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The Leadership Demands of Value Based Care

Posted on November 8, 2018 I Written By

The following is a guest blog post by Mary Sirois and Heather Haugen PhD from Atos Digital Health Solutions.

The topics of Population Health and Value Based Care continue to swirl through nearly every healthcare conversation.  Leaders across the healthcare provider and payer industries are looking for strategies to reduce costs and improve quality in hopes of improving the bottom line and increasing the viability of the organization within the community; and every vendor has a solution. We recently formed an expert panel to study and better understand the current state of work being done across healthcare provider organizations.  We explored the topics of leadership strategy and commitment, data aggregation, data analytics, and consumer engagement.  Our conversations reinforced the importance of developing a research-based approach to help healthcare leaders navigate the breadth and depth of this critical initiative: value based care.  Our findings continue to drive our work in defining solutions that meet healthcare leaders’ needs to better serve their organizational missions as care providers and employers in their communities.

The expert panelists included Zach Goodling, Director, Population Health and Care Coordination at Multicare; Randy Osteen, VP Applications, Information Management at CHRISTUS Health; and Ruth Krystopolski, SVP of Population Health at Atrium Health.

The panel discussion gave attendees the opportunity to:

  1. Understand experiences and lessons learned from industry population health and informatics leaders in preparing for value-based care opportunities to improve care quality and reduce costs in their communities
  2. Learn about approaches to data aggregation and analytics to support population health’s strategic and operational priorities
  3. Gain an understanding of various care models deployed by different organizations to manage high risk populations
  4. Appreciate the organizational culture and leadership challenges faced within each of the value-based care journeys of three different dynamic organizations

The discussion began by recognizing that the current state of healthcare is isolated and disconnected; it has interoperability challenges, misaligned incentives for employers, payers, providers, and community services; it tends to focus on sickness for an uninformed and confused user population; and it places accountability on providers that often results in duplication or even scarcity of services.

The opportunity here is tremendous!  We can find ways to:

  • Enhance the ability to improve care quality and consumer (patient, member, employee) quality of life and reduce the cost of care.
  • Come together in consumer-centric manner, using interoperable, technology-enabled, data-driven, innovative business models that cross stakeholder boundaries and focus on quality of life across the continuum of care and services, acknowledging shared risk and creating a more accountable consumer population.

Key messages from the group were enlightening and reflected the progression of the entire healthcare industry.

We heard from all three panelists about the arduous work required to make even small amounts of progress. “We have been on a five-year journey to create capabilities in population health management, managing plans to assist members, identify care gaps, and develop care plans.”  The topic of data arose throughout our interviews.  The panel discussed various concerns around data aggregation. “The biggest hurdle is aggregating data from non-affiliated places and various systems.”  “Data is vital to supporting a broad view of each patient; without it, it is very difficult.” And they cautioned organizations about relying on too much data. “When it comes to analytics, being more actionable is better than gathering more data.”

Many leaders find the array of solutions and systems available to healthcare organizations overwhelming. Our experts provided some insight on platform strategy. “Must identify consistent, reliable, scalable solutions.  It is difficult when you have too many solutions/platforms. If you can get users onto the same system, even if it is not the best of class, using the same governance model and tools creates important consistency and scale.”

The panelists had some ideas about other success factors beyond the tool set.  “Social determinants are often the biggest impact when managing a population. We joke that we are all social workers. We are putting these resources in place and able to monitor 400-450 patients with some of the highest risk patient populations.” They encouraged a paradigm shift for those setting strategy for value based care. “I am often impressed by the level of expertise in healthcare, but surprised by the lack of awareness about the macro environment.  We need to ensure we help our people understand the “why” behind the need for change. The organizational work pales in comparison to the cultural changes required to make progress.” Several panelists also reinforced the long-term focus required for value based care programs to succeed. “This is an iterative process that will evolve over time, not a program with a beginning and end.”

