Author: Heather Guild

OHI started following “The Health Care Blog” (THCB) which the Wall Street Journal considers the leading online forum covering the business of healthcare and the new ideas that are changing the health care industry. THCB is read by a daily audience of 4,000 – 5,000 healthcare professionals across a spectrum of roles. These include executives at healthcare networks and organizations, policy makers on the state and federal level, decision-makers, doctors and nurses, med students, investors and entrepreneurs and consumers trying to come to grips with the changes impacting the healthcare system.

A recent post “The Low Hanging Fruit is Lying on the Ground” caught our eye since the topic reflects the transformation of approach we’ve seen in our hospital clients over the past couple years. And this in only one of dozens of thought provoking blogs THCB features. After reading the excerpt below, OHI would welcome the chance to speak with you about how your organization can improve its processes and gather up some of that “low hanging fruit”.

“With hospitals and doctors under tremendous pressure to improve costs and quality fast, clichéd calls to “aim for the low-hanging fruit” are ringing in every boardroom and bedpan from Sarasota to Seattle. But medical providers should set their sights a bit lower. Why? Because “in health care, the low-hanging fruit isn’t just low-hanging fruit; the fruit is lying on the ground, and we have to be careful not to trip over it.”

That’s the axiom that Indiana University management professor Mohan Tatikonda repeats regularly to the physicians in an MBA program for MDs started in 2013 by IU’s Kelley School of Business in Indianapolis. His students, who hail from around the country and have been practicing medicine for an average of 20 years, shortened the phrase to simply “watermelons on the ground.”

It means that first-year MBA concept employed decades ago in most other industries can yield huge results among health care providers. “On average, the state of operations in health care delivery is primitive. Fundamentally primitive,” Tatikonda said. “Just the basic understanding of patient flows, materials flows, information flows. Having them documented and diagrammed. This kind of thing until very recently was just not very common.”

It’s not that things such as Six Sigma or Lean are unknown to health care leaders. Consultant Chip Caldwell estimates that about 75 percent of hospital systems are using Lean in some way, compared with 53 percent identified by a 2009 survey by the Association Society for Quality. Only about one in 10 hospital systems is using Six Sigma currently, Caldwell estimates, down from a peak of popularity in the 2000s.

Some hospitals, such as Virginia Mason and Barnes-Jewish, have employed these techniques to wide acclaim. What few health care provider organizations have done, Tatikonda said, is make a regular, sustained habit of using process improvement concepts, so that all the people in their organizations became used to thinking that way.

For the full article, please follow this link: https://thehealthcareblog.com/blog/2015/07/29/the-low-hanging-fruit-is-lying-on-the-ground/

Optimium Health has had numerous discussions over the past 6 months with hospital administrators and unit managers who all seem to highlight the same issue: while EHR’s promise to improve workflow and productivity, they more often than not do the opposite. A recent feature in iHealthBeat appears to back this up.

“According to survey conducted by Software Advice, and reproduced in iHealthBeat, slowed productivity is the greatest challenge cited by electronic health record users. Other key challenges cited by EHR users include integration with other EHR systems, customizing the EHR system, importing existing records and learning to use the EHR system.”

For a full view of the Top 10 Challenges for EHR Users survey findings, please follow this link: https://tinyurl.com/lxkrvpe

Given what we have heard from the people on the frontlines of providing patient care, Optimium Health could not agree more with these findings.  Our mission is to help health organizations get more value from their existing IT systems by providing overlay software that optimizes clinical workflow orchestration and facilitates timely, accurate communication between caregivers. The net result: improved overall staff productivity, patient throughput, and quality of care.

If you would like more information on how Optimium Health can help your organization improve IT interoperability while lowering operational costs and enhancing care delivery, please contact: heather@waohi.azurewebsites.net

 

The 26th annual HIMSS Leadership Survey showed consistency with prior year priorities, but with increased focus on improving patient satisfaction and the quality of care, which now occupy the top two spots. No doubt the guidelines and regulations set forth in the Affordable Care Act have health IT leadership fully engaged in their organizations’ pursuit of compliance and avoidance of penalties. Sustaining financial viability comes in next, while improving care coordination and operational efficiency/lowering costs round out the top 5.

