October 8th, 2009

Stuart GaddyNCR Corporation

SWVTC Medical Technology SummitHealthcare Self Service Solutions

What is Self Service?... That’s Not It!What is Self Service?... That’s Not It!

Self Service has Arrived !!!

So… What is Self Service?So… What is Self Service?

•Without even realizing it, you probably complete several self service transaction every day.

•Remember when…

You had to walk into a bank, wait in a line, speak with a teller, and even fill out withdrawal forms - just to get $20 bucks from your account?

or - when you had to walk into the gas station to pay for gas?

or - when you had to go to the movie store to rent a DVD?

or - when you had to call the doctors office and wait on hold to schedule an appointment or fill out those same paper forms every time you visit? You still do? Not for long!!!

Self-Service is EverywhereSelf-Service is Everywhere

October 2008 NCR CONFIDENTIAL AND PROPRIETARY 4

BankingBanking HotelsHotels

HealthcareHealthcare AirportsAirportsRetailRetail

Bill PayBill Pay

Healthcare Solutions 5

This is NCR…This is NCR…

•Market Share:– #1 in Healthcare Self-Check-In– #1 in Global ATM Sales– #1 in Retail Self-Checkout– #1 in Airline Self-Check-In– #2 in Entertainment Kiosks– #2 in POS Retail Terminals

•Employees: 23,200•Countries: >100•Founded: 1884•2008 Sales: $5B

23B Self-Service Transactions Annually More than 5 Million Patient Check In’s 580,000 Touch-Points/Units Installed

Over $2B in Self Service revenue

Largest Self-Service Organization in the WorldLargest Self-Service Organization in the World

FinancialSelf Check

OutHealthcare Hotel Airline

Bill Pay / Food Order

Just a few of NCR’s Self Service Offerings and CustomersJust a few of NCR’s Self Service Offerings and Customers

Meeting ObjectivesMeeting Objectives

•Understand the benefits and impact of a patient self-service solution.

•Review strategies for integrating self-service applications with core IT applications.

•Discuss best practices for securing adoption of the technology among patients, executives and staff.

•Establish metrics for tracking the effectiveness of self-service applications.

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The way we interact and transact is changingThe way we interact and transact is changing

Self-Service is GrowingSelf-Service is Growing

• Self-service will account for 58% of all customer service interactions by the end of 2010

• Consumers will spend $1 trillion through self-service by 2011

• Retailers show a 6-8% increase in incremental sales when kiosks are placed in the store

• There will be approximately 1.3 million kiosks installed in North America by the end of this year

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The Wait We Hate the MostThe Wait We Hate the Most

Results from Opinion Research Corporation – Commissioned Study by NCR

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Q: Why would you choose self-service over personal assistance ?

Key FindingsKey Findings

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Q: Why was “I trust myself and the self-servicetechnology more” one of your top choices?

Key Findings - HealthcareKey Findings - Healthcare

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Why Healthcare Self Service?Why Healthcare Self Service?

So… what do you want from your Healthcare Self Service Solution?So… what do you want from your Healthcare Self Service Solution?

• A better Patient Experience• A better Staff workflow• Increased Productivity• Decreased Errors• Reduced Denied Claims• Improved Profit Margins • Increased Revenue • Reduced Wait times• Increased Privacy & Autonomy• Decreased Operational Costs• Reduced Language Barriers• Improved Collections• Decreased Duplicate Records• Eliminated Paper usage • Increased time to spend with patients• and so much more…

It comes in all shapes and sizes! Here’s what to consider…It comes in all shapes and sizes! Here’s what to consider…

Self Service Solutions can be as complex or as basic as you wish.

• Integrated Solutions vs. Stand Alone Solutions– Do you want to tie into your other applications to exchange data?– Do you want to fully automate processes or keep things modular & manual?– Do you want to have the cleanest / most up to date records?

• Multi-Channel vs. Single Channel Approaches– Do you want to offer Online Services?– Do you want to offer Onsite Kiosks?– Do you want to offer Mobile services?– Do you want them to all play well together?

• Customized Workflows vs. Off the Shelf Workflows– Do you want to personalize your Self Service Applications?– Do you need functionality that is not off the shelf?– Do you want the autonomy to make changes moving forward?

