Webinar Review: Closed-Loop EHR Integration Targets Burnout, Improves Workflows

Webinar Link

https://www.healthcatalyst.com/webinar/closed-loop-ehr-integration-targets-burnout-improves-workflows/#embed-code-video

Summary and Application

Jeffrey Wu, Senior Director of Product Development for Health Catalyst, speaks about the integration of closed-loop technology into some of the most common EHR systems that are being used today including EPIC, Allscripts, and Cerner. He begins the presentation by addressing the state of EHR, and how it pertains to physician burnout. A majority of physicians would agree they are burnt out and most contribute EHR systems to being the cause. Jeffrey puts his thoughts into this by suggesting the reason EHR systems are slowing physicians down is because they were built around gathering data to be used for billing; not as tools to be used by providers. At this point he begins speaking about how closed-loop data analytics can work as a solution.

Before moving forward it's necessary to understand what is meant by closed-loop analytics. Jeffrey provides great examples such as analytics used in Amazon and Netflix. When you go shopping for an item on Amazon it will give you suggestions for other items to purchase, or when you go looking for movies to watch on Netflix it will give you suggestions of what to watch next. The reason these suggestions are usually suited to your liking is because of machine learning, aka, closed-loop analytics. The processor collects and compiles data and sorts it in various ways to be able to predict what the next logical choice would be.

How might this be used in healthcare? Closed-loop analytics is the "delivery of analytical insights in a manner that can be immediately acted on" (Wu, 2019). Its purpose is to improve utilization which will in turn improve effectiveness, and as a result decrease EHR use and physician burnout. It does this by first connecting the EHR data to the Health Catalyst analytics environment. Once the data is synced, applications can be directly embedded into the EHR, and new workflow can be created to optimize it as much as possible.

An example of where this could be used is with prescriptions. Let's say a patient is put into the EHR system as having Diagnosis X. What if when the provider went to go fill out a prescription the most common prescriptions for Diagnosis X appeared? This is just one example. However, the opportunities to use this kind of technology are endless, and more benefits will yield to those organizations who are willing to adapt to it. The world of technology is continually changing, as is healthcare, and this is the next step into the future.


References

“Closed-Loop EHR Integration Targets Burnout, Improves Workflows.” Health Catalyst, https://www.healthcatalyst.com/webinar/closed-loop-ehr-integration-targets-burnout-improves-workflows/.

“Introducing Closed-Loop Analytics Services.” Health Catalyst, 1 Oct. 2019, https://www.healthcatalyst.com/insights/introducing-closed-loop-analytics-services.

Top Ten Ways to Improve Patient Engagement

The primary objectives of healthcare leaders should include two things: keep the business and the patient as healthy as possible. Both of these objectives are more easily accomplished by improving the engagement of their patients in their own healthcare. Studies have shown that patients engaged in their own healthcare present with better outcomes and fewer complications. This equates to healthier, happier patients, and a higher net revenue for the organization. Listed below are 10 of the best ways your organization can strive to improve its patients' engagement.

1. Simplify Information- Just because you know what something means doesn't mean the patient does. Most patients weren't taught medical terms or how to interpret complex medical bills. Whenever possible you should simplify things down. In order for a patient to be involved in their own care they need to be able to understand what is going on.
2. Be Specific- It can be difficult for a patient to follow through with something if they don't know exactly how to do it. For example, rather than just saying "eat healthier", you could help them create a SMART (specific, measurable, action, results, timeline) goal. 
3. Encourage Patients to Set Goals- Here is another good place to suggest a SMART goal. Either way goals are important in getting patients active. It opens their eyes to what can be accomplished and results in better outcomes because of it.
4. Know Where Each Party Stands- Communication is key here. The patient's goal can't be achieved unless you are both on the same page. Make sure to explain your reasoning for your suggestions to the patient so that is all makes sense. If a patient thinks something is pointless then they are likely not going to follow through.
5. Be Able to Share Information- This is commonly done through a patient portal. It helps the patient to stay active in their care by opening up a channel for exchange of information. This way they can maintain contact for questions or interact as they track their progress.
6. Hold Patients Accountable- It is in the best interest of the organization and the patient both to keep the patient accountable. Having the information exchange is one good way to help them stay accountable, but there are other options such as weekly check-ins and reminders.
7. Education- A patient can want to be involved in their healthcare all they want, but if they don't know how it doesn't do them any good. Providing education to the patients counteracts that by giving them information about how to use the healthcare system. It can also aide in giving them information related to their conditions so they can take care of themselves better.
8. Maintain Open Access Scheduling- Part of a patient's ability to stay active in their healthcare is their ability to get to the doctor. A heavy schedule can make this difficult when they have other responsibilities. Having access to set their own appointments can help relieve that.
9. Maintain Open Medical Records- Having medical records available to the patient can give them the opportunity to stay up to date with their results and healthcare. They could also be seen at another clinic and easy access to this information would be beneficial in their continuum of care.
10. Provide Patient Reported Outcomes- This goes along with keeping patients accountable and having them share information. Giving patients the option to access an online portal where they can input their progress not only keeps the provider up to date, but keeps the patient involved as well.

