Management Engineering & Process Improvement Community. December 6, 2013 Cecilia Backman, MBA Committee Chair

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1 Management Engineering & Process Improvement Community December 6, 2013 Cecilia Backman, MBA Committee Chair

2 MEPI Community Mission Support and promote the profession of management engineering and process improvement among the members of HIMSS by providing opportunities for networking, collaboration, publication, promotion and professional development of Management Engineers and Process Improvement professionals in healthcare organizations.

networking, collaboration, publication, promotion and professional development of

3 Workqueue Process Redesign for Revenue Optimization Leigh Williams CPC, CPHIMS AHIMA Approved ICD-10-CM/PCS Trainer Director, Revenue Cycle/HIM

4 Learn how an academic medical center conducted a process redesign of HIM workqueues to improve efficiency and significantly decrease processing time for uncoded accounts. A methodology for assessing workqueues is described, along with practical steps for identifying workflow issues and remedies. Hear a description of how this methodology was followed to create a similar positive impact in Professional Billing Charge Review. Learning Objectives: 1. Outline methods for assessing workqueue functionality and workflows. 2. Describe how to analyze workqueue efficiency and success of systems design. 3. Create action plan for resolving work queue process redesign.

Hear a description of how this methodology was followed to create a similar positive impact in Professional Billing Charge Review. Learning Objectives: 1.

5 Today s Agenda Identifying opportunities to improve Assessing WQ functionality Analyzing individual WQs Evaluating multi-wq workflows Creating an action plan Milestones and metrics Working effectively with your build team Realizing your results

Evaluating multi-wq workflows Creating an action plan

6 Identify Opportunities When is the problem your workqueues? When is a process redesign the best option? Look at your data and consider your team Look to both technical and operational solutions Could be a combined effect Isolate opportunities and work them all

Look at your data and consider your team Look to both technical

7 CASE STUDY: UMMC UNCODED ACCOUNTS

8 Epic Go-live Happy New Year!

9 HIM WQ Process Redesign Brought together a multi-disciplinary team Epic build experts internal staff Epic build experts from Epic Coders working in the system Coding management Operational process design specialists Conducted evaluation of existing work flows Reviewed all known outstanding issues Collaborated to identify opportunities

Coding management Operational process design specialists Conducted evaluation of

10 Practical Steps in Evaluating WQs 1. Review the big picture: target high dollar/ high volume concerns first 2. Look at every WQ impacting that target concern 3. Redesign individual WQs 4. Think about how they work in tandem and resolve workflow design issues 5. State your expected results in numerical terms 6. Monitor WQs for performance and address areas that miss their target results

Look at every WQ impacting that target concern 3. Redesign individual WQs 4.

11 1. Fix the Right Problem Define your problem Slow cash? High lag days? High days of accounts? Which queues are involved in the process that generates those results? Make a list of the queues involved Make a list of the employees involved Set a process redesign work session

Which queues are involved in the process that generates those

12 2. Evaluation of a Queue Are accounts moving out faster than they re coming in? Is the staffing on this queue adequate? Are the staffed trained to resolve these issues? Do the rules on the queue support its purpose? Is the queue necessary? Are there too many issues jumbled together? Are there subcategories that could be filtered?

Are the staffed trained to resolve these issues?

13 3. Fix Each Queue Make a list of all action items for each queue Label actions as belonging to operations, DIS or Epic Note an estimate work effort per item Go back over the list for each queue Ask: If we fix each of these things, will the queue work properly?

estimate work effort per item Go back over the list for each

14 4. Fix All Queues Now that you know the purpose and functionality of each queue, consider them in tandem Do the queues flow from one to the other? Flow chart work flows any loose ends? Are WQs owned by other teams receiving and sending accounts using the same mechanisms? Conduct process redesign on the entire work flow and revisit individual queues as necessary

15 5. Establish expectations Know what you are looking for so you can judge your success State expected outcome in objective terms Example: Uncoded days should decrease to 8.0 by February, to 6.0 by March, and to 4.0 by May Identify which reports you will run to obtain your results Plan a monitoring schedule

should decrease to 8.0 by February, to 6.0 by March, and to 4.

16 5.0 By 3/31 Epic Go-live Happy New Year!

17 Epic Go-live Happy New Year! Process Redesign

18 6. Remain Vigilant Success was followed by stagnation

19 Rinse, Repeat 1. Review the big picture: target high dollar/ high volume concerns first 2. Look at every WQ impacting that target concern 3. Redesign individual WQs 4. Think about how they work in tandem and resolve workflow design issues 5. State your expected results in numerical terms 6. Monitor WQs for performance and address areas that miss their target results

Think about how they work in tandem and resolve workflow design issues 5.

20 New Problem to Fix

21 Process Redesign

22 5. Establish expectations Volume of outpatient clinic accounts should remain less than 2 days (5,000 accounts)

23 Process Redesign

24 Today s Agenda Identifying opportunities to improve Assessing WQ functionality Analyzing individual WQs Evaluating multi-wq workflows Creating an action plan Milestones and metrics Working effectively with your build team Realizing your results

25 Your Best Ally Partner with your build team Be routinely engaged and involved Engage your operational owners build everyone s skill sets by sharing knowledge Listen and respond during builds and updates Always participate in testing Make sure your operational work flows pair with your build work flows and options

26 Realizing Your Results Revisit this process often Teach it to your supervisors If a negative trend begins, ask questions Set goals and identify which areas are holding you back Watch for updates, new releases Listen to your build team for opportunities

27 Time for Your Questions

6/30/2015. Physician Revenue Cycle: Basics and Beginnings. Today s Agenda. Codes by Setting

6/30/2015. Physician Revenue Cycle: Basics and Beginnings. Today s Agenda. Codes by Setting Revenue Cycle: Basics and Beginnings Leigh Williams CPC, CPHIMS AHIMA Approved ICD-10-CM/PCS Trainer Director, Revenue Cycle/HIM Today s Agenda Terminology for code sets ICD Modifier RVU What about ICD-10?