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Will workflow technology solve your problems?
Although workflow management is not a new phenomena in the business world, it is relatively new in revenue cycle operations, especially in patient access operations, says John Woerly, RHIA, CHAM, senior manager at Accenture in Indianapolis.
If you are looking at implementing workflow technology, Woerly says that one big hurdle is how you will quantify how such a system, which is typically very costly, will pay for itself in two or three years.
Also, Woerly says it's not always easy to determine where to best use workflow management or design a leading practice process flow, which is "not necessarily the one that you've always used." Another challenge is to provide the resources to implement and, even further, maintain the system and the rules that drive the automated processes.
No step is omitted or delayed
Businesses typically seek workflow management technologies to increase profitability and enhance competency. "Primarily, they hope that the use of such technologies will streamline and automate their transaction flows, better manage exceptions, and identify non-value-added activities," Woerly says.
Workflow management technology supports routing information of any type according to user-defined business rules, allowing information to be routed to one location or multiple locations, either simultaneously or sequentially.
Within patient access, this tool would allow you to move data from patient scheduling to financial clearance (pre-registration, insurance eligibility/benefit verification, pre-certification/ authorization, referral management, and patient liability estimation and collection) and from financial clearance to registration/check-in and/or financial counseling.
Woerly explains that workflow concerns the automation of procedures where documents, information, or tasks are passed between participants according to a defined set of rules to achieve, or contribute to, an overall business goal.
"Much has been written over the years of a 'closed loop' process within revenue cycle operations," says Woerly.
Workflow management allows revenue cycle departments (patient access, health information management, case management, and patient accounting) to automate each step of their process flow in order to ensure that no step is omitted or delayed.
"It also allows process steps to be performed sequentially or simultaneously. This allows several people to work on segments of a patient's account, as an example, at the same time," says Woerly.
If properly designed and deployed, workflow management should have a substantial impact upon the reduction of account receivable days, as well as positively impact customer satisfaction and service.
Woerly says that an example he personally experienced was making an outpatient appointment with his provider hospital for three days out and within only a few hours, receiving a call from the financial clearance staff to be pre-registered.
"Workflow assisted my information to quickly travel from my physician's office to the hospital for the appointment, and then to the financial clearance area, to be alerted that I needed to be pre-registered and have other pre-service activities conducted," he says. "To say the least, I was impressed with the efficiency of the operation."
Woerly gives these tips for making the switch to workflow technology:
Know your needs. "Define your key objectives and projected outcomes," says Woerly.
Develop a project charter. This may include scope, assumptions, implementation issues and risks, organizational impact, critical performance indicators, milestones/timelines, key participants, and deliverables.
Provide and enable the resources to plan, design, test and implement the system. "Don't underestimate the time and knowledge required," says Woerly.
Get user involvement and buy-in, including all key upstream and downstream stakeholders.
Create workflows to document each process step and hand-offs.
Remember that the system is capable of change via rule updates. "Your initial process flows should assist you in defining data needs and flows," says Woerly. "However, as you progress, it is expected that updates will occur."
Implement the new system in a pilot site before taking it across all processes or all departments.
"Look to see where the greatest opportunity in data flow exists," says Woerly. "Typically, in a patient access environment, it is the flow of information from patient scheduling, which many times is decentralized to multiple ancillary departments, to financial clearance."
Provide a feedback loop for issue identification and resolution.
This should ensure that the workflow rules are set up properly and that timing and sorting of information is correct to allow the right people to get the right information at the right time.
Data on turnaround time, number of cases processed, number of cases held, and number of cases referred will assist you in improving work processes. "Statistics that are typically derived from workflow management tools will provide you with the data needed to improve the process," says Woerly. "But, it is essential that you use this information to drive process improvements and to provide feedback to all key stakeholders in an effort to inform and educate."
[For more information, contact:
John Woerly, RHIA, CHAM, Senior Manager, Accenture, Indianapolis. Phone: (317)590-3067. E-mail: email@example.com.]