References

“5 Ways Cleveland Clinic Improved Its Patient Engagement Strategies.” Healthcare IT News, 1 Oct. 2013, https://www.healthcareitnews.com/news/5-ways-cleveland-clinic-improved-its-patient-engagement-strategies.

6 Essential Strategies to Improve Patient Engagement. https://www.beckershospitalreview.com/patient-engagement/6-essential-strategies-to-improve-patient-engagement.html.

“The Essentials for Patient Engagement.” SperoMD, 24 May 2019, https://speromd.com/the-essentials-for-patient-engagement/.

Top Ten Ways to Improve Revenue Cycle

The revenue cycle can be a complex and daunting part of the healthcare system. Even with entire departments and countless hours of preparation  a claim can still be denied. Let's take a look at 10 of the top ways the revenue cycle can be improved to help ensure your healthcare organization is getting properly reimbursed.

1. Focus on Accuracy- Accuracy is vastly important when preparing claims. If one item is wrong the entire claim can be denied. It is the duty of the biller to make sure everything is accurate with the information they have, but it is the responsibility of everyone else in the organization to make sure the information they put in the system is correct as well. Patient access, coders, or even clinical workers inputting the wrong information could cause a claim to fail.
2. Submit Claims Daily- Claims should be submitted daily to help ensure a consistent cash influx. Research also shows that claims that take longer to be sent out have a higher chance of denial so its best to get them sent out as quickly and accurately as possible.
3. Incorporate the Right Technology- Using the right technology, especially the right EHR system is key to being timely and accurate. Being able to keep track of all the data needed can be negatively impacted which results in fewer claims being sent out and less revenue being taken in.
4. Train Staff Adequately- The staff members will be the one's preparing the claims and sending them out. If they are not properly trained then mistakes are inevitably going to be made. Make sure they have the right tools and vet their work before putting them off on their own. 
5. Stay Current on Billing and Coding- Billing and Coding regulations change frequently so it is important to stay as current as possible. Being proactive and knowing about future changes will prevent unsuccessful claims from being sent out your door.
6. Ask for the Patient's Help when Needed- The system is never perfect and information is going to sometimes be missed. Don't hesitate to reach out to the patient for missing information or to clarify that the information you have on file is correct.
7. Monitor Pending Issues- A portion of claims come back with soft denials, in other words they are missing information and are left pending. Staying on top of these issues is vital to successful payment because there could be a specified window of time you have to provide the information they need.
8. Monitor Payments- Just like monitoring issues you should be monitoring your payments. By seeing what is going through successfully and what is not can help you decide what you need to do differently. It could also alert you of changes you weren't aware of.
9. Automate- Automate processes wherever possible to optimize efficiency. This ties in with using technology properly because it is one of the best places to look for automation opportunities. However, be sure to be cautious when doing so because information can get lost if not carried out properly.
10. Focus on Front End- The back end of the revenue cycle tends to take most of the blame for claims improperly billed, but the revenue cycle is a team effort. The billing team can only go so far without the correct information being provided by the front end. Be sure to have processes set in place so that information about the patients is taken in accurately with each encounter.

References

10 Strategies to Improve Revenue Cycle Management. https://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/10-strategies-to-improve-revenue-cycle-management.html. 

Billing vs RCM | Medical Practice Partners. https://www.medicalpracticepartners.com/revenue-cycle-management-vs-billing/. 

Webinar Review: Delivering The Healthcare Pricing Transparency That Consumers Are Demanding

Webinar Link

https://www.healthcatalyst.com/webinar/delivering-healthcare-pricing-transparency-consumers-demanding/#

Summary and Application

This webinar provides an overview of Health City Cayman Islands presented by Gene Thompson. Health City Cayman Islands is a hospital mostly consisting of outpatient procedures, but includes a level 2 trauma center and hospital services. The main focus of the webinar is to give insight on what they are doing to be able to provide the transparent pricing that is demanded by consumers in our modern society. Although it's a system that can't be completely replicated in the United States due to laws and restrictions there is a lot that can be taken and applied to hospitals in the United States. Applicable key points are listed below.

1. Bundled Pricing: Bundled pricing is the biggest factor in being able to be transparent with your pricing. Organizations that have fixed pricing tend to focus more on quality as well. It is what consumers want and the financial model should be built around it.
2. Market Challenges: Some of the top factors hindering low prices includes complications being profitable in a fee-for-service model, profit centers that are individually motivated, payment authorizations with contracted payers, and disorganization of data.
3. Delivery: Delivery should be transparent and predictable enabling everyone to know what they will be paying and avoiding confusion in regards to labor costs. Delivery should also aimed towards simplicity and volume which will decrease variation and drive efficiency resulting in more adjudicated claims. Lastly there should be a focus on data and operations. Metrics should be used as a tool to guide decision making, and operations should be optimized by reducing, reusing, and recycling.
4. Self-Evaluation: Key performance indicators (KPIs) should be used to continually monitor performance. Reports should be analyzed and used to evaluate where improvements can be made.
5. Lessons Learned: A focus on quality and a fee-for-outcomes vs a fee-for-service is what gives the competitive advantage because it aligns provider incentives and drives patient demand.

