CASE STUDY

HealtHPartners

Demographic Information• HealthPartners,Minnesota• 1.4millionmedialanddentalinsurancemembers• SixHospitals• 1,700physicians• SustainabilityLead-CreatedapositionofaSustainabilityProgram

Managerin2011.

Asthelargestconsumer-governed,nonprofithealthcareorganizationinthenation,HealthPartnersintegratescare,coverage,researchandeducationtoimprovethehealthofitsmembers,patientsandcommunity.HealthPartnershealthplanprovidesaccessto700,000doctorsandothercareprovidersfor1.4millionmedicalanddentalinsurancemembers.TheMinnesota-basedhealthsystemalsooperatessixhospitalsrangingfrom25-bedcriticalaccesshospitalstothe454-bedRegionsHospitalandemploysover1,700physicians.Withover20yearsofenvironmentalmanagementexperience,DanaSlade,MS,CHMMhasbeentheSustainabilityProgramManagerforHealthPartnerssince2011.

the ProblemToprovidehealthservicestoitspatientsandhealthplancustomersin2011,HealthPartnerspurchased195,000reamsofofficepaper,enoughtomake26stacksastallastheEmpireStateBuildingoutof11,700trees.Excessivepaperuseimpactstheenvironment,costofcare,andqualityofcare.Thecostof

ExecutiveSummary

Functioningasahospitalsystemandinsuranceplan,HealthPartnersisacomplexorganizationwhereofficepaperisusedinmyriadworkflowprocessesthathavetoconsidergovernmentregulationsonprotectedhealthinformationdocumentation.HealthPartnerstookadvantageofhealthinformationtechnologyandmechanicalstrategiestoreducepaperuseby17percentacrosstheorganizationbetween2011and2012.ThePaperReductionTeamimplementedsystem-widestandardduplexprinting,paperlessmeetings,eliminationofautomaticallyprintedreportsandconductedworkflowevaluations.ThelargestsourceofpaperreductionhasbeenattheDataCenterprintshopthatmailslettersandotherplandocumentstohealthplancustomers.Byallowinghealthplancustomerstoopt-inforelectronicdeliveryofinsurancedocumentsduringonlineregistration,thenewhealthplanquicklyreducedpaperuseatthedatacenterby38percent.

Paper reduction

purchasingpapermayseemsmallcomparedtoahealthsystem’soverallbudget,butassociatedcostsinflatetheactualcostofpapermanagement13-31timesmorethantheupfrontcostofprocurement.Purchasingandmaintainingprintersandscanners,postage,employingworkerstofileandarchivepaperworkandshreddingprotectedhealthinformationareafewwaysthecostsofmanagingpapercanquicklyaddupforahealthcareorganization.

Thetransitiontoelectronichealthrecordsfrompaperrecordsisdrivenbypatientsafetyandhealthcarequality.AglobalcomparisonofphysiciansnotedthattheUnitedStatesislaggingontheadoptionofhealthinformationtechnology(HIT).Inaddition,HealthPartnersmembersandpatientshaveexpressedapreferencetoreducethevolumeofpaperdocumentstheyreceivefromHealthPartners.HealthPartnersclientshavealsoshowntobesupportiveoftheconvenienceassociatedwithelectronichealthrecordsatregularhealthplanmemberoutreachmeetingsandpatientresearchsessions.

strategy & ImplementationManyinstitutionalbarriersmakeitdifficultforhealthcaretofullyembraceHITandsubsequentlyenjoytheenvironmental,costandqualitybenefitsofbecomingmorepaperless.Asbothahealthcareproviderandinsuranceprovider,HealthPartners

hastakenstepstoaddresspaperuseinbothpatientcareanditsinsurancebusiness.

Initspatientcarearea,HealthPartnersestablished“GreenTeams”acrossthesystemtoworktowardsacomprehensivesetofsustainabilitygoals.ThePaperReductionTeam,asubcommitteeoftheGreenTeam,begantotrackquarterlydataonpaperusewiththeirmainvendor,OfficeMax®,andimmediatelyrecognizedopportunitiesformoreefficientpaperuse.WiththesupportofHealthPartners’executivesponsors,theteamselectedareasonablegoaltoreducepaperuseby10percentby2012.Theexecutivesponsorsfeltpaperreductionwasconsistentwiththeorganization’smissiontodrivedownthecostsofhealthcarewhilesimultaneouslyimprovingthepatient’sexperienceandprovidingenhancedhealthservices.

