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American Health Network Reduces Denial Management Time by 75 Percent, Realizes ROI of 200 Percent

Ever since I first attended HFMA’s ANI conference, I’ve been fascinated by the opportunities available in managing a hospitals revenue. There are so many areas where even a small change to your operations directly effect your bottom line. That’s the beauty of any revenue solution.

Thus, I was quite interested to read this whitepaper about American Health Networks experience reducing claim denials. American Health Networks realized an ROI of 200 percent and recovered $1.4 million by changing their denial management practices.

I especially like how American Health Networks chose to roll this out first as a pilot program to a small subset of doctors. Then, after evaluating the results they chose to roll it out to the whole organization. Far too often I see organizations try to go all in with a solution and then fail miserably. There’s a lot of value of rolling out any IT solution to a small set of engaged users before applying them to the whole organization. One of the biggest values of this is the pilot group of users becomes the product champions once you’re ready to roll it out to the whole organization.

There are a lot of places where revenue is figuratively leaking out of healthcare organizations. For many organizations, claim denials is one of those places. I’d love to hear what solutions people have implemented to address claim denials in their organizations.

August 29, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Only 40% of Hospital CIO’s measure ROI on Their EMR Implementations

Today, I stumbled upon this fascinating tweet about hospital EMR ROI. It’s from @dbtech_Ras:

Unfortunately the tweet doesn’t contain the source of their information, but the idea of EMR ROI is a very interesting and important topic. Should a hospital CIO be tracking the ROI of their EMR implementation? Are most hospital CIO’s tracking EMR ROI?

I would imagine many hospital CIOs aren’t tracking EMR ROI, because they see EMR as a necessary requirement of being a hospital today. Do they track the ROI of cleaning supplies? No. They just realize they need them and they try to manage the cost of the supplies as best they can. I think many are treating EMR in this same manner. They see EMR as a necessity regardless of ROI.

The interesting thing is that there are actually a lot of ways to measure an ROI for EMR software. None of them are perfect and they certainly leave out all the intangibles and long term benefits of EMR. For example, how do you measure an ROI on legibility of charts? That’s tough. It’s also hard to predict how having your charts electronic will enable you to be a better hospital 5-10 years from now. Not to mention if reimbursement eventually will require an EMR. Things like this will happen I’m sure.

With those disclaimers, you still can calculate an ROI. The low hanging fruit is the EHR incentive money and the future EHR penalties for not having an EHR. These add up to really large numbers for hospitals. You can also look at productivity before and after the EHR. Of course, depending on how you implement the EMR, this could actually be a cost of EHR as opposed to a benefit. Either way it should be calculated in the ROI. There are many more.

From what I’ve seen everyone sees the future of physician documentation is going to be in an EMR. Just because the move to EMR is inevitable doesn’t mean you shouldn’t still keep focused on the ROI you can receive from it.

Is your hospital tracking your EHR ROI?

August 21, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Homecare Firm Dispatches 4,000 Android Tablets With Nurses

Could Android gear be sneaking up on Apple? Here’s one case where a national healthcare organization decided to go with the Android technology for a very large and clearly mission-critical purchase.

A national homecare agency has bucked the iPad trend in tablets, picking up 4,000 Android-based units to send with its personnel to patient homes. The company, Philadelphia-based Bayada, issued the Samsung 7-inch Galaxy Tab 7.0 plus to its therapists, medical social workers and other home health professionals.

In issuing the tablets, Bayada hoped to make its homecare professionals more efficient, especially when visiting Medicare home health patients who only get one hour each.

The tablet deployment followed a 20-person pilot in which it found that the typical nurse reduced his or her typing by one-half hour every day if using a tablet during visits instead of paper or a laptop.

Not only do workers use the tablets to document care within patient homes, they also pull up patient data before they head out on their patient visits.  This spares the nurses having to report to a central office to get their appointments before they leave in the morning.

To make clinical data entry simpler, Bayada has loaded the tablets with SwiftKey Healthcare’s keyboard software, an app which is preloaded with medical terms. It uses artificial intelligence to anticipate which words will be typed next and “learns” over time what words healthcare workers use most often.

Since implementing the SwiftKey software, 69 percent of Bayada’s nurses said they preferred using a tablet for taking clinical notes.

Given the large price difference between the iPad/iPad mini and Android tablets — with Android, obviously, at a lower price point — I’d be surprised if other large healthcare organizations didn’t follow in Bayada’s footsteps.

