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Sagacious: Case Studies
[+] Carilion Clinic Transforming the Revenue Cycle through EHR & Operational Improvements
Carilion Clinic, a premier, 1,000-bed healthcare institution headquartered in Roanoke, VA, engaged Sagacious Consultants to perform a comprehensive revenue cycle assessment, including a review of organizational leadership, Patient Access, Revenue Integrity (Charging), Coding, Hospital Billing, Professional Billing, Collections, IT support, HR processes, and Training programs. Leadership recognized the need to restructure both Revenue Cycle operations and the IT support relationship in order to increase financial performance and patient satisfaction.
The Carilion Clinic and Sagacious teams have created significant organizational benefits by implementing new reporting capabilities, EHR system optimizations, and industry best practices. These initiatives have allowed Carilion Clinic to surpass its project-to-date cash target by over $22M. AR days are at a 12-month low, and CFB days have been reduced by 40%. Sagacious has worked with the Carilion Clinic Business Office to improve insurance follow-up processes to enhance overall payor reimbursement and expedite
remittance turnaround times.
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[+] Northeast Healthcare Charging Success Initiative
For three go-lives, Northeast Healthcare partnered with Sagacious Consultants to develop a project that supported charging readiness. They understood that a lack of charging readiness at go-live could lead to increased late charges and decreased patient revenue and physician satisfaction.
The Charging Success Initiative focused on four main areas: testing, change management, training, and go-live management. A team of five Sagacious consultants worked with NHC operational leadership, IT counterparts, and end users to help promote charging success as part of the larger EHR implementation project. For all three go-lives, charging exceeded 100% of baseline within 45 days.
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[+] Rady Children’s Hospital Revenue Cycle Optimization and Cash Acceleration
Rady Children’s Hospital San Diego (RCHSD) is a premier children’s hospital in San Diego, CA. Rady opened in 1954 to treat children suffering from polio and has since grown to serve 90% of children in San Diego and the surrounding area.
In 2009, Rady undertook a major IT initiative to replace its existing Electronic Health Record (EHR) and leverage technology to improve patient outcomes, customer satisfaction, and financial stability. The project was a clinical success, helping Rady achieve national ranking in ten pediatric specialties by 2011; however, accounts receivable and cash flow management became more difficult through the added complexity of a new revenue cycle framework. Leadership recognized the need to revamp Hospital Revenue Cycle processes across both operations and IT that could serve as sources of stability and fund further improvements to patient care.
In April 2015, Rady engaged Sagacious Consultants in an initiative to transform the Hospital Revenue Cycle. Since the engagement began in April 2015, Sagacious Consultants improved cash overall by $20 million. To achieve these results, the transformation team focused on staffing analysis and organizational structure, best practice adoption and workflow redesign, and technical configuration and transparency.
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[+] University of Colorado Health Capturing and Reconciling Charges for a "Hospital in a Hospital"
On October 1, 2012, University of Colorado Health (UCHealth) acquired Memorial Health System in Colorado Springs, CO. The lease of Memorial allowed Children’s Hospital Colorado (CHCO) to run a “hospital within a hospital” and operate the NICU, PICU and pediatric units within Memorial Hospital. UCHealth needed a way to distinctly identify the patient population served by CHCO within their hospital to separately account for the revenue generated by CHCO. Sagacious Consultants was brought in to develop workflows to separately track the CHCO patient population within Memorial Hospital and to be able to generate charges within UCHealth's instance of Epic while allowing those charges to be extracted to post within CHCO's billing system.
Sagacious' registration and ADT solution allowed CHCO patients to be registered, admitted, and documented upon within UCHealth's instance of Epic using CHCO specific coverages and custom ADT workflows. The billing solution allowed CHCO revenue to be reported on separately which helped the UCHealth Finance team correctly identify how much AR is attributed to non-UCHealth patients and how much to bill CHCO based on a cost-to-charge ratio.
