CiBA Healthcare Blog

45,000 Excess Deaths Annually Linked to Lack of Health Coverage

By John Mangan, Cincom Systems

Hard To Believe

Here’s another frightening fact about the results of our current health system. Lack of healthcare insurance is responsible for more deaths in the US than either auto accidents or guns. Shocked? I was.
A Harvard study, published in the American Journal of Public Health, suggests that almost 45,000 Americans die prematurely each year as a consequence of not having insurance. Let’s put that in perspective by comparing it to some other US tragedies:

    • 37, 000  deaths annually  related to motor vehicle crashes 
    • 30,000  deaths annually related  to guns

The Harvard-based researchers found that uninsured, working-age Americans have a 40 % higher risk of death than their privately insured counterparts. Lead author Dr. Andrew Wilper, Washington Medical School, said, “The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors and baseline health. We doctors have many new ways to prevent deaths from hypertension, diabetes and heart disease — but only if patients can get into our offices and afford their medications.”

Interesting enough recently auto crash and gun related deaths have been coming down while deaths related to lack of healthcare insurance have been rising. Deaths resulting from lack of insurance are two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002.

A Cost of Not Reforming Healthcare

For me, Dr. Steffie Woolhandler, study co-author, put it in perspective when she noted in, “Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives.”

About the Author
John Mangan, Strategic Product Development, Cincom Systems. John Mangan is the Director of Strategic Product Direction for Cincom Systems. He has solved business problems through automation for manufacturing, financial services, and healthcare organizations for 20 years. Also, he is an active member of NAHAM and HFMA. For more information about how others are using intelligent guidance to “lean” the revenue cycle, please visit our case studies at http://intelligent-guidance.com
jmangan@cincom.com

 

 

Multi-Language Capabilities Even Easier in Cincom Knowledge Master

By Oscar Gonzalez, Cincom Systems

One of the great features already present in CiBA’s Healthcare and MiGuide technologies has been the ability to fully localize both the Administrator and User environments. We currently have fully supported English, Spanish, Portuguese, Japanese and simplified Chinese versions.

From now on, maintaining Intelligent Guides in multiple-languages will be made even easier. Administrators will only have to maintain one set of question trees. This Master Tree can be exported to an external file, for example an excel file, that can then be translated and imported back into Question Master.

This eliminates the need to maintain the logic in each language as a separate entity thus making the process even simpler and faster.

Oscar Gonzalez is the Marketing Manager for the Cincom Intelligent Business Applications group. For over 10 years he has helped develop solutions for customers in the financial services and healthcare markets both in Europe and the USA . Oscar is a member of the Chartered Institute of Marketing, NAHAM and HFMA. He can be reached on on his cell (UK) 07976722197 or via email at ogonzalez@cincom.com 

Automated Intelligent Guidance Helps Preventing Duplicate Records on MEDITECH Magic

By Oscar Gonzalez, Cincom Systems

One of the common problems across hospitals is that of preventing duplicate patient records being entered into the MEDITECH system. Patients are usually issued with a Unit Number which is unique to them and should help maintaining a cohesive view of the patient history.

However, patients tend to forget the Unit Number and this results in personnel with less registration experience, such as nurses or part-time registration officers, entering new registrations for existing patients.

Adding an Intelligent Guide to the Patient field in MEDITECH can help prevent this type of error. The Guide automatically takes the employee conducting the registration through a process of questions and answers to ascertain if the patient has already been registered. Even if the patient do not have the number at hand the Guide will provide the necessary guidelines on how to find the appropriate patient record.

The benefits of this simple but effective Guide are many: reduce registration times, eliminate the need for de-duplication, help identifying patients with a bad-debt history, and most importantly increase patient safety and the quality of the service provided.

Oscar Gonzalez is the Marketing Manager for the Cincom Intelligent Business Applications group. For over 10 years he has helped develop solutions for customers in the financial services and healthcare markets both in Europe and the USA . Oscar is a member of the Chartered Institute of Marketing, NAHAM and HFMA. He can be reached on on his cell (UK) 07976722197 or via email at ogonzalez@cincom.com 

An Expert Looking over your shoulder.............

 When processes are complex many of us wish that we had an expert looking over our shoulder guiding and helping us - but in a these times of financial turbulence few organizations can afford that luxury.

