GlobalNews - Spring 2008

Allscripts TouchWorks Global Works Systems Helps Danbury Physicians in Successful Transition to Allscripts EHR In 2007, Danbury Hospital was completing construction on a three-story, 89,000 square foot addition to the campus that was to house outpatient and diagnostic services. Danbury Office of Physician Services, P.C. (DOPS) was working to finalize the addition of an electronic health records system linking all services electronically. The Cardiovascular, Gastroenterology and General Surgery practices would be moving into the new facility. At the same time, they would all be learning how to use the new EHR. Two of the three practices would function on different floors in the new facility. Two Cardiology satellite offices, located off-campus in two different towns, would also be included in the EHR implementation. Embarking on this transition, DOPS knew that getting support at all of the different locations and meeting the differing demands of each specialty would be a challenge. The physical and technical systems restructuring needed to be finished quickly to meet the opening of the new facility. DOPS also knew additional resources would be required to meet the deadline. "We were dealing with aggressive deadlines and multiple and different specialties so we knew we would need additional expertise. We also knew that help would need to be flexible and patient..." --Richard Lyon, DOPS Executive Director Global Works played a vital role in providing that help and supported the DOPS practices during the deployment and practice relocations. The consulting firm's Allscripts EHR certified services are designed to provide Allscripts clients with the comprehensive assistance that is essential during initial implementation and subsequent roll out to physicians and their various departments...Click here to read the rest of the case study! back to top
GE Centricity Business and EMR PM and EMR Assessment and Implementation Toolkits
By Laurene Edge Management Consultant	We've all heard the phrase, "If you always do what you've always done, you'll always get what you've always gotten." When investing millions of dollars into new technology, you definitely want to get more than "what you always gotten"! When a client implements a new PM or EMR system, they should benefit from all that the system has to offer. However, In order for that to happen, work needs to be done long before the implementation begins and continue well after the system is live. Current business practices and workflows should be documented, analyzed and redesigned as needed. What works well today may not work well with a new system. Analysis must be done to determine standardized "best practice" workflows in each area relevant to the new system in order to provide safe patient care and efficient and accurate billing. Implementation goals, risks and issues need to be tracked to ensure a smooth project. Post-go-live metrics must be established and monitored to confirm that the system and workflows are meeting business goals and requirements and enhancing operations.
Over the last several months, Global Works has been working on tools designed to assist our clients in conducting the necessary pre-implementation assessment work, as well as supporting implementation and providing post-go-live scorecard review and analysis. Both EMR and PM toolkits include forms and guides to help navigate through the vendor decision process, pre-implementation assessment documents and ROI analysis templates. Global Works also offers assistance in communication planning, guidance in creating various project committees and workgroups, and tools for tracking project progress. Both toolkits empower our clients to manage all of the necessary pre-work for planning and executing a successful implementation. Watch for more information coming soon on the roll-out of these new tools. If you have any questions about the toolkits, please contact Laurene Edge. back to top
GE Centricity Business and EMR Achieving Efficiency Through Enhanced SCHED Reporting � VCUHS Illustrates How VCUHS Tackles Operational Efficiency Through Reporting, One Report at a Time For enterprises encompassing a vast array of clinics and specialty departments, managing front office practices can have a tremendous effect on operational efficiency. At Virginia Commonwealth University Health System (VCUHS), an initiative has been under way for a number of years that focuses on optimizing and standardizing the scheduling practices of its providers. These efforts were aimed at reducing the overhead associated with no-show appointments, maximizing provider face-to-face time with patients, and increasing appointment utilization. The Virginia Commonwealth University Health System is part of the VCU Medical Center, located in downtown Richmond, Virginia, and includes a teaching hospital, outpatient clinics and MCV Physicians, a 600+ physician faculty group practice with nearly 200 specialty and sub-specialty areas. VCUHS and Global Works enjoy a long history of working together to maximize the academic medical facility's practice management application. "We can slice and dice the data more ways now, providing a more granular view of each clinic location." --Susan Kelly, VCUHS Ambulatory Care Data Analyst Jim Potyraj, Executive Director of MCV Physicians, envisioned a process that would produce reports detailing appointment availability and patient access on a provider-by-provider basis, allowing for an in-depth view of how individual practices were managing their scheduling operations. He delegated the task to Jalana McCasland, Vice-President of Ambulatory Care, to work with internal technical resources to develop a solution that would allow the necessary intelligence through manual means. While the results were positive, the effort to achieve the necessary results was labor-intensive. Ms. McCasland felt that the program would be more effective if automated and would leverage a more complete data picture than obtainable through provider master schedules. Achieving Scheduling Intelligence Through Hours of Manipulation Jo Weller, Clinical Data Analyst for MCV Physicians, created the PAAR manual process with the guidance of Mr. Potyraj. The task was delegated to VCUHS Ambulatory Care Data Analyst, Susan Kelly, to produce the Provider Appointment Availability Reports (PAAR) on a monthly basis (usually the 3rd Tuesday of each month) to determine physician appointment availability, utilization and