By Bill Slama, business consulting senior manager; Philip Handal, business consulting senior manager; and Jamie Morisco, business consulting experienced manager, Grant Thornton LLP.
Healthcare organizations are scrambling to harness the potential of digital technology to transform their business and gain a competitive edge in the marketplace. Whether they are looking to modernize their back-office systems, optimize their electronic health record, or leverage smart medical equipment and IoT for advanced data analytics, health systems are constantly engaged in transformational projects and programs. According to reports, 25 percent of these technology projects fail outright; 20 percent to 25 percent don’t show any return on investment; and as many as 50 percent need massive reworking by the time they are finished.
But the question is why: Why is it that such a high percentage of these technology enabled transformation projects fail? Studies show that poor project and change management is to blame for 54 percent of failed projects – while only 3 percent can be attributed to technological problems. Having an effective program and change management strategy – and the resources to implement and sustain that strategy – is critical to ensuring the project is on time, on-budget, and aligned with organizational goals and culture.
Change management means understanding the holistic impact of a change and encouraging and empowering employees to adopt and own that change. Without proper change management in place, projects can become burdened by: increased end-user stress and frustration, resistance to new technologies or processes, decreased adoption, and lower financial and operational returns on project investments.
One of the most common change-related reasons projects fail is due to lack of active and visible sponsorship (i.e., sponsors who are engaged, participatory, and of relevant standing/influence). Setting the tone at the top while maintaining consistently visible and active commitment from sponsors and relevant leaders is the foundation of a successful change and ultimately transformation project.
A common mistake is making the assumption that having a kick-off meeting means you’ve effectively communicated the scope, approach, purpose and goals of the project to all the primary stakeholders. Projects are dynamic – change happens on weekly, if not daily, basis – it is critical to engage and stay engaged to truly manage, communicate and effectively enable change through transformation. Stakeholder communication should always outline the benefits, risks and opportunities the change presents to their groups. Doing this with regular cadence across various channels of communication helps establish a network of change agents throughout the organization that can be relied upon to champion change and fully integrate change into the strategy and culture of the organization.
Enabler #1: Change Management
Change management activities should be integrated into the overall project plan through four critical phases:
Awareness – Creating awareness that change and/or transformation is coming and informing those impacted of the timelines and tasks associated
Organizations should provide advance notice that significant change is on the horizon – whether it be a new business application, emerging technology, or automation of manual processes. This step is critical to successful change adoption. Advertising the macro-level timelines and micro-level tasks required to implement and sustain related to the impending change allows those impacted to be better equipped to navigate the change and minimize the impact on their day-to-day operations.
Understanding – Communicating the genesis of the change, why it’s happening, and its impacts/benefits
Those impacted by the change (e.g. user community, stakeholders, sponsors, etc.) want to know why the new change is occurring – especially if the old way of doing things seemed to be working just fine. Fostering a culture of transparency, sharing the impetus for change and its expected impacts, and affording those affected by change the opportunity to ask questions or voice concerns allows everyone impacted to feel more involved in the process. It helps to establish a culture of togetherness and collaboration, and conveys the message that those impacted are part of the solution rather than an impediment to progress.
Adoption – Acceptance and willingness to support and participate in change
Creating ownership of the change allows those impacted to see change is not “being done to me”, but rather “with me”. This can create enthusiasm among those impacted to adopt because they have an ownership stake in the success of the change.
Commitment – Dedication to sustainment and enablement of change over time
The more people feel as if their contributions, ideas, thoughts, work products, and more positively contributed to the success of the change and/or overall program, the more eager they will be to adopt and sustain that change over time.
Always remember change – and ultimately, transformation – does not happen because of the implementation of new and emerging technologies. People drive change and transformation. Without their support, endorsement, and acceptance, change and transformation are not possible.
By Christina Boyd, vice president of client solutions, DocuTAP.
Christina Boyd
Switching to a new EMR is never easy and can be a real challenge for urgent care providers. However, when the current system doesn’t align with your practice’s goals, you’ve got to take the plunge.
Leadership may see the benefits, but getting the staff on board can be more difficult. This is perfectly understandable, since they’re the ones in the trenches every day and learning to use an entirely new system can be daunting. To make the transition successful, the support of staff is crucial.
In the best-case scenario, staff will not only support, but also understand how their lives will actually be easier after the switch. And therefore, it is up to leadership to set the tone by providing insight into the why and how weeks before the actual change is made. The question is: What are the specific steps you need to take to get staff to buy-in?