For most organisations reducing costs mean less people and very often training is an early casualty; the people who are left are expected to do more with fewer resources - and with less training.

This can seriously impact the business particularly when interactions with customers depend on specialist knowledge and processes.

Even today the systems in use at so many organizations require a high level of specialist knowledge - which means the users need training before they are really effective.

To overcome this problem requires creative thinking.  One solution is to develop decision support tools which sit alongside the application and guide the users through the use of the system.

For example the processes necessary to effectively register patients at U.S. hospitals require a high level of specialist knowledge and skill in using the hospital information system patient access screens.  It is often said that it takes three years to train a patient registrar and yet the average time in the job is only two years!  Even experienced registrars have a challenge in keeping up with changing requirements and new processes - such as estimating the cost and then how to ask the patient to make a payment for the treatment they are to receive.

One of the newest customers of our Automated Intelligent Guided Registration solution has built over 70 guides, alerts, prompts and question sets in their patient registration system.  This means that as the registrar is going through the process of registering a patient they have a Virtual Expert sitting at their shoulder.  This makes their job easier and for the hospital ensures that patient data is accurately collected and the interaction with the patient meets their compliance standards.

This is only one example of many systems which can be improved by using a virtual expert.  Any system which relies upon the user to input free form data where previously training has been necessary can be supplemented by the use of automated intelligent guidance.

 

 

 

Automated Guidance beyond Healthcare - A Contact Center Example

The use of Automated Intelligent Guidance goes beyond Healthcare. In this example you can see how it can be applied in a Contact Center environment to help agents provide recommendations.

Cincom MiGuide Short Demo in YouTube (High Resolution) - (takes around a minute to load).

Cincom MiGuide Short Demo in YouTube (Low Resolution)

A better hospital revenue cycle begins at registration

The registration process is often a critical area that is ripe for improvement and one that can have a significant impact in both patient satisfaction and the hospital's bottom line. Inaccurate information can lead to registration data errors, claim payment delays or denials and write-offs. A recent Press-Gainey survey revealed the top two factors that contribute to a patient's positive view of their health care experience: the speed of registration and the cheerfulness of the employees.

However, hospital registrars need to deal with an enormous level of complexity at the registration point: Determining the right insurance code, verifying insurance eligibility, providing and estimate of the cost, collecting patient co-pays, and so many other processes that have a direct impact on the hospital’s ability to get a timely payment for the services it provides.

Not surprisingly, technology providers are trying to respond to these challenges with ever increasingly powerful registration systems. One such solution, Automated Intelligent Guidance, allows registrar to be interactively guided through all the complex processes and to bring information together from previously disparate applications. Think of Automated Intelligent Guidance as having the best, most experienced, most knowledgeable registrar working 24 hours a day, 7 days a week at every registration point.

In the complex, dynamic, payer environment, change is a constant. Allowing registration experts to quickly modify and add new rules easily and graphically with little to no assistance from the IT department eliminates the time-consuming delays that are associated with application re-programming and re-certification. It also allows the implementation of new or changed processes, policies, rules, regulations and procedures in minutes rather than days or weeks.

Healthcare technology providers can enhance their existing products by embedding this functionality into their existing applications, and for healthcare facilities of any size implementing such a solution allows to increase revenue often during the first month the system is deployed. Claims that would previously have been delayed - or written off - are now paid promptly. And this has to be a critical deciding factor: A solution that will pay for itself many times over and, most importantly, the benefits can be realized during the first fiscal year, not years down the road!

Oscar Gonzalez is the Marketing Manager for the Cincom Intelligent Business Applications group. For over 10 years he has helped develop solutions for customers in the financial services and healthcare markets both in Europe and the USA . Oscar is a member of the Chartered Institute of Marketing, NAHAM and HFMA. He can be reached on on his cell (UK) 07976722197 or via email at ogonzalez@cincom.com

Prince William Health System moving to production

Prince William Health System (Manassas, Virginia) is moving to production with the first Revenue360 module. By the end of this month over 60 registrar workstations at the hospital will be fully operational with the Insurance Code Solution.