capacity. In addition, several views of this data were created to provide breakdowns of the measures with supporting detail. To derive these reports, Susan extracted data from the GE system and either imported .txt files or manually input the data into Excel workbooks. The data pulled from the GE Centricity Scheduling system generally covered a 20-work day time frame (4 calendar weeks) and included physician master schedules, templates that could be applied to the physician schedule and appointment information. Once the scheduling data was entered into the Excel spreadsheets, the information was manually manipulated to calculate the number of hours per week a provider was scheduled for clinic time, how many appointment slots were included in that clinic time, how many appointments were actually scheduled for that clinic time, as well as the 3rd available appointment for new and returning patients. Dates were converted by hand to their day of the week value and totals, and work measures were calculated based on AM/ PM slots, work weeks, work week days and the complete time frame. While the reports offered tremendous information about VCUHS' Ambulatory Care clinics, report creation required a significant amount of staff time and they were being derived using the Physician's Master Schedule, rather than the Physician's daily schedule. The Master Schedule didn't accurately represent a physician's true daily schedule and introduced inconsistencies when interpreting the data...Click here to read the rest of the case study! back to top
GE Centricity Business and EMR End-to-End Business Intelligence for PQRI
By Mary Brown BI Manager	Much of the focus in data warehousing is on technology. There are many things to consider: transaction systems, ETL tools and processes, data quality, database structure, analytics tools, delivery mechanisms. While these components are certainly necessary for a strong foundation, value can only be realized when data is leveraged to make changes that reduce costs, increase revenues or improve clinical outcomes. The Physician Quality Reporting Initiative (PQRI) presents healthcare organizations with an opportunity to use information to create value through increased revenue. PQRI is a voluntary reporting program from CMS that offers an incentive of 1.5% of total allowed charges for providers who successfully report on a set of quality measures for the year 2008. Each measure defines a specific process of care or outcome as it applies to selected patient demographics. Measure 1, for example, is defined as:
Hemoglobin A1c Poor control in Type 1 or 2 Diabetes Mellitus - Percentage of patients aged 18 through 75 years with diabetes mellitus who had most recent hemoglobin A1c greater that 9.0% Many of the measures are grouped into clusters. For instance, Asthma Care, cluster 5, includes metrics for Pharmacologic Therapy and Assessment. To participate in the program, providers include quality data codes on claims submitted to Medicare. (For additional information on the PQRI program, consult: www.cms.hhs.gov/pqri. The Physician Quality Reporting Initiative (PQRI) presents healthcare organizations with an opportunity to use information to create value through increased revenue. In order to maximize financial benefits from a PQRI implementation, organizations need a rich data repository. ETLs must be capable of generating a complete data set and ensuring integrity. The data model must be sufficiently flexible to allow for easy identification of patient populations that meet measurement criteria, as well as quick extraction of visit and charge information for these patients. The analytical tools in use should support appropriate views and trending of the data. The distribution mechanisms need to deliver the right information to the right people at the right time, with proper security enforced. Once such an environment has been built, there are three main areas to focus on reporting - identification of measures, monitoring of reporting compliance and monitoring of performance. When embarking on your implementation, the first step should be to determine which measures apply to your business. Since it is not necessary to report on all defined measures in order to be eligible for the incentive bonus, proper selection of measures will help ensure your bonus potential. With a data base that models each measure definition, your BI solution can generate a report that quantifies historical encounter data by measure, department and provider, enabling you to select the measures most appropriate to your practice. Once measures are identified, process and application changes can be made to begin reporting. After implementation, it is crucial to continually monitor progress. Distribution of reports that detail compliance for each measure by department, provider or billing area to the appropriate people will help identify any areas that may require additional training, configuration or work flow changes to maximize bonus potential. Finally, you'll want to estimate the bonus you will receive in 2009. A complete data set, collected throughout the year, will enable you to determine the expected bonus to be paid. Global Works provides End-to-End Business Intelligence services. We combine service and software into solutions that deliver tangible value for our clients, leveraging their existing investments in skills, systems and infrastructure. In the Business Intelligence space, this means robust enterprise-level data warehousing enhanced by clinical, financial and technical expertise designed to deliver measurable improvements. We have a proven ETL, partnerships with application vendors (GE and Allscripts) and alliances with analytics vendors (Microsoft, Anodyne and PDS). Our clinical, business and financial consultants can help with: Requirements definition and elaboration Platform selection Data validation Data model design and construction Customized report definition and development Report generation and delivery Report security implementation Platform installation, configuration and support for multiple toolsets Consulting to improve data completeness and quality Consulting to implement workflows and systems configurations necessary to improve performance For more information on Global Works End-to-End Business Intelligence, please click here: Global Works End-to-End Businss Intelligence or contact Erin Waters at . back to top
MPV Partnership News UT Medical Group: Improving the performance of payor contracts

