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Referral Ease Division of Medicine October 10, 2016
Maria Kamenos, VP Patient Access Cindy Zelis, MD VP Clinical integration
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Advisory Board
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Current State / Proposed Solution
Project Description: Create a frictionless integrated web and mobile application allowing patients to schedule their provider recommended new patient specialty referrals….. Current State: Complicated referral process results: Increased manual intervention Non scalable current process Incomplete orders Lower referral conversion rate contributing to “Leakage” Poor patient experience Potential patient safety issue and provider risk management Missed revenue Proposed Solution: Referral Self-Scheduling: Maximize Referral order capture Enhance clinical integration Patient Experience and Safety Better Consumer engagement Office Operation efficiency Integrated with UHNow Patient Mobile Application
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Referral Ease Committee
Executive Sponsors: Maria Kamenos, Dr. Cindy Zelis Clinical/Operations Members Dr. Drew Hertz -Dr. John DuMont Dr. George Topalsky -Brian Boardman Dani Chickerella -Deb Knox Deb Knox Change Management Members Jennifer DeFrancesco -Scott St. John Kelly Faciana IT Members: Craig Schwabl, Director Applications & Emerging Technology Andy Laytin, Manager IT Development Russ Heimovitz, Supervisor IT Development Marketing Members Caroline Emmet, Director Branding & Digital Strategy
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Referrals with UHNow Process Overview
Step 1: Physician Generated Orders (Promote Best Practice) Physician Driven/ AEMR Referral orders are always linked to a clinical condition.
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Referrals with UHNow Process Overview
Step 2: Interfaced with AEMR to display all orders; user selects which referral order to schedule and which provider: Options for provider choice will be based on Clinical Term match Appointment Availability Location/Distance
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Referrals with UHNow Process Overview
Step 3: When physician is selected, available slots appear for user to click and book. Confirmation screen appears last When Provider is chosen, all location options are visualized.
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Pilot Sites: Twinsburg Family Medicine
UH Cleveland Heights Primary Care Pediatric Services in Parma
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Project Timeline December 12: Pilot Launch
This is Referral Ease 1.0….Continued evolution of the product to schedule follow-up appointments as well as without physician orders will occur in evolution and adoption.
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Project Challenges / Risks
Areas of operational challenge/focus: Incorporating workflows into pilot practices Engagement across UHPS Operations and clinical providers in Primary Care and Pediatric office in process. 2) Operational Barriers Culture of Patient Scheduling (some departments do not allow Central Scheduling to schedule) Appointment Restrictions Culture of customer service if “wrong schedule” No blame Treat patient Do Not Bump
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AEMR Referral Order Assessment
103,000 August 2016 YTD AEMR Referral Orders 80% of the AEMR referral are in top 25 Referral Categories Assessment of each of the 160+ types of referrals based on Presence in Mobile App Phone number link vs. Direct Schedule Contact person to verify information and Template
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AEMR Referral Order Assessment
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Culture of Patient Scheduling Priority specialties for self-scheduling access
VOLUME of Providers to allow for Self-Scheduling access for referral ease PRIORITY based on anticipated demand/ volume as well as ease of electronic referrals HIGH LOW Cardiology Gastroenterology General Surgery Internal Medicine (location dependent) Neurology Otolaryngology General Peds (location dependent Dermatology Developmental Peds Endocrine Family Medicine (location dependent) Neurosurgery OB/GYN (location dependent) Pulmonary Rheumatology Urology Vascular Hematology/Oncology Peds Heme/Oncology Psychiatry Allergy/Immunology Genetics Infectious Disease Nephrology Ophthalmology Plastic Surgery Thoracic Surgery Priority 1
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Culture of Patient Scheduling Ex:MDFit– Cardiology “Warm Transfer”
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Positive Culture of Patient Scheduling is Limited by Appointment Restrictions MDFit - Ortho
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Appointment Restrictions:
For that same Search for Shoulder pain and location, the following “Restrictions” were buried within the individual providers, Will see shoulder and knee under the age of 60 Will not see “end stage arthritis” Please scheduled consecutively Last new patient at 11am and last new patient at 230pm
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Appointment Restrictions
Some other Examples: Must have MRI before see the patient Authorization and Cost control issues Only see “fresh nasal fractures” no more than 3-5 days old. Many “appointment restrictions” can be removed by maximizing the MD Fit profile…..Example: Orthopedic: Do not see neck, spine and neck ENT: no Ears, no General, Only sinus and nasal issues
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Culture of Customer service for “wrong schedule” Professional Courtesy and Education
Past: Central Scheduling or Physician office received punitive calls that things were scheduled “wrong”…has created “fear” by offices to schedule at POS Patients will be told “they were scheduled with the wrong physician” “Why did they send you to me” Future Professional respect and Education Patient treatment – no Bumping
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Action Plan UHMG Steering..Sept 2016 COO/Chairman meeting October 2016
Key Department Engagement: Cardiology, GI, Neurology, ENT, Pediatrics Specialty…October 2016 Division Chief Education including Pediatrics..October 2016 UHPS Operations integration…October Meetings with Directors and Administrators Additional Suggestions & Participants
