ALLSCRIPTS CARE MANAGEMENT OPTIMIZATION

SITUATION

One of the largest health care providers in California required consulting services regarding the underutilization of their Allscripts Case Management (ACM) Discharge Planning and Referral Management software. The software is utilized for Discharge Planning from the acute hospital setting for post-acute placement. The Client was at risk to losing the software that streamlined all of their referrals from 21 hospitals to SNFs, Acute Rehab, Home Health and Hospice due to underutilization and change in operational leadership. The Client’s EHR Vendor led the client to believe that their functionality would be able to replace the Allscripts software. The Client’s Senior Leadership team knew that this loss would be detrimental to day to day operations, overall efficiency, LOS, and data capture. The ACM software was utilized for tracking and trending case management specific productivity and data needed to renegotiate contracts with post-acute providers. In addition, Leadership suspected that the ACM software was not being utilized to best practice standards, and thus, required consulting services to optimize the software and roll out additional features not yet used.

 

ENGAGEMENT

HCIT Consulting became engaged by an executive within the Continuum of Care Division at the regional level of the health system. The deliverables were to provide assessments regarding workflow, process and clinical review, as well as an IT gap analysis for Discharge Planning. The engagement consisted of assessment of the discharge planning process and workflow throughout the health system, providing multiple levels of recommendations based on their budget, resources, and time. The health system is very unique in that they also functioned as the insurance provider/health plan. In essence, the entity operated as its own ACO.

The Health System consisted of:

  • 21 hospitals
  • 14 Home Health Agencies-owned by the health system
  • 10 Hospice agencies-owned by the health system
  • 6 service areas for centralized hub SNF placement services to all 21 hospitals, physician offices and out of area placements.

PROJECT OBJECTIVES:

Optimize Allscripts Discharge Planning and Referral Management to maximize:

  • Standardization and management of Continuum Intake and placement processes required to place members in contracted community providers.
  • Optimize software to utilize best practice functionality and eliminate over processing and paper of post-acute referrals.
  • Leadership visibility into operational productivity and reports.
  • Online communication with community vendors. 

PARTICIPANTS

Health System:

Leader of Strategic Implementation, Senior Leadership across the Continuum of Care (3), Continuum of Care Administrators (12), Service Directors for several lines of business (34), Superusers (70), Director of Admissions (20), Clerical and RN staff at various agencies (250+), Directors of Case Management (11), Managers of Social Work (11), and IT Project Managers, Support, & Analytics (7). 

HCIT Consulting:

Principal Consultant (1)

 

DELIVERABLES COMPLETED

  • Performed Discharge Planning Process and Workflow Assessments for
    • 11 Acute hospitals
    • Centralized Admissions and Placement at SNF hubs (6)
  • Performed Admissions and Workflow Assessments for
    • Owned SNF provider
    • Owned Acute Rehab
    • Owned Home Health Agencies (14, of which 4 were live on Allscripts RM)
    • Owned Hospice Agencies (10, of which 1 was live with Allscripts RM)
  • Evaluated multiple levels of leadership to identify strengths and weaknesses.
  • Reviewed data elements, data capture, reports and recognized area of opportunity based on best practice and optimization of process and data entry to maximize Allscripts Ad Hoc Reporting.
  • Developed a project plan to roll out recommendations across several lines of business and service areas.
  • Implementation of demographic interface from membership directory into Allscripts Care Management.
  • Evaluated, Configured and Educated various levels of leadership on operational reports. (Executive, Service Areas, and Local Leadership).
  • Completed Gap Analysis for the EHR capabilities, Other UM Vendors, and the Allscripts Discharge Planning module and Allscripts Utilization Management module.
  • Reconfiguration of Allscripts Discharge Planning was completed to reflect best practice for SNF, Home Health, and Hospice referrals (referral and admissions).
  • Retrained current users and trained additional users (over 250+ staff).
  • Implemented software to 1 Home Health agency and 2 Hospice Agencies not yet on the Discharge Planning Software.
  • Completed Assessment and recommendations for Pilot of Allscripts Utilization Management software and UR Process Change to reflect best practice.
  • Completed Assessment, best practice recommendations and implementation for identification and utilization of new features related to Avoidable Day and Readmission Tracking tools and reports.
  • Assessment and identification of ROI savings for additional interfaces not yet implemented (budgeted for the next fiscal year).

OUTCOMES

By the end of the 22 week engagement the following outcomes were realized based on 66,000 post-acute referrals made annually via Allscripts Care Management:

  • Standardized the placement process across multiple service lines (Skilled Nursing, Home Health and Hospice) in multiple service areas.
    • Total of $600,000 saved annually in productivity from reconfiguration and reimplementation to current users.
    • Additional $220,000 saved in productivity with implementation of new database interface.
    • ROI proven for additional interfaces (allocated for next fiscal year) with additional productivity savings projected at over $1M annually.
  • Optimized software to utilize best practice functionality and eliminate over processing and paper of post-acute referrals.
    • Saved over 13,250 hours of Intake and Placement staff time annually (RN, LVN and clerical).
    • Over 1.2M pieces of paper eliminated.
  • Leadership visibility into operational productivity and reports.
    • Automated/eliminated 8,500 daily logs and reports with transparency across services lines and areas.
    • Over 200 hours of Management time saved in report automation and analytics.
  • Online communication with community vendors.
    • Eliminated onsite and offsite paper storage as everything is now electronically stored.