The recent UAW strike draws on similar workforce concerns revenue cycle leaders have been facing with their staff for years: technology advancement.
While the recent United Auto Workers’ (UAW) strike is historic for many reasons, the union’s asks aren’t a far cry from the demands of the healthcare workforce.
One demand by the UAW, though, parallels an issue revenue cycle leaders have been facing with their workforce for years: wanting to know where they stand in the wake of technology advancement.
For context, the UAW is voicing its concern—along with better employment benefits and wage increases—over job security related to an increase in electric-powered vehicles that require fewer parts and fewer laborers. They want to make sure their jobs remain secure as technology advances. Who else is thinking the same? Your revenue cycle staff.
We know that healthcare organizations are embracing revenue cycle automation and AI at a fast pace, with executives seeing technology as a means of improving the quality and accuracy of tasks, reducing manual labor, and improving clinical and staff workflows.
In fact, automation in the revenue cycle isn’t an if, it’s a when, and each time you implement new technology in the department, it’s not improbable that your revenue cycle staff is questioning their viability.
While the concerns of your revenue cycle staff might differ slightly from the situation faced by the UAW, at a time when workforce retention is top of mind and nearly half of healthcare workers fear that AI could take their jobs, hospital leaders need to pay attention to these massive industry strikes.
Luckily, there are a few valuable lessons that hospital leaders can draw from in this labor dispute to protect their teams from the fears of job insecurity as automation and AI continues to take hold of the revenue cycle.
Create open and transparent communication
Leaders need to maintain open lines of communication with revenue cycle staff and address concerns about technology and AI encroaching in on their department. Be transparent about the organization's plans and reassure staff that technology is meant to complement their work, not replace it.
Invest in staff training
Demonstrate your commitment to employee growth by investing in continuous training and upskilling. Show that the organization values its employees' development and is willing to adapt to changing technology together.
In fact, advancing employees’ skills should be viewed through the lens of your business objectives. As upskilling and reskilling are increasingly part of the workplace conversation, business leaders need to approach these programs as far more than short-term soultions for staff.
Emphasize job security
Make it clear that while technology may change job roles, it doesn't necessarily mean a loss of jobs. Emphasize the importance of human judgment, empathy, and critical thinking the revenue cycle—skills that are not easily replaceable by AI.
On the front and back end, patients value the human touch in these interactions, and this will continue to be a critical aspect of the revenue cycle.
And as for critical thinking, coders or clinical documentation improvement staff often use these skills to query providers and report more accurately—something AI can’t do.
Make it known AI is a tool, not a replacement
Revenue cycle leaders implement AI and technology to enhance the efficiency and accuracy of revenue cycle processes, not to necessarily replace FTEs—so make sure your staff knows that is the intention. Showcase how these technologies can reduce administrative burdens, allowing them to focus on more strategic and patient-centered tasks.
Employ collective problem-solving
Engage staff in discussions about how technology can improve their workflow and address pain points. Encourage them to provide input and be part of the decision-making process when adopting new technologies.
Provide fair compensation and benefits
While there’s a fine line between competitive salaries and financial stability, leaders should ensure that revenue cycle staff receive competitive compensation and benefits. Address any disparities or concerns related to wages and benefits promptly.
Share the long-term vision
Share the organization's long-term vision for revenue cycle technology and how staff will be integral to achieving it. Make it clear that their roles will evolve and adapt alongside technology. Leaders also need to remember that revenue cycle technology is only as good as the human staff that runs it behind the scenes.
That all being said, incorporating these strategies can help revenue cycle leaders proactively address concerns among their staff. Leaders need to ensure a more stable and collaborative work environment, which will reduce the likelihood of future workforce issues due to automation and AI advancements.
Stuart Battersby, CFO of Firefly Health, a virtual, advanced primary care provider, chats with associate content manager Amanda Norris on the strategies it has implemented to improve financial outcomes and drive growth in a virtual environment and beyond.
OSF HealthCare is one of several health systems launching a virtual nursing program aimed at improving nurse workflows and addressing workforce shortages.
When OSF HealthCare encountered problems hiring nurses for its med-surg units, executives decided to launch a virtual nursing program to fill the gaps and improve nurse morale and efficiency.
