GlobalNews - Winter 2007

Case Study Global Works Helps Provide Seamless Allscripts EHR Implementation at St. Vincent's Family Medical Center "The Family Medical Practice go-live was one of the best I have ever participated in. Instead of trying to make the technology fit the practice, they took a hard look at their processes and what the new technology offered and changed what they were doing to take advantage of the new system." Sherri Atchley Senior Consultant Client Profile St. Vincent's Family Medicine Center, part of St. Vincent's Health System in Jacksonville, Florida, serves as a family practice physician office providing care for private pay, managed care, Medicaid and commercial patients. It is one of the main vehicles by which St. Vincent's fulfills its mission of compassionate, available medical care for all patients in Jacksonville. St. Vincent's Family Practice Residency Program provides primary and obstetrical care through the Family Medicine Center. Approximately 2,500 patient visits per month are provided by 30 Family Practice Residents who are supervised by Board Certified Family Practice, Pediatric, and OB/GYN physicians. Background Ensuring reliable and efficient office communications is central to the Family Medicine Center’s mission of providing holistic health care with respect and compassion. However, the paper chart system used by the practice had serious limitations and was causing concern. The entire staff depended on one paper chart to document notes, review diagnoses and answer patient questions. Finding client information quickly and easily, tracking changes to patient charts, refilling medications and messages going through many different hands all created significant burdens for physicians and staff. It was clear that something had to be done. "We had a check list of do's and don'ts and things that were imperative - and Allscripts TouchWorks fit the bill." Implementing an EHR to Ensure Quality of Care A team was assembled to evaluate electronic health records systems (EHRs) with the goal of improving the efficiency and effectiveness of the health care delivery system. David McInnes, MD, Duaine Murphee, MD, Mary Gray, Senior Systems Analyst, Gwen Lloyd, GME Director, Randall Hartley, Family Medicine Practice Director, and Robin Potts, MD worked together to gather input from clinicians, administration and IT staff. "Under the guidance of Senior Systems Analyst, Mary Gray, we put together a list of specific requirements that would work in a residency practice," offers Project Owner, Dr. David McInnes. "We needed to see an EHR successfully implemented in a situation similar to ours." After careful review and consideration the team selected Allscripts TouchWorks EHR V10.2 from Allscripts in December 2005. "We were looking for a system that fit a practice and residency program," confirms Mary Gray. "We had a check list of needed functionality and things that were imperative for a residency program—and Allscripts TouchWorks fit the bill." TouchWorks EHR automates vital clinical functions that directly affect a patient’s health including writing and refilling prescriptions, ordering tests, viewing results, documenting care and checking for harmful drug allergy interactions. Family Medicine Center implemented seven Allscripts TouchWorks modules including Base, Document, Scan, Rx+ (including SureScripts), Result (Outbound/Inbound with Quest and Lab Corp), Note and Charge for all clinic practitioners and staff in October 2006. After the application selection process, the focus became implementation. Allscripts partner in implementation, Global Works Systems, Inc., provided support during the deployment. Global Works EHR Implementation Services are designed for Allscripts clients who are beginning their implementation and are ready to roll out the solution to their physicians and departments. Global Works Certified Allscripts Clinical Consultants deliver a full spectrum of support across the entire deployment —managing and building vital clinical content, training the project team and physician early-adopters, working hand-in-hand with physicians to ensure their mastery of the technology, and showing up in person to support each go-live event. "The new system really impacts the quality of care. The EHR enables safer, personalized care that is easily accessible and more reliable."