References

Affordable Healthcare | Cardiology | Orthopedic Surgery. https://www.healthcitycaymanislands.com/. 

“Delivering The Healthcare Pricing Transparency That Consumers Are Demanding.” Health Catalyst, https://www.healthcatalyst.com/webinar/delivering-healthcare-pricing-transparency-consumers-demanding/.

Patient Experience and Financial Performance: What's the Link?

For those who are in the healthcare industry for the right reasons, their goal at the end of the day is to provide excellent care for the patients. After all, this is the whole purpose of the hospital/clinic, to help patients get healthy and live better lives. When looking at direct costs from a management perspective, sacrifices towards patient experience often have to be made in order to keep the institution healthy financially. However, in a lot of these decisions, only the direct costs of these sacrifices are being taken into account. Studies have actually shown that higher patient experience contributes to a higher financial outcome. Here we will look at how the patient experience indirectly impacts financial performance.

To understand how an organizations revenue is positively impacted by patient experience you must first start from the beginning, the patient experience. By working to increase the patient experience you are going to give the patient incentive to get more involved in their own care. This happens as a result of the patient feeling more trusting of the providers they are working with. Then this is where you will start to see the increase in better outcomes. There have been numerous studies showing patients who are more engaged in their care have better outcomes. This can be from almost anything with examples including decrease in medication errors and a reduction in falls.

The outcomes are going to enhance the organizations revenue in two different ways. The first of which is simply by reducing costs. In most cases providers are paid based on the outcome of the patient or the procedure being performed. This doesn't take into account any extra costs such as those resulted from previously mentioned medication errors and falls. These costs have to be absorbed into the hospital/provider. The other way revenue is effected is directly a result of how the provider gets paid. Like mentioned, they are paid on outcome that involves the quality of the patient's care. The more the patient's outcomes suffer the less the provider will be reimbursed for services.

Last but not least, the financial performance is going to be effected by patient experience due to its impact on the organizations reputation. Patients choose where to go it's based on how good a brand's (hospital's) reputation is. The brand is primarily impacted by word of mouth of patients throughout the community. So it goes without saying, by improving your patient experience you improve your reputation. This then brings in more patients which eventually turns into higher revenue.

References

“How to Improve Patient Satisfaction & Why It Matters.” PeerWell’s PreHab and ReHab Blog: All Things Joint Replacement Surgery, 17 Mar. 2017, https://www.peerwell.co/blog/2017/03/17/why-patient-satisfaction-matters/.

“The Impact of Improved Patient Experiences.” NRC Health, 12 May 2017, https://nrchealth.com/impact-improved-patient-experiences/.

Bundled Payments: What Are They Good For?

In the relatively new bundled payments system, providers are given one payment for each "episode of care" provided. In the past providers would be provided payment based on a fee-for-service system. In this system, all items were billed for separately, including things such as supplies, anesthesiology, and ancillary services. The first thing most would probably wonder is why move to such a system? To uncover this you must look at some of the advantages and disadvantages.

The first advantage, which could be argued is the primary reason for moving to the bundled payment system, is that it saves money by saving on resources. This works because when the provider knows they will only be getting one payment regardless of how many services they provide then it forces them to lock down on their budget. For example, a provider billing under the bundled payment system may realize they only need to do one MRI rather than the three they would have performed under a fee-for-service system.

The second major advantage of the bundled payment system is that it encourages providers to increase their quality of care. With the providers knowing their payments are based on the outcomes of these "episodes of care", more of an incentive arises to provide better care. Compared to the fee-for-service system, providers would more likely be concerned with providing care to more patients rather than the quality of care because they can bill more. With bundled payments, there is a clear shift from quantity to quality.

While the new system brings some great advantages, there are a couple of disadvantages worth mentioning. The first is that it could be a lot to take on as far as getting the infrastructure and technology in line to carry it out. This would be especially true for a smaller institution lacking the necessary resources. The other disadvantage is concerning splitting up the payments. As we know there is one single payment, and so this must be distributed among the providers involved. Coming up with a system to accurately measure contribution while being fair could present an issue.

All in all, the bundled payment system is something that was needed in the healthcare system. As prices continue to swirl out of control, strategic approaches such as this must be taken. Although there may be some minor struggles in implementing this strategy, it will certainly continue to provide benefits concerning the cost and quality of healthcare.


References

“Balancing Patent Quality and Patent Quantity to Maximize ROI.” IPWatchdog.Com | Patents & Patent Law, 26 May 2015, https://www.ipwatchdog.com/2015/05/26/balancing-patent-quality-quantity/id=58028/.

Marketing, B. H. M. “6 CMS Bundled Payments of Care Improvement Innovations Under the ACA.” BHM Healthcare Solutions, 22 Oct. 2013, http://bhmpc.com/2013/10/6-cms-bundled-payments-of-care-improvement-innovations-under-the-aca/.

“The Pros and Cons of Bundled Payments.” CarpeVita Inc. | Integrated Health Networks for Wellness, 1 Sept. 2015, http://carpevitainc.com/the-pros-and-cons-of-bundled-payments/.