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Centralizing HIM Operations: An Enterprise Approach

Posted on August 15, 2018 I Written By

The following is a guest blog post by Patty Sheridan, MBA, RHIA, FAHIMA; SVP, Life Sciences at Ciox.

Technological advances, policy changes and organizational restructures are continuously bringing trends to the healthcare industry, specifically impacting healthcare facilities. Centralization of operations is one of those trends. Driven by a value-based model, the centralization of health information management (HIM) aims to streamline operations, standardize processes, reduce costs and improve quality of care and patient satisfaction.

Oftentimes, HIM departments operate with disparate processes due to legacy standard processes and acquisitions of new entities and are unable to efficiently integrate and access information when it is derived from multiple sources. This causes inconsistencies in processes and procedures, as well as incompleteness of information and unavoidable redundancies. Furthermore, decentralization can result in risks such as ineffective information management, inaccurate coding and breaches.

Silos of information hinder standardization, and as a result create compartmentalized pockets of information from sources, slowing down communication and making change more difficult. However, through the use of electronic HIM technology, secure information can be shared and processed across various departments and facilities at a quicker pace than ever before. Taking these efficiencies one step further, instead of siloes of information, many organizations are moving to a centralized model that can reduce operational costs by streamlining organizational performance, establishing consistent processes through standardization and eliminating redundancies.

Patient health information must be linked across the healthcare continuum to provide the best quality of care. Additionally, sources of information must be linked to electronic health records (EHRs) to support centralization and enhance patient care. To connect silos and reduce risks, healthcare facilities must centralize HIM operations to create standardization and improve coordination across the continuum of care.

Benefits of Centralization

Healthcare facilities can greatly benefit from incorporating the centralization of HIM operations into their long-term organizational plans. In fact, the benefits are greater than any hurdles encountered during the transition. Benefits include:

  1. Improves operational efficiency: Moving from a fragmented system to a model that streamlines operations improves efficiency and decreases administrative and operational costs.
  2. Eliminates redundancies and reduces errors: Helps to standardize processes, procedures and forms across a healthcare system to ensure they are the same throughout facilities.
  3. Improves financial performance: Restructuring improves productivity and efficiency as resources are centrally located, which positively impacts the bottom line.
  4. Fosters collaboration: Eliminates silos of communication that cause a stagger in the flow of information – improving communications and optimizing patient outcomes.
  5. Increases accessibility: Provides the benefit of system-wide accessibility to patient information for release purposes, such as billing and coding.
  6. Optimizes workflow: Allows opportunities to reexamine workflows for optimal efficiencies across the HIM continuum, bringing business value.

Driving Transition Towards Centralization

When an organization transitions to centralized HIM operations, it’s important that the journey be completed with the right preparation and execution. HIM professionals must establish processes that foster opportunities for consolidation and standardization that then result in reduced cost, mitigation of risk and overall improved patient care.

Prior to implementing a centralized model, HIM professionals must take certain steps into consideration:

  • Acquire an executive sponsorship to provide direction, support, budget and resolution to potential problems that may arise during the transition.
  • Establish a multidisciplinary steering committee to address centralization and your organization’s information policy, aligning resources with strategy.
  • Identify challenges, gaps, risks and opportunities while working with collaborators to achieve goals for improvements.
  • Define and establish standards, processes and procedures.

Centralization: The Decision is Yours

It is important for HIM professionals to be proactive when determining his or her organization’s vulnerabilities and address them immediately, as breaking down barriers that add risk ultimately drives down costs and improves efficiencies.

Additionally, everyone in an organization may not support the transition. However, executive sponsorship and collaboration between staff, departments and facilities is essential. To gain consensus, HIM professionals must understand the culture of the departments involved and how to leverage their individual technological capabilities.

The work of healthcare professionals is being reshaped by the centralization of HIM operations. If you’re looking to succeed during this ambiguity of change, transforming HIM to a centralized model throughout an enterprise provides healthcare facilities with a competitive advantage, as the integration of emerging technology continues to become a crucial step towards efficient, successful operations.

About Ciox
Ciox is a health technology company working to solve the clinical data illiquidity challenge by providing transparency across the healthcare ecosystem and helping clients manage disparate medical records and is a proud sponsor of Healthcare Scene. When stakeholders do not have timely access to the complete clinical picture of patients, critical decisions about patient care, medical outcomes research, disease prevention, reimbursement, and payments are sub-optimized. Ciox’s scale, expertise, expansive provider network and industry leading technology platform make it the most reliable clinical data company in the US. Through its standards based technology platform, HealthSource, Ciox helps clients securely and consistently solve the last mile challenges in clinical interoperability.  Learn more about Ciox’s technology and solutions by visiting www.ciox.com

Edge Computing Provides Security for EHR, Healthcare Applications

Posted on August 10, 2018 I Written By

The following is a guest blog post by Eric Fischer is the Digital Marketing Specialist for Estone Technology.

As more and more practices, both small and large, move from traditional patient records to fully electronic health records, the advantages of cloud-based EHR systems are becoming more readily apparent. In a cloud-based EHR system, data is stored on an external server, usually owned and operated by a third-party company, reducing an individual practice’s investment. Setup is often limited to installing certain software, and subsequently, data can be accessed anywhere.

However, in the modern day of HIPAA rules and patient privacy regulations, sending all of your patient data to a third party service can be dangerous if not managed properly. Even worse, as more and more devices gain intelligence and connectivity, joining the Internet of Things, patient data is often sent as soon as it as gathered, without human input, creating backlogs of pointless data and additional windows for data theft or misuse.  Though cloud-based records systems should offer flawless security, it only takes one person at any level in data processing to be careless with their password, or one device affected with malware to render patient records totally insecure. In a recently reported story, a security expert identified a data breach caused when an employee plugged their eCigarette into their work computer’s USB port to charge. The eCigarette had been loaded with secret data harvesting software.

The IoT has made the problem more severe as it grows, as many simple, connected devices lack any sort of security measures whatsoever, and simply send gathered data on as they have been programmed to do, no matter how they were programmed to do so. It is shockingly simple for these devices to be compromised and misused. The benefits of patient data recorders that automatically send their data to EHR’s is obvious, but the danger is also quite clear.

Cloud-Based IoT systems automatically send much of requested patient data from sensors directly to third party companies, ripe for data theft as well as failure in a network outage. *Data from the Journal of Intensive and Critical Care.

Fortunately, there is a solution. As small, embedded chips and boards have become more and more powerful, the need to send all data to the cloud to be processed and stored has lessened. Today, the IoT is shifting rapidly towards a new model of computing – Edge Computing. In this new computing format, data from individual IoT devices like patient monitors and data recorders is processed by intelligent, embedded boards and devices at the edge of the local network. Once the processing has been completed, any relevant data can be encrypted and forwarded to the cloud for additional processing and storage.

