Do you know about - The New approach to Healthcare enterprise information management - Ehr, Emr, Eim
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The lack of a healthcare specific, compliant, cost-effective coming to firm information management (aka Eim) is the #1 reason integration, data quality, reporting and execution management initiatives fail in healthcare organizations. How can you build a house without plumbing? Conversely, the organizations that successfully deploy the same initiatives point to full Healthcare centric Eim as the Top reason they were successful (February, 2009 - Aha). The cost of Eim can be predicted - preventing many healthcare organizations from leveraging firm information when strategically planning for the entire system. If this is prohibitive for large and medium organizations, how are smaller organizations going to be able to leverage technology that can passage vital information inside of their own firm if cost prevents consideration?
The Basics -
What is firm information Management?
Enterprise information management means the organization has passage to 100% of its data, the data can be exchanged in the middle of groups/applications/databases, information is verified and cleansed, and a expert data management recipe is applied. Outliers to Eim are data warehouses, such as an Ehr data warehouse, firm brain and execution Management. Here is a roadmap, in layman terminology, that healthcare organizations ensue to conclude their Eim requirements.
Fact #1: Every healthcare entity, agency, campus or non-profit knows what software it utilizes for its firm operations. The applications may be in silos, not accessible by other groups or departments, sometimes within the team that is responsible for it. If information were needed from groups across the enterprise, it has to be requested, in firm terminology, of the host group, who would then go to the source of information (the aforementioned software and/or database), retrieve what is needed and submit it to the requestor - hopefully, in a format the requestor can work with (i.e., excel for additional pathology as opposed to a document or Pdf).
Fact #2: Because firm terminology can be distinct Within an organization, there will be additional "translating" required when incorporating information that is gathered from the distinct software packages. This can be a nightmare. The conferrence of information, converting it into a distinct format, translating it into tasteless firm terminology and then preparing it for consumption is a lengthy, high-priced process - which takes us to Fact #3.
Fact #3: Consumers of the gathered information (management, analysts, etc) have to convert the type of information required - one-off article requests that are continuously revised so they can convert their dimensional view (like rotating the rows of a Rubik's cube to only get one color grouped, then choosing instead of lining up red, they would truly like green to be grouped first). In many cases, this will start the conferrence process all over again because the primary set of information is missing needed data. It also requires the attentiveness of those that understand this information - typically a extremely valued branch Matter expert from each silo - time-consuming and precious distractions that impact the requestor as well as the information owner's group.
Fact#4: While large organizations can cope with this precious recipe in order to derive enough information to make productive and strategic firm decisions, the whole of time and money is a barrier for smaller or cash strapped institutions, freezing needed data in its silo.
Fact #5: If information were accessible (with safety and passage controls, preventing unauthorized and inappropriate access), time frames for pathology improve, results are timely, strategic planning is productive and costs in time and money are significantly reduced.
Integration (with cleansing the data, aka Data Quality) should not be a foreign idea to the mid and smaller organizations. Price has been the overriding factor that prevents these tiers from leveraging firm information. A "glass ceiling", solely based on being limited from technology because of price tag, bars the observation of Eim. This is the fault of technology vendors. firm Intelligence, execution management and Data Integration providers have unknowingly created class warfare in the middle of the Large and Smb healthcare organizations. Data Integration is the biggest culprit in this situation. The cost of integration in the typical Bi deployment is commonly four times the cost of the Bi portion. It is easy for the Bi providers to tantalize their prospects with functionality and uncostly cost. But, when integration comes into play, reluctance on price introduces itself into the scenario. No performance has become the norm at this point.
What are the Financial Implications for a Healthcare organization by maintaining the status quo?