Key Themes from Panelists

  1. A clearly defined leadership strategy and commitment are imperative.
  2. Most organizations are still in the early stages of defining their value based care processes. They are working to improve their understanding of consumer engagement and activities that potentially influence consumers. They are exploring new ways of leveraging technologies to engage consumers and provide new models of care.
  3. The lack of interoperability makes data aggregation difficult and the application of meaningful analytics even more challenging.

A Value Based Care Model

Understanding these key themes provides healthcare leaders with a better understanding of where to focus their efforts, but they still need a model to navigate the various domains of value based care.  The model below includes five areas of consideration for healthcare leaders to use as they continue to define their value based care efforts.

  1. Leadership Strategy & Commitment: Define, refine, and commit to a strategy that allows the organization to realize the benefits of value based care. Leadership engagement is imperative and has the power to accelerate or limit the amount of progress in every domain.
  2. Data Aggregation: Compilation of disparate clinical, financial, social, supply chain, administrative, public, and consumer data is vital for supporting clinical and business decisions.
  3. Data Analytics and Business Intelligence: The ability to utilize aggregated data to make informed clinical and business decisions that improve quality, reduce costs, and offer value to consumers
  4. Models of Care: Leveraging digital technology as appropriate, selection of a care delivery model based on collaboration and communication among all health care providers, payers, consumers, and community resources that contribute to individual consumers’ health and well-being
  5. Consumer Engagement: Connection and engagement between external stakeholders (consumers) and organizations (company or brand) through various channels of correspondence. This connection can be a reaction, interaction, effect, or overall customer experience that takes place online and offline.

Maturity and Organizational Evaluation

An example of the progression in organizational competency within each dimension is shown below, focusing on the most important dimension: Leadership Strategy and Commitment.

Value based care domains establish a critical foundation for assessing progress.  Organizations can then begin to evaluate their maturity within each domain. Atos is developing an innovative algorithm to rank organizational maturity within each domain, as seen in the following chart:

This type of insight helps healthcare leaders to think more strategically about where they invest and how they prioritize the many competing initiatives that impact value based care. This strategic view often results in new operating models and elucidates new ideas, innovative approaches, and ultimately better outcomes for consumers, both inside and outside of the healthcare system.

Atos believes that the digital transformation in healthcare is facing three shockwaves:

  1. Shockwave 1: Requires leaders to rationalize and streamline existing systems, notably through real-time clinical delivery and an EHR, in addition to the integration of financial, revenue cycle, and clinical data to fully understand care quality and costs that impact overall revenue and the organization’s financial viability
  2. Shockwave 2: Interconnect and increase collaboration between all ecosystem players, notably through collaboration and digital solutions. Deeply analyze and optimize treatments with new big data and cognitive technologies for population health (achieve early detection of epidemics, discover new risk factors, uncover new treatments, etc.). This is also at the heart of the research in which Atos is participating.
  3. Shockwave 3: Leverage the latest advances in artificial intelligence, machine learning, and genomics analysis. Leverage high performance computing solutions to enable precision medicine. This is probably the most striking advance on the healthcare horizon.

It will be no small feat for organizations to navigate these shockwaves, respond to ongoing payment reform, and address a changing consumer population; it will require discipline and focus. A complete, thoughtful approach will enable healthcare organizations to move from systems of reactive, disconnected care to a global health system that supports individuals throughout their lives.

About the Authors:

  • Mary Sirois is the Vice President of Integrated Solutions Delivery, focused on population health and value-based care services and technology delivery across all of Atos’ solutions. In addition, Ms. Sirois is a member of the Atos Scientific Community.
  • Heather Haugen is the Chief Science Officer for Digital Health Solutions for Atos.
  • Inbal Vuletich serves as the editor for Atos Digital Health Solution publications.

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.

Five Guiding Principles for Leveraging the Healthcare Contact Center

Posted on November 2, 2018 I Written By

The following is a guest blog post by Mike Wisz, Director, Analytics – Healthcare, Advisory Services, and Melissa Baker, Business Analyst, Healthcare, Advisory Services, at Burwood Group.

