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Methodist Healthcare System of San Antonio

Challenges

Providing High Quality Care in a Volatile Market Like most healthcare organizations, Methodist Healthcare faces a range of pressures in an industry challenged in recent years by declining reimbursements and a slew of new operating requirements mandated by healthcare reform.

With revenues and margins at risk of shrinking, the healthcare system has been focused on reducing ancillary expenses wherever possible and redirecting the savings into patient care. “When we think about patients, we think about how we can save money so we can take those dollars and put them into clinical care,” said Geoffrey Crabtree, senior vice president at Methodist. “We’ve got to find new and innovative ways of cutting down our ancillary costs”

Adapting to Healthcare ReformThe Affordable Care Act is requiring providers like Methodist to meet a host

of new operating requirements. Reimburse- ments from Medicare and other govern- ment programs (the source of 60% of Methodist’s revenue) are increasingly tied to performance metrics like patient readmission rates. As a result, Methodist has had to spend more time educating patients after they leave the hospital to ensure they don’t return.

“With the Affordable Care Act, we will be spending more time concentrating on better educating our patients about what they should be doing when they get home out of the hospital,” said Palmira Arellano, vice president of marketing and public relations at Methodist. “That means developing and printing of more manuals, brochures, and fact sheets, which arms our patients with the information they need to keep them out of the hospital.”

Driving Growth Growth has been central to Methodist’s success in the last two decades. But that growth also led to operational challenges, including how to support the

“It is often said that location is everything. Having the Print Center on-site in the corporate office right next door to marketing absolutely increases productivity.”

Healthcare

Business Benefit Assessment

– Geoffrey Crabtree, Senior Vice President Methodist Healthcare System of San Antonio

Study HighlightsMethodist Healthcare System’s investment in Xerox products, solutions and services are projected to generate $262K net benefits for YTD May 2014.

• 21% return on investment (ROI) for YTD May 2014

• Managed growing print center operation with no increase in staffing

• Print on demand production model enabled zero inventory on hand

• Achieved 100% compliance with branding, legal, and compliance requirements

• 95% of all print requests returned within five business days (meeting or exceeding service level agreement)

• Reduced print-job submission time from 1–2 minutes to less than 30 seconds

Fifth Largest U.S. Healthcare System Teams with Xerox to Save on Printing Services and Sharpen Focus on Patient Care

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organization’s expanding need for print services. Methodist executives reasoned that by improving the patient experience compelling after-care education, the healthcare system would attract new patients and stimulate growth.

Getting Lean and FlexibleMethodist also sought faster and more flexible ways of meeting the printing demands of its expanding organization. One way it could do this was by bringing printing services in-house and creating a lean, just-in-time delivery model to minimize waste, better manage inventory, and speed turnaround.

On-demand printing makes sense for healthcare organizations that need to keep up with constantly changing regula-tions. Printing and storing forms that quickly become outdated can create a cost burden for the organization, while delays in distributing new documents can lead to bottlenecks in delivering care and filing for reimbursements.

Solution

Introducing Xerox® Centralized Print Services Methodist addressed these challenges by forging a comprehensive partnership with Xerox. “We wanted to find someone in the

printing business who understood healthcare,” said Crabtree.

One of the partnership’s most important initiatives was creating a centralized print services organization. Originally run out of a local warehouse, Methodist later moved the print center to its corporate head-quarters to more effectively serve the needs of department heads as well as revenue-generating “walk-ins” from businesses around San Antonio.

In addition to the central print center, Methodist deployed a fleet of 275 Xerox® printers and multifunction devices, of which more than half are currently connected to the healthcare organiza- tion’s network. Xerox® multifunctional devices continue to provide value while reducing the environmental impact of print as Methodist continues to grow and expand.

Seamless Partnering That Delivers ExcellenceNow into its second decade, the partnership between Methodist and Xerox continues to uphold the shared values of the two organizations. “This is one of those partner-ships that we brag about a lot,” Crabtree said. “It’s two organizations that think alike. Xerox is looking at ways to save us money, and we are looking to Xerox to help us save money.”

Methodist Healthcare System at a Glance• Largest provider of health services

in San Antonio and South Texas

• Fifth largest healthcare system in the U.S.