Choose technology wisely
A smooth transition begins with choosing the right solution, so it’s important to find a solution that’s intuitive and user friendly – in essence it should work just like the technology the staff uses as consumers in their daily lives. Take the time to make sure it’s the right solution to prevent a subsequent change, and your confidence will trickle down.
Prepare and plan
There is no substitute for good preparation and planning. Know and communicate the plan for pre-launch training, go-live and post implementation support because the unknown is often a source of anxiety. If everyone on staff knows the process and the plan they will be more confident in managing the change.
Additionally, knowing how to discuss the change with staff is critical to effectively lay out the vision. What you are changing and why? How will this change impact each person? How will success be measured? At the end of the day, employees need to understand why the new technology is an improvement – not an inconvenience.
Choose a physician champion
Find one physician that believes strongly in the vision for the practice and the value a new EMR solution will bring to the clinic. The entire team is more likely to get on board if they hear the enthusiastic support of a respected colleague.
Start at the top
Urgent care owners know their staff best, so foster this personal relationship and secure the support of team leaders first. Start by asking them what they see as top challenges for the organization when it comes to the EMR or other technology used and allow them to offer solutions. Think about their roles and responsibilities and approach them individually to talk about how the change will affect their work life. This approach shows leadership recognizes the unique challenges each team member will face, and it matters to them.
Have you thanked a nurse today? Or any day, for that matter?
If not, you now have an entire week to make up for lost time. National Nurses Week 2019 runs May 6 through 12 and celebrates the innumerable contributions nurses make each day. This year’s theme is “4 Million Reasons to Celebrate,” pointing to the 4 million registered nurses licensed in the United States and the vast contributions they bring to care delivery.
Healthcare may be an ever-evolving industry, but the one thing that hasn’t changed is the integral role played by nurses. In fact, their skill set is more in-demand than ever before, especially as today’s healthcare organizations navigate the evolving value-based care landscape. For example, nurses must constantly absorb new information to keep up with rapidly-changing evidence in practice while simultaneously honing their critical thinking skills to stay current in a shifting healthcare model.
The reality is that the role of nurses is changing dramatically as healthcare organizations see increased demand for services and higher-acuity patients, many with more comorbidities than ever before. Today’s nurses are critical members of the multi-disciplinary care team. They need to be the collaborators and leaders, giving a voice not only to their patients but to other nurses and caregivers as well. This is a profession that needs to produce leaders with the savvy and acumen to feel as comfortable inside a boardroom as they do at a bedside.
Simply put, knowledge is power when it comes to producing the best possible patient outcomes. Forward-thinking healthcare organizations understand this dynamic and are designing workplaces that optimize and support a culture of learning that elevates nursing skills to align with healthcare initiatives related to chronic disease management and population health.
These strategies not only support nurses as they care for patients in today’s fast-paced healthcare environments, but they help clinical leaders address growing staffing challenges amid critical professional shortages. For example, turnover rates in 2017 shot up to nearly 17 percent as the industry faces growing challenges related to burnout and dissatisfaction. Hospitals pay dearly when nursing turnover is at its highest, and it isn’t only the quality of care that suffers. According to one survey, the average cost for the turnover of a bedside RN is between approximately $40,000 and $60,000. Each percent change in nursing turnover, the survey says, will either cost or save the average hospital more than $373,000.
Nurses who feel well-equipped and supported in their professional trajectory are much more likely to find satisfaction in their work. Consequently, healthcare organizations must provide that support from the outset—addressing education gaps during onboarding while continuing to educate new nurses on how to deliver the highest quality of care. It’s a difficult balance considering nurses are dealing with a growing number of patients and a plethora of complex diseases.
CPSI, a community healthcare solutions company, announces that it has entered into a definitive agreement to acquire Get Real Health. Based in Rockville, Maryland, Get Real Health delivers technology solutions to improve patient outcomes and engagement strategies with care providers. Their broad set of cutting-edge products have garnered awards for the company and its clients and earned them a reputation as a vanguard in the healthcare information technology (IT) industry.
Get Real Health has established a presence in both domestic and international healthcare markets. Collaborating with organizations like TELUS Health, the University Hospital Southampton NHS Trust and KeyHIE, Get Real Health delivers solutions to government and private organizations in Europe, Canada, Australia and the United States.
In addition, earlier this month, Get Real Health launched its latest product, Lydia, when it was identified by Microsoft as a destination for HealthVault users to transition their existing data after the pending retirement of HealthVault. Lydia is a trusted place where people can organize, store and share their health information with family and healthcare providers.
