HDM Provides Tips for EHR Interoperability

Health Data Management wrote a brief set of top level tips to be considered to improve EHR interoperability.

Tip #3 (“Embrace user centered design”) is critical to the success of any guided workflow. Quoting the tip, “Most of the criticism and dissatisfaction with EHRs stem from enforced workflows and user interfaces. Healthcare organizations will need to invest in providing flexibility that reflects actual care processes rather than institutional ideas of how care should be delivered.”

Our experience at Optimium Health is that this particular piece of advice is the most important of the series. Whether the application is from the EHR vendor, an ISV such as ourselves, or an in-house developed application the overall success will be determined by the level of engagement with the “front line” staff during the specification and development process.

By embracing the end user, one can create a workflow that is natural and very easy to in-service. The workflow can then create a standard of care that requires no “work arounds” that are so often seen in applications built without the experience of the end user. Of course, blindly implementing an existing workflow without consideration of the “why” of certain steps/flows is also problematic. Creating an assisted workflow of a bad or sub-optimal process just results in a bad or sub-optimal electronic form of the same. Changing a workflow and adding best practice steps can get you to a more elegant and sustainable endpoint.

One addition to the tip is to be on the lookout for the following: Adjunct spreadsheets, colored sticky labels, colored file folders, and sorted piles of folders. These are all indicators of a workflow that is crying out for additional help. Of course, this means that you have to be out and about with the front line staff to get this close to the care experience; but this is a topic for another post…

Lean Healthcare: Top 10 Challenges For EHR Users

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@optimiumhealth.com


Top Hospital IT Priorities

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@optimiumhealth.com

5 Hospital Inefficiencies & Thier “Quick” Fixes

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@optimiumhealth.com

Renewed Focus on Care Transition Technologies

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

LEAN Healthcare: Discharge Planning – Looking for Help Beyond the EHR

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$ERTM Clinical Workflow Technology Suite. Importantly, OPTIMI$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@optimiumhealth.com 

100 Things to Know About Medicare Reimbursement

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$ERTM Clinical Workflow Suite for the Perioperative Setting, In-Patient Units, and Discharge Planning has a proven track record of bottom line contribution and return on investment. Importantly, OPTIMI$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@optimiumhealth.com


LEAN Healthcare: IT Interoperability – Reality or Myth?

Getting data to work together is easier said than done. But with the right focus, the result will be knowledge that is readily accessible and delivered when and where it truly matters. -Joseph Frassica, MD

Fulfilling the promise of IT interoperability has been the Holy Grail of health IT for the past decade. EHR’s like Epic have given consistency and depth to what goes into every patient’s medical record, but they do little to improve overall hospital productivity and financial performance. Enterprise systems like Cerner have all the pieces: EHR, scheduling, lab, financial, etc. However, not all the parts “talk” to each other so multiple sign on and data transcription is still necessary.

An article written for Hospitals & Health Network (H&HND) by Joseph Frassica, MD, the Chief Medical Informatics Officer, Chief Technology Officer and Vice President at Philips Healthcare in Andover, Mass. discusses this very problem and why it is so. Specifically, he calls out the lack of IT interoperability or IT system integration as one of the critical issues health systems must address in order to improve their financial performance and quality of care. He goes on to suggest how hospitals and health systems can ultimately achieve IT interoperability but recognizes to do so will require organizational leadership to “change mindsets” and “think big.” Below is an excerpt from the article:

The Road to Interoperability for Health IT

The rush to implement electronic health record strategies has fueled a proliferation of solutions. But systems, like people, need to work together seamlessly to deliver their maximum value. Easier said than done. So why hasn’t the promise of interoperability with all the various systems — electronic health records, monitors, labs, finance, and so forth — been realized? To answer that question, let’s look at the past decade or so. As hospitals and health systems invested in EHRs to collect and store data, they didn’t always do so with an eye on the future.

The Rise of Silos

EHR systems evolved organically as silos of information, because leaders weren’t thinking ahead enough about how the collected data could impact decisions and processes for the entire health system. A large health care delivery system might have 90 or 100 point-to-point interfaces over which information is shared between systems, often with a core EHR serving as the primary data repository. If you were to draw the information model of the average health care system, it would look like a spider web with links stretching off in all directions: an extremely complex informatics infrastructure, with enormous maintenance requirements and hundreds of potential points of failure. Clearly, this is not a sustainable model.

Click here for the entire article.

