Archive for June, 2020

Virtual Go-Live: A New Approach To Support Health Systems

Posted by Samantha Serfass on June 30, 2020 in Blog, News

VIRTUAL GO LIVE:

A NEW APPROACH TO SUPPORT HEALTH SYSTEMS

As the HIT industry continues to change, the demand to reduce on-site presences of traveling ‘At the Elbow Resources’ for a Go-Live continues to rise. Hospital systems also need to decrease the costs for activation support.  Providing virtual support at Go-Live can tackle both of these issues.

A virtual Go-Live occurs when a health system uses technology to virtually train their end-user staff and to help support them remotely after go-live. In most cases, health systems will still need some onsite lead resources to assist with end-users communication and escalation.

Virtual Go-Live staff will act as the on-call help desk support team. Clinicians and support staff will access the end user’s desktop remotely and walk them through the trained workflows – addressing any questions they may have via virtual “command center”.

By creating a custom icon on the desktop, an end-user can quickly connect to a support team.  These team members can assist the end-user by shadowing them while communicating via message or by phone. End-users can also email and video conference with support staff but the preferred method of communication used is based on each organization and the end-users specific challenges.

Virtual Go Live staff will act as the on-call help desk support team. Clinicians and support staff will access the end user’s desktop remotely and walk them through the trained workflows – addressing any questions they may have via virtual “command center”.

The support staff can offer assistance in two ways. First by either verbally walking end-users through issues; this can be done over a simple phone call. The second way the support staff can offer assistance is by gaining access remotely to the PC to show the end-user how to resolve the issue. It is critical to provide support staff that is extremely knowledgeable about the details surrounding the workflows.

ADVANTAGES

  • Quick set-up with multiple ways to communicate with end-users
  • Onboarding and travel costs are eliminated
  • Providers have more flexibility in “attending” classes/webinars
  • Pre/post Go Live “walkthroughs” including personalization labs that can be scheduled to train on feature and functionality

There are two key factors to consider when implementing a virtual Go-Live: the people and the process. Excite Health Partners not only has the experienced professionals to assist with a virtual Go-Live, but we also have the ability to tailor our processes to best fit the unique needs of each facility.

People: Virtual ATE Support places a large emphasis on having the right talent. Resources that intimately know the EHR screens which support the workflows, understanding the job responsibilities of the end-user and having superior communication skills are vital.  Excite has conducted over 30 activations over the years and has a database of nearly 25,000 support staff who we’ve already worked with. After each Go-Live engagement, we update the profiles of our support staff so performance expectations can be set appropriately allowing everyone to be set up for success.

Process: Excite comes to the table with a set of standard processes that addresses available support staff communicating issues and initial communication to end-users.  Our resources are trained to process escalating issues, handoffs, documenting throughout the life cycle of the ticket and finally creating new tips and tricks. Many times, our client will have specific needs around documentation and processes. Excite works with each individual client to meet their unique needs while remaining flexible in our business operations.  

As the need for virtual Go-Lives continues to increase, our experienced team has the tools to tackle your next project. Excite Health Partners can help offer the right talent, resources and approach to not only reduce onsite presence but also lower activation support cost.

Todd Klein, CIO, VP of EHR Services & Digital Solutions

Harnessing Remote Resources for Internal Coder Training

Posted by Samantha Serfass on June 23, 2020 in Blog, News

HARNESSING REMOTE RESOURCES FOR INTERNAL CODER TRAINING

In the ever-changing world of health information management, the ability to train and maintain knowledgeable and highly qualified coding specialists is a necessity.  Shrinking budgets, lack of available training staff, tools, time, and focus on keeping current workloads current are just a few of the challenges impeding a facility’s ability to train current or new incoming coders.  With the emphasis on quick turn-around to keep Discharge Non-Final Billed (DNFB) and Accounts Receivable (AR)  at a minimum,  supporting coders in learning other coding specialties takes time away from sole focus on their designated patient type.

A 700- bed facility had talented internal coders who expressed the desire to progress into other patient types; however, the facility did not have the bandwidth to perform the training and education internally.  Through an existing relationship, they reached out to Excite Health Partners seeking support with expanding existing coders’ skill sets.   

The first step in the project was to define the Scope, Goals, Timelines, Challenges to the project with respective solutions, and outline Project Details.

THE SCOPE

The client needed the education to span multiple coding modalities:

  • training new coders to perform outpatient ancillary coding,
  • train current outpatient ancillary coders to be proficient in emergency department coding,
  • and to educate current emergency department coders on ambulatory surgery and observation coding. 

THE GOALS:

Numerous benefits drove the facility to support this investment in their coders:

  • well-rounded coder skills to support fellow coders;
  • cross-coverage during vacations and sick time;
  • reduced need to call in additional contract coding support;
  • improved marketing for new coders demonstrating the facility’s commitment to supporting expanding coders’ career path;
  • improved coder morale and coder loyalty;
  • improved coder confidence;
  • coders felt like they were a part of a team working together to achieve a common goal.

THE TIMELINES:

All education would be performed in specific timeframes, with the ancillary training set at 6 weeks, emergency coding requiring 8 weeks, and ambulatory surgery/observation coding spanning 12 weeks.

