How New Technology Will Improve Hospital Efficiency

April 10, 2013

When he took a job as a pro­grammer at Brigham and Women’s Hos­pital, fourth-​​year stu­dent Nathaniel Bessa had never devel­oped his own soft­ware appli­ca­tion. “I went there with no rel­e­vant expe­ri­ence, but with the con­fi­dence that I would figure it out,” said Bessa, who is pur­suing a com­bined degree in com­puter sci­ence and busi­ness with a con­cen­tra­tion in entre­pre­neur­ship.

And figure it out he did. In just two months, Bessa devel­oped an appli­ca­tion to mon­itor a new physi­cian pro­duc­tivity incen­tive pro­gram, which includes sev­eral layers of analysis and func­tion­ality and has already impacted the hospital’s fiscal efficiency.

Bessa’s pro­gram allows doc­tors to mon­itor their patient insur­ance bills directly through a web appli­ca­tion called the RVU Tracker. The bills, which insur­ance com­pa­nies use to deter­mine reim­burse­ments for the hos­pital, con­tain infor­ma­tion such as the date and time of a patient’s visit, the med­ical record number, and admis­sions codes. The first two help track a doctor’s activity, but it’s the admis­sions codes that Bessa’s pro­gram uses to deter­mine per­for­mance compensation.

The five-​​digit codes, devel­oped by the Amer­ican Med­ical Asso­ci­a­tion, embed infor­ma­tion about the stage of a patient’s care and the dif­fi­culty of the case, both of which are trans­parent methods of deter­mining hos­pital rev­enue. If, for example, a doctor rates a case as easy when the code indi­cates that it should have been dif­fi­cult, then the hos­pital receives less money for the case. More­over, if a doctor waits months to fill out the bills, insur­ance com­pa­nies can refuse to pay.

By intro­ducing more trans­parency and a better method of tracking and visu­al­iza­tion, Bessa’s pro­gram incen­tivizes physi­cians to bill on time and as accu­rately as pos­sible. If they do these two things on a reg­ular basis, they see higher bonuses at the end of each quarter.

Tra­di­tion­ally, it has taken hos­pi­tals longer than main­stream cul­ture to adopt new tech­nolo­gies. “It is a prin­ciple mis­sion of a hos­pital to pro­vide quality patient care,” said Bessa, “not to focus their resources on designing advanced infor­ma­tion tech­nology with cool desk­tops and touch screens.

“That is where we can come in as pro­gram­mers,” he added. “Part of what the health­care industry needs is a tech-​​aware advocate—someone who can pio­neer and cham­pion the use of new tech­nolo­gies in hos­pi­tals, someone who under­stands doc­tors and also under­stands computers.”

Bessa wants to be that cham­pion. To that end, he plans to con­tinue pur­suing health­care tech­nology inno­va­tion on co-​​op at the Broad Insti­tute, a bio­med­ical research center in Cam­bridge, Mass., where he’ll be working on devel­oping metabo­lite pro­filing software.