iHT² CMIO & Physician Executive Symposium, “Moving Past Hype to Outcomes” with John Showalter, M.D., MSIS, Chief Health Information Officer, University of Mississippi Medical Center
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iHT² CMIO & Physician Executive Symposium, “Moving Past Hype to Outcomes” with John Showalter, M.D., MSIS, Chief Health Information Officer, University of Mississippi Medical Center
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Similar a iHT² CMIO & Physician Executive Symposium, “Moving Past Hype to Outcomes” with John Showalter, M.D., MSIS, Chief Health Information Officer, University of Mississippi Medical Center
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iHT² CMIO & Physician Executive Symposium, “Moving Past Hype to Outcomes” with John Showalter, M.D., MSIS, Chief Health Information Officer, University of Mississippi Medical Center
- 1. GETTING BEYOND THE HYPE TO OUTCOMES John W. Showalter, MD MSIS University of Mississippi Medical Center March 27, 2014
- 3. 0 to 5 Years5 to 15 Years
- 4. 0 to 5 Years5 to 15 Years High Expectation s Low Expectation s
- 7. Distractions
- 9. Discharged Not Billed Due to Incomplete Physician Documentation • Problem • Charts aren’t coded until all physician documentation has been complete • $14 - $15 million in charges not submitted to insurance companies due to incomplete documentation • No transparency into the problem • Approach • Descriptive Analytics • Provide department chair with detailed and graphic reports • Remote support • Deployed a remote support application to HIM • HIM became the primary support for the physicians
- 10. Discharged Not Billed Due to Incomplete Physician Documentation • Result • Six months later • $7-8 million • One year Later • Less than $5 million • Revenue cycle has been shortened by more than a full day
- 11. Lab Draws • Problem • Excessive and duplicative lab draws • CBC and BMP identified as target areas • Approach • Simple predictive analytics • CBC and BMP more often than q4 in ICUs and q8 on the floors were frequently unnecessary • Rules-based decision support • “Duplicate Lab” alerts if a new order was placed within 4 hours (ICU) or 8 hours (floor) of another lab
- 12. Lab Draws
- 13. 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% 50.0% BASIC METABOLIC PANEL CBC CBC WITH AUTO DIFF Precent of Time Each Order was Cancelled in Duplicate Alerts
- 14. Lab Draws • Result • CBC • 2,650 CBCs cancelled • BMP • 3,021 BMPs cancelled • $41,300 savings per year • 28.4 liters of blood not drawn
- 15. Data Visualization and Real-Time Alerts • Problem • No nursing unit based monitoring system for pediatrics • Approach • Implement Epic remote ICU application “Epic Monitor” on both the nursing units and our telehealth center • Combine real-time predictive alerts with data visualization and nursing protocols • Develop guidelines and protocols for nurse response
- 16. Data Visualization and Real-Time Alerts • Results • Created patient specific vital signs alerts • Increased physician and nurse engagement • Expected improvements • Earlier interventions • Fewer transfers to the PICU • Decreased LOS
- 17. Biometric Registration • Problem • 6 employees doing chart corrections for MPI • 30%+ of errors from the ED • Approach • Palm scanning a ED registration
- 18. Biometric Registration • Predicted Result • Cost • 3 biometric devices (palm scanners) for ED patient registration - $1,500 • 2 months of analyst time to set up - $14,000 • Return • 50% reduction of ED errors means 15% total error reduction • Eliminate 1 FTE at $50,000/year • 2 year ROI • $100,000 - $15,500 = $84,500
- 19. Questions/Contact • Email • jshowalter@umc.edu • Twitter • @johnshowaltermd