Download Providers find solutions to their greatest challenges with

Transformational
Technologies
Providers find solutions to their greatest challenges with intuitive IT solutions
CONTENTS
HealthLeaders Custom
Media Solutions
Project Director
ALEX MULLEN
Contributor
Jeff Elliott
Art Direction/ Cover Illustration
Doug Ponte
Advertising & Production
Sara La
This installment of the Leadership Series was
produced by HealthLeaders Custom Media
Solutions, HealthLeaders Media. The views
expressed in this publication are those of the
participants and do not necessarily reflect the
views of BLR, HealthLeaders Custom Media
Solutions, the publisher, or the editors
of HealthLeaders.
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Copyright © 2014 HealthLeaders Media
A division of BLR.
4
Transformational Technologies
7
8
Bringing Analytics From Academia to the Community
Providers find solutions to their greatest challenges with intuitive IT solutions
Wireless interoperability helps optimize intravenous infusion safety,
documentation and management
10
12
Data Interoperability in the Eyes of True Visionaries
14
Technology Aids Swift Emergency Department Response to Mass
Shooting in Aurora, Colorado
19
What transformational technologies do healthcare organizations
require to ensure financial stability while continuing to
accelerate positive patient outcomes in the new era of
accountable and performance-based care?
Improving Daily Workflow and Decreasing A/R Days With an
Integrated HIS and RCM
Sponsored Material | Special Supplement to HealthLeaders
January/February 2014 3
Transformational
Technologies
Providers find solutions to their greatest challenges with intuitive IT solutions
H
ealthcare is an intensely complex
industry where innovations, regulations, and business models constantly
morph and patient lives hang in the
balance. To manage these intricacies, hospitals
have been employing IT solutions for decades. But
with the Patient Protection and Affordable Care Act
in full swing, accountable care and pay-for-performance delivery and reimbursement models taking
shape, and meaningful use stage 2 and ICD-10
on the horizon, never has it been more apropos
for healthcare organizations to deploy truly
transformational technologies.
TFrom analytics to interoperability, from patient
engagement to revenue cycle management, healthcare IT is steadily maturing, helping healthcare
organizations deliver the highest-quality care and
simultaneously control costs. But with so many competing priorities, leaders must carefully evaluate the
many solutions available to them and decide which
ones will deliver the greatest return on investment (ROI).
This article breaks down the critical issues healthcare
providers face in the coming months and years
and posits the question: “What transformational
technologies will bring the most value to your
4 January/February 2014
organization, your employees, and perhaps most
importantly your patients?”
Challenges Abound
While a majority of providers have gotten on board
with meaningful use over the past couple of years,
a look back at the stage 1 provisions reveals some
significant hiccups. According to a study published in
the Journal of the American Informatics Association,
the biggest challenge for hospitals participating in the
meaningful use program is computerized provider
order entry (CPOE). Many of the respondents cited
limitations of their IT systems and disruptions in their
practice workflows as reasons for not easily meeting
the CPOE requirements.
Compliance is not likely to get any easier with stage 2.
In fact, it is being billed by some as a “giant leap” for
data exchange. While the rules designed to advance
the secure exchange of information between all
healthcare constituents—including patients—are
rooted in good intentions, many believe they also
present an opportunity for big missteps. As reported
in a white paper titled The Remarkable Risk of a
Disconnected Health Care Environment, published
by the Center for Connected Medicine, a partnership between the University of Pittsburgh Medical
Center and leading technology firms such as IBM and
Alcatel-Lucent, providers continue to find it difficult to
exchange information in a meaningful way.
87%
of respondents indicated they
expect to complete their conversion
to ICD-10 by its rollout in autumn.
According to Dr. Andrew Watson, the paper’s primary
author, the healthcare industry is heavily reliant upon
comprehensive, accurate data to achieve optimal
results. However, the effectiveness of care delivery
has been eroded by information silos, piecemeal
workflows, and antiquated models of care. “Systemic
fragmentation and disconnection have extracted a
steep price and costs have spiraled,” says Watson,
the Center’s medical director. “Quality and safety have
never received adequate attention as critical feedback
to providers of healthcare.”
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While many of the issues are political—healthcare
organizations still desiring to maintain control and
possession of their valuable data—part of the blame
also goes to disparate technologies that don’t easily
communicate with one another. The latter problem is
where stage 2 meaningful use will attempt to make
a difference. To improve their chances for success,
healthcare providers must make themselves aware
of the new data exchange and other requirements
to ensure they are prepared to demonstrate compliance. They can accomplish this by first making sure
their IT vendors are delivering optimal technologies,
then rehearsing how they plan to integrate those
technologies into their daily workflow to ensure
maximum efficiency while maintaining high-quality
care delivery.