After all, Apple fan though I am, I have to admit that as the suite of apps available for the Android platform matures, there’s less and less reason for institutions to pay the premium Apple demands.  I wonder if we’re seeing the beginning of a major shift in Android investment by healthcare organizations.

February 27, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Study: EMR ROI Stronger In Low-Income Setting

Well,  here’s some information which caught my eye right away. According to a new study published recently in the Journal of the American Medical Informatics Association, EMRs can provide a good return on investment for hospitals located in low-income areas.

In the study, researchers studied the what happened when a tertiary hospital in Malawi implemented an enterprise- wide EMR system.  The felt it was important to evaluate an EMR implementation in a low-income area such as this, the authors noted, because such hospitals face obstacles unlike those in more prosperous areas, such as marked supply and staff shortages, which might change the effect of such a system.

To examine the impact of the EMR, researchers looked at three areas: length of stay at the facility, transcription times and lab use.  The hospital saved an estimated $284,395 per year in U.S. dollars. By the third year of operation, the EMR  started generating a positive ROI, and by five years, it provided net benefit of $613,681, according to FierceEMR.

This is an inspiring study for those who hope to see EMR success stories, as until recently, there’s been little if any information to suggest that EMRs can offer a substantial savings on operations, much less help to generate a profit.

This doesn’t necessarily mean that hospitals aren’t generating savings or even profits by implementing an EMR.  As we noted in a previous story, few hospitals are planning for and implementing EMR ROI measures early in the game, according to a recent study from Beacon Partners.

If hospitals don’t dig in and integrate EMR ROI measurements into their strategic planning, it’s not surprising that they aren’t getting the fullest picture of what their systems are delivering. Backward-looking measurements aren’t likely to do as much as measurements built on a hospital’ls entire vision for success. Let’s see what happens when hospitals focus on ROI as a top-of-mind item going forward.

November 23, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Hospitals Behind On EMR ROI Measurements

Buying an EMR is one of biggest investments a hospital IT department is likely to make. To date, however, few hospitals are planning for and implementing EMR ROI measures early in the game, according to a new study from Beacon Partners.

Beacon interviewed more than 300 healthcare leaders about the clinical system performance measures they used for their EMR, as well as the resulting ROI.  What researchers found out was that most respondents weren’t happy with their organization’s attempts to measure the ROI on their EMR spend — and that many hospitals aren’t directly measuring ROI at all.

According to healthcare leaders who spoke with Beacon, quality management and IT departments, rather than financial executives,  generally institute EMR performance measures. All told, 40 percent of respondents said that they were using performance measures, but only 36 percent were satisfied with the extent to which the data was being used to measure the value EMRs brought to their organization, Beacon reports.

The problem may spring from a lack of planning. According to Beacon’s respondents, less than half (48 percent) of performance measures are determined during planning.  In fact, 32 percent of providers said that performance measures were implemented in at least one patient care area post-EMR implementation.  Fifty-one percent of respondents said that they would have preferred to implement clinical system performance measures earlier than they had done so.

It’s hard to tell what would deter these healthcare execs —  mostly leaders with community hospitals — from demanding more results from their EMR investment. My best guess, though, is that adhering to Meaningful Use guidelines has taken up all of their bandwidth, and that CFOs have been mollified by the promise of incentive payments from the feds.

As the Beacon study suggests, though, healthcare leaders aren’t satisfied with this state of affairs. Vendors, expect to get more searching questions about ROI measurement over the next year or two.

October 26, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Epic EMR ROI

I think we are familiar with the HUGE institutions that have selected Epic. The most famous of these is the Kaiser implementation of Epic which started at $1.2 Billion and was projected to cost $4 Billion. Yes, that is Billion with a capital B for an EHR implementation. I haven’t done any in depth research on the average cost of an Epic installation, but I can’t remember seeing one lower than a few hundred million at the least.

As I consider these numbers, the following question keeps nagging at me: What’s the ROI for an Epic installation?

Don’t get me wrong. I already know about the many EMR benefits. Although, billions or even hundreds of millions of dollars is a lot of money to make up.

The problem is that covering the EMR space as long as I have, I have yet to see someone do a ROI analysis of an Epic installation. If there’s one out there that I don’t know about, I’d love to take a look. Maybe Epic has some, but it’s part of their tightly controlled process for selling their EHR. Although, if the ROI was so good, it makes you wonder why they wouldn’t want that information in the public domain.

A part of me wonders if hospital CIO’s really care about the ROI of an Epic EHR install. Epic seems to be similar to what enterprises use to say about IBM: “Nobody ever gets fired for buying IBM.” Do many hospital CIOs see it as “Nobody ever gets fired that buys Epic”?

