Issue: Second Quarter of 2009

Kanawha County Emergency Ambulance Authority
Larry Cole, KCEAA Director of Finance

Kanawha County Emergency Ambulance Authority (KCEAA) was created in 1977 by an act of the Kanawha County Commission to ensure quality and reliability of ambulance services to the citizens of Kanawha County. In the thirty-one years of its existence, KCEAA has undergone many fundamental changes in its business model including its entry into the non-emergency transportation market in 1994 with the acquisition of a transport company.

KCEAA has become a regional health care transportation provider for not only the citizens of the county, but also a provider of 911 service and emergency assistance to contiguous counties as well. Additionally, KCEAA is cornerstone to the State’s emergency preparedness planning. In 2007, KCEAA entered into an agreement with American Medical Response (AMR), a national ambulance service, to provide resources to the Federal Government in times of disaster.

KCEAA now staffs a peak of 31 Advance Life Support (ALS) units as well as paramedic certified operations supervisors. Additionally, KCEAA employees support staff in areas of Communications, Billing, Maintenance, Account Payables and Training to accomplish the mission of providing quality service to all patients encountered.

Since 1992, KCEAA has understood the advantage that technology plays in the deployment of emergency units. Starting with the Olmstead review of technology, KCEAA has prided itself on using cutting edge technology in the pursuit of efficiency and effective delivery of services. As a result, each of the outlying stations is equipped with a high-speed internet connection and a desktop computer for use by the ambulance crews. More importantly, the Central office complex has hundreds of thousands of dollars of computer technology currently in use to provide multiple services to the staff, community and steak holders. These systems include, Computer Aided Dispatch (CAD), Billing platforms, Accounting platforms, Accounts payable software, Time/Attendance software, just to name a few.

Where KCEAA is lacking is the ability to communicate with mobile units through this computer infrastructure. With the advent of the West Virginia State’s initiative to use electronic Patient Care Records (ePCR), KCEAA is reliant upon several decisions that will need to be made to carry us into the next decade and beyond.

What makes your service unique?
KCEAA serves as a local 911 provider and regional transport provider covering 952 square miles of an unique geographical mix of urban and rural area, with a river splitting the county. These factors can cause response times that range from 2 – 20 minutes; the AVL technology helps immensely to deploy assets within these challenges.

KCEAA also bills for four other services using the Sweet-Billing software. Although KCEAA averages 70,000 calls annually, when combined with what they bill for the other four services, the KCEAA billing department processes a total of 83,000 calls a year which carries a value of approximately $27,000,000 – on a billing staff of 10! Currently, the KCEAA billing department averages a four day turn around from haul to bill, but when they have all of their planned systems in place by 2010 (which includes implementation of the Fusion electronic patient care reporting application), the goal is to achieve zero-day billing.

KCEAA prioritizes employee satisfaction and well-being near the top of their concerns. In addition to authentically valuing their employees from the Executive Director Joe Lynch, on down, KCEAA also offers many unique benefits for their employees. One of the newest benefits in the billing department involves a telecommuting option, in which employees can work from their respective homes and connect through terminal services to access their computer and applications. This not only allows more flexibility for employees, but also allows office space to be utilized for other purposes. Another technological implementation that has made their billers’ jobs easier is the scanning project that KCEAA has employed. The digitizing of documents allows employees to locate information quicker and easier, and also saves on space required to store the mounds of paper required when working in healthcare and with state policies.

Other unique employee benefits offered at KCEAA include:

• Chaplin Support – KCEAA keeps a full-time Chaplin (who is also an EMT) on staff to support the spiritual and emotional health of their employees
• Critical Incident Stress Management
• Peer Support Teams
• Full-time Educational Department (offers 24-hour access to accommodate various employee shifts)

Software programs in use:
Ortivus Sweet-Billing and Sweet-CAD, E-Pro Scheduler and (soon) Fusion ePCR

• E-mail and Administrative Systems
• Scanning Project (Software: World Docs)
• Computer Aided Dispatch
  – AVL
  – Messaging
• Billing System
  
• Payroll
  – Scheduling
  – Education Requirement Tracking
• Accounts Payable
• Time Attendance Software
• Accounting Application
• Drive Cam
• Supply and Inventory
• EKG Transmission
• Office Phone System
• Security Camera System
• Digital Voice Logging Equipment
  

What advice would you offer other EMS services that you wish you may have known when you first got into this business?
“EMS, like other healthcare industries are on the edge of a potential extensive shift in Federal reimbursement methodology. This methodology may in fact be based on quality and patient outcomes. Information technology will need to be accelerated in many organizations to ensure a stable fiscal outlook for the future. The only foreseeable way to initiate such change is to create systems to decrease error, both clinical and clerical as well as to speed the cash flow cycle from call to receipt.”