"That's one of the hardest positions to fill," says Kelly George, the Illinois-based health system's vice president of performance improvement. "And we were seeing that a lot of our nurses [were dealing with] a heavy workload. We decided that we would try anything we could do to better support the staff that we have."
With workforce shortages across the board, from nurses to doctors to IT and support staff, health system leaders are leveraging a number of strategies to improve the workplace, reduce stress and turnover, and entice more people into the industry.
HealthLeaders is convening a select number of the industry's top decision-makers next week in Nashville to address clinical and financial approaches to workforce shortages. The two-day HealthLeaders Teams Exchange will feature panel discussions on four topics: Strategic workforce planning, recruiting and retaining clinical talent, workforce innovation and technology, and physician alignment and partnerships (including nurse staffing and scheduling).
Workforce stabilization, especially in the nursing ranks, is top-of-mind for many healthcare executives. According to a survey of about 780 healthcare professionals conducted in April by Joslin Insight on behalf of telehealth company AvaSure, the two most important metrics for chief nursing officers using virtual nursing platforms are nurse satisfaction and retention (86%) and improving the workload for current staff (82%).
OSF HealthCare is one of several health systems across the country to explore virtual nursing platforms to stabilize the workforce (among them are Jefferson Health in Philadelphia, Michigan-based Trinity Health, and Nashville's Vanderbilt Health, all of which recently announced new programs). George says OSF looked to other health systems for guidance and found that many are at the same stage of development.
"It's still very early for everyone," she says.
Indeed, inpatient telemedicine programs were popular during the pandemic, as health systems sought to separate infected patient populations from doctors and nurses to curtail the spread of the virus. Virtual platforms were also effective in monitoring multiple patients, rooms, or even departments from one location, like a nurse's station, giving hospital administrators a means of doing more with a depleted staff.
The challenge for healthcare decision-makers with these platforms is ROI. Telemedicine programs aren't exactly inexpensive, and CEOs and CFOs need to see the hard benefits to a new program before signing off.
At the Medical University of South Carolina (MUSC) in Charleston, officials tested a virtual nursing service about a year ago, says Emily Warr, MSN, RN, administrator for the health system's Center for Telehealth. That program was geared toward helping new nurses learn the ropes.
"We learned from that endeavor that it's not enough," Warr says. "It has to be much more complex and bring more value."
So MUSC pivoted, creating a platform designed not only to remotely monitor patients in their rooms but to help with administrative tasks, from charting in the EMR to onboarding and discharges. That program will debut soon in four of the health system's rural hospitals, where the nursing ranks are especially strained.
"This program can't just focus on workforce economics or quality [of care]," she says. "One is not enough. There has to be a quality component. We've got to impact patient care."
At OSF HealthCare, George says the virtual nursing program will be closely watched by executives, and that clinical outcomes have to be included in the ROI, alongside nurse retention and satisfaction.
"We recognize that we have to be able to show the value," she says.
Kelly George is a contributor to the HealthLeaders Teams Exchange Community. HealthLeaders Exchange isan executive community for sharing ideas, solutions, and insights. Please join the community at https://www.linkedin.com/company/healthleaders-exchange/. To inquire about attending a HealthLeaders Exchange, email us at exchange@healthleadersmedia.com
A pilot program in Maine is proving the value of a telemedicine network that links remote primary care providers with specialists.
An eConsult program launched in Maine last December has improved care management and coordination for several small, rural primary care providers, while reducing expensive and time-consuming trips to a specialist.
The Maine eConsult Network, a one-year pilot program developed by the non-profit MCD Global Health, now encompasses eight primary care organizations across the predominantly rural state. More than 500 specialist consults have been conducted through the virtual network in the past six months, officials say, with 70% of those eConsults resulting in continued care by the patient's PCP, just 25% leading to an in-person visit with the specialist, and 5% needing more information.
The program addresses a care gap plaguing healthcare organizations across the country. Access to specialist consults is difficult owing to the declining numbers of specialists and high demand for their services. In rural areas those specialists are few and far between, requiring patients to travel long distances for in-person visits. Urban areas may have more specialists, but scheduling an appointment can often take months.
An eConsult platform enables a primary care provider to send patient information through a telemedicine portal to a specialist, who reviews the case and can ask for more information, request an in-person visit or determine that the PCP can handle the case, perhaps even offering clinical decision support. The platform is designed to reduce unnecessary in-person visits and the stress they put on patients, while speeding up the treatment process and improving clinical outcomes. It also helps PCPs treat more of their patients, a key business metric.
