Creating A World-Class IT Integration Strategy

Transcription

1 Creating A World-Class IT Integration Strategy 2014 PARALLON BUSINESS SOLUTIONS, LLC What Does Integration Really Mean? Integration encompasses more than the clinical integration of medical devices. Full Integration seamlessly connects health information systems to financial systems. Why It s Critical To Have A Strong Integration Model Today. 1

2 Macro Trends in the New Healthcare Marketplace Demand Turnkey Integration and Simplification: Growing demand for big data Consumerism Costly reforms such as ICD-10 Increasing cost pressures Industry leaders say government mandates are the No. 1 barrier to achieving cost reductions. Cost containment will be the most important contributor to improving margins in the next 3 years. HealthLeaders Media, 2014 A Strong Integration Platform Also Readies Organizations For The Next Frontier In Healthcare The Next Frontier In Application Integration 1 BuildData Hubs That Perform System-Wide Analysis Advanced technologies are pulling more useable data from the integration layer. We now can garner insights from unstructured data such as notes and free text. Data analytics enables providers to identify key trends across entire enterprises. 2

3 The Next Frontier In Application Integration 2 Gather Intelligence Sooner Interact with data in real time: Have visibility early in the reporting process. Deploy more dynamic processes: Transition from static to data-oriented standard operating procedures. Faster Claims Processing: Use data analytics to predict when a claim will be paid and how the claim should be submitted. The Next Frontier In Application Integration 3 Take Command of Payer Processes and Payments Manage Payer Variability: Seamlessly handle hundreds of methodologies from hundreds of payers. Ensure all payers are recognized by your AR system. Gain flexibility as reform drives increasing complexity. Now Is Time To Deliver World-Class Integration Be Ready For New Care And Business Models. The push for better quality and care coordination, brought on in part by value-based purchasing initiatives, are driving the need for interoperability. Control Costs. Hospitals need new and innovative ways to reduce IT TCO. Improve Data Analytics Strategy. Strong integration across IT systems, increases data accuracy and gives birth to new business intelligence, resulting in higher reimbursements. 3

4 Before We Can Succeed, We Have To Eliminate The Black Box Of Application Integration. Despite Advances, Hospital IT Integration Remains A Black Box IT integration still happens in the basement: Problems aren t fixed until something breaks. Limited visibility into key transactions occurring between different systems. Limited tools and processes in place to connect clinical applications to the revenue cycle workflow. Little strategic planning on how to gain business intelligence from transactions in the integration engine. Unlocking The Black Box Of Application Integration Where s the Proof? Most hospitals believe their applications are fully integrated, but where s the proof? You may have a revenue cycle partner, but do you know if they are providing you with stateof-the art technology that struly integrated with all of your HIS? 4

5 There Are Many Ways To Integrate Business And Clinical Applications A Successful Approach: Involves interfacing through an existing HIS system Enables all clinical systems (lab, radiology, pharmacy and admissions) to integrate seamlessly with one patient accounting/accounts receivable system Uses the same technology to integrate with payer systems How Do You Know Your System Is Fully Integrated? Five Critical Questions Do you have the flexibility to insure that all data makes it to its end destination? Do you have real-time tracking and visibility for key transactions? Does your system have robust auditing and reconciliation capability? Can you identify 30, 60 and 90-day integration trends? 5 Are you leveraging intelligence garnered from integration to the fullest extent? Let s Go Deeper Is Your Integration Strategy Flexible? A successful integration of HIS applications and AR systems results in: scalability and agility when dealing with variations in data format and volumes. 5

6 Real-Time Visibility Monitoring Things That Go Bump in the Night What kind of visibility do you have with processes such as auditing, tracking, alerting and monitoring? Auditing And Reconciliation Capability Can you reconcile the number of charges, medical records information points and admissions information points? Have they all been processed to ultimately drive the generation of a claim? Spot Problematic Trends By Looking Back Through The Integration Process Do you have a range (30, 60 and 90-days) of automated alertingthat identifies everything from volume trends to issues within an interface? 6

7 Gather Powerful Information During Integration Can You Apply Business Rules Inside the Integration Layer? Gain More Visibility Transform Your Data Take Action in Real Time World-Class Integration Also Requires Top-Notch Talent Change Is Rapid In Healthcare IT. It calls for an advanced team that can quickly develop and test your platform. It demands a staffing model that will allow you to flex up and down. Taking The Mystery Out Of Integration: Our Approach To Creating A Smarter Revenue Cycle Operation Bending the Cost Curve: Industry-leading integration technology removes the challenges of AR data integration for full-service revenue cycle outsourcing. The Result: Seamless connection between AR and clinical applications Unveil the black box of integration Simplify technology footprint Reduce costs Increase cash flow 7

8 Parallon Integration Case Study Challenge A public hospital upgrading its technology to meet MU and ICD-10 requirements lacked the resources to achieve ICD- 10 remediation and to develop interfaces or extracts. How We Helped We implemented a complete integration between the hospital and Parallon in 90 days, including: Sending HIS data to Parallon for ADT, charges and master files in HL7, real-time and nightly extracts. Sending 3M data to Parallon for coding. Daily, weekly and monthly extracts from HIS to Parallon for reporting and reconciliation. Results Parallon s solution enabled the hospital to code ICD-10 in 3M without remediating the HIS.? QUESTIONS 8