September 6, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Differences Between ROI, Ease of Meaningful Use Vary Between Vendors

New research by KLAS seems to have uncovered important differences between the way EMR vendors perform when organizations are mounting them for Meaningful Use compliance.

According to the research firm, which interviewed 104 MU-compliant providers, both large and small hospitals successfully passed through Meaningful Use attestation.  However, the choice of vendor did seem to make a difference — one which, if KLAS is right, hospitals would be ill-advised to ignore.

KLAS concluded that hospitals using Allscripts, Healthland, HMS, McKesson had a harder time moving ahead on MU than organizations that went with MEDITECH, Cerner, CPSI and Epic. (It should be noted that while MEDITECH had the highest number of successful attesters, most of those came from a single large IDN, which makes it a bit hard to tell whether the IDN’s execution strategy or the product deserves the credit.)

One surprising bit of data, for me at least, that community hospitals were having an easier time covering their costs than larger IDNs.  KLAS notes that this varied from vendor to vendor, but didn’t name which were the higher performers.

Why the difference? My guess is that the bigger IDNs bought “Extormity” software (such as Epic and Cerner) and are having a hard time paying for it; that they have higher integration costs; and that they’re dealing with larger piles of smoking heaps of machinery (oh, excuse me, I meant very outdated mainframes and what have you).

As for problems, providers obviously had plenty to share.  Reporting and problem list functions were the most commonly reported challenges, KLAS said. In these areas, it seems, all vendors performed poorly, including the ever-popular Epic Systems.

March 21, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Guest Post: iPad or Android? Maybe We Need Both

This post is written by Brian Martin, MD.

Brian Martin is a physician informaticist – a software engineer who went to medical school, spent most of his career designing clinical software, and now spends his time helping physicians select technologies that improve their personal lives, their clinical practice, and the health of their patients.

I was asked today about whether iPad or Android-based devices will become the device of choice for practicing physicians. My answer? It could be that both have their place.

The issue isn’t whether someone will create the perfect iPad or Android tablet. Technological barriers, security issues, hackers, HIPAA, encryption, voice recognition, handwriting recognition are all technology problems. Easily solvable, especially with all the under-employed rocket scientists looking for work.

The hard work is to develop an elegant solution to the user experience that lies at the crossroads between technology and the physician’s workflow. And different situations may call for different devices.

If the doc is seeing patients in an outpatient setting or rounding on inpatients, then it’ll be the iPad. If the doc is away from the office or hospital, on personal time, then it’ll be the fits-in-your-pocket mobile device – an iPhone or Android device. It’s all about the user experience, how the technology fits into the doc’s workflow, and how the technology impacts the patient’s experience of the face-to-face physician visit.

For many, and perhaps the majority of physicians, being a doc isn’t a 40 hour-per-week job that you leave at the office. Not a chance. Clinical excellence is more than a full-time commitment, and for many, it’s a 24×7 commitment. Sure, you can go out to a nice restaurant, play a round of golf, a set of tennis, but…

When you are away from the office or hospital, and one of your patients needs your attention, do you really want to interrupt your personal life to drive to the office?

Or if you’re on a dinner date with your spouse/partner/date, and the lab calls to say that one of your patients has a wacked-out finding that you need to make an immediate treatment decision on, do you cancel your date and head back to the office? I wouldn’t want to. But if I’ve got 3,000 patients in my practice, I don’t have a choice, simply because I’m not going to rely on sheer memory power, no matter how highly I might think of myself (snicker if you will), to remember what diagnoses and allergies this patient has, what medications I’ve prescribed and why, and what the last test results were. Nope. No one’s that good.

But what if I could excuse myself for 5 minutes, step outside, pull this patient’s summary EMR up on my iPhone, make a diagnostic and treatment decision, select and submit one of my standard order sets, transmit a prescription to the pharmacy, then call the patient and tell him to stop taking one of his medications and go to his pharmacy to pick up the medications I just prescribed? Fantastic! I don’t cancel my date and ruin what was developing into a seriously romantic evening, my patient is properly managed, and life is good.

Have you ever seen a doctor walk into the doctor’s lounge in the hospital, then call the nursing station with his/her patient orders just to avoid entering data into the hospital’s EMR? I have. I’ve also watched my primary-care physician, who is not a touch typist, try to maintain eye contact with me while his eyes flitted rapidly between the keyboard and monitor.