The other regulatory elephant in the room is, of course,
ICD-10. Nearly 20 years after it was first proposed,
the 10th Revision of the International Classification
of Diseases—ICD-10-CM for diagnosis coding and
ICD-10-PCS for inpatient hospital procedural
coding—is on the healthcare industry’s doorstep,
poised to go live on October 1, 2014.
It’s a highly ambitious undertaking of a scope never
before seen in the industry. The 14,000 ICD-9 codes
currently in place are being replaced with 69,000
new codes, requiring clinicians to document with
much greater specificity. If not done correctly, coding
presents substantial, concurrent risks to cash flow
and patient care reimbursements, potentially causing healthcare organizations to lose hundreds, if not
thousands, of dollars per month. As with meaningful
use, healthcare providers must take the opportunity to
familiarize themselves with the new standard, reaching out to their technology partners as needed to
ensure a smooth transition come October.
“Quality and safety have never
received adequate attention as
critical feedback to providers
of healthcare.”
—Dr. Andrew Watson; The Remarkable Risk of
a Disconnected Health Care Environment
In spite of these challenges, it appears that healthcare
providers have been relatively successful in embracing solutions. According to the most recent HIMSS
Leadership Survey, released in the spring of 2013,
the federal government’s efforts to inspire provider
investments in IT to qualify for meaningful use financial
incentives have paid off. In fact, approximately 66% of
survey respondents have already qualified for stage
1 meaningful use, while 75% indicated they expect
to qualify for stage 2 in 2014. Additionally, 87% of
respondents indicated they expect to complete their
conversion to ICD-10 by its rollout in autumn.
Clinical Decision Support
Gains New Meaning
While healthcare’s various hurdles in 2014 do bring
with them the potential for disaster, it’s far more likely
that the industry will prevent a meltdown by building on
the criticisms it has received over the years—indeed,
it seems poised to continually gain in technical and
operational sophistication by following the principles
of the “Triple Aim.” Devised by former Centers for
Medicare & Medicaid Services administrator Don
Berwick, the Triple Aim emphasizes three objectives:
Sponsored Material | Special Supplement to HealthLeaders
1) Improve the overall health of the population being
served by acquiring a better understanding of their
health status
2) Enhance the care experience by designating a
personal provider and care team who are responsible for coordinating each patient’s medical and
behavioral healthcare activities
3) Provide the best care possible while lowering the
per capita costs of care over time by applying
evidence-based care and eliminating duplicative
or unnecessary procedures
The Triple Aim’s message highlights the need for
healthcare to embrace emerging multidisciplinary
care models that transfer more financial risk to providers based on clinical outcomes and controlling
expenses. These approaches—which take the form
of patient-centered medical homes and accountable
care organizations, for example—harness the power
of collaboration among providers, hospitals, specialists, payers, and even patients to deliver thorough,
effective, and coordinated care.
With greater emphasis on patient safety and outcomes, providers are relying on digital tools to facilitate
January/February 2014 5
“While providers busily deploy EHR,
revenue cycle management, and
analytics technologies, they cannot
overlook perhaps the most enabling
solution of all: the healthcare
information exchange (HIE).”
real-time decision-making at the point of care. One
well-known academic institution in the Southeast
was involved in implementing a clinical decision
support solution designed to elevate care quality. With
data aggregated from multiple information systems,
providers had information at their fingertips that was
previously unavailable, filling them in on medications
they didn’t know patients were taking and tests
conducted at other facilities.
Technology Helps
Providers Watch the
Bottom Line
Healthcare organizations are also using technology
solutions to more accurately and effectively collect
patient data during scheduling and registration. If a
patient’s correct information isn’t captured up front,
the whole revenue cycle for that patient falls apart.
One facility identified $9 million in undercharges from
a single payer due to registration information not being
appropriately categorized.
Technology can also play a significant role in claim and
denial management. Industrywide estimates put net
revenues lost to third-party claim discrepancies at 1%
to 3%, though for many providers that number is much
higher. Many healthcare claim issues can be traced
back to registration and coding problems. However, if
providers are able to effectively leverage solutions to
prevent claim rejections, denial management will take
on a whole new meaning.
