Hayes' Healthcare Blog

By Susam Vang

One of the biggest concerns I hear from providers regarding electronic medical record system (EMR) use is that the computer will interfere with communication and patient care during the visit. Concerns range from not being able to have eye contact with their patients, having to look at the computer screen, and doing computer work instead of taking care of their patient. 

By Kayley Wolf

Would you like to learn how to better utilize the tools that you have? Could your workplace and workflows be more streamlined and efficient? If your practice or hospital wants to improve its clinical processes so that you are more productive, patients are happier and your overall operations are more efficient, here are five ideas to get you started:

1. Document and standardize workflows. Observe users and listen to their "pain points." When are users frustrated? Does each provider have their own process? Evaluate which processes are most efficient through research and observation. Talk to other users – inside and outside of your company – to find better ways of doing things. Look at resources and ideas provided by industry groups, user groups, LinkedIn groups, etc. Users, including clinicians, are working in the system every day; they are going to have some of the best feedback. They know when they are missing something, even if they do not know what that is.  They get frustrated when an activity takes too long. Use this frustration as a springboard for moving forward. Also, talk to IT staff – they will be able to tell you their most frequently reported complaints. Take this information, combine it with the knowledge of a system and workflow expert, and you have the potential to find powerful new solutions.                                                                                                                                                
2. Re-train the “bells and whistles.” During initial training, it is all users can do to remember the basics. However, additional functionality, i.e., ‘bells and whistles’ can dramatically increase productivity. Train on these again if needed. Create easily accessible reference guides and shortcut cheat sheets. While working with a recent client, my team was able to find and teach a simple concept missed during implementation. Although it took about one minute to train each user, this ended up saving the group approximately 615 hours per year. Training on this “bell and whistle” was also a great way to gain enthusiasm for more optimization.                                                                   
3. Evaluate add-ons. Make sure that you are using your system’s functionality to its full extent. Do not use functionality just to use it – only use that which improves your work. Then, once you are sure that you know all the shortcuts and tools that your system provides, research possible add-on functionality that would bring productivity and accuracy to an even higher level. The benefits of some add-ons far outweigh their cost.                                                                                                             
4. Create and utilize a knowledge bank. Document common issues and processes, and store them in a central location so that it can easily be accessed by all in the organization. This helps new hires and veteran employees alike. If everyone is recreating the wheel, it is far from optimal.  For example, one client (without a knowledge bank) reported spending four hours working through a problem, only to find out in a hallway conversation that his colleague had worked through the same issue and had a solution. Think of how staff satisfaction will improve when people can find answers quickly. (The Help Desk will thank you as well.) You can be proactive regarding researching documentation. If you are going to go through an upgrade or learning new functionality, read and summarize the information!
5. Clean up your EMR on a regular basis. Review your preference lists and favorites. These become more customized as time passes. Options can become either outdated or just plain cluttered, making searching more time consuming. Creating and sticking to a clean-up calendar for regular maintenance will help decrease the clutter and time wasted due to clutter. Often, organizations do not train on preference lists and favorites during the initial implementation, yet these tools improve productivity dramatically.

We do not have a lot of spare time to make changes. Plus, we are all creatures of habit – which can make it difficult to know where to even start. It is important that optimization initiatives are supported by the whole organization – from everyday users to management. It gives you permission and the time to make your clinical operations more streamlined and effective. Start by finding and fixing “low hanging fruit” to help build enthusiasm and momentum. The time spent optimizing will position you and your organization to be top performers.

By Don Michaels, Ph.D.

The concept of price transparency for healthcare consumers is clearly gathering steam. An example of this is a recent article on CMS’ effort to provide consumers with pricing information on 100 of the most common diagnoses. On the surface, this is very positive, as having cost information available to the public is a logical step in creating educated consumers.

