'ELVIS Project' targets UAMS revenue cycle
'ELVIS Project' targets UAMS revenue cycle
Eight design teams are involved
"Tagging," or naming, a project is often credited with creating a sense of ownership and empowerment for those involved.
With that — and perhaps a small homage to a Southern-born national icon — in mind, a team at the University of Arkansas for Medical Sciences (UAMS) Medical Center in Little Rock has dubbed its multi-faceted revenue cycle initiative the "ELVIS Project: Taking Care of Business," say Holly Hiryak, RN, CHAM, director of hospital admissions/access services and ELVIS Project leader, and Jeri Garland, CNMT, information technology manager and ELVIS Project leader.
The project objectives — which will involve eight design teams and multiple components — are as follows, Hiryak adds:
- Improve scheduling and registration workflow.
- Perform address verification on patients prior to scheduling an appointment.
- Perform up-front medical necessity review.
- Automate charity and Medicaid application processes.
- Automate denial follow-up activity.
- Integrate the HealthQuest Patient Management and Patient Accounting systems to leverage existing investment into future state.
The project vision, she notes, is "to create a patient-friendly access environment while optimizing reimbursements and reducing operational costs."
Hospital Access Management will follow the project and publish periodic updates based on reports from Hiryak and Garland.
"It's a huge project," Hiryak says. "Some of these products will be new. Some we've never had, some we'll be replacing." She and Garland were chosen as co-leads because of the different skill sets they provide, she adds. "The project encompasses so many areas that it's important to have that blend."
The ELVIS acronym, Hiryak explains, stands for "eligibility, verification, insurance, and scheduling."
The decision to have co-leaders was also about perception, Garland says, and reinforces the idea that the project is "UAMS-owned — not just for the hospital, not just for the outpatients — and that this is not something that IT is putting in and handing to the users. It will be jointly designed, with the participation of the hospital and IT. There are people from all areas that will be involved." The IT department, she notes, is not a part of the hospital, but rather serves both it and other campus operations.
UAMS Medical Center has some 26,000 inpatient discharges and 32,000 emergency department visits annually, while the UAMS outpatient clinics see approximately 390,000 patients each year.
The timeline has not been completely defined, Hiryak says. "Some [phases] we'll complete in a few months, while scheduling — the largest piece — will take several months. Some need to be concurrent while others don't."
UAMS already uses McKesson Corp.'s HealthQuest Patient Accounting and Patient Management for ADT and patient accounting, she notes. "The addition of the various components will round out the revenue cycle tools supported by one vendor."
The four-pronged approach in that area, she adds, includes:
1. Front-end verification via Verification Assistant, which validates patient demographic and credit data and predicts payment modeling.
Charity Advisor will facilitate the handling of discounts and billing and collections issues associated with uninsured patients, and its Medicaid Advisor will allow UAMS to prescreen for program eligibility, among other features.
2. Real-time eligibility with HealthQuest's Eligibility Assistant, which verifies the status of patient coverage directly from payers, using HIPAA implementation guidelines.
3. Medical necessity checking up front with Pathways Compliance Advisor, which works in conjunction with Pathways Healthcare Scheduling to enable checks during and after scheduling a procedure.
4. Re-engineering the registration process with HealthQuest's Registration Workstation.
Work on the billing component — the EC2000, which will replace the Premis system — was already under way when the project began in early 2006, Hiryak says, and it is expected to be implemented by June 2006.
The part of the project that will impact the most users is the implementation of Pathways Healthcare scheduling, also a McKesson product, an enterprise-wide application that is designed to provide a coordinated method for scheduling people, rooms, supplies, and equipment.
Another facet of the ELVIS Project is the Interface Link Engine (ILE), a tool that allows users to scan documents at the point of access, she explains. "The scanned document then appears on the [appropriate] HealthQuest screen. A Medicare card, for example, would appear on the Medicare screen, a driver's license on the patient information screen, and so on."
While UAMS is already using the ILE for inpatient and emergency department operations, it will be rolled out to outpatient clinics as a part of the ELVIS Project, Hiryak adds.
With such a massive project, she points out, one question that comes to mind is "Where do you start?" In UAMS' case, Hiryak says, the first piece of business was developing "project governance" — laying out the roles and responsibilities of those involved. (See illustration below.)
 |
"You don't want any one or two people making decisions," says Garland. "Different groups are responsible at different levels so you keep things moving forward," she explains. The different groups, Garland notes, are called design teams, with one team for each component.
"The value of the design teams is that the end users will design the utilization and implementation of the various tools," Hiryak points out. "The leader on each team," she adds, "is also part of the project workflow group, which comes together at a designated time to update the project and address any overlap or interface issues.
"From our perspective," Hiryak says, "there is better buy-in and accountability when you set up governance. People know what's expected and how to act and respond."
The ELVIS Project has its roots in a revenue cycle group that in 2000 began meeting once a month to discuss "where we are currently, any potential improvements, and to report on measurable goals," she explains. "There have been ongoing discussions on the need for an enterprise-wide scheduling system and some other support tools."
During the early part of 2005, UAMS hired consultants to target process improvements in the outpatient arena, and their conclusions reinforced the need for those tools, Hiryak says. With their recommendations, she adds, "several of us moved forward to leadership, and said, 'These are the tools we need,' and put together a proposal."
The inspiration for the project, Hiryak explains, actually came from the strategic objectives laid out by UAMS' chancellor with the goal of improving access to clinical care.
"The components we've purchased will help us achieve those clinical objectives," she says. "We're placing the tools in the hands of users to better achieve them."
(Editor's note: Holly Hiryak can be reached at [email protected]. Jeri Garland can be reached at [email protected].)
">"Tagging," or naming, a project is often credited with creating a sense of ownership and empowerment for those involved.Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.