At present, many of the systems that handle accountability, billing and inventory management in the 150 million annual surgical operations are manual. Consequently, processing takes a long time, with large numbers of unhappy vendors having to wait for 90 or 120 days to get paid. In addition, manual systems are labor intensive, requiring high-cost staff, but many back-office processes in the health care information management system can be handled faster and with less error by automation.
A McKinsey study (http://dtn.fm/2RwJg) demonstrates the extent of the problem. It reports that ‘fifteen cents of every US healthcare dollar go toward revenue cycle inefficiencies’. That would mean close to half a trillion dollars ‘go to claims processing, payments, billing, revenue cycle management (RCM), and bad debt—in part, because half of all payor-provider transactions involve outdated manual methods, such as phone calls and mailings.’ The study warns that for hospitals to survive requires ‘aggressive automation’.
However, RCM IT systems cost a packet. For example, Scripps Health, a nonprofit health care system, recently ‘spent nearly $19.9 million on software and hardware to make the switch to ICD-10’ (http://dtn.fm/h9ImE). ICD-10 is a medical classification system for diseases and related health problems.
The San Diego, California-based provider, which operates four hospitals and 19 outpatient facilities and treats half a million patients annually through 2,600 affiliated physicians, expects to expend $360.5 million over the next 10 years to upgrade its inpatient and ambulatory electronic health record (EHR) and revenue cycle management (RCM) systems. Faced with such financial hurdles, hospitals and other health care providers are likely to turn to cloud-based solutions. McKinsey expects ‘that RCM outsourcing will take off over the next several years— potentially, up to 40 percent of providers may consider end-to-end outsourcing in the near future’.
ORHub already has its foot in the door of this market. The production version of the first release of its digital platform is currently in daily use at two regional hospitals. ORHub plans to gain a dominant share of the surgical market. The company estimates the segment at about 150 million surgeries annually, a number that is expected to grow with demographic trends.
The company will focus its marketing efforts on major national hospital operations. Even though there are around 5,600 hospitals in the United States, 80% of surgeries are performed by the top 12 hospital ownership groups and performed at the 1,100 largest surgical hospitals.
ORHub is transforming the business of surgery. By creating a new category of health care IT vertical-specific software known as Surgical Resource Management, the company is offering enhanced capabilities over traditional EHR solutions in the operating room. The ORHub platform, which employs Microsoft’s Azure Cloud, is at present the subject of a study in which its impact on participating institutions is being assessed. The study, funded by Microsoft and Intel, will be concluded sometime in Q2 2017.
For more information, visit the company’s website at www.ORhub.com
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