Consumer experience is more critical than ever for healthcare organizations. Today, the financial performance of health systems increasingly depends on converting consumers into patients and retaining patients within network—patients who now have expanding options for urgent, primary, and elective care. A contact center is a critical component of an inviting “digital front door” for consumers—which is why forward-looking healthcare organizations are envisioning how to transform call centers into patient engagement centers.

As part of an enterprise approach to patient access and experience, each organization will chart its own path in building out contact center capabilities. Healthcare CEOs increasingly recognize that consumers want to interact with their healthcare services as they do with companies in other industries, such as retail or hospitality.

The following are five guiding principles for developing a consumer-grade contact center experience.

First do no harm.

A poorly performing call center can result in frustrated patients or guests whose experience prompts them to look elsewhere for services. So first, deal with current problems, even if they are not easily discoverable. Using all available data sources, assess call handle times, customer effort required, and call routing accuracy against established targets or external benchmarks. If service levels are not acceptable, these problems must be resolved.

Make it easy for patients to connect.

Health systems should make it very easy for customers to access services using their preferred channel of communication. This access should be aligned from the customer’s perspective across touchpoints such as consumer-facing websites, patient portals and self-scheduling applications, and mobile applications offered to patients.

Remember: Productive agents create happy customers.

Consolidating contact center operations should result in more efficiency. Improving efficiency while offering additional services across more medical groups requires automation. Domain-specific knowledge support including scripts and protocols, empowers agents to rapidly resolve service requests. Skills-based routing gives managers the ability to staff flexibly while ensuring target service level performance. Desktop integrations with scheduling, billing, and clinical systems inform agents of highlighted information to reduce contact handle times and increase first-contact resolution rates.

Focus on outcomes. Measure and monitor.

Identify the business outcomes that are most important to determining success. These will likely focus on customer experience, agent productivity, and overall operational effectiveness. Many KPIs and metrics can be measured, but pick a few that will highlight performance against your most important outcomes. Ensure reports are available that provide visibility into key metrics and that reporting is timely enough to be actionable.

Align to enterprise vision and objectives.

It is not always clear in healthcare organizations who owns the “consumer experience.” Leaders from groups representing marketing, population health, clinical quality, and revenue cycle management should align and work together to ensure the contact center serves as a vital component of the organization’s comprehensive approach to patient experience.

In this new environment driven by consumerism, competition for patients will only continue to escalate. Successful health systems will learn to better leverage their contact centers as a way to attract and retain patients and optimize physician utilization, and to tackle a complex set of new challenges.

About Burwood Group
Burwood Group, Inc. is an IT consulting and integration firm. We help forward-thinking leaders design, use, and manage technology to transform their business and improve outcomes. Our services in consulting, technology, and operations are rooted in business alignment and technical expertise in cloud, automation, security, and collaboration. Burwood Group was founded in Chicago, IL and is celebrating over 20 years in business. Today, Burwood includes 250 employees and seven U.S. offices including a 24×7 Operations Center in San Diego, CA. Whether you are developing strategy, deploying technology, or creating an operational model, Burwood is a dedicated partner. To learn more, visit www.burwood.com.

Insights from Ted James, MD at the MEDITECH MD & CIO Forum

Posted on October 17, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Over the next couple days, I’m attending the MEDITECH MD and CIO Forum. This is essentially the user conference for the MD and CIO users of MEDITECH software. This morning, they kicked off the event with Ted James, MD, Medical Director at BIDMC/Harvard Medical School. He provided a number of great insights into what’s happening in healthcare and what leaders can do to be more successful.

Below you’ll find a Twitter summary of Ted James, MD’s keynote. You can also watch the live video interviews I’m doing from the event on the Healthcare Scene Facebook page and follow along on Twitter using the hashtag #MDCIO2018.


Healthcare change seems to be an ever ongoing theme. The question really is around the pace of change.


Anyone that’s been through meaningful use understands this experience.


Routine is a powerful idea. So powerful that it prevents change.


Leadership is the key to any change and was a definite theme from Ted James, MD’s keynote.