Multi-Channel Approaches to Self-Service offer greater value to Providers & PatientsMulti-Channel Approaches to Self-Service offer greater value to Providers & Patients

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Pre-registration

Bill Payment

Secure Messaging

Self Scheduling

Personal Health Record

Patient Check-In

Paperless Workflow

WayFinding

eSignature

Co-Payment / Account Payment

Insurance Card / License Scanning

Remote Check-In / Authentication

Scheduling Notification

Lab Results Delivery

Physician/Staff Activity Monitoring

1

2

3

4

5

6

7

Workflow Sample of a Multi-Channel Self Service Patient ExperienceWorkflow Sample of a Multi-Channel Self Service Patient Experience

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DOCUMENT IMAGINGDOCUMENT IMAGING

EHR / EMREHR / EMR

SCHEDULINGSCHEDULING

ADT / EPMADT / EPM

BILLINGBILLING

Applications Layer

Integration to Existing Applications is Critical Integration to Existing Applications is Critical

Self-Service Platform

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Select Vendors with Integration ExperienceSelect Vendors with Integration Experience

Company logos and trademarks are property of their respective holders.Company logos and trademarks are property of their respective holders.

Benefits of a Patient Registration Kiosk SolutionBenefits of a Patient Registration Kiosk Solution

•Positively Identify your Patient•View and update their demographic information•Confirm that insurance information is accurate & complete

•Register for a specific appointment•View and update any information regarding that appointment

•Pay co-pay or other outstanding balances•Electronically review & sign required forms•Complete any needed surveys•Provide directions to service area

Benefits of offering Flexible Device OptionsBenefits of offering Flexible Device Options

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Wireless TabletsPerfect for areas where multiple patients check-in simultaneouslySolves issues where space is limited to implement stationary devicesAllows for Patients to register from the comfort of their seat or

wheelchairMost similar to paper-based registration processes

Freestanding KioskOffers ability to add peripherals, such as printers & card

scannersHighly accessible and clearly visible to incoming foot trafficIdeal for high-traffic environments

Desktop KioskCommon to deploy in existing Registration Desk settingsFlexible mounting options, from tabletop to wall mounts

Can be mounted at Wheelchair accessible heightsSmall footprint does not take up too much desk space

Sample Point of Service Kiosk – Patient Workflow…Sample Point of Service Kiosk – Patient Workflow…

Can be deployed in multiple Can be deployed in multiple languages such as Spanish, languages such as Spanish,

French, etc.French, etc.

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Positive Patient IdentificationPositive Patient Identification

Authentication can occur via credit Authentication can occur via credit card, health plan card, Military ID or card, health plan card, Military ID or

by manual authentication.by manual authentication.

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Demographics ReviewDemographics Review

Patients can review their Patients can review their related demographics, related demographics,

contacts, guarantor and contacts, guarantor and insurance information.insurance information.

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Self Service Scanning Self Service Scanning

Patients can scan Patients can scan Insurance Cards and Insurance Cards and

Drivers Licenses Drivers Licenses themselves via the Kiosk.themselves via the Kiosk.

Visit and Patient Specific ConsentsVisit and Patient Specific Consents

The patient reviews visit The patient reviews visit specific consents and signs specific consents and signs

directly on the device.directly on the device.

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Co-Pay and Bill-PayCo-Pay and Bill-Pay

The patient is presented The patient is presented with co-pay and/or bill with co-pay and/or bill

payment options…payment options…October 2008 NCR CONFIDENTIAL AND PROPRIETARY 27

Survey CollectionSurvey Collection

Patient Experience Survey Data Patient Experience Survey Data can be easily captured.can be easily captured.

Benefits of Improved Staff Activity MonitoringBenefits of Improved Staff Activity Monitoring

•Staff easily monitors the Kiosk Activity from an Activity Monitor or “Dashboard”.

•This is similar to the scenario you have all seen deployed in a Retail self check out environments, where 1 staff drives a cluster of terminals via a workstation or handheld device.

•This is a process change from Serial to a Parallel workflow.

•Far more efficient to Manage by Exception vs. manually executing each step - for each Patient.

•Visual icons allow for quick snapshots of Patient progress & interaction when required.

•Allows you to easily identify changes that should be confirmed, monitor arrival & wait times, and Triage patients accordingly.

Activity Activity Monitor Monitor

Grouping Grouping enables enables staff to staff to

manage the manage the work-list.work-list.

Patient Patient tracking for tracking for

Business Business Activity Activity

Monitoring Monitoring metricsmetrics

Activity Monitoring Cont…Activity Monitoring Cont…

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Edited fields are Edited fields are highlighted for review with highlighted for review with before/after comparisons.before/after comparisons.

Staff Review of Patient ChangesStaff Review of Patient Changes

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Move from a Serial to a Parallel ProcessMove from a Serial to a Parallel Process

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Serial : 1 staff to 1 Patient per Registration Transaction

Serial : 1 staff to 1 Patient per Registration Transaction

Parallel : 1 Staff can simultaneously transact with

multiple Patients

Parallel : 1 Staff can simultaneously transact with

multiple Patients

Role of the Registration Staff in a Self Service EnvironmentRole of the Registration Staff in a Self Service Environment

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• Staff now becomes a “patient registration partner”, assisting those who need more guidance.