Providers today face greater competitive pressures,
higher costs to deliver care, and lower reimbursement
rates, inspiring many business managers to revisit
finance-side operations. As a result, providers must
continue to strive for revenue cycle improvements with
Financial business intelligence and decision support
innovative technologies.
analytics are also becoming more sophisticated,
Among those technologies are insurance eligibility ver- largely due to the greater number of sources from
ification solutions that allow a provider to electronically which to mine data. Similar to challenges faced in
submit eligibility requests, either in batches prior to incorporating clinical data from multiple sources,
appointments or in real time when a patient presents. however, healthcare organizations must place a high
6 January/February 2014
priority on data integration. In order to leverage analytics to their fullest, executives must define the metrics
of greatest importance to their organizations, employ
robust technologies that can harmonize the data, and,
crucially, make it a priority to regularly review the data
and create actionable process improvement plans.
Tying It All Together
While providers busily deploy EHR, revenue cycle
management, and analytics technologies, they cannot
overlook perhaps the most enabling solution of all:
the healthcare information exchange (HIE). Alone,
clinical and financial systems will have little value in
the new healthcare environment if they are unable to
extract and share vital patient and financial data across
the continuum.
HIEs are becoming vital for widespread data exchange,
connecting physicians, hospitals, laboratories, pharmacies, and other service providers throughout their
communities and beyond. Not only can they improve
physician efficiency by speeding the ordering and
results distribution process, they can help lower
administrative costs, a clear indicator of ever-important ROI. In fact, one large Illinois health system
reported it was able to eliminate more than $2 million
in manual report distribution costs with an HIE solution.
It’s clear that the industry is juggling a host of competing IT priorities. Fortunately, technology developers are stepping in with workable clinical, financial,
and connectivity solutions that will enable healthcare
organizations to qualify for meaningful use and
other incentives that reward quality and efficiency.
More importantly, those organizations will be better
positioned to ensure patient safety, improve access
services, and create a sustainable value-based
healthcare system. n
Sponsored Material | Special Supplement to HealthLeaders
A discussion with
Asif Ahmad of Anthelio
Healthcare Solutions
HL: Explain how analytics has evolved over the years to become a vital
part of healthcare operations.
Asif Ahmad: Historically, analytics, business intelligence and decision support
systems have been the domain of hospital administrators who mainly used
back-office data to help evaluate operational performance. As we move toward
accountable care and value-based reimbursement models, healthcare providers,
particularly clinicians, require a much more robust data set to draw upon to assist
them in making strong clinical and financial decisions for their organizations and
patients alike. Effective analytical solutions must now have the ability to integrate
data from multiple, often disparate, sources and deliver it quickly and efficiently
at the point of care.
warehousing solutions capable of harmonizing both clinical and administrative
information enabled with analytics and delivered to providers via the cloud or
other platforms in real time. Technology developers must take their queue and
move beyond the low-hanging fruit and produce intelligent decision support systems that provide access to the information locked in the individual IT systems.
We have learned a lot from academia, using our knowledge to effectively invest in
research and development and engage clinicians to help us drive product viability. Our efforts produced an on-demand warehousing product that healthcare
organizations can utilize to store historical data, which has since evolved into
a technology that provides real-time analytics much more cost-effectively than
solutions healthcare organizations could build on their own.
“Unfortunately, much of the valuable
information resides in silos and is
not easily integrated.”
Bringing Analytics From
Academia to the Community
HL: What are the barriers to adoption of analytics solutions?
Ahmad: Unfortunately, much of the valuable information resides in silos and is
not easily integrated. And because of the costs involved in developing interoperability platforms, technology developers have had very little incentive to introduce
robust decision support technologies that can extract and harmonize data from
a variety of different financial and clinical systems. The winds of change are in
full force, however, and technology developers such as Anthelio are stepping
up to provide interoperable analytical solutions that can truly help advance
clinical care.
HL: What is the recipe for success when so many other companies have
failed to deliver effective solutions?
Ahmad: Academia has laid the groundwork for workable analytical solutions.
They have access to research grants that most healthcare organizations and
technology developers do not, which has assisted them in advancing both the
science and business of medicine. From this setting has emerged intuitive data
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HL: What future improvements can we expect as analytics move from
academia into the broader healthcare community?
