Client story

Training a front desk took three weeks. Now it takes three hours.

A 27-center network across New York and Florida, run by a lean central team. Fifteen years of bringing business problems to a vendor and co-designing the answer, instead of buying something off a shelf and working around it.

27 centersNew York and FloridaFifteen years
Zach Harman
RIS/IT Administrator,
HMCA
+1 more on the record ↓
Practice profileDiagnostic imaging center management, New York and Florida
27centers
across New York and Florida
400staff
approximately, full-time
39MRI scanners
including stand-up and high-field 1.5T
15years
of co-designing what they needed
On the record

Two people from one network, on what a lean team can run.

Zach Harman has been at HMCA thirteen years and runs the RIS and IT. Mike Christie works on operations and business process improvement across the network.

The clerical work

what the front desk stopped doing, and how fast it learns
1 interview
Zach Harman
RIS/IT Administrator
Thirteen years at HMCA
“It would take us anywhere from three weeks to a month and a half in order to get a front desk staff person trained… we’ve been able to cut our training back for our scheduling team to about three hours.”
3 wks → 3 hrsto train a front-desk scheduler
10–15 → 3–5minutes of check-in paperwork
3–5 → 1–2minutes to complete a billing record
In the interview: what a lean central team can run across 27 centers
Jump to a chapter10 chapters

Fifteen years of it

why a 27-center network builds instead of buying
1 interview
Mike Christie
Operations & Process Improvement
Fifteen years of it
“We come to you with a business problem and we essentially co-design the answer… It may not have been bought off the shelf, it may have taken a little longer, but that’s okay, because it does what we want.”
In the interview: why they never bought this off a shelf
Jump to a chapter6 chapters
3 wks → 3 hrs
to train a front-desk
scheduler
77%
less spent on paper
and printing
<60
days to recover the
cost of the tablets
01 — The unseen work

“There’s a lot of clerical work here”

Zach Harman has a name for the thing he goes looking for: the unallotted work, the unseen work, the clerical work. It is the time that never appears on anyone’s job description: hunting a document out of a chart, printing a form one page at a time, searching charts by hand to check a billing record. His method is to take each of those to AbbaDox and ask for help with it, and the example he picks is deliberately unglamorous: the fax sorter, “a pretty simple tool, but it makes things a lot more efficient.”

  • Documents and reports pulled into the workflow, in pane view
  • Pending worklists ordered so each team works its own queue
  • Billing records checked by rule instead of by hand
  • A billing record completed in one to two minutes, from three to five
02 · Fifteen signatures

Check-in was like buying a car

His description of the old check-in is exact: like buying a car, about fifteen signatures, every page printed individually and typed on. Paper packets and clipboards across the network meant printing, storage, shredding and courier runs on every visit, and handwriting that could cost a claim. Tablets replaced the clipboards; patients enter demographics, consents and safety questions once and the data goes straight into the RIS, with validation that refuses a mismatched date or an illegible entry before it reaches billing.

  • Fifteen signatures, once printed and typed one page at a time
  • Ten to fifteen minutes of paperwork down to three to five
  • Validation catching mandatory fields and mismatched dates at the source
  • A complete digital audit trail on every consent
Why it matters
“We come to you with a business problem and we essentially co-design the answer… It may not have been bought off the shelf, it may have taken a little longer, but that’s okay, because it does what we want.”
Mike Christie, Operations & Process Improvement
HMCA
03 · What the tablets cost, and what they returned

Paid back in under two months

The paperless intake program paid for itself in under sixty days. Across the network, paper and print-related costs fell by about 77%, and the filing, storage and shredding went with them. The arithmetic is unusually plain: at 150 tablets across the network, each individual tablet covered its own cost after 209 patient visits, on hard savings of $1.07 per patient. Two years in, exactly one device has been damaged.

  • About 77% off paper and print-related costs
  • Investment recovered in under 60 days
  • 150 tablets across the network
  • Each tablet paid back after 209 patient visits
  • $1.07 per patient in paper, printing and shredding eliminated
  • One damaged device in two years of operation
04 · Integration everywhere

Ninety percent of the constraint is interfaces

Mike Christie is asked what drives the complexity of the business and answers in one word: integration. Every system has to talk to everything else: texting workflows for patients, referring doctors needing records online, specialists who never referred the patient, external radiologists, transcription, insurers, the billing system. By his estimate 90% of the constraint on efficiency sits in those interfaces. Which is also why he does not want an off-the-shelf answer: he wants to be in the design early enough that the product does what HMCA needs when it arrives.

  • Every system expected to talk to every other one
  • Around 90% of the efficiency constraint in the interfaces between them
  • Co-design rather than off-the-shelf, repeated over fifteen years
  • “A trusted integration vendor”, in his words, rather than a product to work around
05 · The portals

A third fewer calls where the referrers came across

The portals moved work off the phones. Patients self-serve their reports and images instead of ringing to ask for a fax; referring practices send orders with the prescription attached, so nobody re-keys them. Zach can put a number on one call center: in Orlando, handling the Ormond office, about 13% of referrals now arrive through the portal and roughly a quarter of referring doctors use it, and call volume there fell about 30%. He is careful that it is not proportional: landing one high-volume referrer takes far more calls out than the share suggests.

  • About 13% of referrals arriving through the referring portal
  • Roughly 25% of referring doctors using it
  • Call volume down about 30% in that call center
  • Patients retrieving their own reports and images
  • No duplicate data entry on referrals that arrive complete

What changed at HMCA

3 hrs
To train a front-desk scheduler, from three weeks to a month and a half
10–15 min→3–5
Minutes of check-in paperwork, before and after
77%
less spent on paper
and printing
Interview figures from Zach Harman and Mike Christie on camera. Paper, tablet and payback figures from the published HMCA eForms case study.
Under 60 days
to recover the cost of 150 tablets
~30%
fewer calls in the call center handling Ormond

Still printing the
paperwork one page
at a time?

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