Paul Brousse Hospital Elevatates Critical Care with MetaVision

About the hospital

Paul-Brousse Hospital is a specialty hospital near Paris with 800 ICU patients annually, specialising in liver transplantation, liver surgery acute hepatitis and various other liver diseases. Paul-Brousse is also part of a system of national hospitals specialising in the treatment of cancer, treating oncology patients from all over Europe. There are 15 ICU beds in Paul Brousse currently monitored by MetaVision.

The challenge

In light of increased regulations, medical billing complexity and a drive to increase the standard of care, Paul-Brousse began a search to computerise its ICU wards, improve billing efficiency and decrease physician administrative workload. Reimbursement for a hospital in the French public system depends on many factors, including a labour-intensive coding classification set by the Department of Medical Information (DMI).

The process requires accurate diagnoses, SAPS II scores, as well as classification of major procedures. Without accurate and complete information, the “Caisse Nationale d’Assurance Maladie (CNAM)” does not reimburse the hospital. Due to the cumbersome manual documentation process, clinician work load was high, quality of care suffered and financial results were held hostage to reimbursement refusals by the French government. Paul-Brousse set out to identify a system that would improve the quality of their coding and reduce both the errors and the administrative workload for their clinicians.

The solution

iMDsoft and Paul-Brousse implemented MetaVision over an 8-week period in 2005 and went live in the hospital‘s ICU. The impact of the computerisation of the records was felt immediately. Paper charts were replaced with comprehensive electronic patient, records including advanced drug, fluid and task management, and automated scoring and calculations. The system provided clinicians with automatic data collection to enhance their analytical and research capabilities and powerful decision support tools to enable more informed clinical decisions in the ICU.

MetaVision results

After a lightning 8-week implementation program, Paul-Brousse achieved both the clinical and financial improvements it was looking for.

Clinical improvements

The automatic capture, display and documentation of several data streams coupled with an intelligent, rule-based decision support engine significantly reduced medication errors and clinician workload. MetaVision adapted seamlessly to the unit workflow at Paul-Brousse, meeting their unique and complex practice patterns and needs that included multiple users and disciplines. It provided a single platform for accurate inter-departmental data sharing, which resulted in enhanced team communication.

Financial improvements

The MetaVision solution simplified the process of compliance with the CCAM billing codes and significantly increased the percent of billable procedures. MetaVision collected all of the required CCAM codes at the end of each patient’s hospitalisation and made them available for transmission to Paul-Brousse’s existing Hospital Information System. This solution almost halved the time that physicians spent on coding, from nearly 7 minutes per patient to 3.6 minutes and reduced the number of errors in coding by 72%, from nearly 8% to 2.2%. Based on current billing rates for Paul-Brousse, these discrete improvements alone are increasing the ICU’s revenue capture by nearly $300,000.
Clinicians are now able to devote more of their time to patient care and administrators know that nearly all of the ICU’s billable events are being captured and reimbursed accurately.

“MetaVision enables us to adhere to complicated coding and billing procedures of the French medical system. As a result, clinicians spend less time on coding and coding is more accurate. This has all led to better compliance with the CCAM system and increased revenue for the hospital.”
Docteur Eric Levesque, AP-HP Hôpital Paul Brousse

References

¹ Berger MM, Bouvry S, et al. Impact of a computerised information system on .quality of nutritional support in the ICU Nutrition 22 (2006): 221–229.
² Roth-Kleiner M, Stadelmann DC, et al. Evaluation of different POCT devices for glucose measurement in a clinical neonatal setting. European Journal of Pediatrics 169: 11 (2010): 1387-9.