This improves data security in a few very simple, fundamental ways – first of all, more data stays local. Everything from blood pressure to MRI scans can be processed locally by edge devices using machine learning techniques. Most of this data is, of course, irrelevant and can be discarded. But when the Edge Computing device identifies something important, it can forward that data to the cloud-based EHR system, ready for additional use.

Secondly, since these devices are more powerful, and managed locally, they’re easier to secure than other IoT devices, or third-party managed cloud devices. It’s possible to load embedded boards performing edge computing functions with modern operating systems and anti-malware programs that keep data secure. This barrier between your internal devices, and the digital world offers a layer of protection for your most sensitive patient data.

Developers of hospital networks and hospital IT managers, EHR software developers, and other healthcare information technology professionals can work with hardware designers and manufacturing firms to discuss Edge Computing solutions for themselves and their customers.

About Eric Fischer
Eric Fischer is the Digital Marketing Specialist for Estone Technology – a designer and manufacturer of OEM/ODM computer solutions for Medical and Rugged Industries. Our solutions include specialized Tablet and Panel PCs, Embedded Boards, and Industrial Computers. We offer solutions that are IEC-60601 certified, waterproof, and antimicrobial, specialized for hospital environments.

Experts Tell All: How Leaders Ensure Successful Healthcare ERP Adoption

Posted on August 9, 2018 I Written By

The following is a guest blog post by Sallie Parkhurst, Carol Mortimer, Michelle Sanders, and Heather Haugen PhD from Atos Digital Health Solutions.

According to Gartner, approximately 75% of Enterprise Resource Planning (ERP) implementations fail despite the significant opportunity for process management improvement in key business areas including human resources, payroll, supply chain management, and finance.  We gathered critical feedback from experts who have lived through hundreds of implementations across a broad spectrum of industries. Their advice was insightful!

Our discussion focused on three distinct areas where leaders should focus in order to avoid some of the common missteps of large complex implementations. That is, leaders must clearly define their strategic approach to these key business functions beyond the selection of ERP tools. This work spans the system selection and implementation phases of an ERP project. Engaging the appropriate internal experts early in the process ensures effective governance, reality in the “current state” and data accuracy.  This effort is required for the entire life cycle of an ERP.  Finally, leaders need to consider the resources, time and leadership required to continue successful adoption after implementation; this is often left until after implementation and creates significant financial surprises and resource constraints.

Clearly Defined Strategy:

  • Leadership and Communication: Most ERP systems have an impressive array of functions and options to make processes more efficient and effective. How those systems are used in your organization must be defined, communicated, and governed throughout the entire process.  The leadership team is ultimately responsible for this effort, but must consider how to best communicate and engage the entire organization to achieve the goals.  The change management effort is quite extensive and is a key predictor of success!
  • Functionality: The functionality you need should be driven based on your business needs. While this seems obvious, many organizations buy a suite of products that includes more advanced functionality than they need, functionality they can’t take advantage of because of other system constraints, or functionality that requires data from other systems they don’t have. Set the parameters for demos and consider defining the scenarios to get an accurate picture of system capabilities for your specific needs.
  • Interfaces: ERP systems can interface with many different systems ranging from clinical systems to warehouse applications. This is a great opportunity to ensure better overall integration of business processes, but don’t underestimate the work required. Ask about the cost of interfaces, maintenance required, potential impact from upgrades, and any limitations of your current systems and data specifications for accurate and efficient electronic transmission. Also, be sure to ask about any third party vendor software required during discussions involving interfaces.

Engagement of Experts:

  • Knowledge Experts: Most organizations don’t engage their internal experts early enough in the project. Involving your subject matter experts during system selection can be tricky, but it pays big dividends in the end. These experts know the current systems or manual processes, but they also know the workarounds and issues that need to be addressed. Ensure that these people are also involved in defining data tables and other “area specific” customization.
  • Document Current State: This is cumbersome work, but organizations that take the time to define their current workflows gain more efficiency and cost savings from their new ERP systems. When this step is skipped, implementations stressors (time and resources) force the new system to mimic old system processes or manual processes that degrade the overall value of the new system.
  • Competencies and Development: Your new ERP system will probably stretch your team’s competencies, and will often require additional team training. This is a great opportunity to offer growth opportunities in your organization.  It may also require hiring for specific skill sets.
  • Priorities: The toughest question a leader faces when implementing a new system is “What are we going to stop doing to ensure the success of this effort?” Give your team time to focus on and perform high quality work.

Long-Term Commitment

  • Resource commitments: Any large system capable of making dramatic improvements in efficiency and accuracy of business processes will always require an investment of time and resources after implementation. Organizations almost always underestimate the long-term investment associated with maintenance, upgrades, training, and optimization. However, organizations that commit even a few hours per week in a disciplined manner find it easy to maintain and even improve on the value they expect from their ERP.
  • Beyond implementation – achieving adoption: The difference between simply installing a system and achieving business value lies in the long-term commitment by an organization’s leaders to optimize the use of the system.

ERP tools offer a significant opportunity to better manage critical business functions, but adoption of those systems requires:

  1. A clearly defined strategy for the key ERP business functions you plan to implement;
  2. Engagement of your internal experts early and often; and
  3. Commitment of resources and funds to realize the value of your investment.

About the Authors: 

  • Sallie Parkhurst is Senior Project Manager and an expert in Finance for ERP implementations for Digital Health Solutions Consulting, Atos.
  • Carol Mortimer is Senior Consultant and an expert in Supply Chain Management for ERP implementations for Digital Health Solutions Consulting, Atos.
  • Michelle Sanders is Senior Project Manager and an expert in HR and Payroll for ERP implementations for Digital Health Solutions Consulting, Atos.
  • Heather Haugen is the Chief Science Officer for Atos Digital Health Solutions.
  • Inbal Vuletich serves as the editor for Atos Digital Health Solution publications.

What Clients Value about Atos’ ERP Solutions and Services:

  • Expertise across all ERP business functions
  • Depth of knowledge of the ERP systems and how they function in various environments
  • The combination of industry expertise and system expertise
  • Ability to solve problems and understand clients’ challenges
  • How our team cares about their problems and challenges like they are our own

About Atos Digital Health Solutions
Atos Digital Health Solutions helps healthcare organizations clarify business objectives while pursuing safer, more effective healthcare that manages costs and engagement across the care continuum. Our leadership team, consultants, and certified project and program managers bring years of practical and operational hospital experience to each engagement. Together, we’ll work closely with you to deliver meaningful outcomes that support your organization’s goals. Our team works shoulder-to-shoulder with your staff, sharing what we know openly. The knowledge transfer throughout the process improves skills and expertise among your team as well as ours. We support a full spectrum of products and services across the healthcare enterprise including Population Health, Value-Based Care, Security and Enterprise Business Strategy Advisory Services, Revenue Cycle Expertise, Adoption and Simulation Programs, ERP and Workforce Management, Go-Live Solutions, EHR Application Expertise, as well as Legacy and Technical Expertise. Atos is a proud sponsor of Healthcare Scene.