[+] Indiana Health System Improving Revenue Cycle Operations through Streamlining IT Support
This is one of Indiana’s largest health systems that recently completed an implementation of Epic. After the implementation was complete, the revenue team began to experience a large backlog of production support tickets. Various issues contributed to this backlog which negatively impacted their overall AR. Sagacious evaluated the current state of issue resolution process to find inconsistencies and inefficiencies. During the engagement, operations and project team reviewed all 200 plus tickets to set a priority, identify owners, define issues that were vague and document specific examples. Communication improved with the implementation of a new ticket submission template as well as clear expectations for operational involvement in testing. By focusing priority and having clear ownership, the ticket backlog dropped by over 40 tickets.
[+] Midwest Health Increased Productivity from Claim Follow Up Automation
This Midwest health organization is a leading, religious, not-for-profit health system serving communities up and down the Midwest corridor. After a new VP of Revenue Cycle took office, he decided to address system issues that caused billing staff to lose productivity and ultimately hurt key performance indicators. Sagacious Consultants was engaged to relieve a major pain point for the billing office staff; payor rejections and a building backlog of accounts requiring follow-up. Sagacious Consultants collaborated with the organization's Information Technologies department, clearinghouse, and the billing office staff to implement electronic claim status messages (ANSI 277) to drive follow-up workqueues and reduce manual intervention on the part of the payor. The implementation was completed over a month ahead of schedule and resulted in the reduction of over 40 hours per week of staff time spent following up on accounts with payor rejections. Additional benefits such as reduced wait time to follow-up on accounts and more a complete billing history available in accounts were also realized from this project.
[+] Regional Medical Center Reduction in Coding AR through Increased Operational Rigor
This regional medical center is a non-profit, 450 bed regional center and serves 10 counties over a 150-mile radius. After a new Director of Revenue Cycle took office, he decided to address workflow processes and Epic system issues that caused an elevated number of Account Receivable days. A team of 11 consultants from Sagacious were tasked with improving AR metrics within their application specialties. One large area of improvement was observed in the HIM / Medical Records department. The department reported that it was holding an average of approximately $6 million in open accounts awaiting Coding completion at the end of each business week. Through a combination of targeted attention on high-dollar accounts, tightened documentation and suspension policies for hospital physicians, and an increased focus on work queue assignments for missing documentation, declined documentation, and physician/coding queries, the department was able to improve to an average of approximately $2.5 million in open account at each week’s end within 2 months of Sagacious engagement. This represents a 58% reduction in average end-of-week Coding AR.
[+] Georgia Health System Sagacious Focus on Optimization Allows Billers to Focus on AR
This Georgia health system is the largest public hospital in the state of Georgia. With the increasing demand of new projects and current system issue resolutions, this client engaged Sagacious Consultants to address the system issues and projects that their current employees were not familiar with. Sagacious Consultants performed a thorough review of current system build and billing office workflows to not only resolve the issues the organization is currently struggling with but to also identify areas where system optimization could improve AR and billing office productivity. The optimization projects included the revamping of remittance and follow-up workflows, more robust self-pay discount logic, the implementation of clearinghouse claim reconciliation process, and over 10 claim processing automations, allowing the billing office to allocate resources to more high dollar and high impact accounts and improve overall productivity. In addition, Sagacious Consultants’ involvement in their behavioral health billing process increased the claim acceptance rate by approximately 15%.
[+] Rural Health System Automating Self-Pay Follow Up Reduces Inbound Calls
Just west of the Rockies, this health system is the largest rural, not-for-profit health system in the nation. After bringing up several new sites onto Epic, the collection staff was not able to make outbound collection calls due to the inbound call volume. This resulted in a significant increase in self-pay AR enterprise wide. Sagacious Consultants was engaged to implement Experian’s Propensity to Pay functionality. This functionality ranks accounts based on the likelihood of payment and allows staff to maximize the return of their follow-up. This likelihood to pay was used to automate the self-pay follow-up for approximately 50% of accounts drastically reducing the volume of inbound calls. In addition to productivity gains and more targeted self-pay follow-up, improved and targeted financial assistance workflows were realized from this project.
