Practice Management
Solution Set
 PM Application Services
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Achieving Efficiency Through Enhanced SCHED Reporting - VCUHS Illustrates How
"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
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.
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.
The Team Delivers a Comprehensive and Automated Solution
Because of their existing relationship, it was a logical choice for VCUHS to seek Global Works' assistance in developing the updated solution. "We've been aware of Global Works' expertise since we implemented their Form Letter System a number of years ago," mentioned Sharon Grow, Patient Access IS Liaison. Global Works Senior Software Engineer, Lisa Jaramillo, was brought in as the technical resource to automate the reporting environment. She also offered perspectives on best practices for manipulating the data for automation. Susan Kelly and Sharon rounded out the project team for VCUHS. Susan had been producing the reports in their manual incarnation. Throughout the automation project Susan and Lisa devised conceptual improvements. Sharon possessed intimate knowledge of IDX provider scheduling setup and logic.
The goal of automation was to significantly reduce the time required to create the various reports while offering a greater consistency and accuracy in the data presented. The team produced reports in various formats, including a .txt delimited version for Excel import capabilities. With Susan and Sharon's guidance, Lisa created a set of statistical reports that demonstrated a consistent and accurate view of provider availability, capacity and utilization. Susan professed, "Lisa is wonderful, always available, easy to work with, and technically intuitive. I can't imagine anyone knowing as much about IDX as she does." Sharon added, "Lisa's been invaluable…she's helped with concepts and ideas of where to go with reports and provided the roadmap of ‘how to get there' with the data. She's open and responsive, provides quick turnaround and never says ‘we can't do that.'"
Scheduling reports are now produced in a matter of minutes and offer enormous flexibility in how users produce and view them. The intelligence has aided VCUHS in determining the efficiency of their clinic schedules and the ability to monitor provider availability based on current and future workloads. This data also is used to understand if more providers are possibly needed to keep up with current patient needs, as well as determine when to restructure appointment types to best help the appointment availability of a provider or clinic. Because the reports can be run for future or past periods, it allows VCUHS Ambulatory Care to be proactive in structuring of appointments as well as monitor them retrospectively for best utilization. Susan added, "We can slice and dice the data more ways now, providing a more granular view of each clinic location."
The Global Works solution offers VCUHS separate analytical reports that serve up a full spectrum of data regarding provider, department, location, appointment availability as well as overall bookings. Detailed breakdowns of the data include new measures for slot and appointment views and statistics on "new" and "return" appointment measures. There are a variety of filtering and sort options allowing the customer to create reports easily for a given audience or target group. Data is maintained on the system for a minimum of 30 days, which allows VCUHS to reproduce intelligence for comparison and analysis with complete consistency within the data set. Data retention and purging from the system are entirely customizable.
Currently, the data is presented in Excel sheets and distributed to Department Chairs, administrators and Medical Directors. The intelligence that is now available sheds light on ambulatory clinic activity and allows optimization of scheduling practices. Schedules are viewed a month in advance and retrospectively up to 90 days. Susan's production of reports, which at one time consumed a great deal of her allotted time, now takes mere minutes. Furthermore, practice managers are constantly requesting new data they'd like to see and retroactively auditing to measure performance, as well as proactively addressing access issues as they may arise. One feature of the Retrospective PAAR shows how many minutes a provider actually scheduled. Also, administrators can now attempt to address high no-shows and cancellation rates since being provided with regular reporting.
VCUHS's reports continue to evolve as end-users find new and innovative ways to fine-tune the management of provider scheduling. One might say that at VCUHS scheduling is now "right on time."
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