While these may not be particularly surprising, what is surprising is the apparent lack of understanding about inter-dependency of all these priorities. There is still a tendency to address each priority area as its own problem, with its own IT solution, and not to unpack the “cause and effect” relationship one priority area has on the other. To do this, IT departments must involve front line clinicians, not just the C-Suite, in problem identification, best practice, and corrective action. By doing this, IT can better understand the intricacies of clinical processes, the bottlenecks that occur, and the communication failures that lead to errors, omissions, and duplications of effort that waste time, money, and compromise outcomes.

Below is an excerpt from the 2015 HIMSS Leadership Survey and the top hospital IT priorities:

“While a majority of respondents to the 26th annual HIMSS Leadership Survey reported an increasingly higher stature for IT within their organizations, information system departments will be supporting new initiatives in the years ahead, as healthcare organizations focus on changes in reimbursement. HIMSS released results of its survey during its annual conference and exposition in Chicago. Results are based on responses from 330 respondents. Data showed increased reliance on healthcare IT to achieve improved care delivery.

Some 87 percent of respondents said improving patient satisfaction would be a top priority for their organization in the next 12 months. Improving patient care, quality of care or outcomes ranked second as a top priority, followed closely by sustaining financial viability, named by 86 percent of respondents. Rounding out the top five are improving care coordination (75 percent) and improving operational efficiency and lowering operating costs (72 percent).”

For more survey details, please follow this link: https://www.healthdatamanagement.com/gallery/top-IT-concerns-issues-from-the-HIMSS-survey-50282-1.html?utm_campaign=daily-apr%2017%202015&utm_medium=email&utm_source=newsletter&ET=healthdatamanagement%3Ae4205767%3A3694212a%3A&st=email

Optimium Health brings over 25 years of clinical process and Health IT expertise to this discussion. Importantly, we ensure both hospital staff and patient satisfaction scores improve and that operational efficiency will lead to lower costs. Our clients consistently achieve a break-even on investment in less than 3 months. If you would like to learn more about how Optimium Health can help your organization, please contact Heather Guild at heather@waohi.azurewebsites.net

An article in the on-line publication, Healthcare Dive, that is geared to the diverse universe of healthcare payers highlights 5 key areas of inefficiency that nearly each of the 5800 hospitals across the US are struggling with to some degree.  While Optimium Health would argue that none of these “fixes” are “quick”, we do agree that hospitals would be well served to tackle these issues as soon as they can with what ever strategies and tools they can afford.

The article begins with a reference to a survey completed among 400 healthcare providers:

Hospital inefficiencies not only interfere with workflow, but also cost hospitals billions of dollars each year. A recent Ponemon Institute Survey of more than 400 healthcare providers found that inadequate communication alone has an estimated annual economic impact of around $1.75 million per US hospital and more than $11 billion industry-wide.

Although many of the issues that lead to inefficiency may be complex, there are still some quick fixes that can add up to huge savings in both staff time and money. Here are some of the most common hospital inefficiencies:

• Inadequate communication methods
• Duplicate documentation requirements
• Poor patient flow
• Inappropriate hospital admission & length of stay
• Incomplete medication reconciliation

The article goes on to suggest specific strategies to address these inefficiencies. For access to the entire article, please follow this link: https://www.healthcaredive.com/news/5-basic-hospital-inefficiencies-and-their-quick-fixes/361954/

OPTIMI$ER, the clinical workflow technology solution Optimium Health designed to overcome the types of information exchange, duplication of documentation, poor patient flow, and overall care coordination issues described in the article is an affordable tool worth considering if your organization is about to embark on a mission to solve any of the problems highlighted above. OPTIMI$ER has a proven track record of success, earning its clients an average of over $1 million net bottom line improvement, significantly higher staff satisfaction, and improved patient experience.

Please contact Heather if you would like to set up a brief demonstration targeted to your specific area of concern: heather@waohi.azurewebsites.net

Before the Patient Protection and Affordable Care Act, the healthcare industry was, “more or less, smooth sailing,” according to Matt Tanzer, chair of the National Transitions of Care Coalition’s Healthcare IT Innovations Task Force, in a recent webinar.

Mr. Tanzer goes on to say “Revenue was increasing, employment was growing,” he continued. “There was little financial justification for serious investments in transitional care quality. Readmission was a poor patient outcome, but not a poor financial outcome.”

However, with the transition from fee-for-service to fee-for-value, healthcare providers are having to refocus on preventing readmissions. If they don’t, and organizational performance is poor, it will not only get a financial penalty, it will get the “black ball’ stigma of public notice of failure. While it has certainly been a period of adjustment and transition, Mr. Tanzer said improving the transition of care process can help providers decrease readmissions and improve their competitive advantages and Optimium Health could not agree more.