[+] Northern California Health Better Patient Access Reports Causes Increased Provider Availability
This health & hospital system is a third level trauma center in northern California that began their Epic implementation with few baselines to draw from due to limited reporting functionality across several EMR modules. With growing competition across health systems in their area, this client looked to track their productivity and patient accessibility to ensure they maintained and increased their patient population. Sagacious Consultants identified and created reports to track how accessible they were in their patient scheduling as well as turnaround time for patients to be seen for follow-ups and consultations. With that information, this client was able to alter their policy on required provider availability (type and time of visit) which increased their patient flow and decreased patient turnover.
[+] White Paper Using EHR Reports to Manage Charge Reconciliation
Transitioning to a new EHR and Professional Billing system can often result in a temporary dip in charges. This can arise from many different reasons, including: staff unfamiliarity with system navigation during a clinical encounter, user difficulty in triggering charges, or larger workflow difficulties when the EHR transition is used as a catalyst to move to a new charge generation method. Using a set of EHR reporting tools and ensuring that the reports are monitored by clinical management can mitigate the chances of missing revenue. Two items should be regularly followed by Clinic Managers to ensure their departments do not suffer from lost revenue.
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[+] White Paper Creating a Strategic Roadmap
A strategic roadmap is a great tool to demonstrate a client’s path to success. It is a way to focus on a client issue or set of issues, to define opportunities for improving efficiencies, and to recommend solutions to our clients. It also provides the client with the tools to continue the same analysis in the future to ensure they continue to meet their goals. It supports the DMAIC methodology (Define, Measure, Analyze, Improve and Control) in creating a path to success.
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CLINICAL OPERATIONS PERFORMANCE IMPROVEMENT
[+] Hartford Healthcare Medical Group Enhancing Provider Adoption
Hartford HealthCare Medical Group (HHC MG) is one of the largest surgical and medical practices in Connecticut, with over 250 physicians and advanced practitioners. HHC MG is a member of Hartford HealthCare (HHC), which recently chose to launch the CareConnect initiative and implement Epic system-wide, replacing several legacy EHRs and paper processes. The CareConnect initiative is the leading mechanism for delivery of the HHC Five Ones: One Registration, One Health Record, One Standard of Excellence, One Bill, and One Relationship.
However, as CareConnect was implementing Epic with the HHC MG specialists, they became concerned by the low EHR engagement among these specialists and the increasing number of requests for scribes. Given the strategic importance of the CareConnect initiative, leadership recognized the need to bring in outside expertise to ensure successful EHR adoption and ongoing high levels of productivity.
In June 2015, HHC MG turned to their existing partner, Sagacious Consultants, to lead this provider adoption effort. Sagacious provided customized deliverables to ease the transition for each specialty, and engaged a Physician Informaticist to collaborate with providers and address their concerns.
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[+] Community Health Network Improved Labor and Delivery Workflows
Community Health Network is a multi-hospital system with over a dozen locations and hundreds of affiliates. As they prepared for their upcoming Meaningful Use measures, the obstetrics team realized that in order to attest in 2015, they would need to improve some workflows, including lactation. Sagacious Consultants worked closely with the analyst and trainer to build new lactation workflows for both the inpatient and outpatient areas. The new build enabled the lactation consultants to document all the necessary data to accommodate Meaningful Use and streamline their daily work. Labor & Delivery managers were also able to run reports to track their patients’ breastfeeding rates from the initial prenatal appointment through the post-partum visit. Lactation consultants can now follow up with mothers who indicated an interest in breastfeeding, and follow up with breastfeeding mothers to ensure successful intervention after delivery, as well as improve their maternal skin-to-skin time.
[+] Lehigh Valley Health Network Incorporated Clinical Practice Model Content
Lehigh Valley Health Network is a network comprised of 3 hospitals, the largest being an 800-bed general medical and surgical facility. In order to maintain continuity and establish more rigid clinical guidelines, they adopted Clinical Practice Model content as the basis for all of their build. The Anesthesia subject matter experts were anxious, as they felt the content was overly complex and demanded more content than they needed to document to provide effective care for their operative patients. Sagacious performed a gap analysis and created an integration strategy to consolidate the new CPM content into their existing build. We then worked with them to pare down their documentation processes and create simple, straightforward workflows that incorporated the necessary CPM content. Sagacious helped them achieve their goal of having all providers (including skeptical anesthesiologists) adopt CPM documentation to support their broader goal of improving patient care. This also allowed for more standardization within the anesthesia workflows, and therefore more consistent processes for end users.
