Presented by Jack Hueter amp Novi Vinod Agenda for today Introductions LVHN organization and timeline Steps taken throughout implementation End results Lessons learned 5 Campuses 1 childrens Hospital ID: 801586
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Slide1
Revenue Impact with Big Bang Implementation
Presented by: Jack Hueter & Novi Vinod
Slide2Agenda for today
Introductions
LVHN organization and timeline
Steps taken throughout implementation
End results
Lessons learned
Slide35 Campuses
1 children’s Hospital
140+ Physician practices
17 Community Clinics
12 Health Centers
10
ExpressCARE
locations
80 Testing and Imaging Locations
13,100 Employees
1,340
Phsycians
582 Advanced Practice Clinicians
3,700 Registered Nurses
60,585 Admissions
208,700 ED Visits
1,161 Acute Care Beds
Slide4Scope at LVHN
Ambulatory Big Bang Go Live – February 18, 2015
175+ sites
700+ Physicians and 300+ AP’s
90% converted from GE Centricity
10% paper
Inpatient Big Bang Go Live – August 1, 20153 Inpatient Campuses – Cedar Crest, Muhlenberg, 17
th StreetIncluded Hospital based Outpatient clinics 100% converted from GE Centricity Enterprise – Revenue, Clinical, Radiology, PharmacyOther major systems – T systems, PHS Scheduling, OR Tracker, RIS, Metavision ICU/PICU, Teletracking, Orion portal
Slide5TIMELINE
Slide6Big Bang Implementation Guidelines
Governance and Team structure
Project management support
Importance of scoping & direction setting
Build phase
Testing phaseTraining phase
Slide7Steps taken to minimize revenue impact
Revenue cycle ownership and governance
Set expectations with department heads and leadership
ARCR leads identified and leveraged
Identified Key KPI’s to monitor pre go-live
Compute accurate baselines prior to go-live
Testing
Slide8Testing
Charge
testing
Parallel Revenue Charge Testing (PRCT)
Claims testing
Slide9Ambulatory Accounts Receivable
Slide10Ambulatory Claims Acceptance
Slide11Ambulatory Charges to Baselines
Slide12Inpatient Focus Area Achievements
Revenue Cycle Management
4 Weeks
8/1
8/29
9/26
10/31
1/30
8 Weeks
Payments in Epic exceed baseline weekly
13 Weeks
(90 Days)
26 Weeks (180 Days)
Legacy AR Days <10% of Baseline
HB 100% charging
HB weekly claims sent exceed charges.
Achieved on/before target.
Upcoming target.
Achieved after target.
HB go-live hold fully removed
HB first Epic-AR week over week decrease
Slide13Inpatient Charges to Baseline
Slide14Inpatient Claims Acceptance Rate
Slide15Inpatient – Revenue Tracker
15
Daily Revenue Tracking Snap
Shot
Slide16Inpatient Metric Guardrailsweek 7
Metric
Guardrail/
Top 25%
Long-term Target
Current
Week
Change
Status
AR
(Percent change from baseline)
17% - 3%
-
-2%
0%
Cumulative Charges
99% - 101%
100%
100%
0%
Cumulative Cash Variance (in Weeks)
-1.19 Weeks - -0.39 Weeks
0
-1.44 Weeks
-0.04 Weeks
CFB Days
12.03 Days - 7.68 Days
-
10.56 Days
-0.39 Days
Coding
in CFB
4.91 Days - 7.68 Days
-
3.6 Days
-0.11 Days
Claim Errors
4.18 Days - 1.68 Days
-
3.02 Days
0.25Days
Open Denials Days
<4 Days
-
0.13 Days
0.04 Days
Legacy AR % of baseline
38% - 31%
-
33%
-2%
Claims Acceptance %
90% - 99%
-
93%
19%
= On track
Improving
= Watch
= Serious Negative Trend
Slide17Important to have SMEs and operational owners “on board” with
Epic
These
are the people that will be key in helping shift focus of current state to new improved future state with
Epic
Revenue Cycle Lessons Learned
17
Early buy-in from SMEs and operational owners
Slide18Identify
and validate future workflows building off current
workflows
B
uild
in Epic to maximize efficiencies in current workflows and process Focus on maximizing efficiencies within Epic and build to future state workflows
Incorporate 3rd party tools upfront in design and planning workflows
Revenue Cycle Lessons Learned18
Identify and validate future workflows
Slide19Revenue cycle representation needs to be included in decisions made at on the clinical
side
This ensures charges
are captured and revenue is not impacted negatively at
go-live
Testing begins right away with unit testing of workflows and continues until go-live
Revenue Cycle Lessons Learned
19
ALL build, testing and communication needs to include representation across ALL modules within Epic
Slide20Align Epic’s project workplan with
organization’s project
workplan early and set expectations/targets
Incorporate
enough time in the project plan to build, test and validate for the revenue
cycle Users need to not only understand basic functionality within Epic but
also to understand how to navigate within Epic so they can do their jobs efficiently and effectively
Revenue Cycle Lessons Learned20
Revenue Cycle cannot wait for optimization to get it right
Slide21Important to begin new revenue cycle with clean slate
Have
a plan to support the legacy run
down
Revenue Cycle Lessons Learned
21
Keep AR in legacy system
Slide22Facility design is an integral part of the Epic’s core build - it
touches every module within
Epic
Revenue Cycle Lessons Learned
22
The facility structure is the most crucial build in your Epic system - once built, cannot be “undone”
Slide23Again
- start
the planning and build process in the very early stages in the project and involve both the
hospital
side and professional sideRevenue Cycle Lessons Learned
23
Payor/Plan is the another crucial build in Epic because it is shared between hospital and Ambulatory in Epic
Slide24Takeaways
Testing
Operations have to own the process
Knowing your current condition (baseline) pre go-live to assess your success post go-live
Outsource or work down legacy A/R prior to go-live
Be ready to be flexible with your workflows (based on how build is interacting with other modules or SME feedback)