Patient access leadership must communicate the department’s needs to information services during the switch to a new electronic medical record, to avoid ending up short-staffed.
- Plan for staffing to cover for registrars who are attending training.
- Be sure all third-party software used by patient access “talks to” the new system.
- Keep in mind that required registration fields can cause delays at check-in.
Were the needs of patient access carefully considered in the planning process for a new electronic medical record (EMR)? This step will determine if the registration process is “seamless or a traffic jam,” says Nancy A. Crehan, CHAM, director of patient access at Cambridge, MA-based Mount Auburn Hospital.
Yaroslav Voloshin, vice president of revenue cycle advisory solutions at MedAssets in Alpharetta, GA, says, “every time an organization switches its EMR platform, patient access is the first area to be impacted.” He offers these five ways to avoid problems:
1. Get involved early on.
“Be part of the planning and design meetings to participate in the initial development,” says Voloshin.
2. Practice before the new EMR goes live.
This step will keep the amount of time to register new payments to an acceptable industry standard of 7-10 minutes for the average registration. “Many organizations just overstaff to compensate. However, this isn’t the most efficient solution,” says Voloshin.
3. Do a gap analysis to identify weak areas in the system.
4. Create a hotline so members of the registration staff can reach out for help if they need to.
5. Have a backup plan.
“Have a paper process to register patients if the system is down or there is an issue bringing up the new EMR system,” says Voloshin.
Avoid Planning Woes
Most EMR implementation issues involving patient access can be avoided with good planning.
Crehan says, “For example, use a conversion calculator to determine the number of scheduling and registration staff necessary.” She recommends these other strategies:
• Inform hospital leaders of resources needed early in the project planning phase.
Patient access needs adequate staffing coverage during the testing, training, and go-live phases. “Abdicating this analysis to consultants could leave your operation short-handed while you’re attempting to meet critical project deadlines,” warns Crehan.
• Bear in mind that too many required fields can slow down check-in, admission, or registration.
“We include very few required fields, but we have added alerts — warnings, but not ‘hard stops’ — to assist users as they complete screens,” says Crehan. If an alert field is missing information, it goes to a registration work queue for resolution.
• Expect registrars to be pulled away for training for hours or days.
“Someone has to keep registering patients in the department,” says Crehan, noting that some vendors suggest a 50% reduction in appointment volume the first week after go live. This volume ensures new users, including patient access, aren’t overloaded. “It’s a balancing act, as you do not want to impact revenue,” cautions Crehan.
• Build a strong relationship with project leaders who work in information systems (IS), admission/discharge/transfer (ADT), and other areas.
“Have monthly meetings with your ADT and IS support team, and take them to lunch,” suggests Crehan.
• Inventory all third-party software used in patient access areas, and make sure these “talk to” the new system.
For the department’s patient estimator tool to work properly, for example, it must integrate with the hospital’s registration system to receive appointment types, CPT/DRG codes, and provider information.
“In a large EMR implementation, patient access is usually the only stakeholder thinking about these types of front-end tools,” says Crehan.
If glitches are discovered only after go live, revenue cycle metrics and patient satisfaction scores could plummet. “Do not leave real-time eligibility or patient estimate software functionality at risk,” Crehan emphasizes.
- Nancy A. Crehan, CHAM, Director, Patient Access, Mount Auburn Hospital, Cambridge, MA. Email: firstname.lastname@example.org.