I love the concept of nudges, but it only works for a subset of use cases in healthcare. Why? Because so many things in healthcare are really complex.


These 3 ideas were really interesting, but I definitely need more time to fully process what they mean. What do you think of these 3 ideas?


This was a really fascinating idea. It illustrates the need to constantly communicate changes so that people get use to the change before the change even occurs. Familiarity with something changes the experience.


Moving an iceberg feels like an apt descrition of healthcare.


This reminds me of when I recently heard that more yoga won’t fix the physician burnout problem.


This is an important lesson for leaders.


This was a refreshing experience to see so many women at a MD and CIO event.

Check back later for more coverage from the MEDITECH MD and CIO Forum.

Healthcare Leaders: Feeling a Bit Discombobulated?

Posted on October 11, 2018 I Written By

The following is a guest blog post by Heather Haugen PhD and Inbal Vuletich from Atos Digital Health Solutions.

After passing through the security checkpoint at Milwaukee International Airport (MKE), a frazzled traveler is greeted by a low-hanging placard.  It reads: Recombobulation Area.  Clearly someone on the MKE management team with a sense of humor was acknowledging the fact that many travelers become a bit discombobulated as they proceed through security and that many probably need an area where they can get their collective psyche back in order.

The idea of a Recombobulation Area seemed especially appropriate as we returned from a healthcare conference on Lake Geneva where a wide spectrum of thought leaders presented and discussed their experiences from the past decade.  The group’s shared conclusion was that no one could have prepared for or predicted the level of change experienced in the healthcare environment over the past decade.

The changes we discussed encompass every aspect of how care is delivered, from EHRs to ERPs. Healthcare leaders navigate clinical, financial, and compliance hurdles daily – often all tangled together. Clinicians face new technologies, new workflows, new regulations and standards (that often conflict), new reimbursement requirements, new governance models, and something new… coming soon.  How can we expect better care in such a tumultuous environment?

During this time of dramatic change, it is important to identify a way to measure progress (or lack thereof) so that we can stay focused on our goals and desired outcomes.  One of the best mechanisms for assessing the impact of our work in healthcare is the use of data.  A simple research plan such as the one below can be used to assess the impact of changes – and could possibly even elucidate new ideas.

  • Research question: An overarching question to define the effort
    • For example:
      1. How effective are EHR alerts in preventing medication errors?
  • Specific aims: Specific objectives that address the overarching question
    • For example:
      1. To characterize the differences in medication errors before and after EHR implementation
      2. To understand the factors that increase alert fatigue
  • Methodology: How to address each specific goal. This step often requires some collaboration with a statistician or someone with research experience.
    • Define the sample population
    • Define the data elements to collect
    • Determine appropriate timeframes
    • Data analysis plan
  • Results: The presentation of the analyzed data
  • Conclusions: Discussion of the results and their meaning. What are the actionable steps for the organization?

Healthcare has evolved significantly to embrace new advancements in technology, but the challenges we continue to face need to be assessed objectively.  Thus far, our research has focused on the factors that influence adoption of new technology.  It has been fascinating and the outcomes caused us to consider new ideas and better approaches. Our EHR research published in Beyond Implementation remains relevant and valuable to healthcare leaders.  We are committed to helping healthcare organizations shift from the tumultuous set of ongoing changes to a research-based approach to ensure ongoing process improvement and discipline for technology adoption.  Our colleagues’ experiences, the rich research and data that exist today, and the stories of successes and challenges in healthcare organizations provide us with a critical Recombobulation Area. We must take the time to pause and learn from objective data and research methodologies to ensure that all this change focuses on improving patient care.

About the Authors:
Heather Haugen is the Chief Science Officer for Digital Health Solutions for Atos. She is also the author of Beyond Implementation: A Prescription for the Adoption of Healthcare Technology.

Inbal Vuletich serves as the editor for Atos Digital Health Solution publications.

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.