Ahmad: Clinical and administrative decisions are increasingly the domain of
physicians. To effectively respond to new healthcare delivery and payment
models, physicians today require access not simply to EHR data with a current diagnosis, but historical information that allows them to quickly make
critical medical decisions, which is only possible with data aggregated from
many different clinical systems. This capability becomes even more powerful
when integrated with health plan data that provides insight into health plan
coverage details, including copay and deductible amounts, so patients have a
thorough understanding of the costs for their care. Clinicians within healthcare
organizations with many different, incompatible information systems stand to
benefit greatly by gaining access to an aggregated, longitudinal view of the
most important data in real time. This intelligence will not only assist them
in delivering the best medical decisions for their patients, but also help them
make wise cost containment choices, effectively adding value to the entire
healthcare system. n
January/February 2014 7
CASE STUDY
Wireless interoperability helps
optimize intravenous infusion safety,
documentation and management
Children’s Hospitals and Clinics of Minnesota integrates
CareFusion Alaris® System smart pumps with Cerner
Millennium® electronic health record system
Children’s Hospitals and Clinics of Minnesota (Children’s
Minnesota), partnering with CareFusion and Cerner, became the
first pediatric hospital system to achieve interoperability between
smart intravenous (IV) infusion pumps and an electronic health
record (EHR) system. Children’s Minnesota is also the first hospital
of any type to implement infusion interoperability for both largevolume and syringe IV infusions. The state’s largest provider of
neonatal, cancer, diabetes and cardiac care, Children’s Minnesota
is a nonprofit, independent pediatric health system with 381 beds,
1,700 professional staff, 12,218 inpatient admissions, 20,453
surgical cases, 403 active research programs and approximately
$590 million in annual revenue.
Following its successful pilot study in a pediatric intensive care
unit (PICU) in March 2012, Children’s Minnesota has implemented
smart pump-EHR interoperability for all 381 inpatient beds
throughout its Minneapolis and St. Paul hospitals, including
ICUs, medical/surgical units, short-stay units, the emergency
department (ED) and surgical services for acutely ill pediatric
patients ranging from 400-gm neonates to 150-kg adolescents.
The goal is to continually increase medication safety while
reducing costs, using technology to help decrease costly
adverse drug events (ADEs) by 10% to 15% per year.
High-risk IV infusions present much greater medication safety
challenges than non-infusion medications.1 IV infusion errors,
which involve high-risk medications delivered directly into a
patient’s bloodstream, are the medication errors with the
greatest potential to cause harm, especially for pediatric and
neonatal patients requiring precise weight-based dosing. 2
Traditional barcode medication administration (BCMA) systems,
which help ensure the 5 Rights (right patient, medication, dose,
route and time) for a single dose, provide only limited safety
value for high-risk IV infusions. 3
Improved infusion administration
The Alaris smart pumps’ dose-error-reduction software (DERS)
alerts clinicians to manual infusion-pump programming that
exceeds hospital-established limits. Smart pump Auto-ID systems
have used barcode scanning to populate the pump with limited
infusion-order information from the IV medication label. Now
wireless interoperability between the Alaris System and Cerner’s
CareAware Infusion Suite™ EHR makes it possible to pre-populate
the pump with the ordered infusion parameters transmitted
directly from the EHR.
Scanning the barcode labels on the patient wristband,
medication label and infusion pump helps verify the 5 Rights
and triggers wireless transmission of the ordered infusion
parameters from the EHR to the smart pump module. This
solution helps eliminate order transcription errors and almost
all of the error-prone manual programming previously required
to begin an IV infusion. The solution also automatically engages
the Alaris System Guardrails® dose-error-reduction software to
further protect the infusion. During IV administration, infusion
data is wirelessly transmitted from the Alaris System in near
real-time to populate Cerner CareAware Infusion Suite
documentation, graphing, patient infusion view, and unit
infusion views. This helps secure the 6th Right of medication
administration—right documentation.
Results
Results from the six-week PICU pilot study of the integrated
system* showed that nurses’ compliance with barcode scanning
was close to 90%. Guardrails-protected infusions increased by
15%, and manually programmed infusions decreased 33%.
Personnel-reported medication errors decreased 71%. Nurses
increased their adoption of scanning for pre-population of
infusion parameters at a higher rate than with the earlier Auto-ID.
Since completing enterprise-wide implementation of the new
system, preliminary data show even greater, sustained increases
in Guardrails-protected infusions. The integrated system also
can help Children’s Minnesota quantify the return on investment
(ROI) to the leadership team.
“We’ve broken new ground and shown what’s possible,” says
Bobbie Carroll, Senior Director for Patient Safety and Clinical
Informatics at Children’s Minnesota. “While this is not the
first time barcodes have been used to match medications with
patients, it is the first time they have been used to pre-program
both large-volume and syringe infusion smart pumps in a children’s
hospital. This really opens a new era in IV medication safety in
helping protect our most vulnerable patients.”
* Children’s
Hospitals and Clinics of Minnesota’s results reflect the facility’s infusion
processes and protocols in combination with Alaris technologies.
References
1 Carroll, B. Integrated solution helps improve pediatric patient safety, streamline IV
medication management. Pt Safety Qual Healthcare, March/April 2013. 2 Williams, CK.,
Maddox, RR., Heape, E. et al. Application of the IV Medication Harm Index. J Patient Saf,
2006;2:132–139. 3 Vanderveen, T. IVs first. Pt Safety Qual Healthcare, May/June 2006.