HCCs: An Operational Perspective – HIM Scene

Posted on August 8, 2018 I Written By

The following is a guest blog post by Cathy Brownfield, MSHI, RHIA, CCS, Chief Operating Officer, TrustHCS.

Hierarchical Condition Categories (HCCs) were mandated by the Centers for Medicare and Medicaid Services (CMS) in 1997. In 2003 HCCs were selected as a risk adjustment model to be used to determine reimbursement for Medicare Advantage Plans.  They describe chronic condition diagnoses for patients and are determined from other codes assigned during physician encounters—including ICD-10 codes, CPT codes and medication codes.

The HCC framework is progressively being applied to numerous healthcare reimbursement reform initiatives. As the shift from volume to value advances, so does the importance of accurate HCC coding. This month’s blog explains the correlation between HCC coding and value- based reimbursement.

Two HCC models prevail

There are two HCC models in use by the federal government: CMS-HCC and HHS-HCC. Both models employ a risk adjustment score to predict future healthcare costs for plan enrollees. They operate within a hierarchical structure in which the more complex diagnoses absorb and incorporate less complex, chronic conditions.

The CMS-HCC model addresses a predominantly elderly population (65 years and over) and includes more than 9,000 ICD-10 codes that map to 79 HCC codes; these numbers do change and will increase slightly in FY 2019.

The Department of Health and Human Services (HSS) maintains the HHS-HCC model, which addresses commercial payer populations and covers all ages. This system incorporates CPT and medication codes and is currently comprised of 128 HCC codes.

Relationship to risk adjusted payment programs

The following are some of the risk adjusted payment programs currently using HCCs to determine reimbursement:

  • MA – Medicare Advantage Plan
  • MSSP – Medicare Shared Savings Program (ACO)
  • CPC+ – Comprehensive Primary Care Plus (Medical Home Model)
  • Commercial – Mainly the ACA

Each of the models primarily use ICD-10 codes taken from claims data to identify individuals with serious or chronic illnesses and assign a risk factor score to each enrollee based upon a combination of the individual’s health conditions and demographic details. Each HCC has a risk factor, an individual can have multiple HCC’s and those factors add up to their overall risk adjustment factor.

According to the CMS website, “risk adjustment allows CMS to pay plans for the risk of the beneficiaries they enroll, instead of an average amount for Medicare beneficiaries. By risk adjusting plan payments, CMS is able to make appropriate and accurate payments for enrollees with differences in expected costs. Risk adjustment is used to adjust bidding and payment based on the health status and demographic characteristics of an enrollee. Risk scores measure individual beneficiaries’ relative risk and risk scores are used to adjust payments for each beneficiary’s expected expenditures. By risk adjusting plan bids, CMS is able to use standardized bids as base payments to plans.”

How to operationalize accurate HCC coding

The risk-adjustment data for these programs is based on active diagnoses. In order to ensure the information is accurate, providers must conduct face-to-face encounters with their patients and all pertinent diagnoses must be documented in the medical record on an annual basis. Accurate documentation and coding is paramount to proper reimbursement under risk adjusted programs that use HCCs.  Beyond accurate HCC coding, it is important for HIM professionals to be aware of CMS reporting and data collection methodologies when operationalizing HCCs.

Reporting considerations to know

In 2012, CMS began transitioning the Medicare Advantage Organizations (MAOs) data collection method from its original format to an Encounter Data Payment System (EDS). The data collected under the EDS is unfiltered and more detailed than EDS’s predecessor, Risk Adjustment Payment System (RAPS). While CMS has gone back and forth on which algorithm to use, a blend of 85 percent RAPS and 15 percent EDS scores is currently in place for 2018.

Data is submitted directly to CMS where filtering logic is applied to extract the valid diagnosis codes from the data. The codes are then used in the risk score calculation process. With this process, MAOs must verify the completeness and accuracy of the data submitted to CMS to ensure that all appropriate diagnosis codes have been accepted for risk adjustment by CMS.

The RAPS/EDS blend will return to a 75/25 split in 2019. Additionally, CMS is proposing to calculate the EDS risk scores amended with RAPS inpatient diagnoses. Other 2019 changes are listed below.

2019 CMS-HCC Model Changes

  • Behavioral Health Conditions
    • HCC 55 Drug/Alcohol Dependence: Add opioid (and other substances) overdose ICD-10 diagnosis codes to HCC 55
    • Add HCC 56 Drug Abuse, Uncomplicated, Excluding Cannabis, includes opioid dependence diagnoses (among other narcotics)
  • Mental Health and Substance Abuse Disorders
    • Add HCC 59 Reactive and Unspecified Psychosis
    • Add HCC 60 Personality Disorders
  • Add HCC 138, Chronic Kidney Disease Stage 3 (Moderate Only)

Role of HIM and where to learn more about HCCs

In the new frontier of value-based payment, HIM is the purveyor of accurate coding and HCC assignment for organizations and providers. Savvy HIM leaders ensure they have the most up-to-date information by monitoring the following websites and information sources:

About Cathy Brownfield
Cathy Brownfield is the Chief Operating Officer of TrustHCS. She holds over 17 years of operations, auditing and coding experience. Prior to TrustHCS, Cathy served as the Operations Director for HealthPort’s Coding Operations division overseeing scheduling, billing, and quality assurance efforts.

Cathy holds her Master of Science in Health Informatics from Arkansas Tech University. She received her Bachelor of Science in Health Information Management from the same university. Cathy is a Registered Health Information Administrator and a Certified Coding Specialist. As a member of the American Health Information Management Association she volunteers on the Coding Community Council and also the PPE work group.

Remote Release of Information: The Next Step in Secure and Compliant Exchange of Patient Health Information

Posted on July 18, 2018 I Written By

The following is a guest blog post by Patty Sheridan, MBA, RHIA, FAHIMA; SVP, Life Sciences at Ciox & Tarun Kabaria; Executive VP, Provider Operations at Ciox.

Across the industry, there is an influx of health information management (HIM) departments and medical groups moving their HIM operations from hospital main campuses and individual physician practices to centralized, offsite locations to gain efficiencies and make better use of valuable square footage in their facilities. For many organizations, this move began decades ago with the implementation of remote coding and/or the need to free up space for patient care.

These ‘virtual HIM” departments can be located at a separate facility, home-based office or remote vendor locations, and result from the continued adoption of electronic health records (EHR) and pressure to manage costs, offering HIM directors and practice administrators the opportunity to reorganize and form more efficient spaces and processes. Outsourcing functions, such as release of information (ROI), allows HIM staff to focus on other priorities of data governance while maximizing available space.