And why can’t he maintain eye contact? Because his employer mandated that all physicians do their own clinical data entry, including progress notes, lab and medication orders, referrals, etc. Sure, that’ll get the employer to HIMSS Level 6, but at what cost? Or imagine a psychiatrist constantly switching his/her attention between the patient and a computer monitor during a psychotherapy session… And if that patient has paranoid/delusional traits?

I have yet to see an EMR with a keyboard/mouse/monitor (KMM) interface that does not interfere with the physician/patient experience. What we need is a technology that enhances the clinical experience FOR THE PATIENT. Docs know how to use traditional paper charts and pens for taking notes and looking up information during a face-to-face patient consultation, while keeping their focus on the patient. The iPad is the closest we have to a replacement for the pen and paper chart. Creating iPad, iPhone and Android interfaces to existing EMRs can be a first step.

The hard work is to develop an elegant solution to the user experience that lies at the crossroads between technology and the physician’s workflow. And different situations may call for different devices.

So. If you are a C-level health systems exec who is being pitched to make a “me-too” decision to spend mega bucks on an enterprise-wide KMM-interface EMR built using 1960s-era software (MUMPS is the COBOL of medicine), spend some time walking around and visiting docs in your community who use EMRs. Ask them if they’ll let you watch how they interact with their patients and their EMR. Pay attention to the user experience, and ask them about some of the scenarios I’ve described above. Then watch a three-year-old use an iPad.

March 16, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

ROI Calculators For Hospital EMRs: Worth Using?

If you’re a hospital IT executive, you may just be slogging through your EMR/EHR installation at the moment and hoping to hit Meaningful Use deadlines.  Sure, you wouldn’t mind if your system generated a return on investment, but if you’re like most of your colleagues, that’s the least of your worries.

According to some folks out there, though, all you need to do is zip through a formula — pre-baked by outsiders who’ve never visited your facility — and calculate pretty accurately how much you’ll save on operating costs once your system is in place. I’m talking about sites like these, most of which actually aren’t tied to one vendor’s sales pitch:

http://www.emrexperts.com/emr-roi/index.php

http://www.ingenixconsulting.com/HealthCareInsights/InsightARRA/insight_100/

http://www.dr-solutions.com/forms/calculate-the-impact/

http://www.emrapproved.com/research_tool_ROIcalc.php

http://www.emrapproved.com/emr-cost.php

The truth is, there seems to be a lot of careful thought behind these calculators. And though one size never fits all, my bet is that you might glean something from them.

That being said, I think there’s a reason that HIMSS seems to have officially gotten out of the ROI estimation game for EMRs/EHRs.  ROI is a political football, after all. Vendors in any enterprise software niche like to toss out huge ROI numbers and short break-even times. EMR/EHR vendors aren’t any different.

Given all of the variables involved, I’m not sure it’s worth accepting anyone’s estimate of how much you can save — or what it will really cost — when you implement your EMR/EHR. But I could be too cynical. What do you think?

August 24, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Do Consulting Firms Increase or Decrease Your Bottom Line?

I’ve been learning a lot more about the Health IT and EHR consulting industry as I work with many of them who post jobs on our Health IT job board. In fact, I’ve written previously asking the question, “Are Most EHR Consulting Companies Really Staffing Companies?” The reality is that many of the so called consulting companies out there are much more like staffing companies than they are consultants. It’s just a lot more sexy to call someone a consultant than a temporary staff member. Plus, it’s hard to charge the rates they do as a temporary staff member, but a consultant seems to justify the higher rates.

I should make clear that there’s nothing wrong with this approach to business. Many healthcare organizations need the temporary staff that consulting companies provide. However, it has diluted the term consulting quite a bit in the process.

If you’re looking for a good way to know what type of consulting company you’re working with consider this question: Does the Consulting Firm Increase or Decrease Your Bottom Line?

The reality is that consultants are expensive. It costs money to get someone to come in and share their time and expertise with you. Plus, when you look at how many “billable hours” a consultant has available to them with travel, finding business, etc, they have to charge a premium to make up that time. However, just because something costs money doesn’t mean that it’s not worth it.

If I told you that you could spend $50,000 and you would save $200,000, every one of you would do it. If I asked you if you’d spend $100,000 in order to generate $500,000 in increased revenue you’d all be interested. This is the model a great consultant provides. Sure, the numbers are projections of value and that what makes it difficult. Although, many consultants are hired these days to complete specific tasks as opposed to provide ROI. That’s how you can quickly recognize the difference between a true consultant and a temporary staff.

The challenge consulting companies face is that it’s much easier to prove that tasks were complete. It’s much harder to really impact a company’s bottom line.

July 25, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.