"With MPV Phynance, we can produce customized reports and accurately document our reimbursement levels and contract performance with each payor. This information strengthens our negotiation position during contract renegotiations with our payor partners." � Shannon Tacker, Vice President of Revenue Services
The Situation In 1999, UT Medical Group consolidated billing functions for 12 different clinical departments into one. As a part of this process, the group focused on perfecting front-end processes and submitting cleaner claims because it felt this was the key to reducing back-end tasks, like appealing denials. After implementing a claims scrubber, electronic claims submission software and an imaging system, the group quickly realized that while very valuable, none of these technologies gave staff the ability to ensure that payors were holding to the terms outlined in their contracts. "We initially employed a manual process for tracking underpayments where we ran queries from our practice management system and compared payments received against contract terms," said Shannon Tacker, CPA, vice president of revenue services, analysis and decision support at UT Medical Group. But without the staff required to manage this process, UT Medical Group was forced to focus exclusively on high-dollar claims. It also tried to track payment variances by payor, but this method only verified if a payor was reimbursing the group accurately at the time of payment, not for payments going forward. The Challenge While UT Medical Group knew it was being underpaid, it was often difficult to determine the exact amount. With payors constantly changing their fee activity, payment variances were constantly being created. "Whether it was a modification to a fee schedule or an unknown system issue, we had to stay on top of each payment or we would lose money. Manual tracking requires a great deal of staff resources, so we either had to increase staff or find a more efficient way to handle this process," said Tacker. The Solution UT Medical Group selected MPV Phynance in December 2004, with very specific goals in mind. "We needed to better understand our contracts, improve our communications with payors, support denials management � and most importantly � improve our overall cash flow," said Tacker. "If we could achieve these goals, we knew we would have a winner." Almost immediately, the group realized improvements in efficiency and productivity. By tapping MPV's expertise in contract definition and modeling, UT Medical Group gained an electronic database that contained fully defined and modeled terms outlined in their payor contracts. Billing representatives can now access this centralized contract database and quickly reference specific contract language related to appeals when talking with payors. Staff members can also monitor payment trends and flag potential issues. "When a payor recently changed its interpretation of the contract language and its payment policy accordingly, we were able to identify and address the change as a contract issue, rather than a payment issue," said Tacker. The Results UT Medical Group uses Phynance daily to identify and validate payment variances and better manage bundling and medical necessity denials. The benefits include: $660,000 recovered in the first 22 months A more efficient appeals process Ability to perform "what-if" analyses on proposed contract terms and negotiate better performing contracts "MPV has given me the tools I need to negotiate improved rates on an individual CPT code basis," said Cassandra Taylor, manager of managed care contracting at UT Medical Group. "While negotiating with one of our largest payors who was adamant that we were being offered a substantial increase, I was able to show that although the entire range of codes showed an increase, we would actually experience a decrease in reimbursement given the codes we actually bill to the payor. The MPV contract analysis data provided me with the information needed to avoid a costly mistake." Tacker feels another benefit has been how Phynance has enhanced internal communications at UT Medical Group. "In many healthcare organizations, revenue services and the managed care department are two separate entities. Through Phynance, these two groups in our organization have forged a strong bond. By working as a team, these departments regularly review payments received and the policies that drive them, allowing us to appeal and recover more revenue than each department could on its own." To learn more about our combined solution, please read our promotional information. For more information on MPV and Global Works, visit our Partners web page! back to top
GE Centricity Business and EMR Introducing Virtual Support for PM and EMR Practices Many organizations today face challenges in spanning resources and expertise across all of their important initiatives, projects and daily tasks. Many factors can impact the ability to achieve all that needs to be done. Downsizing can create gaps in bandwidth and core expertise, as can employee attrition. In both cases, the timeline for growing the lost proficiencies internally, or permanently hiring for it, can take weeks or months. Organizational priorities can shift to new initiatives, such as system migrations to new platforms or preparing to respond to federal mandates or changes. Both of those scenarios can require the bulk of organizational resources to adequately support. Management of legacy systems and related business needs can suffer in these circumstances. Some smaller organizations or offices haven't migrated to new systems in many years. They simply do not have the workforce infrastructure to handle the post-live phase of a solution deployment, especially ongoing "help desk" support. Help desks can be challenging and costly to maintain, given the myriad of expertise and breadth of resource availability required. In 2007, Global Works launched "Virtual Support Services" (VSS) to address these critical staffing requirements. VSS allows for the outsourcing of remote IT support to meet a variety of needs. Our VSS team is comprised of resources with extensive practice management and EMR system experience, specializing in support of all past and current versions of GE Centricity Business Solutions, GE Centricity EMR and Allscripts Touchworks solutions. We can help with interim or long-term resource support, such as help desk or IT analyst outsourcing, or interim or long-term support of one-time projects. Today, Global Works currently provides Virtual Support Services to two key customers in the Southwest and Midwest. For one site, Global Works supports the help desks for GE Centricity Business Solutions and Allscripts Touchworks production issues and questions. For the other client, the emphasis is on primary IT resources for their current system migration to Epic. As such, the organization has contracted with Global Works to provide remote IT analyst support for primarily project and request work for their GE Centricity Business Solutions production system. If you are interested in learning more about our Virtual Support Services for both practice management and EMR systems, please contact Erin Waters: . back to top