Alaris
®
© 2013 CareFusion Corporation or one of its subsidiaries. All rights reserved. Alaris, Guardrails, CareFusion and the CareFusion
logo are trademarks or registered trademarks of CareFusion Corporation or one of its subsidiaries. Cerner Millenium and
CareAware Infusion Suite are trademarks or registered trademarks of Cerner Corporation or one of its subsidiaries. IF2794 (1213)
8 January/February 2014
Sponsored Material | Special Supplement to HealthLeaders
THE FUTURE
OF HEALTHCARE.
TODAY.
Infusion management
Simplified documentation
All systems go—with infusion interoperability. The solution wirelessly
transmits order data from the EMR to large-volume and syringe pumps,
reducing risk of manual errors and helping protect vulnerable patients.
It also sends back status information in near real time,* enabling timely
and accurate documentation to help enhance decisions, workflow and
your bottom line. We make patient safety a standard feature.
Cost reduction
Medication error reduction
Learn more at carefusion.com/AlarisFuture.
Alaris
®
*Subject to internet connection, devices variability and selected settings.
© 2013 CareFusion Corporation or one of its subsidiaries. All rights reserved. Alaris, CareFusion and the CareFusion
logo are trademarks or registered trademarks of CareFusion Corporation or one of its subsidiaries. IF2791
Workflow optimization
A conversation with Gary
Zegiestowsky and Jeffrey
Cunningham from Informatics
Corporation of America
HL: Discuss the issues today that are forcing healthcare organizations to
take a closer look at interoperability.
Gary Zegiestowsky: Meaningful use is a major motivation, particularly stage 2
provisions that incentivize providers to share more information with each other
and utilize technology to engage patients. There is also a push toward accountable care and pay-for-performance reimbursement models that require providers
to gain a greater understanding of their patients to ensure they are delivering the
highest-quality care possible.
The greatest challenges aren’t centered on the technical aspects of information
sharing. Rather, they are more directly related to provider workflow improvement.
Based on feedback from our healthcare delivery partner, we are creating automated
solutions designed to enhance caregiving processes. That being said, the technology
has progressed to a point over the last few years to help this become a reality.
HL: What is your company’s technical approach to interoperability?
Zegiestowsky: We support every major interoperability standard in the healthcare industry. More importantly, we do this in a way that allows these standards
to work in conjunction with one another within the same platform. This allows us
to support more complex workflows, making it easier for providers to access the
appropriate information when and where it’s required. We have also focused on
building intelligence into our solutions by providing seamless and easy-to-use
application programming interfaces (APIs) that deliver data from our platform
back to the native program the caregiver is using. Providers then have the ability
Data Interoperability in the
Eyes of True Visionaries
HL: What are the greatest barriers to interoperability?
Jeffrey Cunningham: Traditionally, providers have not had a strong financial
incentive to liberally share patient data. Additionally, it has taken the industry a
fair amount of time to develop and adopt standards that enable the different technologies—including electronic medical record (EMR) and healthcare information
exchange (HIE) solutions—to easily communicate. Fortunately, over the last few
years, we have made great strides towards interoperability via innovative business
and technical solutions that are breaking down these barriers and facilitating
coordinated care delivery.
HL: What must happen for the interoperability
floodgates to open, so to speak?
Zegiestowsky: Technology developers must be able to move beyond the notion
of simply providing connectivity between different information systems and deliver
innovative solutions that truly help providers improve their workflow. ICA is devoted
to assisting healthcare organizations in establishing new processes that streamline
caregiving as patients move throughout the continuum of care.
Cunningham: We are in the middle of a pilot project designed to help a healthcare
organization manage its dual-eligible population (Medicare and Medicaid recipients).
10 January/February 2014
to turn raw administrative, claim, and clinical data into actionable information that
they can use to manage patient populations, assess financial risk, and comply
with the bevy of regulatory protocols.
HL: What does the future hold for interoperability in healthcare?
Cunningham: While there has been a tremendous amount of technical progress in
sharing information such as continuity of care documents and patient history data, I
expect there will be a much stronger emphasis on solutions that tailor content that is
harmonized in support of point-of-care applications and clinical and financial analytics. There is also likely to be an increased focus on ancillary services such as home
health, ensuring data from these facilities enters the mix. This will only help ensure
patients are receiving the best care in any setting. There are some great examples
emerging of how EMR and interoperability solutions are helping to improve workflow
and assist providers in delivering high-quality care while managing costs. It’s an
exciting time to be in the healthcare industry … never before have providers relied
on information technology to effect such meaningful change. n
____________________________________________________________________________
Gary Zegiestowsky is CEO of Informatics Corporation of America.