[+] Texas Health System Increased Nursing Documentation Compliance
This Texas client is a $1.3 billion dollar integrated delivery system with 3 hospitals and many ambulatory clinics. They are also an Academic Medical Center with two university partners.
The client was looking for a more efficient method to track their nurses’ documentation compliance, to help with audits performed by third party organizations. They also needed a better way to identify which methods of documentation were more useful to their users. They had struggled to find a solution that integrated seamlessly into their current workflows while providing timely feedback.
In order to address this, Sagacious Consultants performed an analysis to identify how relevant metrics were being captured in the system. The analysis focused on KPIs provided by leadership and mainly centered on Clinical Documentation toolsets.
After working with end users to establish best practices, Sagacious developed patient summary reports to help individual nurses keep up with their daily workload and a nurse manager dashboard to provide a summary of each department’s patient population. The patient summary reports included many embedded rules regarding documentation requirements. This gave nurses real-time feedback pertaining to their current compliance levels.
The dashboards gave nurse managers at-a-glance access to several key metrics including Braden score, Fall Risk, restraint documentation, medication administration, and much more. This allowed them to more quickly address deficiencies in patient care, effectively manage their personnel resources, and easily evaluate documentation compliance.
The overall goal of the project was to provide a tool that made sense for the users. Sagacious worked to make sure the reports and documentation tools were intuitive and easily accessible. Several iterations of build and user validation ensured a product that worked in real world situations and not just theoretical scenarios. Sagacious leverages the knowledge gained from this project to help other institutions increase their levels of documentation compliance while providing managers the tools needed for continued monitoring.
[+] Mountain Health Development of Reports and Workflows for Meaningful Use Attestation
This health & hospital system is a third level trauma center in northern California that began their EMR implementation with few baselines to draw from due to limited reporting functionality. With growing competition across health systems in their area, this client looked to track their productivity and patient accessibility to ensure they maintained and increased their patient population. Sagacious Consultants identified and created reports to track how accessible they were in their patient scheduling as well as turnaround time for patients to be seen for follow-ups and consultations. With that information, this client was able to alter their policy on required provider availability (type and time of visit) which increased their patient flow and decreased patient turnover.
[+] AdvantageCare Physicians Large-Scale Go-Live Staffing
AdvantageCare Physicians (ACP) is a large, multi-specialty physician practice delivering care throughout the New York metropolitan area. ACP’s 400+ physicians went live in three waves in more than 30 locations across all boroughs of New York City. For the first wave, they contracted a staffing company to supply floor support; however, ACP decided to find a vendor with more Epic knowledge and reliability for the new two waves of go-lives. Sagacious stood out for our Epic expertise and flexibility.
ACP needed Epic experts they could count on during the activation. Their providers rotate among their 30+ locations, so they needed an agile staffing model. Their implementation included EpicCare Ambulatory, Radiant, Cupid, Kaleidoscope, and more, so they needed support staff with considerable depth and breadth of knowledge. And they needed someone fast: ACP signed with Sagacious three weeks before the second wave of go-lives, which needed over 100 support staff.
Sagacious followed our proprietary recruiting process to ensure that the floor support we were providing knew Epic thoroughly, would have the behavioral traits that we know perform well in go-lives, and were able to clearly articulate resolutions to end users. Sagacious provided over 120 floor support team members for the second wave of go-lives. During this activation, ACP saw that our no-show and turnover rates were exceptionally low, and that support tickets were both better and more infrequent.
The last wave was the most successful, with fewer tickets and faster adoption in all practices. ACP credits the Sagacious management and floor support staff with these results. Sagacious supplied 165 consultant super users, with only a few weeks to coordinate the staff. Because we utilize our full-time employees between projects, ACP was extremely satisfied with the amount of knowledge at each clinic and the on-site staff management. The project team was able to direct their energy to swiftly addressing issues and resolving workflow concerns, further promoting end user satisfaction.