Global Works Software Solution Highlights Enterprise Security View New Reports Concerns regarding HIPAA and identity theft are raising the stakes for Healthcare Enterprises and driving the need for comprehensive security reporting. Global Works Enterprise Security View incorporates data from the primary systems within the enterprise and provides summary and detail reports, graphs, and charts to the appropriate security officer, administrator or IT Director. A sample of reports available include: Top Patient Views � Displays the count of patient views for users in a functional job role for a specified date range. Assists in the identification of unusual patterns of patient views. Top User Events � Displays frequency of actions by a similar group of users. Global User Event Report � Displays a log of a specific user�s activities across multiple systems for a given date range. I.e. Security Plus, Web Frameworks, Building Access logs or other event sources linked to ESV. Configuration Variation Report � Shows the differences in the configuration between users in a similar functional job role. If you are interested in learning more about how Enterprise Security View can optimize your organization's security initiatives, please contact Erin Waters: . back to top Data Exchange ETL Now Available for AVM and ETM Global Works Data Exchange ETL for GE Centricity Business clients expands the data model to include AVM and ETM. Data Exchange for AVM consists of approximately 23 tables and can be turned on as an independent module for new and/or existing clients. For ETM, Data Exchange has three extractions in production - Action Files, Event Files and Task Files. If you are interested in learning more about how Data Exchange can optimize your data warehousing environment, please contact Erin Waters: . back to top Global Works One Look Integrates MS Exchange with Leading Practice Management Systems
	Global Works One Look provides physicians with easy access to their patient schedules from the same desktop and hand held devices they use for their non-clinical schedules. With One Look, physicians can view their personal, departmental and patient schedules in their MS Outlook calendar. One Look empowers physicians' existing scheduling devices by incorporating pertinent data into one platform for seamless access to information. Global Works has expanded One Look beyond the GE Business practice management system to serve a wide array of clients. One Look has just successfully gone live with its first Misys integration!
One Look leverages Global Works' existing technologies, providing integration via industry standards HL7 and WebDAV to communicate between MS Exchange and any leading practice management systems. Future versions will provide integration with groupware such as Lotus Notes and Novel GroupWise. If you are interested in learning more about Global Works One Look, please contact Erin Waters, for more information. back to top Global Works Patient Statement System Increases Efficiency by Allowing Front Office Staff to View Statements on the Web! Patient Statement System offers enhanced customer service features for Business Office staff working in the Centricity Framework. When a patient calls, the account representative can view an exact image of the statement online from his web workplace. Seeing the same statement as the patient makes it easy to provide a quick and accurate answer to the question. Patient Statement System lets your enterprise: Clarify Patient Obligation Reduce Effort and Overhead of Business Office Staff Easily Customize Statements Using MSWord Outsource Printing to Premier Print Vendors Click here to view sample statement! If you are interested in learning more about Patient Statement System, please contact Erin Waters, for more information. back to top Global Works Form Letter System for Patient Scheduling Is Your Catalyst for Operational Change Improve Correspondence Quality MS Word provides formatting flexibility and professional quality output. Letterheads, images and maps are automatically pulled into letters, providing visually pleasing and accurate information. Automate processes Form Letter System�s scheduled automation produces forms and letters tailored to each department�s workflows. Realtime automation prints documents such as patient instructions, consent forms, receipts and other forms based on trigger events in the Scheduling system. Enhance patient communication from Scheduling Timely reminders, confirmations and instructions reduce no show rates and improve patient compliance. Automated preventative care notifications can be targeted to specific patient populations. For example, some clients may use Form Letter System to notify patients of their Initial Preventative Physical Examination benefit under Medicare. Click here to view sample letters! To learn more about the Form Letter System and the other modules available, click here: Global Works Form Letter System. To receive direct information about the BAR module, please contact Erin Waters: . back to top

