GETTING BEYOND THE
HYPE TO OUTCOMES
John W. Showalter, MD MSIS
University of Mississippi Medical Center
March 27, 2014
0 to 5 Years5 to 15 Years
0 to 5 Years5 to 15 Years
High
Expectation
s
Low
Expectation
s
Distractions
Opportunities
All accepted
technologies
Discharged Not Billed Due to Incomplete
Physician Documentation
• Problem
• Charts aren’t coded until all physician docume...
Discharged Not Billed Due to Incomplete
Physician Documentation
• Result
• Six months later
• $7-8 million
• One year Late...
Lab Draws
• Problem
• Excessive and duplicative lab draws
• CBC and BMP identified as target areas
• Approach
• Simple pre...
Lab Draws
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
50.0%
BASIC METABOLIC PANEL CBC CBC WITH AUTO DIFF
Precent of Ti...
Lab Draws
• Result
• CBC
• 2,650 CBCs cancelled
• BMP
• 3,021 BMPs cancelled
• $41,300 savings per year
• 28.4 liters of b...
Data Visualization
and Real-Time Alerts
• Problem
• No nursing unit based monitoring system for pediatrics
• Approach
• Im...
Data Visualization
and Real-Time Alerts
• Results
• Created patient specific vital signs alerts
• Increased physician and ...
Biometric Registration
• Problem
• 6 employees doing chart corrections for MPI
• 30%+ of errors from the ED
• Approach
• P...
Biometric Registration
• Predicted Result
• Cost
• 3 biometric devices (palm scanners) for ED patient registration - $1,50...
Questions/Contact
• Email
• jshowalter@umc.edu
• Twitter
• @johnshowaltermd
iHT² CMIO & Physician Executive Symposium, “Moving Past Hype to Outcomes” with John Showalter, M.D., MSIS, Chief Health In...
iHT² CMIO & Physician Executive Symposium, “Moving Past Hype to Outcomes” with John Showalter, M.D., MSIS, Chief Health In...
iHT² CMIO & Physician Executive Symposium, “Moving Past Hype to Outcomes” with John Showalter, M.D., MSIS, Chief Health In...
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iHT² CMIO & Physician Executive Symposium, “Moving Past Hype to Outcomes” with John Showalter, M.D., MSIS, Chief Health Information Officer, University of Mississippi Medical Center

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iHT² CMIO & Physician Executive Symposium, “Moving Past Hype to Outcomes” with John Showalter, M.D., MSIS, Chief Health Information Officer, University of Mississippi Medical Center

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iHT² CMIO & Physician Executive Symposium, “Moving Past Hype to Outcomes” with John Showalter, M.D., MSIS, Chief Health Information Officer, University of Mississippi Medical Center

  1. 1. GETTING BEYOND THE HYPE TO OUTCOMES John W. Showalter, MD MSIS University of Mississippi Medical Center March 27, 2014
  2. 2. 0 to 5 Years5 to 15 Years
  3. 3. 0 to 5 Years5 to 15 Years High Expectation s Low Expectation s
  4. 4. Distractions
  5. 5. Opportunities All accepted technologies
  6. 6. Discharged Not Billed Due to Incomplete Physician Documentation • Problem • Charts aren’t coded until all physician documentation has been complete • $14 - $15 million in charges not submitted to insurance companies due to incomplete documentation • No transparency into the problem • Approach • Descriptive Analytics • Provide department chair with detailed and graphic reports • Remote support • Deployed a remote support application to HIM • HIM became the primary support for the physicians
  7. 7. Discharged Not Billed Due to Incomplete Physician Documentation • Result • Six months later • $7-8 million • One year Later • Less than $5 million • Revenue cycle has been shortened by more than a full day
  8. 8. Lab Draws • Problem • Excessive and duplicative lab draws • CBC and BMP identified as target areas • Approach • Simple predictive analytics • CBC and BMP more often than q4 in ICUs and q8 on the floors were frequently unnecessary • Rules-based decision support • “Duplicate Lab” alerts if a new order was placed within 4 hours (ICU) or 8 hours (floor) of another lab
  9. 9. Lab Draws
  10. 10. 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% 50.0% BASIC METABOLIC PANEL CBC CBC WITH AUTO DIFF Precent of Time Each Order was Cancelled in Duplicate Alerts
  11. 11. Lab Draws • Result • CBC • 2,650 CBCs cancelled • BMP • 3,021 BMPs cancelled • $41,300 savings per year • 28.4 liters of blood not drawn
  12. 12. Data Visualization and Real-Time Alerts • Problem • No nursing unit based monitoring system for pediatrics • Approach • Implement Epic remote ICU application “Epic Monitor” on both the nursing units and our telehealth center • Combine real-time predictive alerts with data visualization and nursing protocols • Develop guidelines and protocols for nurse response
  13. 13. Data Visualization and Real-Time Alerts • Results • Created patient specific vital signs alerts • Increased physician and nurse engagement • Expected improvements • Earlier interventions • Fewer transfers to the PICU • Decreased LOS
  14. 14. Biometric Registration • Problem • 6 employees doing chart corrections for MPI • 30%+ of errors from the ED • Approach • Palm scanning a ED registration
  15. 15. Biometric Registration • Predicted Result • Cost • 3 biometric devices (palm scanners) for ED patient registration - $1,500 • 2 months of analyst time to set up - $14,000 • Return • 50% reduction of ED errors means 15% total error reduction • Eliminate 1 FTE at $50,000/year • 2 year ROI • $100,000 - $15,500 = $84,500
  16. 16. Questions/Contact • Email • jshowalter@umc.edu • Twitter • @johnshowaltermd

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