The overall project came in roughly 2% under budget. Sagacious successfully managed all aspects of our floor support staff, including hours logged and expenses, so that ACP could focus on their providers and patients.
After working so closely with Sagacious during the go-live, ACP chose to partner with us again for post-live optimizations. Specifically focused on difficult workflows and areas of revenue loss, Sagacious provided teams to work with ACP on their referrals and charging processes. As a result, ACP has seen improved system adoption and increased charging compliance.
Sagacious Go-Live Success gave ACP accountable, professional floor support staff with on-site experts as managers. And because these managers were our own consultants, ACP received the benefit of our extensive Epic experience at each of their clinics, which helped both avoid and identify risk areas. Further, ACP quickly addressed system issues by partnering with Sagacious for strategic projects – a testament to our ability to build strong working relationships.
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[+] Great Lake Multi-State Healthcare Flexibility and Dependability Make for a Successful Outcome
This multi-state client, providing care to 3 million people in the Great Lakes region, contacted Sagacious to assist with an ambulatory go-live that they were hoping to staff internally. The client found that they needed additional resources to assist in four locations for shifts their teams couldn’t completely fill.
Sagacious provided off-project consultants to assist with the activation, with little time for training specific to the client. The healthcare system applauded the floor support team’s awareness of the specific workflows and the lack of hesitation to reach out to the appropriate resources and super users to ensure the answers they were providing were correct. We recognize that providing the right answer is extremely crucial during go-live, and without the time to attend training, our resources worked hand in hand with super users to ensure their complimentary areas of expertise were being utilized to their fullest.
Staffing flexibility is very important in go-lives where support needs change quickly. Our team was able to move within departments and between clinics with ease and confidence due to their Epic expertise, our staffing structure, and defined communication paths.
The healthcare system graciously thanked our team for the peace of mind they felt during go-live knowing they had Epic experts on hand to go where needed.
[+] Midwestern Health Network Quick Staffing of 50+ Resources for Go-Live
This health network provides coordinated clinic, hospital, and home-based care for patients in the Midwest; they have nearly 300 providers working in more than 50 clinic locations. They are extending Epic to their ambulatory practices in waves throughout 2014 and 2015. For their second wave of go-lives, the client needed 20 additional resources to fill their staffing needs, and 70 resources for their third wave. Sagacious provided expert resources for the ambulatory go-live utilizing our off project consultants and contracted industry experts.
Sagacious’ flexible staffing model allowed us to quickly adjust our scope as the client’s needs for the third roll-out grew from 20 to 70 staff with just ten days’ notice. Increasing the staffing numbers was crucial to the clinics feeling supported and ready for the go-live.
Sagacious had the additional resources already screened and knew of their availability in case of this exact scenario. Our team worked diligently to coordinate all logistics and schedules for the support teams.
Together we learned what it takes to successfully ramp up staff numbers, including clear communication, efficient tracking tools, and the best way to coordinate travel. These lessons will be applied to future projects with this customer and others who have moving staffing targets.
The client has asked to partner with Sagacious for their next round of go-lives.
[+] Multi-Specialty Medical Group Community Connect Epic Selection Support / Subject Matter Expertise
This client is a multi-specialty medical group that provides healthcare for cancer, cardiology, diabetes, thyroid, endocrinology, gastroenterology, internal medicine, infectious disease, primary care, dermatology, hematology, oncology, pulmonary medicine, and sleep medicine services. Sagacious Consultants provided subject matter support to this clinic group as they worked with a nearby medical center on expanding their Epic install. We conducted a careful analysis of current and future workflows, as well as the functionality they hoped to implement. Based on our own analysis, and on collaboration with both organizations, we crafted scope recommendations for the Connect partnership that blended current successful methods with newly available tools. Bringing our extensive experience to bear, we reviewed the proposed partnership contract between the clinic and the medical center. We provided recommendations based on other organizations’ successful agreements, and supported the contract negotiations between these two new partners.