Leveraging Technology to Improve Processes Sherri Atchley, Global Works Senior Consultant and Certified Allscripts Consultant, has been involved in a number of Allscripts EHR installations. "The Family Medicine Practice go-live was one of the best I have ever participated in," affirms Sherri. "Instead of trying to make the technology fit the practice, they took a hard look at their processes and what the new technology offered and changed what they were doing to take advantage of the new system." Working in concert with team leaders, Family Medicine Practice Director, Randy Hartley began reengineering the practice to leverage the new technology and improve the processes. At the time, Family Medical Center was using GE Healthcare Business Services (IDX Flowcast), Cerner Classic, Cerner Millennium and Siemens MedSeries 4 systems. Beginning in the summer of 2006, Mr. Hartley created the initial flow chart to capture existing baseline flows and then developed cross-functional groups to review existing processes and understand TouchWorks processes. His goal was to refine internal processes and leverage the software’s new flow. He gathered input from all areas of the practice, including physicians, patients, nurses and lab technicians. "Creating an efficient practice flow is a two-step process," mentions Mr. Hartley. "Doing the two things simultaneously is sort of like building an airplane while you’re flying it," he adds. Valuable Training Before Go-Live An important aspect of the Family Medicine Center EHR implementation that Sherri Atchley noticed was the enthusiasm for the project. "The entire staff was upbeat and excited about the go-live. I didn’t see any of the resistance or objections to new technologies that I’ve seen during other implementations." Sherri attributes this to staff involvement in the process to thorough training well before the actual go-live. "My sense was that physicians and staff alike were eager to start using the new EHR and were excited about the changes." Several months before the go-live, Physician Champion Dr. Duaine Murphee started meeting with staff on a one-on-one basis to give a system overview before training. "We wanted to provide a continuous loop of training," offers Dr. Murphree. "We would often meet during lunchtime and look at demos of the product so that everyone was familiar with the idea and on the same page with the plan and the timeline." The staff also attended functional training with support that included integrated testing on weekends. According to Mr. Hartley, "the integrated testing helped lower the fear factor of the support staff." Global Works Assistance Provides Seamless Integration Global Works supplied invaluable assistance, according to the team members. The expert on-site support provided seamless integration. Mary mentions, "We would progress to a certain point and start to feel unsettled. Then Sherri would arrive, explain the ramifications of the design changes we were making and everyone would feel that it was possible again. Sherri provided great continuity during the lifecycle of the project." "We would progress to a certain point and start to feel unsettled. Then Sherri would arrive, explain the ramifications of the design changes we were making and everyone would feel that it was possible again. Sherri provided great continuity during the lifecycle of the project." Impressive Changes in Work Flow Family Medicine Center is the first of St. Vincent’s outpatient clinics to move to a completely electronic format. The team is extremely pleased with the results of the Allscripts EHR implementation. The clinic now enjoys 100% medical record availability—visible throughout the practice, with messages and prescriptions handled in a timely manner. Authorization approval is a one-step process with attached documentation. "The change in workflow is pretty amazing," says Dr. Murphee. Mr. Hartley agrees: "The new system really impacts the quality of care. The EHR enables safer, personalized care that is easily accessible and more reliable." ^GWS -- Allen Mireles, Mireles Communications Global Works Allscripts certified consultants can assist clients with training, implementations and application roll out. Click here to learn more! back to top
Software Solution Highlight HIPAA, the Media and the Educated Patient are Putting Pressure on Healthcare IT to Manage, Monitor and Control Security Access and Privileges Enterprise Security View^TM Delivers Security Data to your Desktop! 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. *Top User Events Report* For more information about Global Works Enterprise Security View, please contact or call 802-846-2550. ^GWS back to top

Calendar of Events WRUG - Costa Mesa, CA February 8-9, 2007 Don't miss Global Works' presentation: "LEVERAGE YOUR SCHEDULING THROUGH SOFTWARE PRODUCT ENHANCEMENTS" presented by Margaret Golden Global Works Form Letter System and One Look extend your Scheduling capabilities by leveraging industry-standard Microsoft tools. Global Works Form Letter System and One Look calendaring integration tool combine the essential information contained in your practice management scheduling application with physicians' personal calendars using MS Exchange/Outlook and Microsoft Word. Global Works will demonstrate through client case studies how these tools can improve workflows and increase efficiencies enterprise-wide. Be sure to stop by Global Works' Booth! T-WRUG - Denver, CO March 21 - 22, 2007 Don't miss Global Works' presentation: "TOUCHWORKS OVERHAUL: SIMPLE WAYS TO ACHIEVE ROI WITHOUT SPENDING A DIME" Presented by Deena Marlow Global Works Consultant Deena Marlow will demonstrate tools that can make a difference in your organization's utilization of TouchWorks. Her presentation will include tips and tricks for: Standardizing menus and security Simple sql queries analyzing your user base Producing reports on all patients on certain meds or with certain problems Utilizing file cabinets in Scan Customizing your document headers and rx formats Please see the T-WRUG