Since eConsults are relatively new, many payers don’t reimburse for the service. That includes CMS, which this year began offering Medicare and Medicaid coverage in specific circumstances and is seeking data on the overall value of the platform. MCD received funding from the state's Department of Health and Human Services to set up the program, and an evaluation will be done by the Maine Rural Health Research Center at the University of Southern Maine.
Daren Anderson, MD, was one of the first to explore the value of eConsults with the Connecticut-based Community Health Center and the Weitzman Institute, where he served as director. He's now president of ConferMED, an eConsult company serving federally qualified health centers (FQHCs) in several states and the platform for the Maine eConsult Network.
“With traditional specialty consultations, complicated logistics, and tracking combined with limited access, especially for patients in rural areas, can result in delays and worse clinical outcomes," he said in a press release issued by MCD. "As an alternative, eConsults provide advice and guidance from specialists quickly and easily and reduces the need for face-to-face visits. This results in better care for patients and a better process for everyone. For most cases, it takes far more work to coordinate and track face-to-face visits than simply getting an eConsult from a specialist, and the eConsult often provides all that is needed.”
In Maine, specialty consults can be especially challenging. At Mount Desert Island Hospital (MDI) in Bar Harbor, doctors treat patients on several nearby islands as well as small communities along the rugged coastline.
“I work on an island, but sometimes, it feels like I’m an island and I don’t have specialty resources,” Natasha Neal, DO, MPH, a family medicine provider at MDI, said in the MCD press release. “Knowing that I can place this consult and have this conversation with a specialist makes us less isolated and better equipped to serve patients, especially when they otherwise will wait months to learn more.”
“It is often possible, via eConsults, to get guidance on what tests to order, help interpret results, and recommend medication,” added Jennifer Monti, MD, a cardiologist based in southern Maine who is part of the Maine eConsult Network. “These three core functions reduce the amount of time it takes for care plans to be executed, which means more efficient, less expensive care for patients, and the face-to-face visit with the specialist, if needed, can be more nuanced and higher value because the patient will be present with relevant testing already performed.”
Check out our featured stories and podcast for the week: The Exec: Physician Cultural Shift From Autonomy to Administrator Partners Hospitals are Focusing on the Benefits of New Ultrasound Technology...
Aalpen Patel, chairman of the radiology department at Geisinger, explains how point-of-care ultrasonography (POCUS) technology is revolutionizing imaging operations and improving both business and clinical outcomes.
Healthcare organizations are moving away from the bulky ultrasound machines of years past and embracing digital health platforms that make imaging more mobile and integrate directly with the EHR to improve care management and workflows.
One of those health systems is Geisinger, which today announced a partnership with medical imaging and software company Exo to streamline the mobile ultrasound process. The Pennsylvania health system is using point-of-care ultrasonography (POCUS) in its women's health, emergency, and sports medicine departments and plans to expand to more than a dozen other locations in the future.
The streamlining of inpatient services is on every executive's to-do list as healthcare organizations seek to reduce workflow stress on staff and clinicians, reduce hefty medical costs, and boost clinical outcomes through better data access and analysis. Medical imaging costs are a significant burden on a hospital's bottom line and an area ripe for innovation.
"POCUS is perhaps the single most revolutionary technological advancement in medicine in the last 30 years," says Aalpen Patel, MD, MBA, FSIR, chairman of the Geisinger's radiology department, in an e-mail conversation with HealthLeaders. "Its scope spans almost every specialty and exponentially extends the clinician's ability to make rapid diagnoses and guide many procedures safely."
"Historically, ultrasound was performed in radiology or cardiology, where in-depth, time-consuming studies performed by techs were then interpreted by a physician (not at the bedside). This often required the patient to be transported to another area of the hospital, which is problematic, especially if the patient is unstable. POCUS has significantly extended the bedside clinician's ability to rapidly answer important clinical questions about the patient and narrow their differential."
Aside from improving workflows and care coordination, the technology also impacts clinical outcomes.
"POCUS allows clinicians to rapidly diagnose or exclude life-threatening conditions at the bedside," Patel says. "It is also used for procedural guidance, making procedures significantly safer for patients. Having the ability to archive images and generate reports in a streamlined workflow allows other members of the healthcare team to view this data and make clinical decisions."