Optimium Health could not agree more with Dr. Frassica’s observations and recommendations for how to, at last, grasp the interoperability Holy Grail. 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 LEAN Healthcare: IT interoperability while lowering operational costs and enhancing care delivery, please contact Vicki Harrison at vicki@optimiumhealth.com.

LEAN Healthcare: A 10x Return on Investment – The New Reality

It is one thing to pat yourself on the back for job well done. It is quite another to have a nationally recognized thought leader in process efficiency and continuous improvement acknowledge your technology as an important tool for healthcare organizations to adopt if they are serious about making sustainable changes to the way they deliver patient care and degree to which they embrace Lean Healthcare .

Focus & Leverage

Bob Sproull, a senior business consultant, speaker, and author of three books who has expertise in Healthcare, Manufacturing and MRO, gave Optimium Health and our clinical workflow suite, OPTIMI$ER, a special call out in his blog earlier this month. Below is an excerpt:

My blog is focused primarily on the Theory of Constraints and how to use it to maximize the profitability of any company. I also discuss why integrating TOC with Lean and Six Sigma is the most dynamic improvement methodology available today.

In this posting I want to shift gears a bit and talk about some real problems facing healthcare today. This posting is based upon conversations I’ve had with Vicki Harrison of Optimium Health, Inc. As you will see, Vicki’s company has some great solutions for problems that have plagued hospital perioperative services for some time. I know of these problems because I have been confronted with them on my own healthcare consulting engagements. Specifically these problems are centered on work flow into and out of surgical units.

Optimium Health has developed amazing new software that more or less synchronizes all of the required activities needed to prepare a patient for surgery. They call their product OPTIMI$ER and based upon results seen during Phase I it is worth every dollar spent.

Phase I Results Summary: $1,088,000 Net of Increased Revenue and Expense Reduction for Pre Anesthesia Screening Services: Note – Results below reflect only patient clearance process not a full perioperative setting implementation.

Click here to view Bob Sproull’s blog.

About Bob Sproull

Bob is a certified Lean Six Sigma Master Black Belt and a Theory of Constraints Jonah. He is a nationally known speaker and author of three books. His consulting engagements focus on teaching companies how to maximize their profitability through an integrated Theory of Constraints, Lean and Six Sigma (TLS) improvement methodology. He is an experienced manufacturing executive who has served as the former Manager of the Office of Continuous Improvement for Army Fleet Support and a Vice President of Quality, Engineering and Continuous Improvement for two different manufacturing companies.

LEAN Healthcare: Answering The Readmissions Challenge

A recent article in Health Leaders Media that showcases what Detroit Medical Center (DMC), an eight hospital system, is doing to answer the readmissions challenge by improving the workflow that leads up to and follows on from discharge. In fact, the caregivers at DMC’s hospitals no longer use the word “discharge” to describe the process of getting their patients out safely. “Now the word we use is transition, a much more refined process, to get our patients back into their community,” says Suzanne White, MD, the eight-hospital system’s executive vice president and chief medical officer. Optimium Health applauds the work Suzanne White and the team at DMC is doing.

Process Efficiency Can Reduce Readmissions

The challenges DMC faces with high readmission are not uncommon. And with new requirements and payment terms under the ACA, lowering patient readmission rates has become a high priority. To this end, White and her colleagues have detailed descriptions of more than 30 process steps or checks, with potential interventions, that now take place at specified points within the acute care stay. Some are tailored to where the patient is headed: home versus a skilled nursing facility, for example. But the process begins the moment a person is registered as an inpatient, and often involves agencies or care settings outside the hospital, especially private practice physicians and home health agencies. The results, a 25% readmission rate in December 2012 had fallen to 20% in January 2013 and 15% as of August 2013. For the entire article click here.

How Optimium Health Can Help

In response to the growing demand from our hospital partners, Optimium Health has developed a proven workflow technology, OPTIMI$ER, to address the workflow complexities and need for timely and accurate information exchanges between caregivers that accompany discharge planning, or transitions in inpatient care. OPTIMI$ER’s Care Management Suite will interface with existing IT systems to push and pull relevant data which eliminates duplicate entry and data entry errors, as well as to communicate patient status and next step process alerts to the relevant caregivers. Based on discharge planning best practice, the OPTIMI$ER Care Management Suite is customizable to a particular hospital’s needs.

If you would like to learn more about OPTIMI$ER Perioperative Setting or OPTIMI$ER Inpatient Care Management Suites, please contact Heather Guild at: heather@optimiumhealth.com.