THE CHALLENGES:

There were three primary challenges we had to tackle:

  • Maintaining current workloads while the coders were training.
    • Excite Health Partners provided additional staffing to the client to cover productive hours lost during internal staff training.
  • Creating an educational program for the ambulatory surgery/observation trainees that would effectively cover all body systems and related procedures while moving at a pace that would meet the client’s 12-week training expectation.
    • Two body systems and related procedures were covered weekly with practice exercises to apply information covered.
  • Ensuring an effective remote training/education environment.
    • Remote training sessions were interactive and inclusive in nature, using 1:1 phone calls and group screen-sharing applications.
    • Following classroom and education time, the coders would then code “live” accounts for the duration of their training. 

THE PROJECT DETAILS

A total of eight coders were trained in ancillary and emergency department coding, four for each modality.  These two training sessions were performed simultaneously, with the 8-week emergency department training starting first for two weeks, then adding the ancillary training for the remaining 6 weeks.  Each training session began with review of basic outpatient coding guidelines and also review of the facility’s specific outpatient coding policies.  After the initial training sessions, ED trainees were expected to code a total of 40 charts per week, not exceeding 10 charts per day.  The ancillary coders submitted 50 charts a week.  On a daily basis, the educator would review the accounts for coding accuracy and make recommendations for any changes.  All audit results were sent back to the coder at the end of the day for review.  Once a week, the educator and coder had individual meetings scheduled to review the audit results and discuss any issues.  Once all meetings had occurred for the week, the educator would submit progress reports to the facility’s coding management team, reflecting the coder’s progression towards overall 95% coding accuracy.

The training program for the ambulatory surgery/observation coders was developed in a different manner.  Because a thorough understanding of anatomy and physiology is needed to code surgeries, it was important to include review of individual body systems and related surgeries prior to the coders moving to coding actual charts.  The educator met with the coders in a virtual classroom setting twice a week.  During each class time, the educator focused on one body system.  This focus included anatomy and physiology of the body system, review of common surgeries on the body system, and review of coding resources pertaining to those particular surgeries.  On completion of the class time, the coders would be given simulated system-specific operative reports to code.  Their coding were returned to the educator, who would audit the codes and respond with feedback.  Throughout the week, the coder and auditor would have calls to review and discuss the audit findings, and at the end of the week the coder’s weekly score would be provided to the facility’s management staff.  Once all body systems had been covered, then the coders were assigned 25 actual charts to code on a weekly basis, following the same auditing/feedback/scoring format.

THE CONCLUSION:

The current coding team is now more well-rounded, confident, and able to support the various incoming workload types of the facility.  The facility now has more flexibility in workload assignments with the multi-skilled coding team.  Within three months of the end of the training sessions, the facility had an external audit performed on all of their coders.  Particular attention was paid to those coders who had recently attended the education, with all having done well with passing scores.

“I was thrown into the External Audits and I passed with a 98%!! I couldn’t believe it! This has made my entire day.  I’m over the moon LOL!   Thank you so much for the training and the assistance that you gave us. This is why we have been so successful!”  — Ambulatory Surgery Coder

Excite Health Partners is here to partner with you on your education and training projects and support any level of coder development, education, and training needs.  We are ready with experienced coder educators that can train coders into separate service types and offer education to coders on specific coding topics.  All education and training projects are tailored to each individual client’s needs and goals.

Robyn McCoart, RHIT, Managing Auditor Excite Health Partners

FAST HEALTHCARE INTEROPERABILITY RESOURCES: DISCUSSING WORKFLOW AND INTEGRATION

Posted by Samantha Serfass on June 16, 2020 in Blog, News

FAST HEALTHCARE INTEROPERABILITY RESOURCES: DISCUSSING WORKFLOW AND INTEGRATION

The first version of FHIR was published Feb 2014, by the HL7 International organization.  FHIR was developed in part because of the lack of the HL7 standards to easily share real time data across a variety of EHRs.  FHIR is an intraoperative data integration tool/language which allows EHRs to deviate from exchanging complex Clinical Document Architectures (CDAs).

FHIR takes advantage of open API using a structured language to access and modify discrete data. Built on HL7 and HTTPS protocol, FHIR allows for real-time data gathering from multiple specific segments of data. In 2018 Apple announced its iPhone Health application. This app would allow viewing of end user’s medical record, via FHIR.  John Hopkins, Cedars- Sinai and other large hospital organizations supported the effort.  

EHRs like Epic and Cerner have supported the use of their open API’s via FHIR and SMART. Within the SMART App Gallery Store, hundreds of applications from Care Coordination, Patient Engagement Disease Management and COVID-19 use FHIR to access systems and provide specialized support for end users. By using SMART on FHIR, developers can create applications rapidly at a fraction of the cost. These new tools and technologies have helped to improve telehealth solutions.

Excite Health Partners is a partner with SnapMD. SnapMD is a top rated KLASS telehealth solution which can be utilized within the whole hospital system. By leveraging both SnapMD and the hospitals systems open APIs we can help support a smooth workflow for patients and providers.  It is paramount when integrating the systems SMART on FHIR is used to support the right clinical & patient processes. Use Cases are identified within each specialty of care and which devices are leverage throughout each type of patient interaction.  

To confirm the bills are dropped for reimbursement, it’s important to ensure the use cases and workflows are seamless and efficient while supporting proper sharing and storage of the data. SMART on FHIR is the way of the future and provides not only a reduced cost but also a rapid integration, allowing hospitals implement and utilize these systems quicker.

Whether an organization chooses to store clinical notes and discharge summaries within their EHR or in a telehealth solution, such as SnapMD, Excite Health Partners can offer the right support. Once the desired workflows are established, Excite leverages our technical expertise to provide the integration required to support efficient operations.

Todd Klein, CIO, VP of EHR Services & Digital Solutions