increase efficiency and prevent backlogs of that nature. Since installing the IVR system, they have seen a 33 percent improvement in on-time patient transport, indicating a sizable efficiency gain that most probably emanates from the administrative or logistics end of the job, rather than from the actual transport time.

The new system already has allowed the OSUMC to reduce their dispatch staff by one and they anticipate being able to make another reduction soon. Also, the organization expects to be able to reduce the number of transporters necessary to operate patient transport because of the efficiency gained. The reduction may be as high as 20 percent of transporter staff, once the application is fully deployed for use in all buildings.

Neal says that training costs were nonexistent because of the simplicity of the application for users. “We feel speech applications like this provide a very compelling means to simplify routine processes, and could potentially save us dozens of hours each day on call scheduling.”

Neal and his team are already building new applications for the system, including a tool that employees can use to automatically reset their passwords, which should reduce help desk calls by 25 percent. Also, he is looking into building another application similar to the transport system, but one that can be used for bed capacity management. The system will provide faster alerts for housekeeping staff to clean and turn over available rooms for newly admitted patients, leading to a more efficient use of available beds. Neal priced the technology with an external vendor and arrived at a $250,000 cost, but anticipates he can develop the solution internally for about 10 percent of that amount, using tools that have already proven their worth to him in transporting patients.

For more information about Brooktrout TR1000 for Microsoft Speech Server and other products from Cantata Technology,
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