By Sondra Bruderer, published in ADVANCE Perspective: HIM

If you were to walk into almost any healthcare organization’s business office, you would probably find that staff and Accounts Receivables (A/R) follow the traditional payer-centric model. There is typically the “Government Team” (Medicare, Medicaid and Tricare), the “Commercial Team” (Blues, UHC and Aetna), the “Self Pay Team,” and other supporting players that do not discriminate by payer (i.e., Payment Posting). Individuals within these payer-centric teams are often broken into smaller groupings by specific payer. Some organizations divide work by department or specialty to align the staff with key areas within the organization. One could debate for hours the pros and cons of dividing the work in this way or that. Over the years, your business office has probably tried multiple ways to slice-and-dice the A/R.

Seven years ago, I was introduced to a slightly different concept for denial management. The concept centered on organizing workflow by denials rather than by payer. Staff could still sort work by payer, but the central concept for building work lists was to focus on the categorization of the denials. Therefore, all coding related denials were grouped together, front-end issues grouped, and so on.

By Amitav Hajra

Clinical care today has become increasingly more complicated, but optimization has the potential to streamline it. Over the next decade, it is possible that we will see better clinical care by optimizing today’s workflows than we will by inventing new therapies.

I define clinical optimization as “the process of improving patient care by streamlining access to data, facilitating clinician collaboration, refining processes and strengthening outcomes.” A successful clinical optimization program incorporates three critical components, which I refer to as the ‘three pillars’.  These pillars are (1) technical enhancements, (2) process improvement, and (3) a strong governance structure. All three pillars need the same amount of focused attention or the optimization “structure” will be unbalanced.

Pillar 1: Technical Enhancement

By Kathryn Williamson

I have been fortunate to have had many opportunities to train users on hospital or physician practice IT systems. Most training sessions were either:

1. Ongoing new hire training sessions
2. Short-term system implementation training during a system conversion

Both types of training can be very stressful for adult learners and the trainer. Both need to be concerned that the training will “take hold” out of the classroom, when the user is back at his/her busy, patient-focused work area.

By Robyn O'Connell

Medicare has started sending the 2% Medicare payment reduction over the last few days. It has been a busy couple of days while we have helped organizations that had this on the back burner. Two critical things to remember are:

1. The reduction CANNOT be passed off to the patient and must be adjusted off as a contractual adjustment.
2. Your organization needs to confirm that these payments are posting correctly and not billing the patient for the 2% payment reduction. Many organizations base payments on the Medicare Approved Amount which does not reflect this 2% reduction.

This will be a big issue for organizations that process remittances automatically, since there is a short window to introduce this reduction.

By Angela Hunsberger

As a consultant and a healthcare consumer, I am very aware of the HIPAA Security Rule. However, when many of us think of privacy, we think of patient health information (PHI), not employee health information. Protecting employee health information has not been under the same scrutiny, and therefore; it is critical that healthcare organizations have a process in place to protect this information.

The HIPAA Security Rule called for us to protect patient’s electronic personal health information to the best of our ability. Now, Meaningful Use Section 45 CFR 164.308(a)(1) - Protect Electronic Health Information, prompts us to perform a security risk analysis. When you review your policies and procedures, remember to think about the patients who are also employees. Your employee health records should be protected with extra safeguards because the data is at a higher risk of being accessed.  Unfortunately, this extra layer of protection is often an oversight or it is put on the back burner.

By Lisa Cozatt
When an EMR training program is ineffective, organizations often see the results in lost revenue, decreased productivity and increased patient care errors.

To get the most from your training dollar:

By Sou Chon Young

Are your clinical and financial data living separate lives? As reimbursement models move away from fee-for-service and more toward performance-based pay, providers will need to determine the services rendered and the associated outcomes. This will be critical for two reasons: 1) to determine if services/protocols have the desired positive outcomes; and 2) to determine the costs associated with the episode of care. Bundled payments and ACOs will now require coordination of care. Given your current reporting and analytics tool set, are you ready?

One item that you should use regularly is a good business intelligence (BI) tool. In my experience, the patient accounting department typically does not use the same tool(s) as the clinical departments, and the data usually does not reside in the same database.