ron bussa project manager jen nichols manager, revenue cycle systems jim dejonge
DESCRIPTION
Implementing Emergency and Inpatient Cerner Registration while Retaining Existing Patient Accounting Technologies. Ron Bussa Project Manager Jen Nichols Manager, Revenue Cycle Systems Jim DeJonge Manager, Patient Access Services. Agenda. Objectives of Today - PowerPoint PPT PresentationTRANSCRIPT
Spectrum Health
1
Implementing Emergency and Inpatient Cerner Registration
while Retaining Existing Patient Accounting Technologies
Ron BussaProject Manager
Jen NicholsManager, Revenue Cycle Systems
Jim DeJongeManager, Patient Access Services
2 Spectrum Health
AgendaObjectives of TodayOverview of Spectrum Health and
Quick Facts (Who)The Vision (Why)The Plan (What)Technical ElementHuman Element (Most Important)Lessons Learned
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ObjectivesUnderstand “Human Aspect” of the
Implementation and What You Can Do
Lessons Learned from Implementing Inpatient Cerner Registration
4 Spectrum Health
Overview of Spectrum HealthWho we are:
7 hospitals
13,000 staff
1,400 physicians
2,000 volunteers
140+ service sites
Who we serve:Service area covers a population of 3 million
450,000 health plan members
6,300 employers
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Quick Facts around Inpatient Registrations
Emergency Department (5 Hospitals)Average # of Emergency Visits/Day = 492Average # of Emergency Visits/Month = 14,760Average # of Emergency Visits/Year = 177,120
Admissions (5 Hospitals)Average # of Admissions/Day = 198Average # of Admissions/Month = 5,940Average # of Admissions/Year = 71,280
Outpatient* Visits/Year = 482,400 * Already Using Cerner as Registration System in
Production
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The Vision (Why)Deliver Exceptional Experience:
Deliver Better Patient Care and Patient Experience Demand Superior Quality:
Deliver Superior Care through the use of Technology
Optimize System Performance: Tighter Integration with Clinical Systems
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Revenue Cycle Technologies
Cerner
Scheduling
Cerner
Registration Clinical Care
Cerner
Coding
HealthQuest/Third Party
Patient Accounting
HealthQuest
Denials/Revenue Management
HealthQuest/Cerner/Third Party
Scheduling
Cerner
Registration
HealthQuest
Clinical Care
Cerner
Coding
HealthQuest/Third Party
Patient Accounting
HealthQuest
Denials/Revenue Management
HealthQuest/Cerner/Third Party
Account Closure
HealthQuest
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Inpatient DataFlowMcKesson Technology: Role/Functionality Workflow—Surgery Future State
Bille
rO
ffice
Sta
ff/R
egis
trar
Fina
ncia
l C
ouns
elor
Sche
dule
rPr
e-Ar
rival
C
linic
alPr
e-Ar
rival
Fi
nanc
ial
Cod
erC
linic
ian
Scheduling Queue
Pre-Procedure Planning
Credit Verification
Authorization Tracking
Elgibility Verification
Address Verification
Register
Clinical Evaluation and
TreatmentEnd
Coding
Needs information and may have to re-perform
Credit Verification
Address Verification
Elgibility Verification
Authorization Tracking
Possible route toFinancial Couns.
Financial Counseling
Patient Payment Collected/Receipt
Patient Payment Collected/Receipt
Patient Responsibility Determined
Billing and Follow Up
End
End
Patient Identification
Possible route to surgery
Legend:
= Undecided
= HealthQuest = Cerner
= Plus
= Work Queue
= Third Party Vendor
=within application
=interface/integration between applications
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Registration Integration
CernerFull EMPI
OrdersResults
Results
Orders
Health Quest
Full EMPIADT: Person, Visit, Combines
Charges
ETL
ADT
CernerFull EMPI
Pyxis BW
DictaphoneMcKesson
PACSMayoClinic
SpecialtyLabs
Pyxis BL
Robot BL
Robot BW
Orders
Rad Onc BL
Rad Onc BW
CBORD
WittCardio PACS
Results
Cyto Lab
Mary Free Bed
GV IM
Priority Health
Mercury MD
Results
Philips BMDI
MMPC Orders
Winscribe
SoftMed
Health Quest
Full EMPIADT: Person, Visit, Combines
Charges
PracticePlus
Partial EMPI
Charges
ADT: Person,
Visit Combines
“Look Ahead”Active Integration
Lawson
Data Warehouse
ETL
ETL
ETL
ETL
Supporting Systems
Spectrum Health Enterprise System Backbone
ADT
Master Integration Model
• Real Time ADT• Full “person” knowledge
• FIN alignment
• Ongoing monitoring, management
• Batch Charges
• Manual Master Files
• Synchronization and timing critical
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Technical Requirements
Defined Technology Build NeedsCerner Registration ConversationPhysician PrivilegingRobust Integration
Rules and EditsCerner and HealthQuesteGate/IIP (Integration)
Monitoring and Reporting Tools
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Human Element:Staff Preparation
System Policies and Procedures Equipment Emotions
Make it intentional!
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Human Element:Current Registration System
What do they say?
“I can almost do a registration with my
eyes closed--I know it so well.” “I haven’t looked at a reference manual
for years.” “I like it when I can help a new staff
member find their way out of difficulty.”
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Human Element:Current Registration System
How do they feel?
Feel confident with self Feel comfortable with job Feel effective and efficient Feel good about accomplishments at the end of
the day Satisfactory emotional levels
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Human Element:New Registration SystemWhat do they say?
“Don’t see how this new system has anything over the one we were using.” “I have to go so slowly now. I have to think about each field.” “I’m lost. What do I do now?” “I know you need help. But, I really do not know what to tell you to do.”
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Human Element:New Registration System
How do they feel?
Don’t feel very confident about their own abilities
Don’t feel very comfortable about their capacity to do the job well
Feel slow and not very efficient
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Human Element:How Can Management Help?
Pre-Implementation Take time to have staff talk about the up-coming
changes Identify super-users; have them dig into the new
system; have them report back findings to staff Prepare staff for all changes: system, process,
procedures, equipment Have a training system that is identical to the Go-
Live systemHave staff Practice, Practice, Practice on New
Registration System
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Human Element:How Can Management Help?
Implementation & Post-Implementation Be a cheerleader during implementation (and after) Have candy, fruit, pizza available for staff Provide education / training and TIS support Provide super-user support Do relaxation exercises Watch for staff-in-stress and offer assistance Provide recognition and thank-you letters (movie
tickets)
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The Lessons Learned:Leadership Involvement is Critical to SuccessDecision might be a “Political Battle” “Open Line” of Communication to Physicians, Nursing Staff,
Revenue, Patient Billing etc…Open Lines of Communication to Staff. “The Why?”Customer Ownership and Scope Management (Phase I,
Phase 2, Phase 3 etc.)Functional/Integration/Enterprise TestingHave Cerner Domains “In Sync” (TEST, TRAIN, PROD etc.)Practice, Practice, Practice on New SystemBe Prepared for Issues/Comparisons but Have Staff
Understand Process of Reporting Issues/SuggestionsDefine Comprehensive Support Model Through Payment