[+] Family Medicine Group Community Connect Implementation Support / Subject Matter Expertise
Sagacious Consultants was engaged to provide subject matter support for a family medicine group as they worked with a major academic hospital to extend their EHR offering. Our Epic experts provided subject matter expertise at both the project advisory and application level for the Connect project. We worked with our client to ensure they understood the coming changes in workflows. We answered questions and identified issues throughout the implementation process and go-live, including go-live planning and post-live revenue cycle success.
[+] Midwestern Health System Community Connect Implementation Support
Sagacious Consultants was engaged to provide Orders and Hospital Billing implementation resources to support this Midwestern client’s first independent hospital implementation with a nearby hospital. We worked with both the Orders team and the HB team on build, testing, and guidance, as well as overall implementation support.
In cooperation with both Connect partners, our Orders team completed core build. Along the way, we worked with the teams to validate and test all the new build. We worked closely with the Willow team to complete dual authentication for Ohio Board of Pharmacy requirements. As part of our inclusive approach to project management, we collaborated with both build team and end users to establish workflows in several clinical areas. We also met regularly with integrated area owners to identify solutions to issues as they arose.
Our Hospital Billing consultants allowed our client to complete and test their revenue build, and therefore their Community Connect project, on an abbreviated timeline. Our team completed core build, testing scenarios, and support for HB, including system settings, charging workflows, Home Health billing, workqueues, and reports. We also worked with this client to develop cutover planning documentation for revenue stabilization.
[+] East Coast Heath System Implementation Support
Sagacious implemented 10+ Community Connect projects for this large, East Coast health system. Our consultant led this client team in workflow analysis and validation; this allowed us to provide custom solutions for new Community Connect practices. We managed security assignment and configuration for all Community Connect users. Before and during go-live, we maintained change control and issue tracking logs, which ensured a compliant change control process and a manageable issues list. We also on-boarded new FTEs to transition control of maintenance and new implementations.
[+] Midwest Health Community Connect Project Management & Support
This Midwest health system provides coordinated clinic, hospital, and home-based care for patients in Plains states, Illinois, and Wisconsin; they have nearly 400 providers working in more than 40 clinic locations. They are extending Epic to their ambulatory practices in waves throughout 2014 and 2015. Sagacious Consultants provided a Willow implementation resource for eight months while preparing for eight community hospital go-lives. Our consultant co-owned all aspects of Willow application.
Our Sagacious consultant worked closely with this organization's leadership, Willow team, and pharmacy managers to communicate all aspects of build, training, scheduling, and testing, including script preparation, issue documentation, cutover, dress rehearsal, go-live tickets, and training. We first performed a gap analysis to determine what changes would be necessary for system configuration and hospital workflows during the transition to a larger Epic IT network. We shared findings, provided recommendations, and made improvements. We also assisted with management and maintenance of NDCs and medication lists throughout the install and go-live.
[+] Northwest Health Community Connect Implementation Support
We worked with one of the largest not-for-profit health systems in the United States, a mission-oriented group with more than 30 hospitals, nearly 500 physician clinics, 20+ long-term care facilities, several hospice and home health programs, and hundreds of supportive housing units. They pride themselves on serving everyone – especially the poor and vulnerable – in a diverse range of ministries from birth to end of life, including acute care, physician clinics, long-term and assisted living, palliative and hospice care, home health, supportive housing and education.
Sagacious Consultants was engaged to provide implementation support for their first and second Community Connect sites
Sagacious provided an implementation manager to lead a Community Connect site, which included one critical access hospital and three rural health clinics. We planned and managed the project from Kick-Off through Go-Live, with a team of 11 analysts and a $40,000 budget. Our management also included coordinating, contracting, and integrating interface and third party solutions. Additionally, Sagacious initiated and led strategic planning for integrated areas including Reporting, Testing, and Printing for the Community Connect program. We also provided the project’s only Clin Doc and Stork analyst for the first Community Connect site, and led strategic planning and set build standards for subsequent sites. We also worked to empower the client’s own team by mentoring new analysts for future implementations.
[+] Mountain Health Community Connect Project Management & Support
This mountain health system is a partnership between two health systems and a major teaching hospital. Sagacious Consultants was engaged to provide a Professional Billing implementation resource for 6 months while they extended Epic to community practices.