According to Patel, hospitals are turning to this technology for several reasons.
"First and foremost, using an enterprise POCUS workflow can improve the quality of care for patients," he says "It allows the ability to perform quality assurance on images. This data can be used for assessing clinician competency, helping with credentialing and privileging, and providing quality feedback for continuous POCUS skill improvement and education."
"It also allows health systems to collect previously uncaptured revenue for POCUS studies," Patel adds. "Creating a POCUS workflow and archive also provides a database for quality review and helps mitigate medicolegal risk. And it can improve ED and hospital throughput, decreasing procedural complications and high-end radiology utilization such as CT, MRI or Interventional Radiology."
On the other side of the ledger, there are challenges to adopting this technology. And in this turbulent economy the biggest barrier may be the cost. Imaging systems aren't cheap, and it's up to the CIO or radiology department head to connect the dots for the CEO and CFO between expenses and ROI.
"Sometimes it can be difficult to convince leadership that a standardized POCUS workflow is needed to ensure that POCUS is performed properly and safely," Patel says. "However, demonstrating the quality and safety benefits along with the positive ROI from both soft and hard revenues gained by investing in an enterprise POCUS workflow solution can help overcome this barrier."
Ther's also the challenge of integrating new technology into the workflow.
"Clinicians are extremely busy, and every extra click they are asked to make takes them away from direct, patient-facing care.," Patel says. "Ensuring that the POCUS workflow is streamlined and seamlessly integrated in the EMR can help overcome this barrier. These exams allow the clinician more time at the patient's bedside, and [the technology] has been shown to improve patient satisfaction and experience scores."
"Another challenge is the ability to standardize a POCUS workflow across multiple departments," he adds. "Different specialties have different needs and expectations from a POCUS workflow. Providing a flexible workflow with customizable reports can help overcome this challenge."
And finally, Patel says, it's important to have resources on hand to educate staff about how to use the technology.
"Some specialties have POCUS education embedded in their residency and fellowship training curriculum, but others do not," he says. "Providing attending clinicians with educational and training resources including internal courses, didactics, image review sessions, and hands-on training sessions and simulation can help overcome this challenge. Fortunately, POCUS is being incorporated into not only residency and fellowship training but in many medical school curriculums."
A lot of the potential around this technology lies in its mobility. As health systems look to move more services outside the hospital and closer to the patient—be it in the home, a community health center, a remote clinic or doctor's office or even an accident scene—mobile ultrasound platforms are showing their value for providing on-demand care.
"POCUS technology and workflow is evolving at light speed," Patel says. "In the last 10 years these machines have transformed from large, clunky, cart-based machines with suboptimal image quality to compact and handheld units that can be taken to almost any environment inside or outside the hospital. Many newer machines are equipped with Wi-Fi capabilities, wireless technology, significantly improved imaging quality, and various Doppler technologies. Many of the newer devices have built in AI/machine learning [capabilities] that allow for auto-labeling and auto-calculations, and they can direct novice learners to the correct scanning plane and beam angle. And POCUS workflow reporting from various vendors allows mobile reports to be generated on iPhones, iPads, and android devices with a few swipes of the finger."
The recent flurry of collaborations between healthcare organizations and Big Tech is a good sign that health systems are finding their footing in AI development.
Healthcare organizations are joining forces with some of technology's heaviest hitters to push AI projects out of the planning stages and into the hospital.
The announcements are, in part, an effort to get in front of the AI hype machine and demonstrate that health systems are putting this technology to work to improve critical issues like workforce stress and administrative overload. The industry doesn't want to repeat the missteps of the EMR rollout, when news stories about bad experiences overwhelmed talk of the positives and hindered EMR adoption and development.
In just the last month:
Mass General Brigham announced the rollout of an AI algorithm for radiology "that will help increase operations' effectiveness and productivity." The technology was developed in a partnership with GE HealthCare, which agreed to a 10-year collaboration in 2017 "to explore the use of AI across a broad range of diagnostic and treatment paradigms."
HCA Healthcare announced that its partnership with Google, forged in 2021, had led to the pilot of an AI platform to document emergency department conversations between doctors and patients, and that the two were now testing an AI tool to facilitate nurse handoff reports.