From a financial perspective, costs associated with regulations, staffing, printing, mailing and square footage are increasing; and in some instances, volumes of requests are increasing due to health plans, lawsuits and the portability of healthcare. Furthermore, allowable fees for releasing medical records are decreasing in some states. As a result of these rising financial pressures, healthcare providers are finding it more difficult to make ROI a profit center in their organizations.

HIM departments are experiencing additional pressures from rising health plan request volumes, requiring flexible operational solutions in order to meet the increasing demand. In a typical year, the volume of health plan requests tends to increase to the order of 20-30 percent, and this year those numbers are expected to triple. With such an influx of requests, moving to a virtual model allows for the onsite staff to be augmented with the remote team, fulfilling these large volume requests without impacting the core ROI and patient requests.

Another prevalent challenge is timeliness. With the advent of rebranding the Meaningful Use program to focus on promoting interoperability and the increase in various governmental and payor audits, timeliness of response to requests for medical records is critical and penalties for non-compliance are steep. As such, healthcare providers are reaching the point of diminishing returns in regards to managing the ROI function on their own, and in some cases, will not be able to meet the time deadlines imposed upon them to gain incentives, avoid penalties and takebacks.

These new industry influences create the need for even faster, more efficient, error-free fulfillment of medical record requests and pave the way for a new approach designed to help your organization meet this demand: Remote ROI.

The Remote ROI Process

The ROI process is a time-consuming administrative challenge for HIM professionals, requiring compliance expertise, secure and efficient technology, and a trained and knowledgeable staff. The Remote ROI process starts at your healthcare facility when requests for release of health information are received. From there, your chosen third party vendor, such as Ciox, receives the request from the hospital or practice via a mutually agreed upon, secure mechanism. Securely connected and able to access the hospital or practice EHR, an offsite ROI Specialist then reviews the requests for proper authorizations, identifies and captures the records to be released, and transmits the medical records from your facility’s EHR in an encrypted electronic format to the third party vendor’s ROI centralized processing center. The release is delivered to the requestor through an automatic print and mail process or electronically via a secured delivery method. Ciox’s process is computer-assisted using artificial intelligence and natural language processing thereby reducing turnaround time, improving patient satisfaction and ROI outcomes.

When creating your Remote ROI process, follow these three fundamental steps to ensure its success:

1. Determine the method of access to the Request Letter/Authorization received by the hospital or physician practice.

There are several mechanisms by which requests and authorizations are securely made available to Remote ROI Specialists for ROI processing. The most common methods include:

  • Requests/Authorizations are scanned into the EHR – Staff at the facility scans the requests/authorizations into the EHR. The Remote ROI Specialist accesses the EHR to view the information and begin the process.
  • Requests/Authorizations are faxed – Staff at the facility faxes the requests/authorizations to a fax-in queue provided by the third party vendor. The Remote ROI Specialist accesses the fax-in queue to view the information.
  • Requests/Authorizations are scanned and placed in a shared folder – Staff at your facility scans the requests/authorizations into a shared folder accessible by the Remote ROI Specialist at the third party vendor’s secure Remote ROI Processing Center.
  • Requests/Authorizations are automatically received via health data exchange or health information exchange.

2. Establish connectivity to the EHR to validate the authorization, review the medical records and process the request.

An acceptable baseline for securing the connection to your EHR system(s) must be established for Remote ROI. The appropriate connectivity scenario depends on the underlying technologies at your facility. When understanding which technologies are at your disposal and establishing connectivity, remember that security is key in this part of the process. Keep that in mind when selecting a third party vendor, as it’s paramount to select a company that makes the security of the exchange of protected health information a top priority. Furthermore, it’s of critical importance to select a vendor that has earned certified status for information security by the Health Information Trust (HITRUST) Alliance. The HITRUST CSF Certified Status ensures that key healthcare regulations and requirements for protecting and securing sensitive private healthcare information are met.

3. Ensure compliance standards to track when and who accessed protected health information.

As an added security effort, it’s crucial to follow compliance standards that allow insight as to who accessed patient health information and when it was accessed. To ensure maximum security, computers located at the third party’s Remote ROI processing facility should be secured utilizing encryption, anti-virus protection and web filters.

Passwords should be provided by the facility for access to their specific EHR and stored in an electronic password vault. The password vault should be linked to the third party’s directory that is only accessible by the ROI Specialist using their directory account. Third parties should provide complete audit trail capabilities to track personnel accessing the EHR and processing medical record requests from your applications.

By moving some or all of the onsite ROI functions to a Remote operation, you can streamline the ROI workflow, reclaim square footage for other purposes and have additional capacity available for request volume fluctuation. As an added benefit, the immediate access to requests and authorizations speeds turnaround times on processing requests, which is particularly important when considering tight timelines for meeting Meaningful Use and audit-related releases.

If you’re looking to make HIM operations more efficient and cost effective, Remote ROI can open the doors to achieving those goals.

About Ciox
Ciox is a health technology company working to solve the clinical data illiquidity challenge by providing transparency across the healthcare ecosystem and helping clients manage disparate medical records and a proud sponsor of Healthcare Scene. When stakeholders do not have timely access to the complete clinical picture of patients, critical decisions about patient care, medical outcomes research, disease prevention, reimbursement, and payments are sub-optimized. Ciox’s scale, expertise, expansive provider network and industry leading technology platform make it the most reliable clinical data company in the US. Through its standards based technology platform, HealthSource, Ciox helps clients securely and consistently solve the last mile challenges in clinical interoperability.  Learn more about Ciox’s technology and solutions by visiting www.ciox.com

Connecting the Data: Three Steps to Meet Digital Transformation Goals

Posted on July 16, 2018 I Written By

The following is a guest blog post by Gary Palgon, VP Healthcare and Life Sciences Solutions at Liaison Technologies.

A white paper published by the World Economic Forum in 2016 begins with the statement, “Few industries have the potential to be changed so profoundly by digital technology as healthcare, but the challenges facing innovators – from regulatory barriers to difficulties in digitalizing patient data – should not be underestimated.”

That was two years ago, and many of the same challenges still exist as the digital transformation of healthcare continues.

In a recent HIMSS focus group sponsored by Liaison, participants identified their major digital transformation and interoperability goals for the near future as:

  • EMR rollout and integration
  • Population health monitoring and analytics
  • Remote clinical encounters
  • Mobile clinical applications

These goals are not surprising. Although EMRs have been in place in many healthcare organizations for years, the growth of health systems as they add physicians, clinics, hospitals and diagnostic centers represents a growing need to integrate disparate systems. The continual increase in the number of mobile applications and medical devices that can be used to gather information to feed into EMR systems further exacerbates the challenge.

What is surprising is the low percentage of health systems that believe that they are very or somewhat well-prepared to handle these challenges – only 35 percent of the HIMSS/Liaison focus group members identified themselves as well-prepared.