Fraud detection is the focal point for Cms in their Ehr requirements of healthcare organizations, Let's take a deeper, more meaningful look at the impact of Ehr. Integration, a foremost component of firm information management in the New Approach, brings data from all silos of the organization, allowing a Data potential component to verify and cleanse it. The next step would be to whether send it back to its originating source in an strict state and/or put it into a repository where it will be accessible to auditing (think Cms Sanctions Auditors), firm brain solutions, and Electronic health Records applications. With right away accessible Ehrs, hospitals and their outlying practices can verify patients with payors, retrieve curative histories for pathology and treatment decisions, and update/add patient connected information. What impact to treatment does a tell of a new patient's history have for both patient and practice? Here are some elements to consider:
1. pathology and treatments that are based on former patient dispositions - reducing rescue time, eliminating Medicare/Medicaid/Payor denials (based on their interpretation as to fault of the practitioner in primary treatment or error incurring additional treatment).
2. Instant fraud detection of patients seeking treatment for the same malady across the practices within the organization. Designate abuse and Medicare fraud saves money not only for the payors, but the healthcare organization as well.
3. The connection of Fraud Examiners states that 9% of a Hospital's revenue each year is truly lost to fraud.
One overlooked but tasteless impact is in the cost of managing patient records. Thousands of file folders in storehouse with new instances being added each time a new patient enters into the system. Millions of pieces of paper capturing patient information, payer data, charts, billing statements, and various items such as photo copies of patient Ids, are all stored in those folders. The folders are then stored in vast filing cabinets - permanently being accessed by filing clerks, nurses, practitioners and various staff. Contents of the files being misplaced or filed incorrectly. Hundreds, if not thousands, of quadrate feet being consumed for storage. The Aha projects that an firm leveraging Electronic health Records will recover no less than 15,000 quadrate feet of usable space. That space can be used for additional services, occasion up new channels of revenue. The justification is easy: how much would it cost the hospital to build out 15,000 quadrate feet for a new service? The average cost to build space utilized for health Services is per quadrate foot, or 5,000 total. An Eim solution straight through the New coming would be less than 20% of that. Not only has the Eim solution reduced dollars lost to fraud, lowered the days for payor encounters to be paid, increased cash on hand, but it will also open up new services for the patient community and revenue back to the healthcare organization.
Electronic data is precious in its own way. Bad aka "Dirty" data has titanic impact. Data can be corrupted by error in data entry, systems maintenance, database platform changes or upgrades, feeds or exchanges of data in an incompatible format, changes in front end applications and fraud, such as identity theft. The impact of bad data has a cause and ensue connection that is pervasive in the financial landscape:
1. Bad data can ensue in payor denials. Mismatched member identification, missing Drg codes, empty fields where data is predicted are examples of immediate denials of claims. The delay lowers the whole of Cash on Hand as well as extends the cycle of submitted claim to remittance by at least 30 days.
2. Bad data masks fraud. A reversal of digits in a communal safety number, a claim filed as one person for the treatment of someone else house member, curative histories that do not reflect all pathology and treatments because the patient could not be identified. Fraud has the many impact on cost of delivering healthcare in the United States. Ultimately, the health system has to suck up this cost - reducing profitability and limiting growth.
3. Bad data results in non-compliance. Cms has already begun the architecture and deployment of Sanctions Data Exchanges. These exchanges are a network of data repositories that are used to associate to health healthcare system, retrieve Cms connected data, and store it for auditing. The retrieval will only be limited to the patient encounters that show a possible for denial or fraud, so the repository will not be a store of all Medicare and Medicaid patient encounters. But, the transfer has to be able to read the data in its provider data source in order for Cms to apply sure conditions against the information it is reading. What happens when the information is incomplete or wrong? The healthcare system is held accountable for the encounters it cannot read. That means self-acting and unrecoverable denials of claims Prior to an audit, regardless of claim legitimacy.
