Workflow optimization in OPD billing services in a tertiary care teaching hospital in Karnataka: A smart card based system

Background: Outpatient services are medical procedures or tests that can be done in a medical centre without an overnight stay. Outpatient service starts on registration until policlinic services and billing. The quality of service provided by the hospital leads in long queues during registration or billing in out-patient departments. This study looks at measuring the activity time and the waiting time for traditional cash billing service at out-patient departments and then building and implementing Smart card billing system in out-patient departments. Methods: The pattern of workflow of out-patient department was studied. The value of transaction in out-patient departments for the period of one year (April 2016 - March 2017) was analysed. The pattern of patients (new and repeat) to out-patient departments for the period of one year (April 2016 - March 2017) was collected from Medical records department of the hospital. The waiting time and the activity time required in traditional cash billing service was determined via time and motion study. Results: On an average 77% - 82% of the patients visiting out-patient department of the hospital in a day were repeat patients. The average waiting time in traditional cash billing system was 10.65minutes in the morning and 4.23 minutes in the noon. Conclusions: During morning hours (7.30 am to 12.30 pm), the patient traffic is considerably more resulting in long queues and longer waiting time for patients to pay their bill in out-patient billing departments. Smartcard services enable patients to pay their bill immediately in the outpatient clinic and offer greater security and convenience to the patients. Since the percentage of repeat patients are greater than the percentage of new patients, the Smart card was designed to store money (wallet), which would be convenient for the patients for their future visit to the hospital.