ThePaperReductionTeamhas

formalmonthlymeetings,sendsaprogresssummarytotheexecutivesponsorcommitteequarterly,andgivesamonthlyupdatetotheSteeringCommittee.Theselinesofcommunicationkeeptheworkteamaccountableforachievinggoalsandallowsforanexchangeofideasbetweenstakeholders.

Foritshealthplanarea,HealthPartnerslauncheda“GoPaperless”teamtoreducetheamountofpaperHealthPartnersmailstoitsinsurancemembers.Theaveragememberreceivesfivetotenmailingsayear—thatmanymultipliedacross1.4millionmembersmakesforasubstantialcasetopromoteelectronicdelivery.Whiletheteamcontinuestoworkunderstateandfederalregulationsforelectronicdelivery,thegoalistogrowthenumberofcustomerswhosignupto“GoPaperless.”Theprojectteam,ledbyKimberlyDelaney,SeniorManagerRegulatoryImplementation,

CASE STUDYPaper Reduction

andHaiVyThompson,ManagerDirecttoConsumerMarketing,workedwiththelegaldepartmenttocarefullydefinethetermsandconditionsoftheHealthPartnershealthplandigitaltransition,includingabackuppaperprocessandrecoverysystemforinvalidemailaddresses.HealthPartnersbeganelectronichealthplancorrespondenceswiththe2006launchofthe“SecureWebMailbox.”

Implementation ProcessThePaperReductionTeamstartseveryprojectwithamemotothedepartmentmanagerdescribingtheprojectandaskingwhetherthechangewillnegativelyaffecttheirwork

process.Tomakesureadepartment’sworkprocessesareappropriatefortheproposedimprovements,theteammeetswiththemanagerandemployeesofeachdepartment.

Theteambeganwithmechanicalchangesthatrequiredverylittleinvestmentintimeorresourcessuchasswitchingtoduplexprintingasthedefaultsetting.Faxesformultiplepatientsandolderprintersareexamplesoftimesthatduplexprintingdidnotworkforacertaindepartment.Theteamworkedtostopunneededlaboratoryandanesthesiareportsfromautomaticallyprinting.Thesereportsarenowkeptelectronically.HealthPartnersalsomovedtopaperlessmeetingswithtelevisionsorprojectorsinmanymeetingareastoreducethedependenceonpaper.

DanaSlade,SustainabilityProgramManager,challengedthePaperReductionTeamtoexamineworkflowprocessesforefficiencyupgrades.ThePaperReductionTeamuseddatafrominnovativeevaluationtoolssuchastheRapidProcessAssessment(RPA)methodtofindmanyprocessimprovements.AthirdpartyconsultantcompletedanRPAforHealthInformationManagementdepartments.Anotherprojectidentifiedbythepaperreductionteamwastoincreasefaxingefficiencyinthepatientaccountingdepartment.Insteadofprintingelectronicfaxes,affixingamedicalrecordnumber,andthenscanningitbackintotheelectronicmedicalrecord,staffmembersnowhavethesoftwareabilitytoelectronicallyattachthe

medicalrecordnumber.Inoneweek,thepatientaccountingdepartmentatoneclinicdecreasedprintingfrom1,350sheetsto37sheets.Eachprogramispilotedoverafewmonthsbeforeitisexpandedsystem-wide.

Afterinsurancememberadoptionofthe“SecureWebMailbox”hitaplateauof57,000members,KatieSayre,SeniorVicePresidentofHealthPlanOperationsandGovernmentPrograms,spearheadeda“GoPaperless”initiativetargetedtowardallmembersin2011.AccordingtoDelaney,themainreasonforthecampaign’ssuccesscamefrombuildingtheoptiontosignupforpaperlessdeliveryintoonlineregistration.Eachnewhealthplanmemberisautomaticallypresentedwithamessageexplainingtheelectronicdocumentdeliverysystemandaneasyprocesstoaffirmordeclinethefeature.Theplanmemberisalsoabletoselectthetypeofdocumentsheorshepreferstohaveelectronicallyversusonpaper.Theplan’smemberservicesrepresentativesalsopromotethefeaturewhentalkingtomembersandoffertoassistmemberswithsigningup.Bymakingthesign-upprocesssimpleandupfront,HealthPartnershealthplanallowsmemberstoquicklyreducetheuseofpaper.