• Patients that do not require additional assistance can move through the process faster, with greater levels of autonomy and increased privacy.

• Staff will now have much more time to give the attention to those individuals that require it.

• Staff now becomes a “patient registration partner”, assisting those who need more guidance.

• Patients that do not require additional assistance can move through the process faster, with greater levels of autonomy and increased privacy.

• Staff will now have much more time to give the attention to those individuals that require it.

Benefits of an Online Patient Portal Benefits of an Online Patient Portal

• Simple User Enrollment Process• Online Pre-Registration• Online Bill Pay • Appointment Requests & Self Scheduling• Secure Messaging• Personal Health Record• Prescription Refill Requests• Drives Revenue• Increases Convenience• Builds Patient Loyalty

Sample Online Patient PortalSample Online Patient Portal

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Sample Online Pre-RegistrationSample Online Pre-Registration

Sample On Line Bill PaymentSample On Line Bill Payment

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Appointment Requests / Self SchedulingAppointment Requests / Self Scheduling

Sample Personal Health RecordSample Personal Health Record

Mobile Check-In / Appt. Reminders:- Reduce No-Shows- Reduce Administration Overhead- Reduce Lost Revenue- Patient commits through Active Messaging- Can be configured to allow patient to request a new appointment time.

Mobile Bill Payment:- Ability to pay bill via mobile

- Payment type can be stored in a secure wallet

- Ability to Select Method of Payment- Ability to Select Amount to Pay

-

Sample Mobile Self Service Transactions:Check-In / Bill PaymentSample Mobile Self Service Transactions:Check-In / Bill Payment

October 2008 NCR CONFIDENTIAL AND PROPRIETARY 40

Make sure you Projects get the right levels of support.Make sure you Projects get the right levels of support.

The most critical factor in a successful Self Service project is having the right “People Processes” in place to support the

technology.

It takes “Buy In” at all levels for optimal results!• Patient Buy In

• Staff Buy In• Executive Buy In

Let’s talk about how to get there…

Buy-in at the Patient LevelBuy-in at the Patient Level

• Easy-to-use design

• Patients can ask for help at any time during the process

• Introduction of kiosk to patient prior to arrival • Staff assessment of readiness for self service

• Ability to step out from “behind the desk” to be a partner with the patient

• Positive outlook on process with positive promotion from staff to patients

October 2008 NCR CONFIDENTIAL AND PROPRIETARY 42

Buy-in at the Staff LevelBuy-in at the Staff Level

• Staff is the key to success at implementation

• Careful evaluation of the staff acceptance of self-service technology

• Staff must be able to multi-task

• Preparation of staff well in advance of install to make them part of the process

• Ability to step out from “behind the desk” to be a partner with the patient

• Positive outlook on process with positive promotion from staff to patientsOctober 2008 NCR CONFIDENTIAL AND PROPRIETARY 43

Buy-In at the Executive Level Buy-In at the Executive Level

• Create a compelling case for self service in other industries

• Present cost savings opportunities

• Present a potential ROI for the investment

• Minimize the risks by offering a pilot project

• Site visit in a more challenging environment than your own

• Strive to the be the first in your competitive markets

October 2008 NCR CONFIDENTIAL AND PROPRIETARY 44

Potential Impacts: Check-In Process Improvement / Patient Flow Potential Impacts: Check-In Process Improvement / Patient Flow

Minutes

Potential Impacts : Savings from Forms and Staff timePotential Impacts : Savings from Forms and Staff time

October 2008 NCR CONFIDENTIAL AND PROPRIETARY 46

Fewer bad addresses using kiosk demographic validation process.

Fewer bad addresses using kiosk demographic validation process.

Reduced average days to final bill by almost 2 days!Reduced average days to final bill by almost 2 days!

Potential Impacts: Finance / Billing ROIPotential Impacts: Finance / Billing ROI

36% reduction in denial rates!36% reduction in denial rates!

40% increase in copay collection rate!40% increase in copay collection rate!

Potential Impacts: Finance / Billing ROIPotential Impacts: Finance / Billing ROI

Follow a well established Delivery ModelFollow a well established Delivery Model

Healthcare Self Service Value Healthcare Self Service Value

Creates a more Ideal Patient Experience

Helping you deliver Faster, Safer, Better Healthcare

- Expedite processes & reduce wait times

- Better Data Integrity

- More Patient Autonomy

Drives Greater Business Productivity

- Create a more Efficient process & Increase throughput

- Free up resources for more high value tasks

Reduces Operational Costs & Grows Revenue

- Eliminate Paper, Print, and handling costs.

- Grow Revenue

- Improved Collections

- Less Claim Denial

- Account Mgt / Payment options

- Increased capacity for greater business volume

Questions?

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