Set priorities when developing IDS strategy

AMs urged to take leadership role

When new technology knocks at your door, it may bring a load of opportunity, says Janeen Cook, RRA, a computer specialist in access management for HBO & Co. in Atlanta.

Access managers involved in the redesign of their computer systems — particularly when the focus is on an integrated delivery system (IDS) strategy — can find their responsibilities evolving from those of admitting directors to those of access directors, with more control over information critical to the functioning of health care.

Cook, executive director of product strategy for HBO, compares the current transition of traditional admitting managers into access managers to the shift that took place in the medical records arena in the 1980s. "When DRGs became crucial, I never saw [a profession] escalate so fast as medical records, which is now health care information management."

While the admitting field has undergone a similar change, many managers "are still acting very acute-care oriented and not updating their skill sets," Cook says. The proper approach, she suggests, is to gain a better understanding of the potential of marketing and customer service.

"You can only go so far in supply side and cost-cutting," she adds. "In a competitive market, you build your position on superior customer service, and the whole front end — the place where customers first interact with the system — is what determines if that person has a good or bad experience."

Insurance verification, she says, is a key area to target. "If you’re having trouble accurately identifying patients and determining their eligibility, you might want to tackle that first," she says. "You might want to look at moving the multiple patient data bases that are in place to a centralized repository — from a patient focus to a population focus."

Providers, particularly on the West Coast, that have their own health plans are increasingly going to a population database, where information on members is gathered from payers and employers in advance of a patient’s contact with the health system, Cook points out.

Another priority might be scheduling, she says, especially if you’re in an environment with a lot of manual systems, such as a physician group, or with a new health system component, like home care, which uses special scheduling processes that might be unfamiliar to you.

Political and control issues are prone to surface in scheduling discussions, Cook cautions, with some groups — surgeons, for example — leery of others having access to their information. "But, if you can get executive approval that the system wants a patient itinerary that’s conflict free, that tells the patient where to go anywhere in the enterprise, you want to focus on that," she says.

Regardless of which process is addressed first, Cook advises access managers to take a leadership role in solving political battles. "Instead of taking the stance, ‘We’ve always done it this way,’ embrace technology," she says.

Cook also suggests:

• Be patient. Allocate the resources needed to test the system thoroughly and the time to get people trained. "Just because our kids are all used to Windows and [computer] games, that doesn’t mean you won’t have adults who are fearful of using a mouse," she adds. "Let them play solitaire until they get comfortable."

• To avoid "us vs. them" attitudes, pair employees from different care areas when planning implementation and during training.

• If there are hardened political battles, consider bringing in an outside consultant as an objective influence.