• Operates network of nine hospitals and dozens of clinics and ancillary facilities

• Second largest private employer in the area with more than 8,000 employees.

• In 2013, Methodist Healthcare provided services to 86,000 inpatients and 366,000 outpatients.

• More than 2,500 physicians in all specialty areas have privileges to treat patients at Methodist facilities.

“We’re in the healthcare business, we’re not in the printing business.”

– Geoffrey Crabtree, Senior Vice President

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Although they are technically Xerox employees, print center personnel wear the same badges as regular Methodist employees and enroll in many of the same training classes.

No value is more important to Methodist than excellence; in fact, “Methodist Excellence” is one of the organization’s most popular maxims. Not surprisingly this value has been woven into the culture at the print center, where Xerox staff members are encouraged to think of new ways to boost production quality and serve customers — and to freely implement improvements. Far from just taking print orders from Methodist staff, print center employees frequently contribute to the creative process. “When we sit down with the print center manager, any and all printing ideas are fair game for modifica-tion and enhancement,” said Palmira Arellano, Methodist’s vice president of marketing and public relations. “The end product is always fabulous and almost always better than the idea I had when I walked in.”

Benefits

Cost Savings and Revenue EnhancementsAfter introducing process automation and streamlined workflows at its print center, Methodist captured significant savings and enhanced revenue flows. In 2014 the healthcare system is tracking a 21% ROI and $262K YTD May 2014 net cost savings by taking advantage of steep discounts in color, black and white, and offset printing services available through

the Xerox-managed, in-house production model. Currently the print center can handle virtually every request for graphically rich marketing and educational materials, enabling Methodist to avoid paying extra for outsourced services.

Running an in-house print center allows Methodist to capture additional revenue from outside businesses. This year to date (2014) the center pulled in more than $10K per month of walk-in revenue, putting Methodist on track to exceed its annual revenue estimate.

Process EfficienciesUsing an online workflow portal introduced by Xerox, Methodist employees now submit print jobs in about 30 seconds on average, compared to 1-2 minutes before, giving them extra time to devote to other tasks. Employees simply enter their user ID and the system automatically fills in their contact information; users then choose from a menu of service options, such as

selecting a particular form they need printed, or uploading files.

The Xerox system tracks the entire produc- tion process, ensuring accurate chargebacks to the originating department and providing visibility into key service-performance metrics, such as turnaround time. Methodist reports that the print center is exceeding its service level agreement, which calls for fulfilling all print requests within five business days.

Consistently Fast ServiceCurrently the print center fulfills 95% of all print requests within five business days, consistently meeting or exceeding Xerox and Methodist’s service level agreement. Methodist attributes this achievement to a combination of joint commitments, including the online job-submission and workflow system, centralization of services, continuous print technology and process refinements, and ongoing staff training.

Print ServicesCostAvoidance

$1,246K$85K

RevenueGenerationServices

$1,331K

TotalBenefits

$1,069K

$262K

CentralPrint ServicesCost

NetBenefits

Figure 1. Project Cost and Benefit Analysis (YTD May 2014)

“Xerox lives the mission, vision, and values of Methodist.”

– Geoffrey Crabtree, Senior Vice President

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Regulatory ComplianceMethodist executives say that the central printing model has been instrumental in helping the healthcare system meet complex legal and regulatory requirements, including mandates from Medicare, Medicaid, the Joint Commission, and other bodies. Recently, for example, Medicare mandated that all physician signatures also include a date and time, forcing modifications to existing forms.

Using online tools, the print center easily updated hundreds of forms to ensure immediate compliance. And because the print center prints nearly everything on demand — and maintains no physical inventory — Methodist can avoid the waste of throwing out stockpiles of old forms.

Similarly, Methodist’s print center rapidly redesigned a standard disclosure and consent form to meet new medical record requirements; and the center stayed ahead of a new federal mandate by proactively ordering supplies of specialized security paper for writing prescriptions – a move that also helped boost security.