Boyd Douglas
“The demographics and population make-up of the communities we serve support the growing demand for strategies and tools to address the on-going management of chronic care conditions, which are prevalent in these areas,” said Boyd Douglas, president and chief executive officer of CPSI. “Helping our customers secure the future of community healthcare is what we focus on each and every day. By acquiring Get Real Health, we can continue this effort as providers evolve to a value-based care delivery model.”
Get Real Health’s line of innovative patient-facing products will complement CPSI’s existing offerings. CPSI acute and ambulatory customers will be able to use InstantPHR and CHBase to engage their patients in a much deeper way than traditional patient portals. The company’s Ellie app will allow CPSI customers to improve their patients’ health outcomes while strengthening their own bottom lines. Get Real Health also brings a decade’s worth of international business experience and connections, opening potential new markets for CPSI’s existing offerings. Conversely, CPSI’s greater resources and capabilities will help Get Real Health scale to serve existing and new customers and markets.
CPSI anticipates that this acquisition will yield approximately $1.0 million in annual cost synergies, primarily from the replacement of CPSI’s existing patient engagement solutions. Additionally, the acquisition is expected to be accretive to Adjusted EBITDA for 2019.
Robin Wiener, president, chief executive officer and founding partner of Get Real Health, said: “When we met the CPSI management team, there was an instant realization that we could do something amazing together. In addition to the opportunity to bring our solutions to hundreds of communities across the United States already serviced by CPSI, we will continue to empower patients around the world.”
Transaction Summary
The contemplated total aggregate consideration to be paid by CPSI is $11 million, payable in cash, subject to certain adjustments at and after closing, as provided for in the purchase agreement, plus an earn-out payment of up to a maximum of $14 million, depending on the EBITDA performance of Get Real Health during 2019. The completion of the transaction is subject to the satisfaction of customary closing conditions, and is targeted to close in the second quarter of 2019.
To finance the transaction, CPSI will use a draw of approximately $11 million under its existing senior secured revolving credit facility.
One of the most antiquated processes in American healthcare is credentialing. It’s essentially been done the same way for decades and it’s extremely inefficient and costly.
This has to be done every two years and takes anywhere from a few weeks to six months. Even worse, each facility has its own way of doing it, collecting the same exact information and not sharing this information with each other in any meaningful way.
If this process could be expedited, American healthcare would improve in three major ways.
The industry saves billions of dollars
With postponed physician start dates comes lost facility revenue. Lots of it, too.
Currently, a physician earns a facility an average of $2,378,727 a year. If credentialing takes a worst-case scenario of six months, that’s $1,189,363 in lost revenue. Even if credentialing only takes a few weeks, they still lose around $150,000.
That’s only one physician for one facility. Imagine the overall savings faster credentialing can bring the entire healthcare industry, which already wastes half of the $361 billion a year it spends on healthcare administration. We’re talking several billion dollars in savings that can be used to significantly lower healthcare costs for patients.
Doctors see patients sooner
Physicians didn’t get into medicine to become bureaucrats. The reason most doctors enter the field is to help people. Slow credentialing prevents that, adding administrative stress on someone who could be out saving lives. It’s a lose-lose for everyone. It also puts them in limbo for weeks or even months, making them unsure what they should or shouldn’t do. Do they buy that house? Should they wait on that car? Should they move to the city the job’s located in now or wait until the process is finalized? It can be very unsettling.
On top of that, physicians can lose a lot of income during the credentialing process. If they earn the average physician annual income of $299,000, waiting a few weeks to get credentialed would cost around $25,000 in lost income, and waiting six months would cost around $150,000 in lost income. Unless they’re able to work elsewhere during this time, they’re looking at losing as much money as the average American makes in a year—something many physicians can’t afford because of med school debt averaging $192,000.
The Health Insurance Portability and Accountability Act (HIPAA) applies to all companies in the United States. Healthcare providers, covered entities and their business associates should understand HIPAA and take compliance steps to avoid monetary fines and even prison time. HIPAA violations in the workplace can occur in any organization but especially those that provide healthcare benefits to their employees or require health information to process disability benefits or workplace compensation.
Understanding HIPAA violations in the workplace
HIPAA was enacted in 1996 and aimed to protect the health information of individuals as they moved from one job to another. Since then, the Act has been refined to include more coverage and protections.
In 2003, the Privacy Rule, which defines Protected Health Information (PHI), was passed by the US Department of Health and Human Services. In 2005, HIPAA was updated with the Security Rule, which focuses on electronically stored PHI (ePHI). Today, employers must adhere to HIPAA and related regulations, including the Security Rule and the Privacy Rule, as required by industry regulators and the federal government.