The Price Fix by Big Box Healthcare Technology Firms
Are the major healthcare software and technology vendors (Big Box) price gouging? Probably not. They are a victim of their own solution strategies. straight through acquired and some organic increase (McKesson, Eclipsys, Cerner, etc), they find their Eim solutions lose their agnostic approach. This is bad...very bad for health systems of all sizes. With very few exceptions, the vast majority of healthcare organizations Do Not Buy all applications and modules from a singular stack player. How could they? Healthcare systems grow similarly - some organic, some straight through acquisition. When a hospital organization finds over the course of time, an application that is reliable, such as a billing system, there is titanic reluctance to remove a proven solution that everyone knows how to use. Because the major technology providers in the healthcare space act as a "One Stop Shop", they spend most of their time working on integrating in their own product suite with limited to no regard to other applications. Subsequently, they find themselves trapped: they have to position all products/modules to profess the accessibility and integrity of their data. This is problematic for the hospital that is trying to solve one qoute but then must purchase additional solutions to apply to areas that are not broken, just to be able to incorporate information. That is like going to the hardware store for a screwdriver and advent back with a 112 piece tool set with a rolling, 4 foot cart built for Nascar. You will probably never use 90+% of those tools and will no longer be able to park in your own carport because the new tool box takes up too much space!
It resources - including people - must be utilized. In today's economy, leveraging internal It staff to administer a solution post-deployment is a given. If those It resources do not feel comfortable in supporting the integration plan, then status quo will be justified. This is the "anti" coming to providing solutions in the healthcare industry: the sales leaders from Big Box technology firms want their sales people in front of the firm side of the organization and to stop selling to It. While this is a tasteless sense approach, the cheaper in 2010 mandates that It has to at least validate their potential to administer new technology solutions. The expectation of long-term professional consulting engagements to ensue post facility has been shrinking at the same rate as healthcare organizations behalf margins.
Empowering the healthcare organization to apply its existing It staff to administer and found with the new products is not part of the firm plan when Big Box players market to the industry. It is the exact opposite - recurring revenue from lengthy, and sometimes permanent, professional services consulting engagements is part of the comprehensive target. The initial price quote for a Big Box solution is scary enough, but the fact remains that it is still not representative of what the ongoing cost to profess straight through consulting arrangements. This is a variable cost, which is difficult to predict, and drives finance managers and executives crazy.
Solving the Dilemma - A best solution straight through a New coming at a Fraction of the Cost
When Healthcare firm Experts incorporate talents with Technology Architects, Eim Solutions cost drop dramatically. This is the New coming to Healthcare Eim, providing the way health organizations will be able to furnish successful solutions at significantly reduced costs - occasion the door for health systems of all sizes.
The Eim Firm (using the New Approach) versus Big Box Healthcare Technology Providers:
Smaller, more agile firms bring many benefits to Healthcare Organizations of any size. The benefits:
1. They are focused on specific verticals - just like the Big Box health Technology providers. branch Matter Experts (Sme) in the smaller firms typically are commerce veterans with years of perceive and success in their coming who see their resume as a service offering best utilized when they are able to apply their methods for successful strategy planning as opposed to studying the methods of a Big Box player. Their revenue is best since their revenue is applied into a smaller operating cost, extending lower pricing for solutions that are More productive and offering stronger client/vendor relationships as the Sme limits themselves to a sure whole of clients.
2. Solutions built on proven approaches and strategies. Again, the firm's Smes are able to define a methodology that can be re-used or re-configured in each client instance. This saves time and money for the client as delivery is accelerated and the cost of architecting is eliminated.
3. The firms themselves found solutions and methodologies agnostically. Their understanding of the diversity of systems that exist in the technology of a healthcare organization allows them to not only found adaptable solutions but also add a firm Process management Plan (Bpm). The Bpm will define for the organization Exactly how information is received, processed, cleansed, stored, shared and accessed. It also will define an performance plan for training It for management and retain as well as end users at all levels on how they will leverage it going forward. Bpm planning in a healthcare organization is a low six figure venture with an face consulting group. The Eim firms will contain it in the cost of the solution. Basically, it is the contrast in being told what is wrong and here are the recommendations to fix it versus here is what is wrong and this is how it will be fixed with the new solution.
