himss 12 solutions to hie sustainability

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Solutions to HIE Sustainability

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APP Design specializes in reducing the administrative costs of healthcare, building sustainable healthcare information exchanges and increasing patient participation through electronic consent. With more than 15 years of experience in healthcare IT, the company is well-versed in the development, programming and implementation of software. Its professional and development services guide its clients through these stages so they have accurate and up-to-date information to make the best decisions for their business. As an administrative companion to traditional clinical solutions for an HIE, APP Design’s RHIOnet solution connects patients, providers and payers to administrative and value-added services by serving as the community portal for all communications. Also, by utilizing Single Sign-On to access services such as E-Consent, Disclosure Tracking, Eligibility and Claims Status, RHIOnet lowers costs and reduces administrative burden, thereby lessening the burden placed on help desks, improving payment collections, reducing data entry errors and increasing workflow efficiency.

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Page 1: Himss 12 Solutions to HIE Sustainability

Solutions to HIE Sustainability

Page 2: Himss 12 Solutions to HIE Sustainability

Administrative Transactions

Community Portal & Single Sign-on

Provider Claims Inquiry

Provider Demographic Updates

Direct Connect Secure Messaging

E-Consent

Story Engine & Online Education

Password Management

Page 3: Himss 12 Solutions to HIE Sustainability

RHIOnet, an administrative companion to clinical solutions for an HIE, lowers costs, increases workflow efficiency and improves community adoption by shifting from manual to electronic formats in order to promote sustainability.

Page 4: Himss 12 Solutions to HIE Sustainability
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“The cost of healthcare administration in the U.S. was approximately $404 billion in 2009. Of these costs, about $150 billion was spent by payers and providers on billing and insurance administration-related activities.”

--Next Generation Healthcare Information Networks

Marlin and Associates 2010

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“It is clear that healthcare administration is where … employing advanced technologies can make significant contributions.”

--Next Generation Healthcare Information Networks

Marlin and Associates 2010

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X12 Administrative Transactions/EDI

Eligibility ● Claims ● Referrals ● Authorizations

Ease administrative burden.

Reduce data entry errors. Save money.

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X12 Transaction: Eligibility

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An APP Design client is one of 24 self-sustaining health information exchanges in the country1.

1eHEALTH INITIATIVE’s “2011 Report On HIE: Sustainability.”

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Using RHIOnet as the technology platform, provider organizations are increasing their revenue by $120,000 to $200,000 per month by having patient information up front, while the payers are saving millions of dollars in transaction costs.

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Direct Connect (Batch/Real-Time)

Direct Connect routes eligibility transactions from provider systems to multiple entities, supplying patient eligibility information to providers before services are rendered, guaranteeing coverage and streamlining the eligibility process.

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Direct Connect Batch Process

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One location with one password allows access to multiple sites and services, including an HIE, for increasing productivity, improving security and placing less strain on call centers, thereby saving users time and money.

Community Portal & Single Sign-on

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Community Portal & Single Sign-on

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One APP Design client reduced call center costs by nearly $20,000 and eliminated the need for $8,600 per month in communication costs. Combined, these efforts reduced their annual costs by more than $340,000.

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This feature shortens claims inquiries from 5 days to 2, saving provider time and increasing payer productivity by allowing staff to add attachments to facilitate adjustments and receive payments.

Provider Claims Inquiry

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Provider Claims Inquiry

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“HealthxNet has processed nearly 11,000 intakes through the provider inquiry application at only around a 25 percent adoption rate with plenty of room to grow.”

-- Joseph Speroni, VP, HealthxNet

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PDU eliminates calls and forms between providers and payers with online updates such as change in location, phone number, e-mail or tax ID number, saving money on postage and printing to promote sustainability.

Provider Demographic Updates

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One APP Design client estimates they save $80K yearly in postage by using RHIOnet versus sending reports through the mail.

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“Their rigorous approach to software development and depth of healthcare experience allows us to integrate new features and data feeds quickly and feel confident that they’ll run perfectly the first time, every time.”

-- Joseph Speroni ,VP, HealthxNet

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Referral inquiries by phone typically cost $12.50 each. When handled electronically through APP Design, they cost about 50 cents per inquiry.

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Password Management

The Password Management application permits authorized users “in house” to activate, deactivate or reset user passwords to lessen help desk dependency and create a secure and efficient workflow.

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Password Management

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One of our clients is expected to save $6.3 million per year by streamlining processes for patient transactions.

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Secure Messaging

Send confidential personal health information files to and from providers and an HIE securely and quickly while avoiding unsecured Internet communications.

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Markle Survey on Health in a Networked Life, January 2011

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Providing education for an informed consent decision and capturing consent at the point of care increases patient participation and drives community adoption in the HIE.

Electronic Patient Consent

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Electronic Patient Consent

As a single source of truth, patient consent decision is always up-to-date, making PHI available immediately for new encounters.

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E-Consent

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E-Consent Pilot Project

ONC/Department of Health and Human Services

Beginning with a survey, the e-consent pilot project’s goal is to garner a better understanding of the information patients need to make a meaningful consent decision.

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E-Consent Pilot Project

ONC/Department of Health and Human ServicesRHIOnet’s Story Engine will

then deliver multimedia educational content, and its e-consent functionality will capture patient signatures electronically.

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The Story Engine offers consistent, interactive, online educational material and demos for administrative tasks and services in order to reduce help desk calls and save money on training.

Story Engine & Online Education

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“It really is a pleasure working with APP Design because I trust that they will deliver what and when they say they’ll deliver. I’m realizing how unique that actually is for businesses these days.”

--Tom Unger, Program Manager WNYHealtheNet