Jeffrey Cunningham is Chief Technical Officer of Informatics Corporation of America.
ICA’s interoperability and informatics platform addresses and solves data and communication challenges for
healthcare organizations, including hospitals, IPAs, IDNs, ACOs, HIEs, and payers.
Sponsored Material | Special Supplement to HealthLeaders
ICA
untangling interoperability challenges
and creating connected clinical networks
Real Challenges. Real Conversations. Real Solutions.
www.icainformatics.com
[email protected]
copyright 2014 Informatics Corporation of America
l
1801 West End Avenue, Nashville, TN
Carilion Clinic discovered SSI’s
technology solutions were the
ideal fit for its unique needs
C
arilion Clinic is revered in its southwest Virginia community.
With more than 600 physicians in a multi-specialty group practice and
eight not-for-profit hospitals—including a state-of-the-art, 92-bed
children’s facility that provides specialized intensive care to neonatal,
pediatric, and adolescent patients—Carilion Clinic specializes in patient-centered
services, medical education, and clinical research.
Based in Roanoke, Carilion Clinic admits nearly 50,000 patients each year. It
also operates primary care clinics, residency and fellowship programs, laboratories,
health clubs, and an aero medical program. With so many priorities to juggle, the
organization requires leading-edge technology solutions to ensure it continually
provides top-notch healthcare while maintaining a healthy revenue cycle.
Built for Results
Through the use of several SSI products, all of which integrate with Epic, Carilion
has successfully yielded an impressive 47- to 52-day range in A/R days for
hospital billing and 25 - 30 days for professional billing. This tight vendor integration enables a more connected revenue cycle where workflow inefficiencies are
minimized, costs are reduced, and the expanding demands of sharing revenue
cycle data are more easily met.
Most noteworthy may be the way Carilion uses ClickON Bill Date Note
Posting, ClickON Confirmation Note Posting, and ClickON Claims Status Module
to automatically populate work queues and workflow logic within Epic. This
procedure reduces confusion on the front end and is a crucial part of Carilion’s
daily billing cycle.
Overall, Brown is pleased with both of the revenue cycle solutions he has
in operation at Carilion Clinic and feels they operate successfully together to
decrease A/R days and improve the daily workflow. “SSI automates, innovates,
Improving Daily Workflow
and Decreasing A/R Days With
an Integrated HIS and RCM
An Integrated Solution
When comparing past vendor relationships, Chris Brown, project consultant of revenue
cycle management at Carilion Clinic, knew the organization needed a company that
would work with him to deliver a technology tailored to Carilion’s specific needs. Already
a longtime customer of The SSI Group, Inc.® (SSI), a developer of end-to-end revenue
cycle management solutions, he was worried that the software might not be compatible with other technologies designed to keep the organization performing at peak levels.
To his relief, SSI and healthcare information system vendor Epic had been
delivering integrated solutions for years, ensuring seamless data connectivity.
After implementing the Epic system, Brown was impressed with the way he was
able to use SSI’s recurring error report to review the issues reported by this tool
and utilize the Epic build teams to correct within Epic when possible. Being able
to correct errors before the bill was dropped into SSI resulted in a much higher
validation rate and accelerated the remit process.
Brown was also impressed with the customizability of the SSI system. “I
am able to correct most of the errors present on the recurring error report within
Epic,” he says, but if needed, “I can also request an edit or a hardcode within SSI
to increase our validation rate.”
Brown is currently working on a solution for SSI’s ClickON® Claims Status
Module to post real-time notes back to the Epic system. He thinks this new
initiative will alleviate biller confusion caused when receiving multiple notes for
the same claim. If the notes are posted back in real time, the billers will know
to address the latest note on the claim, which should save time and money.
12 January/February 2014
and provides for a consistent claims processing platform for all of our business
offices, including hospital billing, professional billing, and home health and
hospice billing,” Brown says.
“I would definitely recommend SSI as a claims vendor to Epic customers based
on the success we have had at our facility.”
“SSI automates, innovates, and provides for
a consistent claims processing platform
for all of our business offices, including
hospital billing, professional billing, and
home health and hospice billing.”
About The SSI Group
SSI powers the business of healthcare through improved flexibility, connectivity,
and integration. The company offers a single-vendor, end-to-end RCM solution
featuring front-end eligibility; patient propensity to pay and patient access;
best-in-class billing and claims transmission; contract management, release of
information and attachment processing; and an advanced analytics and business
intelligence product suite. n
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Powering the Business
of Healthcare™
Technology Aids Swift Emergency
Department Response to Mass
Shooting in Aurora, Colorado
14 January/February 2014
and dirty bed status. The impact of the system was felt immediately upon ‘go live’
as bed cleaning delays — and the subsequent system-wide capacity issues that
arise as patients are backlogged waiting for room placement — became clearly
visible on screen and in real time.