Brand ProtectionThe Xerox in-house print operation has maintained 100% compliance with the hospital’s branding guidelines as well as legal and regulatory requirements. Enforcing these standards is crucial, executives said, because it ultimately influences perceptions of Methodist’s value in the marketplace. “When we give patients information about their after care, we need to ensure it’s sophisticated

in its approach and has a production value that mimics the organization it represents,” Crabtree explained.

The print center’s proactive attitude extends to quality checking every piece that goes out. Every person working at the center is trained to understand and enforce Methodist’s brand and publishing standards, so when they receive a printing request, workers routinely examine the document for correct branding — such as proper logo placement — and adjust the layout as needed.

Waste ReductionThe print center team also watches out for potentially wasteful printing requests, and routinely questions jobs that consume high quantities of paper or use color output unnecessarily. Long-term stockpiling of printed pieces is discouraged. Whenever possible, the center tries to produce materials on demand and just in time, and it’s not uncommon for the center to suggest smaller print runs to achieve this goal. In some case, the staff will recommend not printing a piece in favor of digital alternatives.

Productivity Boost Efficiency improvements and automation made it possible for Methodist to keep staffing levels at its printing operation steady over time; and with Xerox’s help it is constantly re-aligning resources to squeeze out additional costs. For example, most of the staff has been cross-trained to work in different parts of the opera-tion, adding flexibility to the production

“Maintaining consistency in the use of our logos and the names or our hospitals is important. Xerox has been a great help in enforcing our graphical standards and protecting our brand image.”

– Palmira Arellano, Vice President, Marketing and Public Relations, Methodist Healthcare System of San Antonio

Looking AheadXerox and Methodist continue to brainstorm new ways to boost efficiencies and promote employee collaboration and creativity. Promising opportunities include:

• Adding mobile print capabilities so employees can print from their smart phones, tablets and other mobile devices while visiting different facilities.

• Connect more devices to the network. Plugging the remaining 40% of non-networked printers into the network will give employees more output options and flexibility.

• Adding managed print services (MPS) could offer Methodist more savings through proactive maintenance and consumables replenishment and free employees from fleet-management tasks.

LegacyEnvironment

2 Minutes

1/2 Minute

XeroxEnvironment

83%

Figure 2. Electronic Job Ticket Submission (Minutes)

©2014 Xerox Corporation. All rights reserved. Xerox®, Xerox and Design®, and iGen4® are trademarks of Xerox Corporation in the United States and/or other countries. BR11811

process. A worker in the bindery area, for example, may also be trained to run the high-capacity Xerox® iGen4® Press.

Automation also has reduced the need for additional labor. In the bindery department, for example, new programmable cutting and folding machines made it possible for one employee to handle the entire work- load. The ability to run several pieces of equipment simultaneously adds to the efficiencies. Xerox also found that by staggering job shifts, it could keep the print center open longer and offer personnel a wider choice of work schedules, increasing satisfaction.

About Methodist Healthcare System of San AntonioFor more than 50 years Methodist Healthcare has provided high quality care to patients from San Antonio, its 26 surrounding counties and from around the world. Methodist Healthcare is recognized as the most respected and preferred healthcare provider in San Antonio because of its outstanding team of nurses, medical professionals and physicians. More San Antonians turn to Methodist than any other hospital or health care provider.

About XeroxSince the invention of Xerography 75 years ago, the people of Xerox have helped businesses simplify the way work gets done. Today, Xerox is the global leader in business process and document management, helping people be more efficient so they can focus on their real business. Head-quartered in Norwalk, Conn., United States, more than 140,000 Xerox employees serve clients in 160 countries, providing business services, printing equipment and software for commercial and government organizations.

Centralized Print Services in Action Methodist relies on Xerox® Centralized Print Services to produce and distribute crucial patient education materials and communications. One high-volume “customer” is Methodist Children’s Hospital and Women’s Services. The department’s materials include:

• Physician office brochures. Methodist provides community doctors with informational brochures that end up in the hands of patients. Representatives of Methodist’s pediatric and women services visits more than 150 doctor’s offices a month, helping set up brochure racks where needed. Xerox® Centralized Print Services helps replenish these racks

• Pediatric Directory. Centralized Print Services produces this colorful 40-page directory of Methodist’s pediatric providers and specialists that includes photos and contact information. The directory is updated once a year by Xerox® Centralized Print Services.