What is a typical Eim Firm solution?
1. solution Assessment, noting the current systems, data sources and methods of sharing information as well as firm processes, key personnel identification that are gate keepers if information, timeliness of providing information and comprehensive effectiveness in leveraging firm information for strategic firm planning. See figures 1 for an example of the information process flow visual component of an actual assessment.
2. Eim solution that contains an integration motor that accesses all data sources - reading and writing back to the database or application, providing data potential services and maintaining Hipaa as well as Hl7 requirements. See figure 2 for a diagram.
3. Ehr Data Warehouse. A repository to build Electronic health Records straight through the integrated data flow.
4. Ehr Portal for patient entry (when additional information needs to be added) via a browser.
5. firm brain Dashboards for metrics, Ad Hoc pathology and execution management Scorecards on organizational goals and objectives.
6. Onsite implementation and integration of the Eim solution.
7. Onsite training during facility for It and end users. Ongoing training provided via webinars, documentation and technical retain staff.
8. Relationships maintained by the branch Matter Experts for the life of the solution.
9. Stimulus "Hitech" Act pays ,000 per doctor for an Ehr solution implemented. The Sme creates the grant invite to be submitted so the healthcare organization receives Stimulus funds to pay for the total Eim solution
Key Element of the Solution
Onsite Delivery and full time retain are key. But, the most foremost element is training. Why? As noted earlier, it is preeminent that existing It investments, namely personnel, be able to not only administer but also conduct development as the need arises. In Healthcare, Cms managed Medicare/Medicaid is already margins that are in the negative. As incommunicable payers ensue suit, the whole of uncollectable encounters will increase, impacting current profitability models and addition hereafter cost for treatment. By mitigating It costs, the Total Cost of possession (Tco) qualifier should truly evolve to a Return on venture (Roi). Roi is immediate for this solution approach, but it is sustained year over year by leveraging internal It to retain and develop. Now, the Healthcare organization has eliminated precious professional service consulting engagements and re-investments into new feature licensing. This takes a variable cost every year and makes it a fixed, yet smaller whole - a sensible financial coming to perform a proven strategy.
Summary -
Why Eim? whether it is Omnibus, "Obama"-care or an edit (not overhaul) of the Healthcare industry, Healthcare Organizations know these truths:
1. Electronic health Records are important for the Fraud detection unit of Cms. Each organization must comply with accessibility, Hipaa and format. Fraud reduces comprehensive revenues for a hospital by 9% (Acfe)
2. Ehr/Ehr have proven to be extremely productive in eliminating internal waste, patient fraud, custom fraud and paper overhead. Vast whole of space within the facilities that had been used to store patient records in hard copy can now be utilized to furnish additional services and open new revenue streams.
3. Bad or "dirty" data in electronic or hard copy format is costly. Agreeing to the Aha (September, 2008), the average cost of a patient article with good or strict information is 3 annually. The annual cost of a patient article with bad information is ,054 annually. On average, 18% of patient information within a healthcare organization is bad.
4. Strategies developed by healthcare organizations without 100% of the information they own that is also timely and relevant are ineffective. Objectives cannot be defined, successful processes cannot be identified and correction plans have limited to no metrics in which to conclude success.
5. Stimulus/Hitech Act pays ,000 per doctor when Ehr is part of the Eim solution. With the smaller Eim firms, Stimulus pays for the entire solution.
Why a New coming Eim Firm?
1. branch Matter Expertise from consultants that have proven methodologies.
2. Agility to adapt to the client need instead of the Big Box coming of the client adapting to their product limitations.
3. A best solution at a Fraction of the Cost. Their solutions are based on needs and not features.
4. Relationships with the vendor, resulting in improved services, maximum values from vendor solutions and a focused coming to the client needs and goals.
5. A Return on venture as opposed to a Total Cost of Ownership. Clients need to see solutions that immediately pay for itself and then recover lost revenue while offering channels to new behalf centers.
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