The ability to track each aspect of a patient’s care and movement through the
length of their stay, and the ability to assess hospital capacity in real time, would prove
to be critical in the response to the shooting rampage at the Aurora movie theater.
“The system gave staff the ability
to pull real-time, detailed reports
on each of the shooting victims.”
A Dark Night in Aurora, Colorado
When James Holmes walked into the theater in a Batman costume and began
firing, killing 12 and wounding 58 in less than six minutes, staff at the University
of Colorado Hospital were already challenged by a full emergency room and a
nearly full waiting room. The EMS system used by Colorado hospitals to track
available beds had flagged UCH as being on diversion that evening, but Aurora
Sponsored Material | Special Supplement to HealthLeaders
Istockphoto
O
n July 20, 2012 at a midnight screening of the The Dark Knight
Rises, several people were shot and wounded by gunman James
Holmes. That night, 22 shooting victims — the largest contingent
of wounded — were rushed to the University of Colorado Hospital.
In a state which has unfortunately endured several mass shootings, UCH had
undergone years of regularly scheduled drills to prepare staff for swift action in the
event of an unforeseen medical tragedy.
The hospital’s highly coordinated treatment of the shooting victims that night,
and the ability to track and report each patient’s progress to fam­ily, law enforcement
and the media in subsequent days, was made possible, in part, through the innovative
use of real-time patient flow technology.
University of Colorado Hospital is the Rocky Mountain region’s leading
tertiary care and referral center. Community physicians from around the state,
region, nation and, increasingly, the world, send patients to this hospital for
advanced, collaborative care by some of the leading specialists in their fields.
When the University of Colorado Hospital (UCH) implemented TeleTracking,
an automated, real-time patient flow and data- monitoring system, they did
not know then that the technology would one day support them through their
response to one of the most horrific mass shootings in U.S. history.
UCH had deployed TeleTracking’s Capacity Management Suite™ system
in order to transition from the handwritten clipboard system they were using to
assign beds, track patients through their continuum of care, and monitor clean
“The ability to track each aspect of a
patient’s care and movement through the
length of their stay, and the ability to assess
hospital capacity in real time, would prove
to be critical in the response to the
shooting rampage at the Aurora
movie theater.”
A public hotline was established in collaboration with other hospitals to
assist people who were looking to locate loved ones. That hotline received 2,000
calls within the first 12 hours of the emergency.
Patient Placement Indicators
Facilitate Clarity and Protection
in the Midst of Chaos
In the chaos of that night, ED registration staff did not designate the Aurora
patients as “disaster” victims. In fact, in most registration processes, disaster
is entered as part of the patient’s name and records cannot be subsequently
changed. As a result, when patients are not designated under “disaster” status
during admission, staff must use handwritten lists of people associated with
disasters or work from pages of patient labels for weeks at a time.
shutterstock
police, working to move injured victims as quickly as possible, knew nothing of
the divert status to other emergency departments.
Within 15 minutes of the shooting, nine squad cars carrying 19 patients
pulled into the UCH ambulance ED bay before a single ambulance arrived there.
In total, UCH received 22 shooting victims from the Aurora event, twice as many
as any other hospital. At the same time, other patients not associated with the
shooting continued to walk into the ED, adding to the confusion.
In that moment, the plans and drills implemented after the Columbine tragedy proved to be the difference between life and death for victims treated and
hospitalized at UCH that night. The hospital activated its hospital-wide casualty
response plan as staff rushed to take in the crush of victims, all of whom were
suffering from penetrating gunshot wounds — many to the abdomen or chest —
and needed to get to the operating room quickly in order to survive. Every patient
needed blood and many had perforated and collapsed lungs that needed to be
rapidly expanded. Many were unable to breathe on their own.
By providing the ability to see pending discharges on an electronic bedboard, UCH’s automated patient flow system enabled hospital managers to
prioritize patient placement and re-assign existing patients accordingly. Using
on-screen, real- time data on each patient in the hospital, staff was able to
identify those patients who needed to go emergently to the OR, then triaged
those who needed surgery but could go to a room first, and those that were of
‘treat and release’ status.
To make space for the shooting victims, UCH opened its PACU for inpatient
care and called staff from other units and from home to care for patients moved
from ICUs, and for those who had been boarded in the ED but were moved to
make room for the wounded. As patients were moved and relocated throughout
the hospital, patient flow technology continued to track and highlight the most
relevant information, facilitating decision-making for staff who were working
under stress.