SHSMD Report Shows Healthcare Marketing Budgets Growing Despite Hospital Consolidation

Posted on October 8, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

According to the latest SHSMD By the Numbers report, 25% of respondents who have gone through a hospital merger said their Marketing and Communications budget increased vs 15% who said it decreased.

Today is the first full day of the 2018 Society for Healthcare Strategy & Market Development Conference #SHSMD18 here in Seattle. In preparation, I thought it would be interesting to dive into the 6th edition of the By the Numbers Report recently published by SHSMD and the AHA Data Insights team.

This report is based on survey results collected from almost 2,700 respondents by SHSMD from August 2017 to January 2018. It provides a detailed snapshot of marketing & communications (marcom) at hospitals in the US. Overall, the report paints a rosy picture for marketing. The size of marketing teams is increasing, use of digital marketing tools/techniques is growing and the scope of responsibilities for Marketing departments is expanding.

Here are some of the interesting findings in the report.

Growth in Marketing & Communications Despite Hospital Consolidation

Consolidation is rampant. According to By the Numbers, the number of independent hospitals has dropped from 50% of respondents in 2013 to 30% in 2017. Selection bias was not a factor.

50% of respondents that had gone through a merger said that the marcom function had been centralized (multiple marcom departments merged into a single one). You would expect that this level of consolidation activity would have a negative affect on marcom budgets, but that wasn’t the case. Of those that had been through a merger:

  • 25% said their marcom budget increased
  • 20% said their marcom team grew in size

This is in contrast to:

  • 15% said their marcom budget decreased
  • 5% said their marcom team decreased in size

Hospital Marketing Budgets Growing, but Remain <1% of Overall Hospital Budgets

By the Numbers shows that the average hospital budget in 2017 was $875M – an increase of 39% over the 2013 average of $533M. In that same time period, marcom budgets have grown 65% (adjusted for inflation) to an average of $5.4M.

While it is impressive that marcom budgets have increased at a faster pace than overall hospital budgets, at $5.4M it still represents less than 1% of the overall budget. For most other commercial entities, spending less than 1% on marketing would lead to slower growth and eventually to stagnation.

In 2017, Deloitte published a report that showed the average marketing budget as a percentage of overall budget for a variety of industries:

The Healthcare/Pharmaceuticals category included medical device makers, healthcare software companies and pharmaceutical companies – all of which have much larger marketing budgets compared to hospitals.

I asked Anne Feeney, Research and Data Analytics Specialist for SHSMD and one of the key people behind By the Numbers, why hospitals spend <1% on marcom.

“Some hospitals are the only player in a particular market,” said Feeney. “In those cases there is less need to spend marketing dollars attracting new patients. Also, healthcare has not yet experienced the same competitive pressures that dominate other industries, like consumer packaged goods. In healthcare it’s been as competitive as it has always been, but as an industry we have not risen to the levels of competition we see in other parts of the consumer world.”

Traditional Media Still Dominates Hospital Ad Spend

According to By the Numbers, hospitals are still spending the majority of their advertising budgets on traditional media – TV, newspapers and outdoors.

  Median Average
TV $90,000 $270,859
Newspaper $84,500 $143,810
Outdoor $70,000 $153,278
Electronic ads $56,000 $185,095
Pay-per-click $51,050 $316,112
Radio $50,000 $114,261
Content marketing $33,500 $72,675
Magazines $30,000 $55,227
Direct Mail $30,000 $98,237
Brochures/print collateral $30,000 $73,809
Search engine marketing $22,000 $101,495
Mobile ads $20,000 $108,846
Email $18,500 $21,468
Social media $15,000 $54,584
Location-based ads $15,000 $21,289

 

What I found most interesting is the difference between the Pay-per-click median ($51,050) and average ($316,112). This large delta suggests that the data is highly skewed – meaning that there are some hospitals that are spending a lot more than their peers on Pay-per-click. I believe these high-spending hospitals have discovered something that B2C companies have known for a long time – pay-per-click advertising works. With this knowledge they are exploiting an advantage that their competitors have failed to recognize.