This module of Revenue360 uses Automated Intelligent Guidance to guide and prompt registrars to capture and sequence the correct insurance information with every registration. This results in reduced denied claims and an improved your revenue cycle.

Prince William, a MEDITECH Client/Server user, will see the new functionality seamlessly integrated with their existing HIS. This will keep the need for training to an absolute minimum and it will ensure that the benefits from the new solution are obtained from day one. They are delighted with the job of the implementation team and so are we!

Oscar Gonzalez is the Marketing Manager for the Cincom Intelligent Business Applications group. For over 10 years he has helped develop solutions for customers in the financial services and healthcare markets both in Europe and the USA . Oscar is a member of the Chartered Institute of Marketing, NAHAM and HFMA. He can be reached on on his cell (UK) 07976722197 or via email at ogonzalez@cincom.com

MUSE Conference in Manchester, England

by Chris Woodhead

As reported by Oscar we attended the MUSE event in Manchester England a couple of weeks ago. It was really interesting to listen to the excellent presentations and meet the other vendors who were exhibiting. There were quite a mixture of attendees from both the State NHS and the private sector. Also it was a great venue right in the middle of Manchester which is being transformed into a really cool city and the hotel is a great asset.

We had the opportunity to present our Automated Intelligent Guidance concept and although the Revenue Cycle is quite different from what we are used to in the US there was definitely interest in guiding registration and other staff through the complex processes which are ever present here - just as they are in the US.

We are going to follow up a couple of interesting discussions we had with both prospect customers and prospect partners – we will keep you updated................

Back from MUSE EU

Last week Chris and I visited the MUSE EU conference in Manchester. This was a really interesting experience that gave us the opportunity to learn a lot about the systems that hospitals use in Europe.

The most interesting finding was the fact that despite the differences between the US and European healthcare systems there is also a great deal of similarity. This is particularly true in the registration side of hospitals.

It seems that registration departments on this side of the pond face many of the challenges to which we are so used in the US. Complexity, lack of integration, training... We had the opportunity to present to a group of attendees and they confirmed that these issues are quite difficult to solve. In the next few weeks we will be meeting some of them to continue exploring.

We'll keep you posted.

Oscar Gonzalez

Origins of the Species - Automated Intelligent Guidance in HealthCare - part 1

Origins of the Species – Automated Intelligent Guidance in HealthCare (part 1)

The origins of Cincom CiBA in HealthCare stretch back to Grovewood Financial Management who were a UK based Independent Financial Adviser -  and a customer of Cincom.

The problem for Grovewood was simple; how to advise their customers about Investment Products with a simple to follow guidance process on their website which would give personalised advice and then enable them to make the investment on-line. The system needed to be friendly and easy to follow and give consistent advice.

The solution was complex; first, at the time - early 2000, no other automated advice systems had been authorised by the UK Financial Services Authority for direct use by the investing public so it was necessary to develop a new and robust system which would give compliant advice which could also be easily and quickly updated to reflect the rapid changes in the investment market and get it authorised! And second, the software systems available at the time were designed for development by those with good IT skills; who were definitely not those with the specialist investment knowledge needed to advise investors. Configuration technologies seemed the most suitable; they had after all been used in complex manufacturing!, so Grovewood embarked on a development programme and about three months later were the first Investment Advisor in the UK to offer automated personalised investment advice on the web!

Wind the clock forward a few years (well 6 actually) and what is the problem in US Healthcare (well – actually one of the problems) – how to guide registrars through the many complex processes to accurately and quickly register patients while using both the Hospital Information System registration screens and the third party systems necessary to verify insurance eligibility, ensure the correct insurance identifier is selected and the patient is made aware of any payment obligations – probably needing up to 8 different systems.....................

Using our experience of guided selling of investment products on the web (the Grovewood Team (with some additions of the best talent in Cincom were by then a part of Cincom and called CiBA) we set about solving the problem. First we got a basic understanding of what Automated Guidance was needed by the registrars to enable them to do their jobs more easily and efficiently, with no errors, and then we got an understanding of who had the “expert knowledge” and how we would capture that knowledge and get it into the Automated System. The result was the development of a brand new technology suite for Cincom called “Cincom Knowledge Master................................. and deployed at our first customers.

For how the story unfolds look out for Origins of the Species (part 2)

Chris Woodhead.