For more about what Matt Tanzer and 5 other industry executives had to say about more efficient and effective care transitions and reducing readmission, please follow the following link to the full article as it appeared in Becker’s Health IT: https://www.beckershospitalreview.com/healthcare-information-technology/when-it-and-reimbursement-intersect-the-renewed-focus-on-care-transition-technologies.html

Optimium Health has had numerous discussions over the past 6 months with hospital administrators who all seem to highlight the same issue: a need to lower readmission rates. Much of this focus is due to new guidelines from CMS citing readmission penalties of up to 2% of hospital revenues for poor readmission performance. However, it also has to do with hospitals desire to improve transitions of care both internal and external to the hospital.

A recent press release from the New York State University at Buffalo School of Nursing caught our eye as it illustrates how technology is being developed to create a model for proactive post hospitalization health care delivery. An excerpt from and link to the full press release is below:

It’s an all too familiar story: a patient—specifically a patient with chronic disease—goes into the hospital to get well and is discharged only to be readmitted within 30 days. Medicare spends $15 billion a year on readmissions alone. It turns out that better communication to patients and their physicians about follow-up care might be one way to prevent a return to the hospital or emergency room.

The Agency for Healthcare Research and Quality (AHRQ) has awarded the University at Buffalo School of Nursing a grant to create a pilot project whose goal is to work with primary care physician’s offices, their patients and families to see that patients get follow-up care very soon after leaving the hospital.

Sharon Hewner, PhD, RN, assistant professor of nursing and author of the grant is a specialist in population health analysis, health services research, and informatics. Hewner says that there has been a lack of timely communication between the hospital and community setting. – See more at: https://www.buffalo.edu/news/releases/2014/07/020.html#sthash.pTdB5sut.dpuf

While the University at Buffalo technology will be set up to specifically interface with a regional health information organization, Optimum Health has begun early stage development of a discharge planning module as part of its OPTIMI$ER^TM Clinical Workflow Technology Suite. Importantly, OPTIMI$ER can help your health organization achieve its CMS goals of lowering the cost per patient served, improving the patient experience, as well as reducing the 30-day readmission rate. As with all OPTIMI$ER products, the discharge planning module will interface with Cerner, Epic, McKesson, MediTech and most other EHR systems built on an HL7 platform. If you would like further information for OPTIMI$ER products, please contact: heather@waohi.azurewebsites.net 

One of Optimium Health’s goals is to help our clients and blog readers get easy access to informative, topical articles that have been recently published by reputable organizations. Becker’s Hospital CFO is once such publication and “100 Things to Know About Medicare Reimbursement”, written by Helen Adamopoulos, is one such article. Below is an excerpt and link to the entire piece:

“It’s often said that where Medicare goes, private payers will follow. For hospitals, health systems and other providers, it has been the most influential healthcare program for the industry in recent decades.

Medicare continues to play a prominent part in various reform movements, such as the shift from fee-for-service to value-based payments and the push for greater price transparency. The program’s pay rates and policies have the potential to act as a catalyst for change nationwide, or to provoke coast-to-coast controversy (as has been the case with the new two-midnight rule).

The following list sheds some light on the many facets of and issues surrounding Medicare reimbursement in the form of 100 things to know, covering everything from the latest update to the inpatient prospective payment system to the Bundled Payments for Care Improvement Initiative”.

Click here for the entire article: https://www.beckershospitalreview.com/finance/100-things-to-know-about-medicare-reimbursement.html

With the shift from fee-for-service to value-based payments and the push for greater price transparency, the pressure for hospitals to lower costs and improve patient throughput while delivering higher quality of care with the same resources has never been greater. Process improvement, led by LEAN initiatives, has been cited by leading hospital CEO’s as a viable way to achieve these goals.

Optimium Health’s OPTIMI$ER^TM Clinical Workflow Suite for the Perioperative Setting, In-Patient Units, and Discharge Planning has a proven track record of bottom line contribution and return on investment. Importantly, OPTIMI$ER can help your health organization achieve its CMS goals of lowering the cost per patient served, improving the patient experience, and reducing the 30-day readmission rate. A complement to LEAN, OPTIMI$ER can help improve LEAN initiative overall efficiency and sustainability. If you would like additional information please contact: heather@waohi.azurewebsites.net