HIM Reorganization & Regionalization

Debra Graham, RHIA, MS, CCSRegional Executive Director Health Information Mgmt. & CodingAdventist Health Systems - Central Florida North Division

Objectives

Objectives

• Introduce & Share Our Journey - Central Florida North Region

• Identify Tools Used to Benchmark Success

• Validation of Success

• Employee Empowerment, Satisfaction, Future Opportunities

Get to Know Your Audience

• AHS Hospitals

• Multiple HIM Departments

• Single State

• Multi- States

Adventist Health SystemCentral Florida North Division

Central Florida Division – North Region

Central Florida - North DivisionHospital Beds

Florida Hospital Memorial Medical Center 327

Florida Hospital Fish Memorial 179

Florida Hospital DeLand 164

Florida Hospital Flagler 99

Florida Hospital New Smyrna 112

Florida Hospital Waterman (exception) 269

Technology

• Cerner EMR• Optum Encoder• Dolbey CAC• Kofax Scanning• Panasonic Scanners• High Speed Scanner• Bar Coding• M*Modal – Speech & Front-end voice

Our Story

Christ

Has

A

New

Gift

Each

Second

Timeline Our Story – Our Mission

2008-2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Near-time Scanning

CPOE FHD Coding

RegionalTrans

Trans.FHZ

ProScript Regional Trauma RegistrySummary of CareCCD

Document Imaging M*ModalAcquiredFHNS

CernerNear-timeScanning go liveFHNS

Region -Analysis

Leadership5 HIM Directors

LeadershipFHD to FHMMC

Leadership ContinuedFHD

LeadershipOfficial FHD4 Directors

Leadership3 HIM 1 ComplianceDirectors

Leadership3 HIM 1 ComplianceDirectors

Leadership1 Coding2 HIM Directors

Leadership1 Coding2 HIMDirectors

Leadership1 HIM & Coding Director

Leadership1 Director1 Asst. Director

HIM Traditional FHMMC – 2010

HIM Traditional FHMMC – 2012CFO

Associate VP of Finance

HIM Director, Local Compliance & Privacy Officer

HIM Manager

Scanning Team Leader

Scanning Technicians

Analysts Medical Records Technicians

Release of Information

Services (HealthPort)

Coding Manager

APC Coordinators

Coding Quality Education

Coordinator

Coders(Inpatient/Outpatient)

Transcription Manager

Transcription Quality Assurance

Coordinator

Transcription Technician

Transcriptionists

Sr. Administrative Assistant

Florida Hospital DeLand

HIM & Coding – 2018 5 HospitalsRegional Executive

Director of HIM & Coding(9)

Regional Asst. Director of HIM(15)

Health Care Documentation Quality

SpecialistRegional Trauma Registrar

HIM Analysts11

HIM Manager (18)

Document Imaging Lead

Document Imaging Specialists

5

Document Imaging/Recovery

Specialists10

HIM Sr. Administrative Assistant

Regional Coding Manager(32)

Coding Specialists17

Coders I7

Coders II8

Coding Coordinator Coding Quality Education Coordinators

3

APC Coordinators3

Workforce Reductions• Resignations

• Retirements

• Schedules

• Transfers

• $ Savings

FHFM FHD FHF FHMMC FHNS

9 4 3 1 5Mgmt. & Coding Contract

Have you ever heard this before?

Performance MeasurementBest Practices

Performance Measurements• Critical Success Report - daily

• HIM Scorecard – monthly

• Operational Review Report - monthly

• Turnover – monthly

• Q4B - monthly

Daily Monitoring Tool• Critical Success Report

Scorecard – Yesterday

Scorecard – Today

HIM Coding Scorecard Results2017 vs. 2018

Quest for the Best – HIM & DIC

Quest for the Best - Coding

Operational Review Yesterday

Operational Review Today

Operational Review Today - continued

Operational Review Today - continued

Change

Essential – Key RequirementsManagement Employees

Planning & Preparation Participation

Transparency Buy In

Communication Personal Commitment

Meetings Open Mind

Executive Leadership Support *** Initiative

Space Meeting Attendance

Turnover

Real Estate• Office space – reductions FHF

• Sharing – Workstations & Offices FHMMC

• Newly Renovated Office Space – Windows FHFM

• Construction – Office Sharing FHD

• Vacant Workstations & Offices FHNS

Health Information Management Scanning Centralization

Process Improvements• Lean process standardized

• Increased Productivity

• Reduced Work Hours

• Leadership

• Cross Training of Staff – E-F

• Reduced Space Requirements at

FHD, FHFM, FHF, FHNS

• Staff Reduction

Health Information Management Scanning Centralization

Potential Negative Impact• Staff Morale/Gallup• Potential Resignations• Night Shift Schedule• Limited Staff in the HIM Department at FHD, FHFM, FHF • Phone Tree Implemented at FHD, FHFM, FHF

Document Imaging Center SavingsCurrent Future Impact

Total PagesScanned/Year

3,118,156 3,118,156

Total Hours Worked/Year

39,860 26,104 13, 756

Labor Cost/Year $788,600.26 $516,448.50 $272,151.76

Equipment Cost 1st Year

$31,778.00 $31,778.00

CourierExpense/Year

$61,000 $61,000

Total Cost for 1st

Year$788,600.26 $609,226.50 $179,373.76

Total Cost After 1st

Year$788,600.26 $577,448.50 $211,151.76

Savings

• Director’s Salaries• Management Contract• Coding Contract• Workforce Reductions• Outsourcing of Transcriptionists• Outsource to M*Modal • Space Reductions

Certifications

• HIMMS Level 7 Stage 3

• Joint Commission

• Education

Leadership Impact Meeting Attendance• URMRC

• Medical Record Review – Performance Improvement

• Leadership meetings

• Employee Rounding

• Increased Travel

Change that Empowers Employee Satisfaction & Engagement

Performance Measurement

Performance Measurement

Performance Measurement

Performance Measurement

Performance Measurement

Performance Measurement

Gallup – Heat Map Results

Tenure

Employment Satisfaction/Engagement

2010 - 2011

2016 Heart Walk 2018 UCCE

Hanging in there with a Smile

What the Future Holds

Embracing Opportunities

• Closing the Gap - Concurrently

• Meaningful Use

• Data Analytics - Informatics

• Artificial Intelligence

Summation• Who We Are

• What We Have Done

• How We Validated

• Yes We Did and Yes We Are

• Forging Ahead & Embracing New Opportunities

Thank You!

Questions?