“Chaos” was a word used by focus group participants to describe what happens in a health system when numerous players, overlapping projects, lack of a single coordinator and a tendency to find niche solutions that focus on one need rather than overall organizational needs drive digital transformation projects.

It’s easy to understand the frustration. Too few IT resources and too many needs in the pipeline lead to multiple groups of people working on projects that overlap in goals – sometimes duplicating each other’s efforts – and tax limited staff, budget and infrastructure resources. It was also interesting to see that focus group participants noted that new technologies and changing regulatory requirements keep derailing efforts over multi-year projects.

Throughout all the challenges identified by healthcare organizations, the issue of data integrity is paramount. The addition of new technologies, including mobile and AI-driven analytics, and new sources of information, increases the need to ensure that data is in a format that is accessible to all users and all applications. Otherwise, the full benefits of digital transformation will not be realized.

The lack of universal standards to enable interoperability are being addressed, but until those standards are available, healthcare organizations must evaluate other ways to integrate and harmonize data to make it available to the myriad of users and applications that can benefit from insights provided by the information. Unlocking access to previously unseen data takes resources that many health organizations have in short supply. And the truth is, we’ll never have the perfect standards as they will always continue to change, so there’s no reason to wait.

Infrastructure, however, was not the number one resource identified in the HIMSS focus group as lacking in participants’ interoperability journey. In fact, only 15 percent saw infrastructure as the missing piece, while 30 percent identified IT staffing resources and 45 percent identified the right level of expertise as the most critical needs for their organization.

As all industries focus on digital transformation, competition for expert staff to handle interoperability challenges makes it difficult for healthcare organizations to attract the talent needed. For this reason, 45 percent of healthcare organizations outsource IT data integration and management to address staffing challenges.

Health systems are also evaluating the use of managed services strategies. A managed services solution takes over the day-to-day integration and data management with the right expertise and the manpower to take on complex work and fluctuating project levels. That way in-house staff resources can focus on the innovation and efficiencies that support patient care and operations, while the operating budget covers data management fees – leaving capital dollars available for critical patient care needs.

Removing day-to-day integration responsibilities from in-house staff also provides time to look strategically at the organization’s overall interoperability needs – coordinating efforts in a holistic manner. The ability to implement solutions for current needs with an eye toward future needs future-proofs an organization’s digital investment and helps avoid the “app-trap” – a reliance on narrowly focused applications with bounded data that cannot be accessed by disparate users.

There is no one answer to healthcare’s digital transformation questions, but taking the following three steps can move an organization closer to the goal of meaningful interoperability:

  • Don’t wait for interoperability standards to be developed – find a data integration and management platform that will integrate and harmonize data from disparate sources to make the information available to all users the way they need it and when they needed.
  • Turn to a data management and integration partner who can provide the expertise required to remain up-to-date on all interoperability, security and regulatory compliance requirements and other mandatory capabilities.
  • Approach digital transformation holistically with a coordinated strategy that considers each new application or capability as data gathered for the benefit of the entire organization rather than siloed for use by a narrowly-focused group of users.

The digital transformation of healthcare and the interoperability challenges that must be overcome are not minor issues, nor are they insurmountable. It is only through the sharing of ideas, information about new technologies and best practices that healthcare organizations can maximize the insights provided by data shared across the enterprise.

About Gary Palgon
Gary Palgon is vice president of healthcare and life sciences solutions at Liaison Technologies, a proud sponsor of Healthcare Scene. In this role, Gary leverages more than two decades of product management, sales, and marketing experience to develop and expand Liaison’s data-inspired solutions for the healthcare and life sciences verticals. Gary’s unique blend of expertise bridges the gap between the technical and business aspects of healthcare, data security, and electronic commerce. As a respected thought leader in the healthcare IT industry, Gary has had numerous articles published, is a frequent speaker at conferences, and often serves as a knowledgeable resource for analysts and journalists. Gary holds a Bachelor of Science degree in Computer and Information Sciences from the University of Florida.

Driving Value in the Community: How Atos Invested In Hope TEC and Gained Business Value

Posted on July 12, 2018 I Written By

The following is a guest blog post by Julie Collier, Reverend Sanders, Ron Quidatano, and Heather Haugen PhD from Atos Digital Health Solutions.

Having strong technical expertise is an important competitive advantage in the field of Information Technology. While finding and retaining the right people matters for niche positions, it is also critical for entry-level IT positions.

In early 2010, Reverend (Rev.) Sanders, a senior pastor of the Hope Presbyterian Church of Chicago, met with Atos leadership (formerly ACS/Xerox), led by Chad Harris, Chad recognized the need to discuss the value of identifying resources best suited for IT training programs in the Englewood Community which was hit hard by the downturn of the economy.  With $13B of IT services, Atos deals with the impact of these resource constraints every day.  And together, Sanders and Harris discussed ways in which the tremendous resources of ATOS could be used to make a positive impact, in a community desperately in need of IT training for unemployed and underemployed residents to be lifted out of the grips of poverty.

Cook County Health & Hospitals System (CCHHS), a long-term client of Atos, was another natural partner with which to create an innovative and effective program.  Atos, CCHHS, and Hope Presbyterian Church all committed funds, resources, and leadership to the cause. They identified Chicago’s South Side as a community in need of computer and technology training for low-income residents, youth education, and job readiness preparation for adults.  In September 2010, Rev. Sanders founded Hope Technology and Education Center (Hope TEC), a not-for-profit 501(c) (3).  Atos committed funding and resources to the program, hiring Julie Collier as the Executive Director.  Julie enrolled 20 adult students in the first Beginners Computer Class; it proved to be a small start that quickly gained momentum.

Today, Hope TEC provides digital literacy, essential life skills, job readiness, job placement, and career planning for adults and youth. Julie Collier has grown the program from one Beginners Computer Class into a broad set of training programs that provide skill development from beginner to advanced levels, including Microsoft Office certifications.  The current phase of Hope TEC is leading students to job internship/job placement components. Because of the widespread success of the program, Hope TEC have a far reach and serves participants throughout the Chicagoland area.  Hope TEC serves more than 100 students annually.  Julie manages curriculum development, implementation of offerings, tracking of progress, and train-the-trainer programs. Her passion moved the program beyond just job training to job placement combined with career development, which is a unique aspect of the program.

“Hope TEC was a godsend,” says Alisha, who completed 14 weeks of training in Microsoft PowerPoint and Excel.  “Now I have the computer skills and the confidence to move forward in my job search.” Alisha earned a high score of 99 percent on the PowerPoint skills test administered by the City Colleges of Chicago, where she was hired as a Clerical Assistant.

Hope TEC has partnered with organization Easter Seals, and in the fall of 2018 will begin a partnership with Catholic Charities through their Senior Community Service Employment Program (SCSEP).  This organization provides their hired trainees with the opportunity to train and work at Hope TEC with the ultimate goal of achieving gainful employment. These senior age adults benefit from learning and teaching new technical skill sets.