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16 January/February 2014
Reporting Capabilities Keep
the Records Straight
The system gave staff the ability to pull real-time, detailed reports on each of
the shooting victims. Within 30 minutes of the designation change, relevant
details of their status were distributed to media relations personnel, the family crisis call line, the UCH command center and the Aurora Police Command
Center, which re- quested a spread sheet with demographics, diagnosis, and
admitted or released status for each of the 22 shooting victims.
Results
n All 22 victims who reached the hospital alive survived.
n Because of tracking and data collection capabilities, hospital staff were able to
quickly provide detailed, timely reports on all victims to families, law enforcement and the media in the immediate aftermath of the shooting, as well as
throughout the days and weeks that followed. n
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Istockphoto
UCH was able to configure the TeleTracking system with a “disaster”
code, by using the system’s patient placement indicators (PPIs). A 4 a.m. call
to TeleTracking Technical Support was immediately answered, and UCH staff
were walked through the steps to activate specific details of the disaster PPIs.
With shooting victims now flagged with the disaster designation, patient
flow technology was able to track their every movement and location, whether
they were in the OR, in radiology, undergoing a procedure, or in their beds. It also
provided real-time updates on levels of care.
The “disaster” Patient Placement Indicators also meant that the entire hospital staff was more effectively prepared to deal with patient shock and trauma.
Equally urgent, staff were alerted to protect the victims’ privacy in the face of an
intense flood of family inquiries, detailed reporting requests, and extensive press
coverage. The designation also helped staff to accommodate patient wishes, as
in the case of a wounded couple who were expecting a child. The wife, who was
treated and released, was cleared
to later deliver her baby at UCH where her husband was still in a coma and
where staff knew her situation and would make every effort to assist her. After
delivery, staff members brought the newborn baby to the father who, although
comatose, responded to his child’s cries.
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Access. Insight. Analysis.
What transformational technologies do healthcare
organizations require to ensure financial stability while
continuing to accelerate positive patient outcomes in the
new era of accountable and performance-based care?
Given that physicians are a more integral figure in operational decision making, they require
access to rich stores of both clinical and financial data delivered in real time at the point of
care. As such, they require technologies that can integrate this information, which is often
isolated in disparate information systems. Value is further added with analytics that can help
providers measure outcomes as well as demonstrate the impact that their IT solutions have on clinical quality and financial performance.
Presented in a user-friendly longitudinal, providers now have a vital tool that will help them more effectively respond to accountable care
and value-based reimbursement models.
Gary Zegiestowsky
Chief Executive Officer
Informatics Corporation of America
President
TeleTracking Technologies, Inc.
Chief Executive Officer
Anthelio Healthcare Solutions Inc.
For organizations to thrive in the new era of accountable and performance-based care, it is imperative
that organizations move beyond proficiency in the particular care setting to excellence in managing
patient health across the care continuum. Foundational to this new model is interoperability software
that aggregates patient information and supports bi-directional sharing of that information with all
systems in the care process. Additionally, surveillance and workflow automation capabilities used in
conjunction with interoperability functions allow organizations to move beyond connecting system to system to truly automating
patient care across settings. Finally, analytics software that can evaluate historical data and provide real-time predictive intelligence
supports consistent application of evidence-based care across treatment settings.
A looming October 2014 deadline for ICD-10 coding, along with the broader landscape of accountable care organizations and other population-based health initiatives, presents providers with a serious challenge—as well as a
strategic opportunity. Providers must drive rapidly toward standardized revenue cycle processes while broadening
their scope to encompass partner organizations, health plans, and third parties. This distributed revenue cycle places
increased demands on workflows, underlying data models, and HIS-agnostic interoperability. SSI has adapted its
clearinghouse and revenue cycle software solutions to serve as a “revenue cycle as a platform”—to support the future demands of radically
different reimbursement models.
Michael Gallup
Asif Ahmad
Tom Myers
Chief Strategy Officer
The SSI Group
In this complex, increasingly regulated healthcare environment, the focus should
be on technologies that drive operational efficiencies and not just document compliance. Over the last several years, hospitals have spent millions on systems that
drive compliance. Now is the time to combine compliance-based systems with
healthcare efficiency platforms. Automated operational platforms provide hospitals and health systems with enterprise-wide visibility,
allowing them to maximize use of existing resources and eliminate unnecessary time lags to get the patient to the right place at the
right time. We will never point and click our way to advancing healthcare without the implementation of technologies that eliminate
waste and improve workflows.
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