ASOURCE Times

As the medical management situation becomes increasingly severe,
Improving the efficiency of back-office operations is essential

The 2012 medical fee revision came into effect on June 1. This time, it was a triple revision, and regardless of the number of hospital beds, all medical institutions, especially the administrative staff, would have been busy taking measures and responding. The majority of the medical costs provided by medical institutions are covered by medical fees, but various expenses required to continue medical treatment, such as work style reform for medical professionals, medical digital transformation, and responding to recent rising prices, are swelling. Furthermore, there has been a continuing shortage of human resources in recent years, and it is impossible to win against general companies with steadily increasing salary levels for human resources. Moreover, the cost of measures to prevent employees from leaving is not included in medical fees, so the more measures are taken, the more the deficit increases, creating a vicious cycle.

On the other hand, the hurdles for obtaining loans to medical institutions are getting higher every year, and funding will not be provided unless a highly viable business plan is presented. The days when loans would be given to medical institutions on the grounds that they are public institutions are over.

As the situation surrounding medical management becomes increasingly severe, it is essential to streamline back-office operations. However, there are limits to what can be done alone, and managers are being asked to change their way of thinking. In other words, now is the time for "loose solidarity" to survive the "hospital ice age." The back-office operations that must be undertaken are common to all hospitals, so the aim is to centralize these operations and reduce the workload and cost burden per hospital.

医療人材やPR・啓発活動の面でも
アライアンス効果が期待できる

　この提案は、航空会社のアライアンスの仕組みをモデルにしています。航空会社の経営は独立採算制が基本です。一方でアライアンスを組むことにより他国の空港での整備の人材や機器を共有し、また航空機を共同購入することで１機の価格を抑えるなど運航を継続するためにかかる費用と集客、バックオフィス業務の効率化を図っています。

　医療界でも以前から複数の医療機関が薬剤や医療資材を共同購入する仕組みがありますが、その範囲を拡大することによってさらなるメリットが得られると考えています。そこで、当社では、バックオフィス業務の範囲を広げた支援を行っています。医療機関が希望するサービスだけを個別に提供するのではなく、トータルかつアライアンスを組むことを基本としています。その理由は①アライアンス効果を最大限に引き出したいこと、②どれか1つだけを対策しても診療報酬で要求される医療行為に対してコストをなるべくかけずに行うのは難しいからです。

　アライアンス効果は、医療人材やPR・啓発活動の面でも期待できます。医療界は転職しやすい業界ゆえに今後も人材の流動化が止まることはありません。むしろ発想を転換し、組織を活性化させるうえでもどんどん進めるべきだと思います。しかし、そのためには単なる人材流出にならない仕組みを作ることが肝心で、複数の病院がアライアンスを組むことによって本人のキャリアデザインに応じて人材を流動させることが可能になるでしょう。

　また、集患するうえで地域へのPR・啓発活動は欠かせないものの、一般の人を引き付ける魅力的なコンテンツを制作し、多くの人の目に留まるようプロモーションを繰り返すことを1病院で行ってもコストが見合いません。そのため、多くの医療機関は諦めざるを得ないのが現状です。しかし、これもアライアンスを組むことで実現しやすくなります。

Involving medical staff
Contributing to improving the quality of medical care and regional cooperation

On the other hand, it is also important to involve medical staff in improving the efficiency of back office operations, and the key to doing so is to make the operating income and expenditure public. At one hospital, when they started disclosing the operating income and expenditure to the medical staff leaders every month, not only did it increase their awareness of costs but it also increased their motivation, and each department began to work on ingenuity and improvements in daily medical treatment to find ways to balance the income and expenditure. As a secondary effect, this also led to an improvement in the quality of medical care.

In addition, there have been proposals from the field to utilize free time to make imaging equipment such as CT scans available to local clinics and small and medium-sized hospitals. This initiative has not only increased imaging diagnostic fees, but also promoted regional cooperation and increased the number of patients referred from clinics, which has ultimately led to an increase in the number of patients.

To encourage such spontaneous effects from within the hospital, it is important to ask doctors for their cooperation. At one hospital, the cost of medical supplies used in surgery was presented to doctors, and they were asked to review the quality of surgery (relationship between surgery time and results) and suitability, which led to the optimization of treatment. Similarly, at another hospital, by disclosing the operating income and expenditures to doctors, cost consciousness was increased, and a task shift in outpatient treatment, which had been slow to progress, progressed, and treatment became more efficient. Similar good examples can be found in various medical institutions that have worked to streamline back-office operations, and operating income and expenditures have turned from red to black.

And as a result of seeing a virtuous cycle of sustainable management and clinical activities, the morale of medical staff rises, and better medical services are provided, creating a virtuous cycle that further stabilizes medical management. Through examples like this, we are convinced that forming alliances with multiple medical institutions and centralizing back-office operations will open new doors for hospital management that is fighting for survival.

An example of back office work in the medical field