Hope TEC also provides year-round youth programs for students at the kindergarten through 8th-grade levels. During the summer months, they enroll 60+ children. Hope TEC also partners with Chicago Mayor Emmanuel’s sponsored program, called One Summer Chicago. They hire, train, and mentor more than ten young people, ages 16 through 24, to work in their youth program. The majority of the children enrolled in the summer program are from families in a low-income bracket who enroll in their school’s free lunch programs, and 85% to 90% of the children live in the community. The program is operated by adults who have professional early childhood education experience and credentials. The program consists of educational learning, such as anti-bullying and self-confidence; basic computer training; robotic programming; PowerPoint presentations; 3D printing; and extracurricular programs. They culminate the summer program with a celebratory event where students give presentations to parents and sponsors about what they have learned and receive book bags and school supplies.

Hope TEC also established a partnership with Chicago State University allowing students to serve as mentors and instructors. CSU students can perform volunteer Service Learning Hours through Hope TEC.  The students assist with the Beginners Computer Class and the youth programs.

The outcomes from Hope TEC demonstrate how innovative IT retraining programs provide value in the community and to potential employers. Hope TEC educates and empowers more than 100 adults and youth each year with computer training programs, essential life skills workshops, job readiness training programs, and a host of youth enrichment programs.

Benefits for Adult Students:

  • Utilize technical skills to compete for and secure employment or to enhance existing employment status.
  • Continue education by enrolling in Junior College to pursue an undergraduate degree.
  • Empower those who are raising children to effectively utilize computer skills, assist their children with homework, extend their overall means of communication, and conduct online transactions or business.

Many of our Hope TEC students have stated that in addition to the exceptional educational program, they also enjoy Hope TEC’s safe and genuine services that lead the way to successful individual outcomes.

Benefits for Youth Students:

  • We provide a safe, educational, and engaging environment for our school-aged children
  • We equip youth with essential to advanced computer skills, including basic Windows operations, keyboarding, internet browsing, introduction to PowerPoint, 3D Printing, and more
  • We help connect youth with summer employment opportunities.
  • Our after-school homework assistance program serves as a protective function for youth who are at risk for failing school, particularly those who do not have other structured after-school activities or those whose parents do not have the education required to assist their children.
  • We educate our students with the necessary anti-bullying and other socials skills to help them use critical thinking skills so that they can diffuse delicate situations they may encounter in everyday life.
  • We provide a place where children experience how to bolster their range of coping strategies. They master the simple challenges of learning how to follow basic instructions, create things as a team, or conquer a physical team challenges.
  • Our youth demonstrate their mastery of the complex challenges associated with getting along with new groups of peers, learning how to ask for help from others, and taking manageable risks without parental guidance.
  • We broaden our children’s horizons via field trips, exposing them to the City of Chicago, including the ComEd Youth Energy Assistance Program, Chicago’s Water Taxi ride for sightseeing through the downtown Chicago Canal, Afterschool Matter Exhibits, museums, farms, and many other exciting and educational places.
  • Our program empowers youth by giving them new skills, ideas, strategies, relationships, with their peers, as well as with trusted adults. Our youth view themselves as competent and continue to be better problem-solvers in new situations long after they leave Hope TEC.

Hope TEC is making a difference by providing essential life skills, job training, professional development, and career paths to low-income youth and adults in Chicago. The partnership between Atos, Hope Presbyterian Church, and CCHHS should be a model for other communities to support, fund, and lead similar essential initiatives.  To learn more about Hope TEC, visit us at www.hopetec.org .

“I had some experience with Word, but I had no idea Word was this in-depth,” says Ken, who completed a three-part advanced study of the Microsoft application suite at Hope TEC. “This is a great benefit that’s much needed. With all that’s going on in Englewood, Hope TEC is a blessing. It’s a blessing for Englewood. It’s a blessing for Chicago, and more people need to know about it.”  After completing the Hope TEC program, Ken was hired by SCR Transportation as a desktop support analyst.

About Hope TEC
Hope TEC dedicated to serving some of the most technologically disadvantaged communities in America. They recognize the need for accessible real-life training in inner-city neighborhoods and the need to prepare its residents in the emerging global economy. Hope TEC believes in empowering people with computer training programs, educational classes, and employment opportunities. Hope TEC’s goal is to transform individual lives, enhance family lifestyles, and impact both individuals and their neighborhoods.

About the Authors:
Julie Collier is the Executive Director of Hope TEC for Atos
Reverend Sanders, Founder, and CEO of Hope TEC
Ron Quidatano is a Director with Atos Digital Health Solutions and the CCHHS Client Executive
Heather Haugen is the Chief Science Officer for Atos Digital Health Solutions
Inbal Vuletich serves as the editor for all Atos Digital Health Solution publications

Acknowledgments:
Special thanks to Chad Harris and Atos leadership for creating the vision for Hope TEC, to Cook County Health and Hospital System, and Ron Quidatano for leading the program.  We also owe our gratitude to the Board of Hope TEC.

About Atos Digital Health Solutions
Atos Digital Health Solutions helps healthcare organizations clarify business objectives while pursuing safer, more effective healthcare that manages costs and engagement across the care continuum. Our leadership team, consultants, and certified project and program managers bring years of practical and operational hospital experience to each engagement. Together, we’ll work closely with you to deliver meaningful outcomes that support your organization’s goals. Our team works shoulder-to-shoulder with your staff, sharing what we know openly. The knowledge transfer throughout the process improves skills and expertise among your team as well as ours. We support a full spectrum of products and services across the healthcare enterprise including Population Health, Value-Based Care, Security and Enterprise Business Strategy Advisory Services, Revenue Cycle Expertise, Adoption and Simulation Programs, ERP and Workforce Management, Go-Live Solutions, EHR Application Expertise, as well as Legacy and Technical Expertise. Atos is a proud sponsor of Healthcare Scene.

3 Key Steps to Driving your Revenue Strategy

Posted on July 9, 2018 I Written By

The following is a guest blog post by Brad Josephson is the Director of Marketing and Communications at PMMC.

For healthcare providers struggling to accurately collect reimbursement, developing a revenue strategy based off a foundation of accuracy is the most efficient way to ensure revenue integrity throughout the revenue cycle.

Currently, many hospitals operate under multiple systems running for their different departments within the organization. This type of internal structure can threaten the accuracy of the analytics because data is forced to come into multiple systems, increasing the chances that the data will be misrepresented.

By maintaining revenue integrity, not only does it give hospitals assurance that the data they’ve collected is current and accurate, but it also provides invaluable leverage with the payer when it comes time to (re)negotiating payer contracts.

