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?