Other Highlights

  • Marketing Departments are watching review and ratings sites. 50% of respondents said they actively monitor existing ratings and review sites on behalf of their hospital
  • Hospitals spend very little on marketing professional development. By the Numbers found that the median spent by marcom in this area was a paltry $6,500 per hospital
  • Social media is still used mostly for broadcasting messages vs patient engagement.

“Among our respondents, the social media stalwarts—Facebook, YouTube, and Twitter—were the most commonly used platforms,” said Lisa Isom, Assistant Director of Digital Content and Social Media, Montefiore Health System. “However, few survey respondents report use of these platforms for engagement and development of the types of conversations that build and/or enhance brand awareness. YouTube was most commonly used as a broadcasting medium for one-way communications. Facebook, on the other hand, was far more likely to be used for two-way communications, which saw respondents taking advantage of its capacity both to share information and engage in interactions. Twitter, the third most commonly used, was used primarily to broadcast news.”

For Feeney, the key takeaway from By the Numbers was the movement towards ROI metrics in marketing: “Marketing used to be seen as a fixed cost. Hospitals are doing so much more now to measure the ROI of marketing & communications. It’s good to see this focus on marketing efficiency, even though as a % of revenue remains small compared to the overall healthcare budget. ROI means marketing is more strategic and can grow if can show ROI.”

For me the report’s key message is it’s time for healthcare marketers to seize the moment and become more strategically relevant in their organizations. The SHSMD data clearly shows that healthcare Marketing departments are being asked to take on more and more responsibilities – from managing the hospital’s reputation to operationalizing patient engagement. This expansion in scope is a perfect time to shine.

I’m looking forward to seeing some of these shining examples on Day 2 and Day 3 of #SHSMD18

A Nursing Informatics Perspective on Healthcare Analytics – Interview with Charles Boicey

Posted on September 21, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Healthcare informatics has been around for a long time. However, from my perspective, it feels like there’s something different in the air when it comes to healthcare informatics. I get the feeling that we’re on the precipice of something really special happening. In fact, I think we already start to see value being created by healthcare informaticists.

As Healthcare Scene continues to explore this subject, we sat down with informatics expert, Charles Boicey, Chief Innovation Officer at Clearsense, to talk with him about what’s changed in healthcare informatics that makes it different today than in the past. We also talk about what’s needed to make healthcare analytics efforts successful at organizations and what analytics trend he’s watching most. Plus, we had to talk about his background as a nurse and how a nursing background really helps his informatics work.

If you want to hear of some practical uses of healthcare analytics and how your organization can benefit from it, you’ll enjoy our interview with Charles Boicey.

Be sure and subscribe to all of Healthcare Scene’s videos on YouTube. Also, take a minute to check out EXPO.health and join us in Boston to mix and mingle with amazing healthcare IT professionals like Charles Boicey.

Changing Leadership’s Mentality to Be More Agile

Posted on August 28, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s become increasingly clear that most healthcare CIOs have become leaders and vendor managers. The CIO of today needs to have an understanding of technology, but the majority of their job is managing people and vendors. Hospital CIOs aren’t managing technology.

Much of what a CIO can accomplish is based on the mentality and behaviors they inspire in their people. One of the latest trends in technology thinking is around agile. Many in healthcare have pushed against the concept of agile in healthcare supposing that agile equals reckless. However, it’s been proven that just because you choose to change quickly and efficiently doesn’t mean that you’re changing recklessly in ways that will harm patients.

The move to agile has been hard for many hospital CIOs. This was highlighted recently by hospital CIO, David Chou when he shared this image and tweet:

Culture change in an organization is not really something you can buy. Plus, as the quote specifies, the change to an agile culture is really hard because it is often not the behaviors that put leaders in senior positions in the first place.

The biggest fear with any change is failure. Ironically, an agile approach embraces failure as part of the learning process and incorporates a quick recovery when something goes wrong. This is a massive change in mindset for many senior healthcare executives. It goes counter to the group decision making driven by large committees that occurs in most of healthcare. That’s why it’s scary and why most CIOs don’t do it. However, it’s exactly what’s needed to be prepared for the future.