Let’s begin by starting from the ground up…

Here are the 3 steps needed for maintaining revenue integrity:

  • Creating a foundation backed by accurate analytics
  • Breaking down the departmental siloes
  • Preparing ahead of time for consumerism and price transparency

Accuracy Drives Meaningful Analytics

The first step toward maintaining revenue integrity is to assess whether your data is accurate. We know that accurate data drives meaningful analytics, essentially functioning as the engine of the revenue cycle.

And what happens when you stop taking care of the engine regularly and it no longer works properly? It not only costs you a lot of money to repair the engine, but you may also have to pay for other parts of the car that were damaged by the engine failure.

What if, however, you were able to visualize pie charts and bar graphs on your car’s dashboard that showed the current health of the engine to inform you when it requires a maintenance check?

You would be better informed about the current state of your engine and have a greater urgency to get the car repaired.

This same principle applies to healthcare organizations looking to increase the accuracy of their data to drive meaningful analytics. While some organizations struggle to draw valuable insight from pieces of raw data, data visualization tools are more efficient because it allows the user to see a complete dashboard with a drill-down capability to gain a deeper and clearer understanding of the implications of their data analytics.

Data visualization allows healthcare providers to quickly identify meaningful trends. Here are the 4 key benefits of implementing data visualization:

  • Easily grasp more information
  • Discover relationships and patterns
  • Identify emerging trends faster
  • Directly interact with data

Figure 1: Payer Dashboard

Removing Departmental Siloes  

While data visualization does generate helpful insight into current and future trends, it begins with storing the data in one integrated system so that different departments can easily communicate regarding the data.

System integration is crucial to maintaining revenue integrity because it dramatically lowers the likelihood of data errors, missed reimbursement, and isolated decisions that don’t look at the full revenue picture. Here is a list of other issues associated with organizations running revenue siloes:

  • No consistent accuracy metrics driving performance and revenue.
  • Different data sources and systems drive independent and isolated decisions without known impact on the rest of the revenue cycle.
  • Departments cannot leverage analytics and insight into contract and payer performance.

In the spirit of the recent international World Cup games, think of revenue siloes like playing for a professional soccer team.

Similar to the structure of a hospital’s revenue team, soccer teams are large organizations that need to be able to clearly communicate with each other quickly in order to make calls on-the-spot. These quick decisions can be the difference in turning the ball over to the other team or scoring a goal in the final minutes so it’s crucial that everyone knows their role on the team.

If other players don’t understand the plays that are being called, however, then mistakes will be made that could cost them the game. Each player on the team needs to study the same playbook so they stay on the same page and decrease the chances that a costly mistake will be made.

A hospital’s Managed Care department works in a similar way. If Managed Care is preparing to renegotiate payer contracts, they need to fully understand and have insight into underpayment and denial trends across multiple payers.

Preparing Now for Consumerism and Price Transparency

Now that we know the reimbursement rate is accurate, how do we communicate an accurate price to patients in order to encourage upfront payment?

Studies have shown that by increasing accuracy in pricing estimates, it increases the likelihood that patients pay upfront, which can help your organization lower bad debt.

In an effort to migrate to a more patient-centric approach, these accurate online estimates also enable hospitals to address the patient’s fear of the unknown with healthcare of ‘how much is this procedure going to cost?’ By giving the patient more control over their financial responsibility, hospitals can become a leader in pricing transparency for their entire community while expanding on their market share.

At the end of the day, what this all comes down to is maintaining accuracy to help drive your revenue strategy. By integrating all data into a single system, the hospital is positioned to identify trends more quickly while increasing the accuracy of their patient estimates, ultimately driving your revenue strategy to new heights.

With many healthcare organizations still making the transition away from the traditional fee-for-service model, now is the time to prepare for consumerism and value-based care. Take some time to evaluate where your organization currently stands in the local market as well as any pricing adjustments that need to be made.

About Brad Josephson
Brad Josephson is the Director of Marketing and Communications at PMMC, a provider of revenue cycle software and contact management services for healthcare providers. Brad received a Bachelor of Arts, Public Relations and Marketing Degree from Drake University. He has worked at PMMC for over three years and has a deep knowledge of hospital revenue cycle management tools which improves the financial performance of healthcare organizations.

The Truth about AI in Healthcare

Posted on June 18, 2018 I Written By

The following is a guest blog post by Gary Palgon, VP Healthcare and Life Sciences Solutions at Liaison Technologies.

Those who watched the television show, “The Good Doctor,” in its first season got to see how a young autistic surgeon who has savant syndrome faced challenges in his everyday life as he learns to connect with people in his world. His extraordinary medical skill and intuition not only saves patients’ lives but also creates bridges with co-workers.

During each show, there is at least one scene in which the young doctor “visualizes” the inner workings of the patient’s body – evaluating and analyzing the cause of the medical condition.

Although all physicians can describe what happens to cause illness, the speed, detail and clarity of the young surgeon’s ability to gather information, predict reactions to treatments and identify the protocol that will produce the best outcome greatly surpasses his colleagues’ abilities.

Yes, this is a television show, but artificial intelligence promises the same capabilities that will disrupt all of our preconceived notions about healthcare on both the clinical and the operational sides of the industry.

Doctors rely on their medical training as well as their personal experience with hundreds of patients, but AI can allow clinicians to tap into the experience of hundreds of doctors’ experiences with thousands of patients. Even if physicians had personal experience with thousands of patients, the human mind can’t process all of the data effectively.

How can AI improve patient outcomes as well as the bottom line?

We’re already seeing the initial benefits of AI in many areas of the hospital. A report by Accenture identifies the top three uses of AI in healthcare as robot-assisted surgery, virtual nursing assistants and administrative workflow assistance. These three AI applications alone represent a potential estimated annual benefit of $78 billion for the healthcare industry by 2026.

The benefits of AI include improved precision in surgery, decreased length of stay, reduction in unnecessary hospital visits through remote assessment of patient conditions, and time-saving capabilities such as voice-to-text transcription. According to Accenture, these improvements represent a work time savings of 17 percent for physicians and 51 percent for registered nurses – at a critical time when there is no end in sight for the shortages of both nurses and doctors.

In a recent webinar discussing the role of AI in healthcare, John Lynn, founder of HealthcareScene.com, described other ways that AI can improve diagnosis, treatment and patient safety. These areas include dosage error detection, treatment plan design, determination of medication adherence, medical imaging, tailored prescription medicine and automated documentation.

One of the challenges to fully leveraging the insights and capabilities of AI is the volume of information accumulated in electronic medical records that is unstructured data. Translating this information into a format that can be used by clinical providers as well as financial and administrative staff to optimize treatment plans as well as workflows is possible with natural language processing – a branch of AI that enables technology to interpret speech and text and determine which information is critical.

The most often cited fear about a reliance on AI in healthcare is the opportunity to make mistakes. Of course, humans make mistakes as well. We must remember that AI’s ability to tap into a much wider pool of information to make decisions or recommend options will result in a more deeply-informed decision – if the data is good.

