The implementation of a new Electronic Health Record (EHR) is a transformational endeavor that requires an extraordinary amount of effort and resources. The effort and resources are justified by the forecasted financial and clinical efficiency improvements that will ultimately improve patient care. That said, healthcare organizations often make the mistake of not leveraging the EHR implementation as a transformational event to take advantage of even greater operational improvements. Although there are clinical opportunities, the revenue cycle poses some of the greatest opportunity for improvements with a tangible return on investment.
The revenue cycle is a series of inter-dependent parts that will benefit from an integrated EHR. In turn, the new EHR will improve and most often simplify workflow as well as providing the opportunity for greater insights from a one-system, modern reporting structure. As aforementioned, healthcare organizations often make the mistake of not treating the implementation as an opportunity to make operational improvement prior to the implementation process. These operational improvements should involve the following steps.
- Assess your revenue cycle either through a third party or an independent resource that will take a critical look at gaps and your opportunities to improve.
- Examine the opportunities from the assessment focused on return on investment and organizational bandwidth. Keep in mind that no organization, especially in pre-implementation phase, can address every gap or opportunity.
- Prioritize your opportunities and ensure that they align with your operational goals, bandwidth and true level of effort.
- Begin an optimization process that will address policies, workflow, training, staffing, and governance. Ensure the process has a project plan that addresses key milestones and dates to ensure your organization can finish the efforts prior to the EHR implementation process.
- Measure and analyze your results and ensure your new governance process addresses any concerns. For example, ask yourself if you have a governance process within a revenue cycle committee that lists activities, reporting, accountability, and ownership to ensure sustainment of improvements.
Some key areas of pre-implementation optimization often center on those which are sub-par in many organizations. For example, denial management is an often overwhelming area of reporting, root causes, and payer relationships. Prior to an EHR implementation it is imperative that your denial management program is working well as there will undoubtedly be some unexpected temporary issues associated with your EHR. Another example is point of service collections and is a difficult process where success is largely centered on reporting and training of staff. Optimization is necessary.
An EHR implementation is a great time to overhaul your revenue cycle policies, workflows and outcomes, especially if they have not previously received much examination. Use a transformational project like this to optimize revenue cycle before EHR implementation even begins to maximize success.