Conocé los casos de éxito de Qonnections 2017: Johns Hopkins
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La misión de Johns Hopkins Medicine es mejorar la salud de la comunidad y el mundo estableciendo el estándar de excelencia en la educación médica, la investigación y la atención clínica.
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Conocé los casos de éxito de Qonnections 2017: Johns Hopkins
- 1. Low Hanging Fruit Open Patient Encounters Etter Hoang, Business Intelligence Manager Renee Blanding, VP Medical Affairs
- 2. About Us: Mission • Mission – The mission of Johns Hopkins Medicine is to improve the health of the community and the world by setting the standard of excellence in medical education, research, and clinical care Medical Education Clinical CareResearch
- 3. About Us: Johns Hopkins Medicine • Facilities • The Johns Hopkins Hospital • 1,192 licensed beds • Johns Hopkins Bayview Medical Center • 527 licensed beds • Johns Hopkins All Children’s Hospital (St. Petersburg, FL) • 259 licensed beds • Howard County General Hospital (Columbia, MD) • 284 licensed beds • Sibley Memorial Hospital (Northwest Washington, D.C.) • 318 licensed beds • Suburban Hospital (Bethesda, MD) • 236 licensed beds
- 4. About Us: People & Visits • Quick Facts • 41,000 + combined full-time equivalent employees • Medical and doctoral students: over 1,200 • Full-time faculty: over 2,700 • Part-time faculty: over 1,300 • Annual Outpatient Visits: Over 2.8 million • Annual Emergency Department Visits: Over 360,000 • Annual Hospital Admissions: Over 115,000
- 5. Analytics: Business Intelligence Source: Analytics: Farre, Tom; The Analytical Competitor; Analytics: The Art and Science of Better; pg 11.
- 6. Process: Open Encounters • Assumed Workflow • Provider Compliance Requirements – < 20 open encounters that are <= 7 days old Patient Sees Provider Provider Examines Provider EMR Documentation Provider Sees Next Patient
- 7. Challenge: Open Encounters • Non-Compliance • 39 providers did not meet requirements out of 400 = 9.75% • Accounts for $1.6M in pending charges = 4061 of the 6188 open encounters Compliant 91% Non-Compliant 9%
- 8. Challenge: Open Encounters • Consistent Issue
- 9. Problem: Open Encounters • Clinical Impact • Open encounters unavailable until closed • Accuracy of provider documentation beyond initial encounter • Financial Impact • Unbooked revenue for Professional Fee Billing • $1 Million • Bad debt/free cash flow for booked Hospital Billing • $2 Million ProFee 34% Hospital Billing 66%
- 10. Problem: Open Encounters • How were open encounters tracked? • EPIC Report Excel Pivot Table
- 11. Investigation: Process & Policy • Other Institutions • Emory / Texas / Wisconsin / University of Florida • Shared policies JHBMC Emory Texas Wisconsin University of Florida
- 12. Investigation: Process & Policy • Other Institutions • What policies did we set up? • What did we borrow from their policies • Operational definitions • Time parameters • Departmental / Administrative Responsibilities • Mechanism for suspension (Florida/Emory)
- 14. Application: Build Challenges • Visualization Requirements • Mirror original excel report • Customize parameters • Monthly Trends with custom targets • Track providers on suspension list • Age of open encounters • Financial impact (estimated vs charged) • Provider Open Encounter Risk Scoring
- 16. Impact: Who is Involved? • Multi-disciplinary Team VP Medical Affairs VP Revenue Cycle Clinical Administrators Medical Board Departmental Chairs/Division Chiefs Health Information Management (HIM) Business Intelligence
- 17. Impact: Policy and Enforcement • Methodology and Impact • Key items to the policy • Administrative suspension • Revoke clinical privileges at JHBMC • Suspension list criteria (>20 open encounters that are open for >= 7 days ) • Regulatory suspension • Practice license revoked • Must be on suspension list more than 3 times • Enforcement Methodology • HIM involvement, written letter from VPMA with agreement from departmental chairs • Weekly meetings with Clinical Administrators
- 18. Impact: Policy and Enforcement • Methodology and Impact • Enforcement Impact • Reduction of open encounters by 44% in 4 months • Revoke clinical privileges at JHBMC • Suspension list criteria (>20 open encounters that are open for >= 7 days ) • Institutional suspension • Practice license revoked • Must be on suspension list more than 3 times • Enforcement Challenges • Providers given 7 days to close encounters after letters sent out • Providers are hitting suspension list multiple times 6188 5881 3906 3819 3492 5% 34% 2% 9% 0% 5% 10% 15% 20% 25% 30% 35% 40% 0 1000 2000 3000 4000 5000 6000 7000 16-Nov 16-Dec 17-Jan 17-Feb 17-Mar Open Encounters % Reduction
- 19. Impact: Financials • $ Savings / # Encounters Closed • How did we estimate the $ savings • Average charges by provider • How did we track savings • Pulled data from HIB and Profee Billing (both loaded into EPIC Clarity) • For Maryland, how is $ savings impacted by GBR • Hospital billing affected by booked revenue – affects bad debt / free cash-flow • Profee Billing affected by unbooked revenue – affects revenue stream
- 20. Application: Sustainability • Engagement • Bi-Weekly meetings with clinical administrators • Enabling broader access • Providing resources to help manage open encounters • Predictive Model • Identify ”high risk” providers that do not close their encounters • Targeted intervention prior to suspension status
- 21. Predictive: How to Operationalize • High Risk Providers • Demo in Qlik® application
- 22. Summary: Open Encounters Financial Operational Clinical ~$3 Million Savings Opportunity cost gain 44% reduction in open encounters