The proliferation of legacy systems, continually added applications and multiple EMRs in a health system increases the risk of data that cannot be accessed or cannot be shared in real-time to aid clinicians or an AI-supported program. Ensuring that data is aggregated into a central location, harmonized, transformed into a usable format and cleaned to provide high quality data is necessary to support reliable AI performance.

While AI might be able to handle the data aggregation and harmonization tasks in the future, we are not there yet. This is not, however, a reason to delay the use of AI in hospitals and other organizations across the healthcare spectrum.

Healthcare organizations can partner with companies that specialize in the aggregation of data from disparate sources to make the information available to all users. Increasing access to data throughout the organization is beneficial to health systems – even before they implement AI tools.

Although making data available to all of the organization’s providers, staff and vendors as needed may seem onerous, it is possible to do so without adding to the hospital’s IT staff burden or the capital improvement budget. The complexities of translating structured and unstructured data, multiple formats and a myriad of data sources can be balanced with data security concerns with the use of a team that focuses on these issues each day.

While most AI capabilities in use today are algorithms that reflect current best practices or research that are programmed by healthcare providers or researchers, this will change. In the future, AI will expand beyond algorithms, and the technology will be able to learn and make new connections among a wider set of data points than today’s more narrowly focused algorithms.

Whether or not your organization is implementing AI, considering AI or just watching its development, I encourage everyone to start by evaluating the data that will be used to “run” AI tools. Taking steps now to ensure clean, easy-to-access data will not only benefit clinical and operational tasks now but will also position the organization to more quickly adopt AI.

About Gary Palgon
Gary Palgon is vice president of healthcare and life sciences solutions at Liaison Technologies, a proud sponsor of Healthcare Scene. In this role, Gary leverages more than two decades of product management, sales, and marketing experience to develop and expand Liaison’s data-inspired solutions for the healthcare and life sciences verticals. Gary’s unique blend of expertise bridges the gap between the technical and business aspects of healthcare, data security, and electronic commerce. As a respected thought leader in the healthcare IT industry, Gary has had numerous articles published, is a frequent speaker at conferences, and often serves as a knowledgeable resource for analysts and journalists. Gary holds a Bachelor of Science degree in Computer and Information Sciences from the University of Florida.

Gamification in Healthcare: Just Play or Real Value?

Posted on June 14, 2018 I Written By

The following is a guest blog post by Thomas McFarland, Kerry Harbeck, and Andrea Kamper from Atos.

As early as the 1900s, educators started using rewards to motivate learners. Today, we know that incorporating rewards into learning has limited value; however, gamification spans a much broader strategy than simple reward systems. Coined in 2002, the term gamification takes a variety of complex factors into consideration when studying what makes a person decide to do something; it refers to a multifaceted approach that utilizes psychology, design, strategy, and technology.  The efficacy of gamification relies on experts, often instructional designers, to explore innovative pedagogical solutions.

Jane McGonigal, author of Reality is Broken: why games make us better and how they can change the world, demonstrated the power of games in solving real world problems.  She demonstrates how games can teach players how to make complex decisions and strategize for addressing issues from poverty to climate change. For instance, the game World Without Oil is a simulation designed to use brainstorming in order to avert the challenges of a worldwide oil shortage. Evoke, a game commissioned by the World Bank Institute, teaches players to find strategies for addressing issues from poverty to climate change. McGonigal makes a strong case for significant advantages held by organizations who can think beyond traditional training. She places a high value on simulation learning that involves strategy and role-based behaviors.

What value does gamification provide in healthcare?  Previous research indicates that gamification strategies enhance learning in a few key areas such as content recall and retention. Simulation of complex, critical processes may be one of the most valuable applications in healthcare. For example, the Education Technology group at the Stanford School of Medicine developed an application to teach physicians how to identify and treat sepsis. The web-based program, Septris, quickly gained popularity and led to a group of surgeons requesting a new application, SICKO, to teach doctors about surgical decisions.  Reception of Septris was immediately positive, and it enjoyed widespread usage. Within one year of launch, the game received more than 32,000 visits, with 16,700 plays and 2,500 completions of the game. Also, while 55% of hits were direct/organic, the other 45% of hits came from referrals. The authors demonstrated both the clinical and financial benefits of gamification for these more complex processes.

A vast set of opportunities exists in healthcare around learning that focuses on clinical & financial outcomes. Revenue cycle is a particularly challenging area for healthcare organizations because of its complex workflow, multiple stakeholders, turnover in job roles and importance of both accuracy and timeliness. Revenue cycle education is an excellent fit for gamification. We at Breakaway Adoption Solutions have created a strategy and role-specific approach called Revenue Cycle $im. It presents the learner with the multi-faceted revenue cycle environment as a computerized board game with animated characters, interactive problem solving, and real-world scenarios. This method allows the learner to quickly absorb the complex and role-specific interactions that have a significant impact on rev cycle success.

Check out some of the screenshots from Revenue Cycle $im below (click on the images to see the larger version) or request a full demo:


 
If you plan to use gamification in your healthcare organization, you should begin by asking if gamification is appropriate for the desired learning objectives. In general, gamification is more effective when the learning method meets the following criteria:

  • The learning includes a complex set of processes
  • The learning involves problem solving
  • The learning content creates a realistic simulation or link to real or analogous processes
  • The subjects require reinforcement over time
  • The learning content or processes have multiple “right” answers or various paths to successful completion
  • The activities or processes have multiple stakeholders that require collaboration and cooperation
  • The learning should use a creative and fun approach

Gamification has tremendous potential to create an interactive, memorable, rich experience for a healthcare learner.

About the Authors
Thomas McFarland is the Research and Development Manager for Breakaway Adoption Solutions, Atos
Kerry Harbeck is the Director of Learning Innovation for Breakaway Adoption Solutions, Atos
Andrea Kamper is the Innovations Operations Manager for Breakaway Adoption Solutions, Atos

About Atos Digital Health Solutions
Atos Digital Health Solutions helps healthcare organizations clarify business objectives while pursuing safer, more effective healthcare that manages costs and engagement across the care continuum. Our leadership team, consultants, and certified project and program managers bring years of practical and operational hospital experience to each engagement. Together, we’ll work closely with you to deliver meaningful outcomes that support your organization’s goals. Our team works shoulder-to-shoulder with your staff, sharing what we know openly. The knowledge transfer throughout the process improves skills and expertise among your team as well as ours. We support a full spectrum of products and services across the healthcare enterprise including Population Health, Value-Based Care, Security and Enterprise Business Strategy Advisory Services, Revenue Cycle Expertise, Adoption and Simulation Programs, ERP and Workforce Management, Go-Live Solutions, EHR Application Expertise, as well as Legacy and Technical Expertise. Atos is a proud sponsor of Healthcare Scene.