We helped them bring five new clinics live, more than doubling the total number of affiliates. Our team co-owned all aspects of Professional Billing to support both existing and implementing independents. We helped on-board a PB team member into an Account Manager role, supporting her in assuming additional responsibility. Not only did we provide daily on-site go-live support, but we did it while simultaneously coaching two Community Connect analysts through the various build requirements. Once we went live, we worked directly with Community Connect Account Managers to prioritize and implement optimization requests for the independent practices. We set up vendor statements with Claims Logic, which is now a streamlined process for all future independents desiring automated statements as opposed to in-house printing. We also worked with all independents to implement an automated immunization workflow.
[+] MaineHealth Epic Rollout
When MaineHealth began extending their Epic system from Maine Medical Center to other hospitals and clinics in their network, it was clear that the current reporting configuration would require a lot of new build and additional maintenance for each added site. In order to make build and maintenance manageable and extensible, Sagacious consultants worked with the MaineHealth reporting and security teams to implement dynamic filters based on user settings. This allowed MaineHealth to roll out Epic with a single report that changes dynamically based on the login identity or location of the user. Thus, there is no longer a need to build a new report for each location or department that goes live with Epic. As MaineHealth continues to extend Epic to more sites, the reporting team can now focus their efforts on net-new custom reports for all sites, rather than spending time re-configuring or re-building existing reports.
[+] MaineHealth Report Repository
When MaineHealth went live with their EMR, end users did not know where to find reports, which reports to use, or how to run reports and interpret the results. Sagacious consultants worked with the reporting team at MaineHealth to extend their existing report request tracking system (a home grown system) to include an enterprise report repository. Reports were catalogued in the repository by user role. Users can now easily see a list of all the reports that are applicable to their jobs and brief descriptions of the intent of the report. In addition, analysts can easily link back to the original request for the report and see who requested it, why it was requested, and any notes concerning the development of the report. This has saved analysts many hours in the report request vetting process as well as educating end users. Furthermore, as MaineHealth rolls out their their EMR to additional sites, the report validation process is simplified: each SME can easily see a list of the existing reports they will get with their EMR and determine if any additional reports are needed.
[+] Pacific Healthcare Network Dashboard Proof of Concept
A not-for-profit healthcare network in the Pacific region needed to find a better solution for their reporting needs, especially their Physician Scorecard data. They wanted to be able to run dashboards within Epic and link directly to a patient’s chart. They asked Sagacious to provide a proof of concept encompassing different dashboard vendors. Our consultant provided quick demonstrations of the leading products, allowing the client to make the best decision for their enterprise. The final decision was Qlikview. Our consultant provided guidance and full weekly tutorials for span of several months to help the internal reporting team get up and running.
[+] Academia Medical Center Report Consolidation
This academic medical center is a complex academic facility with equally complex reporting requirements. One reason for this is that their various facilities are structured differently and serve different populations. Their system includes both community as well as major research and academic facilities. This medical center wanted to leverage their existing analytics framework and accommodate new and iterative reporting needs: discovery, consolidation, and request development.
The goal for the discovery and planning phase was to identify existing reports for individual and multiple locations. To gather this information, we created exports based on reporting groups (e.g., departments, functional areas). We paired each report with its description and purpose, and reviewed them with a governance group to achieve signoff and identify reporting requirements at each facility, including which needs affected multiple facilities. This process allowed us to prioritize according to common needs, existing build, and unique needs, while still capturing information about all of the above, which in turn helped us plan our work efficiently and accurately.
The second phase required us to build consensus around reporting standards that would be effective and meaningful for all facilities and stakeholders. We created a tracker for all reports identified during the discovery phase, and used it to divide the reports into weekly work packages for review with stakeholders. This method allows you to accurately plan timelines and required attendance for each session. During a given session, the meeting owner launches each report and solicits feedback from the stakeholders on the reporting elements that need to be added, removed, or modified for the report to meet the organization’s needs. This feedback is then tracked in the report tracker and used to monitor and ensure updates are completed. Once updates have been completed, the final report is passed back to stakeholders for signoff, and then tagged as validated in the tracker. This process allowed us to consolidate reports and minimize redundancies in the reporting library.
