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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. 75 Sylvan Street, Suite A-101 Danvers, MA 01923 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.” Sponsored Material | Special Supplement to HealthLeaders 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 Sponsored Material | Special Supplement to HealthLeaders 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 Sponsored Material | Special Supplement to HealthLeaders THE COMPLETE REVENUE CYCLE, FROM PRECARE TO POSTCARE The whole ball of wax SSI has long been a leading provider of claims processing. From precare, through pa�ent care, to postcare, SSI provides facili�es with a comprehensive product offering designed to meet every revenue cycle need. • Verifying insurance coverage • Predic�ng pa�ent ability to pay • Increasing produc�vity through document workflow • Managing denial rates • Defending against RAC audits and proac�vely controlling ADR requests • And more… U�lize SSI’s knowledge and experience to enhance opera�ons – and the pa�ent experience. Contact SSI today corp.ssigroup.com/everything or call 1.880.881.2739 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. Sponsored Material | Special Supplement to HealthLeaders January/February 2014 15 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 Sponsored Material | Special Supplement to HealthLeaders 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. Join the HealthLeaders Media Council to: • Receive complimentary premium report ($399 value) and quarterly HealthLeaders Media webcasts ($1,500 value) as a thank you for your participation • Share your knowledge of the industry by contributing to brief online surveys • Access survey results and research reports in advance Recently published Intelligence Reports include: • Cost Containment: Harnessing Data to Drive Revenue Cycle and Productivity • Restructuring Executive Compensation for the Shift From Volume to Value Join the nation’s most exclusive executive healthcare intelligence community at www.healthleadersmediacouncil.com. C uncil HEALTHLEADERS MEDIA 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. Sponsored Material | Special Supplement to HealthLeaders January/February 2014 19 W W W. H E A LT H L E A D E R S M E D I A . 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