Understand business intelligence software and benefits in a large post acute network. Presented by: Michael N. Rosenblut, President and CEO Parker Jewish Institute for Health Care and Rehabilitation 271 11 76th Avenue New Hyde Park, N.Y. 11040 1433 Phone: (718) 289 2100 / (516) 247 6500 Learn how business intelligence software can be used to increase collaboration and improve quality care and operating efficiency through real time dashboards. Discuss how business intelligence software can be used to improve operational efficiencies and decrease unnecessary labor expenses. www.parkerinstitute.org 2 For over 100 years we have been a innovator in the design of specialized programs to meet the needs of older adults. We also serve as a powerful advocate on behalf of older New Yorkers, working with a myriad of community organization members to provide needed services to older people. We expanded continuously throughout its history to meet the needs of elderly New Yorkers. Its mission is to rehabilitate and restore its elderly patients, enabling them to return to their homes in the community whenever possible. 3 A major health and rehabilitation center located in New Hyde Park, NY, comprised of a 527 bed skilled nursing facility offering a comprehensive system of post acute care, including short term rehabilitation, and nursing and medical services. We also offer a diversified network of outpatient services including: Adult Day Health Care Center Alzheimer Day Center Home Health Care Program Hospice Program Research and Grants Pharmacy Physician Services Queens Long Island Renal Institute Lakeville Transportation Ambulette MLTCP AgeWellNew York 4 1
5 Located in Queens on the border between of New York City and Long Island one of the largest and most diverse urban areas in the country. According to the last U.S. Census, 48 percent of the population is foreign born. The largest ethnic groups in Queens include Asian (Chinese, Korean), Hispanic, Jewish, Persian, African American, West Indian, Italian, Greek, and Russian. Tremendous amount of immigration from South Asia, the Caribbean and South America. Large number of people with limited proficiency in English who are less likely to access appropriate health & social services. 6 Increased competition Shrinking reimbursement rates and smaller operating margins Complex healthcare regulatory environment New/Tougher Laws Patient Protection and Affordable Care Act False claims act Enhanced protections of whistleblowers Anti kickback Statute Intensified auditing and monitoring by regulatory agencies Heightened emphasis on performance measurement New models of care Healthcare Reform Labor accounts for 60 70% of the cost of operations in a long term care organization. Essential to manage and minimize unnecessary labor expense while assuring proper staffing levels to provide optimal quality of care of residents. 7 8 2
Scheduler and time and attendance are integrated to control labor costs. Automatic schedule generation for employees with fixed or consistently variable schedules. System shows variance from budgeted par levels. System documents potential scheduled overtime and helps reduce costs incurred by finding the best suited replacements. Budgets staffing levels by department, unit, job classification, and shift. System suggests employees to fill in scheduling holes, based on organization's best practices. Manages work constraints. No weeding through written requests for overtime and time off or employees who have expressed availability for the shift in question. 9 Drastically reduce unnecessary overtime costs. Less time spent on payroll through seamless integration of time & attendance and payroll. Increased accuracy. Decrease in payroll errors. Decrease in payroll processing expenses. 10 Identify critical metrics in a intuitive dashboard setting. Eliminate human errors and duplicate data entry. Drive down metrics and spot trends at any organizational level. Identify operational efficiencies and best practices. Identify and proactively apply preventative measure to emerging negative trends. Measure and understand an organization s key performance indicators and performance metrics. Allows for improvement in effectiveness and efficiency in executing strategy and improving processes. Means to gauge organizational progress. 12 3
Accurate and applicable data results and metrics. Identify, track, trend and correct problems. Key performance indicator reports lay context to improve operational efficiencies. Negative trends are identified and remedied. More detailed understanding of organization s finances, including cost per resident day. Improved compliance in meeting regulatory requirements. 13 Achieve MDS data accuracy. Drill down to cost per resident per day. Maximize accurate reimbursement. Lower clinical and legal risks. Predict and improve survey outcomes. Reimbursement appropriate for care actually delivered. Accurate predictions of reimbursement rates. Reduction in health risks for residents. Greater quality of care. More accurate predication of survey results, allowing for better management in identifying and addressing areas of concern. More efficient organizational performance. Analyze competitive performance. 15 16 4
Our Needs: On site, hands on training to ensure everyone uses the system to the fullest. Integration with New York Regional Health Information Organization (RHIO) and billing vendor. Medication cost containment and risk management. Ability to better manage patient care. Our Implementation: Hands on train the trainer instruction incorporating key adult learning principles. Change management from the top down. Challenges and successes. Phase 1 Computerized Physician Order Entry (CPOE), Electronic Medication Administration Records (emar), and Progress Notes. Phase 2 Assessments, Care Plans, and MDS. Phase 3 Nurse Instructions and CNA Assignments. 19 20 5
Went live in November 2010 with a full electronic medical records (EMR) system including: Computerized Physician Order Entry (CPOE) Medication/ Treatment Administration Records Real time Dashboards Census Management Unit by Unit April 2011 Progress Notes 24 hour report Care Planning and CNA Assignments 21 22 Real time dashboard Census management Computerized physician order entry (CPOE), Medication/Treatment administration records Progress notes 24 hour report Clinical assessments Key metrics allow monitoring of facility operations 24 x 7 Trends by nursing unit Monitor care given by CNAs Monitor medication administration and treatments Accidents & incidents Drill down capabilities to the individual patient Care Planning and CNA Charting 23 24 6
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Operational efficiencies Less time spent looking for charts and sifting through paper work. Improved compliance emar/tar documentation improved and on time documentation improved. Improved quality care Significant decrease in medication errors. More time for resident care due to reduction in time consuming paper based tasks. Charts are legible and well organized. Monitoring and auditing more efficient. Formulary compliance increased. Pharmacy costs decreased. On time emar documentation increased through real time med pass monitoring. On time CNA documentation increased. Medication errors have declined. 29 30 QUESTIONS REGARDING THESE PROGRAMS MAY BE REFERRED TO: Ronald Shafran Vice President for Public Affairs Parker Jewish Institute 271-11 76th Avenue New Hyde Park, New York 11040 rshafran@parkerinstitute.org (718) 289-2100 31 8