Our goal in the last phase of this engagement was to develop reports to meet facilities’ unique reporting needs. We reviewed each facility’s unique reporting needs and triaged the build request based on priority. Conducting this process in a centralized way ensures that reporting staff are not bogged down by reports that could be developed once to share across facilities.
The approach we used with this world-class research institution would help any organization maximize your report development process by minimizing the amount of time spent on re-work, developing agreed upon reporting, and identifying areas that truly require one off attention from the reporting team.
[+] Advantage Care Physicians Training Experience Enhanced for a Successful Go-Live
Sagacious assisted AdvantageCare Physicians (ACP), a multi-specialty physician practice with 36 locations in New York City, with revising new hire training for Epic during go-live. The goal of this project was to convert ACP’s instructor-led, classroom training into an e-learning approach as well streamline new hire training.
During the 10-week project, Sagacious created three separate tracks of e-learning for the front desk staff members, nurses, and physicians. Within each track is a participant workbook and e-learning material. Sagacious customized Epic’s e-learning material in accordance with ACP’s workflows and e-learning template.
With e-learning ACP can train all new hires together instead of requiring separate classroom for the front-end staff members, nurses, and physicians. This approach is more efficient for ACP since they use fewer resources and only need two instructors to lead the e-learning training as opposed to six for classroom training.
[+] AdvantageCare Physicians Partnering for Enterprise EHR Implementation Support
When the AdvantageCare Physicians' (ACP) various sites formed a new company, the establishment of new organizational structure was required. ACP leadership decided to consolidate its four disparate clinical information systems into Epic’s centralized electronic health record (EHR) solution. To accomplish this consolidation project, ACP planned three separate regional go-lives, which required at-the-elbow application support.
ACP chose Sagacious to support their second go-live. They preferred to work with one partner rather than multiple vendors to complete the project, and Sagacious was able to provide the required resources so that ACP only had to work directly with them. Not only was ACP impressed with the Sagacious’ knowledge of the Epic system, but they also found many Sagacious staff members to be reputable, given their history as Epic employees.
The second go-live began only six weeks after the first ended, and within that timeframe, ACP trained Sagacious on its processes and procedures. Although Sagacious staff members were familiar with Epic, they required additional knowledge about ACP’s medical office operations and workflows. ACP trained 120 Sagacious staff members remotely for one week.
The second go-live was much larger than the first and included 11 sites in Staten Island and Brooklyn. Sagacious provided 110 staff members for the second go-live, some of whom formed a management team specifically focused on logistics and training. The team worked seven 12-hours days during the three-week go-live period. By the third and largest go-live, which addressed 55% of the practice through 18 sites in the Queens and Long Island areas, Sagacious and ACP had created a strong working relationship.
Given the success of the go-lives, ACP has continued to work with Sagacious on additional projects, including building referral optimization functionality in Epic and revising new hire training. Throughout the relationship, ACP has also used staff augmentation to fill various vacant positions in the practice with Sagacious’ managers and Epic experts.
[+] Baylor College of Medicine Transforming the Revenue Cycle IT Department
Baylor College of Medicine (BCM) is a premier education and healthcare institution in Houston, TX. A member of the Texas Medical Center (TMC), BCM is a part of the world’s largest medical complex that has been leading patient care, research, education, and prevention since 1943 when the College moved from Dallas to Houston to become the first institution in the TMC.
in February 2012, BCM IT undertook a new effort leveraging technology to improve health care, as well as demonstrating leadership in using technology as a change agent. Within a few years, leadership recognized the need for an IT department paradigm shift, both operational and structural. The Revenue Cycle IT department was experiencing high levels of staff attrition and low levels of customer service. A restructured and reinvigorated department was needed that would be an innovation center for the College’s healthcare business office, and that could attract, develop, and retain some of the best problem solvers, project managers, and innovators in the healthcare IT industry.
In November 2014, BCM IT engaged Sagacious Consultants in an initiative to transform the state of the Revenue Cycle IT department.