Medical Coding, Revenue Cycle Management and the EHR – HIM Scene

Posted on July 31, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s unfortunate, but true that very few healthcare organizations thought about the impact the EHR selection and implementation would have on things like medical coding and revenue cycle management. The later has gotten more attention after hospitals implement an EHR and then run into cash flow problems when they realize their collections have started piling up after the EHR implementation. However, it’s surprising how many coding and revenue cycle management challenges exist post EHR go live.

With this in mind, Healthcare Scene recently talked with Susan Gatehouse, CEO of Axea Solutions, at the HFMA Annual conference about how EHR impacts medical coding and revenue cycle management. She shares some great insights into the topic and some practical ideas for those dealing with these challenges. Plus, we ask Susan what thing stood out to her at the HFMA annual conference.

Check out our interview with Susan Gatehouse:

*Note: This video was originally live streamed to Facebook, so please excuse the poorer quality video and audio.

Be sure to check out all of the Healthcare Scene interviews on YouTube. If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

Revenue Cycle Trends To Watch This Year

Posted on July 13, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Revenue cycle management is something of a moving target. Every time you think you’ve got your processes and workflow in line, something changes and you have to tweak them again. No better example of that was the proposed changes to E/M that came out yesterday. While we wait for that to play out, here’s one look at the trends influencing RCM strategies this year, according to Healthcare IT leaders revenue cycle lead Larry Todd, CPA.

Mergers

As healthcare organizations merge, many legacy systems begin to sunset. That drives them to roll out new systems that can support organizational growth. Health leaders need to figure out how to retire old systems and embrace new ones during a revenue cycle implementation. “Without proper integrations, many organizations will be challenged to manage their reimbursement processes,” Todd says.

Claims denial challenges

Providers are having a hard time addressing claims denials and documentation to support appeals. RCM leaders need to find ways to tighten up these processes and reduce denial rates. They can do so either by adopting third-party systems or working within their own infrastructure, he notes.

CFO engagement

Any technology implementation will have an impact on revenue, so CFOs should stay engaged in the rollout process, he says. “These are highly technical projects, so there’s a tendency to hand over the reins to IT or the software vendor,” notes Todd, a former CFO. “But financial executives need to stay engaged throughout the project, including weekly implementation status updates.”

Providers should form a revenue cycle action team which includes all the stakeholders to the table, including the CFO and clinicians, he says. If the CFO is involved in this process, he or she can offer critical executive oversight of decisions made that impact A/R and cash.

User training and adoption

During the transition from a legacy system to a new platform, healthcare leaders need to make sure their staff are trained to use it. If they aren’t comfortable with the new system, it can mean trouble. Bear in mind that some employees may have used the legacy system for many years and need support as they make the transition. Otherwise, they may balk and productivity could fall.

Outside expertise

Given the complexity of rolling out new systems, it can help to hire experts who understand the technical and operational aspects of the software, along with organizational processes involved in the transition. “It’s very valuable to work with a consulting firm that employs real consultants – people who have worked in operations for years,” Todd concludes.

The Challenge of Medical Records Requests in the Healthcare Business Office – HIM Scene

Posted on July 10, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While at the HFMA Annual Conference (Formerly known as ANI), Healthcare Scene was able to sit down with Kim Charland, BA, RHIT, CCS, Director of Revenue Cycle Services at MRO, to talk about some unique issues with Release of Information (ROI) coming out of the healthcare business office.

This was an issue I hadn’t thought much about previously, but it makes a lot of sense that medical billing professionals probably aren’t the best people to be handling release of information to insurance companies. Billing professionals’ goal is to get paid, not ensure that they’re doing a proper release of information to payers. Plus, most of them have billing expertise, not ROI expertise. It makes a lot of sense for the business office to involve HIM professionals with release of information expertise into the process.

To learn more about this topic and what MRO is doing to help healthcare organizations address this compliance issue, watch the video interview below with Kim Charland:

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