Description
Instructions:
1) Read case study: Community Medical Associates, attached below
2) Answer the following questions:
- Explain how CMA used the four principles of lean operating systems to improve performance.
- Using information from the case, sketch the original paper-based value chain and compare it to a sketch of the modern electronic value chain that uses a common database. Explain how the performance of both systems might compare?
- What is a total annual record retrieval cost savings with the old (paper-based) versus new (electronic) systems?
- Does this CMA improvement initiative have any effect on sustainability? If so, how? If not, why?
- Using lean principles, can you simultaneously improve the speed and quality while reducing waste and costs? What are the tradeoffs? Justify.
4) Limit: 4 pages, excluding computations.
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CMA case study
Lean operating systems refers to systems which majorly apply approaches geared
towards elimination of wastes in all forms while enhancing smooth and efficient transmission of
information and materials from different segments of a system while reducing costs incurred,
higher quality services and increased customer satisfaction.
CMA adopted the four lean operation principles to enhance their performance. This
included; Quality improvement, speed and response enhancement, waste elimination and cost
reduction. To improve quality, CMA improved clinical quality by basing physician diagnosis on
a complete set of information, highly enhanced database security and quality of information
(Buckley, Grant, and Glazener). This incorporation of lean system reduced patients wait time and
minimized cases of non-diagnosis due to missing data of patients since data could easily be
retrieved from the database by the Doctor in charge, unlike the earlier case where it could take
several days to transcribe patients' medical notes. Similarly, physician diagnosis made it easier to
do physician audit of electronic records, eliminate incoherent records not attached to particular
files and as well made it easier to track the use of documents.
The database played a fundamental role in increasing speed and response time. Initially,
it could take several days or weeks to transcribe patients' medical notes. With the introduction of
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the new system, however, it could now take less than two days. The developed system reduced
the complex set of appointments and schedules that physicians had to attend to patients in
hospitals, centers, and clinics that was time-consuming. The time that was spent by doctors to log
in and off on a different database was much reduced since retrieval of data was made easier from
the system.
CMA immensely minimized waste of resources and reduction of cost by consolidating 50CMA
database into one thereby reducing paperwork by one-half. This move cut on expenses on
patient’s medical chart access and transportation from $4.46 using the paper-based system to
$1.32 with the adoption of the electronic-based system. The new database regime led to
minimization of hand-written physician notes, space required for filing cabinets and shelves for
data storage was reduced and resulted in labor reduction thus saving on wages.
A comparison of the original paper-based value chain and the modern electronic-based value
chain is shown in the table below.
PAPER-BASED VALUE
CHAIN
MODERN ELECTRONICBASED VALUE CHAIN
DATA RETRIEVAL
Billing and patient insurance
were filed in separate database
systems leading to confusions
and constant corrections on
the bills. Patients’ data were
recorded in hospital and offsite pharmacies.
50 CMA Database integrated
into a single database system
that can be accessed through
7000 computer terminals.
Accurate data record resulting
in minimized editing and
corrections of bills.
COST...