agenda for more information! MRUG - Indianapolis, IN April 1 - 4, 2007 "LEVERAGE YOUR SCHEDULING THROUGH SOFTWARE PRODUCT ENHANCEMENTS" presented by Regan Sonnabend Global Works Form Letter System and One Look extend your Scheduling capabilities by leveraging industry-standard Microsoft tools. Global Works Form Letter System and One Look calendaring integration tool combine the essential information contained in your practice management scheduling application with physicians' personal calendars using MS Exchange/Outlook and Microsoft Word. Global Works will demonstrate through client case studies how these tools can improve workflows and increase efficiencies enterprise-wide. Be sure to stop by Global Works' Booth! SNUG - Atlanta, GA April 17 - 20, 2007 "LEVERAGE YOUR SCHEDULING THROUGH SOFTWARE PRODUCT ENHANCEMENTS" Global Works Form Letter System and One Look extend your Scheduling capabilities by leveraging industry-standard Microsoft tools. Global Works Form Letter System and One Look calendaring integration tool combine the essential information contained in your practice management scheduling application with physicians' personal calendars using MS Exchange/Outlook and Microsoft Word. Global Works will demonstrate through client case studies how these tools can improve workflows and increase efficiencies enterprise-wide. Be sure to stop by Global Works' Booth! back to top
Case Study Baylor Improves Revenue Cycle with MPV Phynance and Global Works Interface Issue As with many medical groups, Baylor College of Medicine's managed care contracts were not performing as expected. The lack of a standard underpayment analysis tool based on contract terms resulted in an uncoordinated approach to identifying and correcting payment errors across the college. Additionally, the manual processes developed to attempt to audit contract performance were time-consuming, expensive and only sporadically identified payment errors. This inability to verify contract performance resulted not only in revenue losses and inefficiencies, but also in considerable physician dissatisfaction over suspected underpayments. Challenge After ineffective attempts to establish effective internal, manual contract compliance procedures, Baylor concluded that automating claims valuation and monitoring was the only way that underpayments could be consistently identified and recovered. "We created extravagant spreadsheets and databases, but we never got above 15% to 16% in monitoring claims," says Sonja Beaty, executive director of business development at Baylor College of Medicine. The group also faced additional challenges that affected payment, including inaccurate registrations, posting issues and a fragmented denials management process. "Our approach was uncoordinated and depended on the judgment and resources available in each area of the practice. We needed a tool that could track claims across all departments so we could have a unified front in dealing with payors." Solution Baylor considered several external contract compliance solutions before choosing Medical Present Value for a pilot in 2002. Eighteen months after testing MPV Phynance in two of its departments, Baylor expanded its use of the application to an additional three departments. The second implementation was complete in just 15 business days, with new departments receiving recoveries in the same month. Today, the group uses Phynance in all clinical practice departments. "We started out looking for a way to identify and recover underpayments, but what we've found is an effective contract management tool that helps us gain credibility with our payors," Beaty says. Baylor uses Phynance to regularly monitor contract performance, and it shares the findings with payors during quarterly meetings. "We've found you can't fix the problems once and walk away. Payor activity is constantly changing, and the payors are just as happy as we are to find and correct payment issues as they arise." Baylor plans to further expand its use of the tool to include additional payor contracts and physician extenders. It also plans to use the MPV Contract Analysis Tool to run "what if" scenarios during contract negotiations, helping Baylor to better understand how new and alternate contract terms will affect payment for the unique mix of services it provides. Results and ROI Since the initial pilot implementation in July 2002, Baylor's ROI reaches far beyond bottom line results, Beaty says. Among the gains Baylor made: Negotiated contract performance standards into new managed care contracts that increase rates to compensate for additional handling costs if payment errors go above set thresholds. Identified and corrected systemic payment errors. Reduced inaccurate registrations from 42% to 15% in the first year. Established uniform revenue cycle management processes across departments, leading to improved workflow and increased efficiency. Achieved payment accuracy and generated an additional $2 million in revenue. Beaty emphasizes that Phynance has forged a partnership among the operations and contracting departments within the college, which she feels is one of the keys to Baylor's success. "MPV has given us a better way to communicate internally, and this increased level of collaboration allows us to maximize the value of our payor contracts much more than any individual department could on its own." MPV adds over $2 million to the bottom line Baylor College of Medicine, March 2003-September 2006 Annual underallowance variance: 3-5% Recoveries from successful appeals: $2 million About Global Works and MPV Global Works and MPV formed a strategic partnership in 2000. Global Works provides the MPV client base with the MPV Interface for practice management systems and the client side consulting services to assist clients in their implementation and use of the MPV Phynance solution. For more information about MPV Phynance, visit: www.mpv.com For more information on Global Works Integration technology send an email to . ^GWS -- Baylor Case Study Courtesy of MPV back to top