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How new technology will improve hospital efficiency

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.


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