BenefitsOver 2011-2012:

1.HealthPartnersreducedpaperuseby17percent(down36,000reamsfrom195,000to161,000reams).

CASE STUDYPaper Reduction

HealthPartners Paper reduction teamViniManchanda,Senior Director, Supply Chain

PegYounghans,Director, Corporate facilities

GinaHall,Senior Director, IS&T Services Delivery

KrisDudziak,Senior Manager, Business Operations

BobSerreyn,Manager, Supply Chain

KevinCzaplewski,Administrator, Office Services

AndreaRooney,Senior Administrative Assistant

LizNicklos,Senior Communications Consultant

DanaSlade,Sustainability Program Manager

2.Thein-houseprintshopsawthegreatestdecreaseof38percent(9,000reams).

3.Annualpaperpurchasesdecreasedby$100,000

4.Papermanagementsavings(printing,filing,shredding,recycling,etc.)areestimatedtobeaminimumof$500,000peryear.

5.260,000healthplanmembers,nearly20percent,receiveelectronicdeliveryofhealthplandocumentseachyear.

Challenges and lessons learnedThePaperReductionTeaminitiallyfacedacomplexproblemwithmanycompetingprioritygroups.Astrong,consistent,butflexibleapproachhelpedtheteamuniteimpactedstakeholdergroups.Asimilarmissionappliedtoallhealthsystemsacrossthecountrycanmeansignificantsavingsincostandenvironmentalimpact.

Sladehasfoundthatthesizeofthedepartmentdidnotimpactpaperreductionprogramimplementation.Rather,eachdepartment’sinternalcultureandleadershipreceptivenesstothechangeshadthegreatestpositiveeffectonmeetingpaperreductiongoals.Astrongrelationshipwiththeirpaperprovider,OfficeMax®,wasintegraltodatacollectionforeachfacilityanddepartmentatlargefacilities.

AccordingtoDelaney,HealthPartners

healthplanwillcontinuetoworkwithregulatorstoallowmoreflexibilitytodeliverinsuranceplaninformationonlineandtopromotethiscapabilitytodriveevengreateradoption.Thenextgenerationofhealthconsumerswhogrewupwithtechnologywillexpecthealthcaretobeevenmoredigitized.“Wearecurrentlyinanin-betweenphaseamonggenerationsandweexpectsignificantgrowthinmembershipwantingelectronicdocumentsinthefuture,”saysDelaney.

HealthPartnershassetanother10percentreductiongoalfor2013asapartofatwo-yearsustainabilityplan.Theirdatapointstomaximizingfeaturesinsoftwaresuitesasafutureareatosavethousandsofsheetsofpaperperday.

endnotesi. About us. (2013). Retrieved August 14, 2013,

from http://www.healthpartners.com/public/about/

ii. Quick facts. (2013). Retrieved August 9, 2013, from http://www.healthpartners.com/public/about/quick-facts/

iii. Trees into paper. (2013). Retrieved August 14, 2013, from http://conservatree.org/learn/EnviroIssues/TreeStats.shtml

iv. Become a paperless office. Retrieved August 16, 2013, from http://www.reduce.org/paper/index.html

v. Health information technology in the United States: Better information systems for better care, 2013. (2013). Robert Wood Johnson Foundation.

vi. Schoen, C., Osborn, R., Doty, M., Squires, D., Peugh, J., & Applebaum, S. (2009). A survey of primary care physicians in eleven countries, 2009:

Perspectives on care, costs, and experiences. Health Affairs, 28(6), w1171-w1183. doi:10.1377/hlthaff.28.6.w1171

vii. D. Slade, personal communication, July 30, 2013.

CASE STUDYPaper Reduction