GE Centricity Business and EMR Centricity EMR Business Intelligence As EMRs are implemented by more and more healthcare organizations, savvy administrators are seizing on the opportunity to enhance their operations by leveraging clinical business intelligence. Global Works Centricity EMR Reporting Services are designed for healthcare organizations utilizing GE Centricity EMR and in need of assistance with their reporting initiatives or individual report requests. Our consultants and technical experts are knowledgeable and experienced with Crystal Reports, SQL, and Oracle database technology in addition to their comprehensive understanding of the GE Centricity EMR application. Whether your organization is in need of a report library revision or help meeting the report requests of a few users, Global Works resources are available to assist you. Some important categories for clinical BI include: Clinical Research Reporting Disease Based Quality Reporting Practice Level Reporting Patient Specific Reporting Audit Reporting Demographics To learn more about Global Works Centricity EMR BI Services, click here: Global Works Centricity EMR BI Services or contact Erin Waters: . back to top
Company News Global Works Welcomes New Employees Global Works clinical, technical and business services continue to experience strong growth. We've expanded our professional services and client management teams and we're happy to welcome:
	Georgette Petner recently joined Global Works as a Recruiting Specialist. In this role, she will be responsible for all recruiting efforts for both new and replacement positions. Her background includes providing both recruiting and human resource functions for various industries, including healthcare, manufacturing and technology. She currently lives in Vermont with her husband, and they are expecting their first child in April.
	Tiffany Steward comes to Global Works with over 10 years of experience in healthcare IT. Prior to entering the consulting world, she spent 4 years as an application specialist for IDX Flowcast and IDXtend at Carolinas HealthCare System where she was responsible for implementing, training and supporting practice management. Tiffany lives in North Carolina with her husband and son. She enjoys spending time with family and friends and meeting new people. In her free time, she can be found involved in church activities, baking, cooking, collecting recipes, reading, and taking long naps!
	Mary Brown served as the Director of Software Development at GE Healthcare/IDX before coming to Global Works. During her impressive 17 years there, she held various roles that involved software and systems development and programming. She helped develop products ranging from eCommerce solutions to integrated EMR systems. At Global Works, Mary directs Business Intelligence initiatives. When not helping clients improve their operations, she enjoys cooking, traveling and reading.�
	Mary Gallicano is the latest addition to the Client Management team. Mary has spent over seventeen years in the healthcare IT industry with IDX Systems Corporation and then GE Healthcare IITS. Mary has been involved with multiple aspects of healthcare IT including support, training, sales, and commercial marketing. Her focus included Centricity Business (IDX Flowcast) hospital access and revenue cycle management systems (VM, HPA, CBO, etc.), ambulatory access and revenue cycle management systems (AVM, BAR, Sched, MCA, etc.) as well as the former IDXrad radiology information systems and PACS offerings. Mary, her husband, 3 yr old son and Siberian husky recently relocated from Vermont to Southwest Montana where they are enjoying skiing, hiking and all the wild west has to offer.
Becky Wible joins Global Works' finance team with over 10 years of bookkeeping and accounting experience in various industries, including retail, telecommunications and public accounting. In addition to working full-time, she runs her own small bookkeeping business. She enjoys gardening and relaxing at home with her husband Dan, son Guy and their three cats. back to top
Global Works is Hiring! Global Works is seeking talented, team-oriented professionals to help our clients achieve their goals. In addition to offering a challenging and satisfying working environment, we provide our employees with a competitive salary and benefits package. We're currently seeking qualified candidates for the following positions: BI/SQL Programmer Clinical Services Consultant Level I Healthcare Clinical IT Consultant Senior Software Engineer Sales Executive Software Engineer/Programmer II SQL Programmer Level I back to top

