A digital room-service system that clinically validates the menu presented to each patient has slashed meal costs and boosted user satisfaction in a three-hospital pilot program at Scottsdale Healthcare in Scottsdale, Ariz.
The not-for-profit healthcare provider partnered with a pair of software companies, San Diego-based Skylight Healthcare Systems and Computrition Inc. of Chatsworth, Calif., to develop and deploy the system known as "At Your Service Dining." In place since last May, the technology permits Scottsdale Healthcare patients to self-order meals using the remote control for their in-room television.
At Your Service Dining is offered at Scottsdale Healthcare's 420-bed Shea, 370-bed Osborn and 70-bed Thompson Peak hospital campuses.
Betty Ann Stephenson, Scottsdale Healthcare's director of hospitality, described the technology as "a win for us" that turned out "even better than I expected."
Hospitals often take patient meal orders at bedside with a tablet computer or let patients phone in orders to an employee. In contrast, Scottsdale Healthcare's digital room service lets patients navigate a restaurant-style menu on their TV screen, perusing photos, descriptions and nutritional information for the foods offered. They can order whatever they want, provided the food is not prohibited by dietary restrictions tied to their treatment, by pushing buttons on a pillow-speaker remote control.
Full room service is available on demand between 6 a.m. and 8 p.m. daily, with an abbreviated menu offered during off hours.
Providing the system's intelligence are two software applications linked by a bi-directional data transfer system. On the front-end is Skylight Access Interactive Patient System, a bedside communication and meal-ordering solution with a proprietary user interface. On the back end is Hospitality Suite, Computrition's foodservice and diet-office management software. An add-on module called TouchPoint Dining keeps the two in communication using the XML programming language.
One of Hospitality Suite's key functions is to align the on-screen menu options seen by patients with dietary restrictions placed on them by their physician or individual allergies, if any.
"When a patient sees the menu displayed on the TV screen, it has already been pre-corrected for their diet," said Stephenson. "Only the things they're allowed to have are displayed, so you don't have fights with patients over menu choices."
Anutritional recap on the screen displays the calories, protein, carbohydrates, fat and other metrics of the meal for the patient's review prior to confirming the order and sending it to the kitchen.
With the dietary department intervening less in meal orders, Scottsdale Healthcare has consolidated three call centers for dietary ordering down to one. In addition, plate waste and the cost of food and supplies have been reduced sharply. Plate waste, for instance, is below 10 percent now, compared with about 20 percent previously, Stephenson said. That's quite positive for hospital foodservice, which considers food "a part of overhead," as she put it. All told, the hospitals have saved about $1 per meal with the system. She pegged the hospital's per-meal budget at $3.06, including food, supplies and labor.
Stephenson said food and supply costs are down because patients order less food but eat more of it. "Our patients tell us they like seeing exactly what they're getting on the screen, and they like taking their time planning a meal online without the pressure of an operator prompting them," she said.
Lower food and supply costs have more than offset the cost of adding six full-time employees to deliver room service orders, which come at all hours now, not just at mealtime. The projected savings at the Osborn campus alone is $270,000, Stephenson said.
Patient satisfaction is higher, too. The Osborn campus has registered the highest score, in the 99th percentile, for five months in a row, with the other two hospitals running in the 80s. All told, 25 percent of patients use the online room service option, less than the initial target of 30 percent, but still a great reduction in department workload, Stephenson said.
Patient feedback from an online survey has helped the dietary department refine its room service choices. The initial menu was kept brief in the belief that patients would dislike scrolling through multiple screens. Instead, they have demanded more variety, especially in home-style items. "We forgot how important comfort food is when you don't feel well," said Stephenson. Thus, things like a grilled cheese sandwich and a macaroni and cheese entrée have been added to the 22-item lunch and dinner menu.
It took 18 months to build a nutritional database of all of the kitchen's various ingredients and special-diet combinations. Thanks to the online menu, the total of 22 different printed menus formerly used for the various combinations of special diets has been whittled down to seven.
The only additional piece Stephenson wishes to add is a guest-meal program that lets a patient's visitors order and pay for room service via the TV screen, too. She said she hopes to have a payment-acceptance solution in place for that "within six weeks."
Stephenson speculated that the interactive TV system someday might allow patients to do a variety of other tasks from their beds, such as requesting information from the medical library, ordering items from the gift shop or asking housekeeping for more towels.
According to Scott Saklad, Computrition's president and chief executive, the software package his company licensed to Scottsdale Healthcare cost around $200,000. It covers menu planning, recipe management, ingredient control, inventory, electronic ordering, patient menu services, diet-office services, clinical nutrition management and catering for the three hospitals. Its fees generally range from $50,000 to $400,000, depending on the size of the installation. Computrition also charges an annual maintenance fee equal to 20 percent of the licensing fee.
Other companies providing front-end interactive patient solutions, in addition to Skylight, include McKesson, LodgeNet, TeleHealth, TVR Communications, GetWellNetwork and Cardinal Health, Saklad indicated.
Saklad said Computrition has several proposals outstanding to roll out the program into other hospitals.
The vendor noted that operators in other segments, such as colleges and corrections, ultimately might adopt such technology as well to help manage special diets among their charges. "We've had colleges say that it takes as much time to manage the 10 students who have allergies as it does the 10,000 who do not," said Saklad.