What information qualifies as PHI or ePHI
The Privacy Rule defines PHI as any health information that concerns the payment of healthcare, provision of healthcare or health status of an individual, which is held by a covered entity.
In the workplace, any employee health plans or medical records that are collected by the employer for the purposes of administering healthcare plans are PHI or ePHI information. Health information that is gathered but not intended for use in administering healthcare plans is not considered PHI or ePHI.
When an employee provides health information to document workers’ compensation or sick leave, the information is not considered PHI or ePHI. On the other hand, if you contact an employee’s healthcare provider, the information that the provider will give you falls under the Privacy Rule. Employment records do not fall under PHI or ePHI even they may include health-related information.
What HR should know about HIPAA
If your organization offers employees a covered health plan, it’s critical to determine whether you need to be HIPAA compliant.
In recent years, medtech innovation tends to be more iterative than disruptive, though every so often we see a truly game-changing new device or modality of treatment. After closely monitoring the medtech market, a recent report by Decision Resources Group (DGR) finds a wave of transformative technologies will likely break over the next five years. More specifically, the report identified four medtech innovations forecasted to shake up the treatment landscape.
Selections were restricted to only include either technologies that were approved in 2018 or were likely to receive approval in the coming few years. The report avoids focus on technologies that were promising solely in terms of revenue generation as well as so-called “me-too” technologies, limiting submissions to unprecedented innovations, significant therapeutic expansions, and drastically improved technologies.
Based on in-depth analysis of the level of innovation, potential patients and potential revenue, the report finds neurostimulation, regenerative medicine; CAR T-Cell therapy; AI and machine learning in interventional cardiology; and transcatheter mitral valve implantation/replacement (TMVI/TMVR) will have the greatest potential impact in terms of sales and patient outcomes over the coming years, and here’s why:
Why it made the cut: After a decade of development, TMVR is finally close to becoming a commercial reality. The complex and difficult anatomy of the mitral valve and the critical nature of the treatment make this an immensely exciting development.
Details: Mitral valve patients who have heart failure are poorly served by extant solutions, including repair or replacement surgeries; as a result, many companies are attempting to develop a solution similar to transcatheter aortic valve replacement (a percutaneous catheter-based solution for patients with stenosed aortic valves who are too frail to undergo surgery) for the much larger population of mitral valve disease patients.
AI and machine learning in interventional cardiology
Why it made the cut: This development paves the way for robotics in some of the most complex and common surgeries. Aside from procedural concision, this technology holds the potential to significantly reduce costs to health care systems.
Details: AI and machine learning are increasingly being incorporated into surgical robots in the cardiovascular space. For example, Corindus Vascular Robotics has developed the TechnIQ, an intelligent robotic arm with an algorithmic assist; the CorPath GRX may be able to perform “autopilot” percutaneous coronary interventions in the near future by relying on image detection/recognition, 3D construction, and force sensors.
Moreover, data collected from such devices can lead to digitized motion information, which can be translated into best practice guidance and further incorporated into software to optimize techniques.
Due in large part to the HITECH Act and the meaningful use incentive program, electronic medical record (EMR) initiatives have dominated the IT efforts of healthcare providers for the better part of the past decade. Most of the focus over this time has been placed on simply implementing the technology and getting clinicians to embrace it.
Now that more than 95 percent of hospitals in the U.S. are currently using EMRs*, it seems the focus is beginning to shift. However, the move isn’t away from EMRs to some other groundbreaking technology. Instead, the focus is transferring from simply implementing EMRs to optimizing the software in order to squeeze more value out of it.
You see, most healthcare providers aren’t very happy with the ROI they are currently getting from their multimillion-dollar EMR investments. In fact, only 10 percent believe they are getting a positive or superb return from their EMRs, according to a recent survey of 1,100 healthcare professionals by Health Catalyst.
The remainder describe the ROI as terrible, poor or mediocre.
As a result, healthcare providers are turning their attention to enhancing their existing EMR systems. According to a recent Black Book Market Research survey, 61 percent of healthcare respondents say technology optimization is the highest priority IT engagement for their organizations by the end of 2020. Not surprisingly, EMR software and revenue cycle management systems are the primary targets of these optimization efforts.
CPSI, a community healthcare solutions company, announces that it has entered into a definitive agreement to acquire Get Real Health. Based in Rockville, Maryland, Get Real Health delivers technology solutions to improve patient outcomes and engagement strategies with care providers. Their broad set of cutting-edge products have garnered awards for the company and its clients and earned them a reputation as a vanguard in the healthcare information technology (IT) industry.