Calendar of Events and Presentations

TouchWorks Western Region Users Group Los Angeles, CA - May 8-9
Don't miss Global Works' Presentation: "Tasking Strategies" Presented by Global Works Senior Consultant Deena Marlow. Deena's insight and expertise has been demonstrated through presentations a number of regional and national conferences. She will also be presenting at TEPR.

Toward an Electronic Patient Record (TEPR)
Ft. Lauderdale, FL - May 19-20

Don't miss Global Works' Presentations:

"How the implementation of a Personal Health Record with an EMR is Improving Quality of Care at LSUHS"
The need for personal health data to be available from any location at any time via the Internet has become increasingly important across the continuum of healthcare and vital in emergencies. This session discusses how one organization implemented a portable health record (PHR) in the aftermath of Hurricane Katrina to help patients better manage their healthcare and improve patient-provider relationships. Participants will be able to gain an understanding of the impact of a PHR, learn how to engage providers in participating in this initiative and provide a unique, cohesive, comprehensive toolset for ALL stakeholders in healthcare. Presented by Leasa Tvedt.

"Selecting the Right EMR Partner Can Ensure Project Success"
Electronic Health Record implementations and upgrades have become an influential part of delivering quality patient care. This session offers insight to selecting the best EHR vendor for your providers, patients, and administrators. Every organization has a different set of objectives for their implementation, which should drive the vendor selection process and help determine internal team readiness. Attendees will learn how selection of the right EHR vendor is critical to blending the unique practices of your physicians with the overall clinic and administrative goals of improved care, reporting capabilities, and increasing reimbursement. Presented by Deena Marlow.

Western Region Users Group
Bellingham, WA - June 12-13

Don't miss Global Works' Presentation:

"BAR Form Letters"
Correspondence is an important part of the billing and collection process. Your business office staff must send letters and forms to patients, insurers and various other external entities in order to resolve receivables. Automating that correspondence and giving users the ability to demand letters tailored to the specific situation can have a significant impact on your A/R days. OSU Physicians shares their experience partnering with Global Works in the development of the new Revenue Cycle module of Global Works' popular Form Letter System. Come see letters and workflows that are improving the bottom line at OSU. Presented by Linda Martinez.