"Everyone's trying to get ahead of it," says Avishkar Sharma, MD, CIIP, director of AI at Jefferson Einstein, part of the Philadelphia-based Jefferson Health network, which has been working with Aidoc in the radiology space for several years and is considered a leader in that space. "It's an ever-present conversation [in every health system boardroom]."
At the AIMed Global Summit this past June in San Diego—as well as other healthcare conferences like ViVE and HIMSS—the focus on AI was around what many call "low-hanging fruit." To wit, healthcare organizations are looking to use the technology to handle administrative tasks that consume time and energy for staff, including doctors and nurses.
"That's the immediate benefit," says Stephen Motew, MD, MHA, FACS, executive vice president and chief of clinical enterprise at the Virginia-based Inova Health System. "Where are the small, value-added opportunities in our day-to-day operations … that can be made more efficient?"
Indeed, while questions remain around AI governance and policy, health system executives who want to get their foot in the door are launching small programs that use tightly controlled, non-PHI data, finding the benchmarks and the benefits, then moving on to more ambitious projects.
Sharma fits AI adoption into the Gartner Hype Cycle, which charts the maturity, adoption, and social application of technologies. The five stages of that cycle are Innovation Trigger, Peak of Inflated Expectations, Trough of Disillusionment, Slope of Enlightenment, and Plateau of Productivity. He says AI has moved beyond that first stage and sits between the second and third, with health systems looking to find meaningful value beyond the hype and potential.
"We're very much in that turbulent phase," he says.
And that's why these recent announcements are important. They show that health systems are putting skin in the game and moving forward with pilot projects.
Motew says these partnerships are also important at a time when operating margins are thin and health system leaders are hesitant to take on new ideas. Few health systems have the IT talent on hand to make these moves on their own or scale them out to the enterprise.
Furthermore, these partnerships support health systems who are moving their data into the cloud and need help with cloud management.
"This is what everyone is trying to figure out now," he says. "And we want a seat at that table."
Sharma says partnerships are essential to developing and scaling AI programs across the enterprise, but they also have to be nimble. Owing to the evolving nature of the technology, an AI program created now that will use a specific subset of data to address a specific pain point won't be the same program in, say, a year's time. The technology, the data, and the governance around it will mature dramatically.
"You have to build relationships that are ongoing," he says.
Lastly, AI programs coming down the pipeline need to be guided by clinicians. Both Motew and Sharma also say that while the C-suite needs to set safeguards and parameters for AI use, the true value of the technology will be found by those using it.
"We encourage our teams to play around with it," Motew says. "The best ideas are going to come from the people using it every day."
"Clinicians very much need to be in the conversation and in the driver's seat," adds Sharma.
HealthLeaders editor Melanie Blackman is once again joined by Maxine Carrington, the chief people officer at Northwell Health. In this special episode commemorating HealthLeaders Worforce Week,...
The health system is reporting positive results from a chronic care management program launched in 2021, and now wants the Geek Squad to manage more patients at home.
Geisinger is expanding its partnership with Best Buy Health to bulk up a remote patient monitoring platform that’s showing positive clinical outcomes.
The Pennsylvania-based health system launched ConnectedCare365 in 2021 and joined forces with the retail giant's Current Health subsidiary to give patients better access to chronic care management tools at home. According to health system officials, the program has enrolled more than 1,100 patients and is seeing an almost 20% improvement in care plan adherence, while speeding up the time patients begin the program after leaving the hospital and cutting technical issues by almost 20%.
The collaboration is being closely watched by the healthcare industry as more health systems move care pathways into the home and RPM programs show results, particularly in managing care for patients living with diabetes, congestive heart failure, chronic obstructive pulmonary disease, hypertension, and other issues.
The partnership enables Geisinger to refer patients identified in the hospital for RPM to Current Health, which visits the patient's home, sets up each patient with the right equipment for the program and ensures the devices are transmitting data to the care team at the hospital. Through the 'Geek Squad' format made popular by Best Buy's retail electronic and computer departments, Current Health keeps in touch with patients and helps with any technical issues.
"We know the myriad benefits of care at home for patients, families, and the health system, and the Current Health platform allows us to care for patients with chronic diseases in the home," Karen Murphy, Geisinger's executive vice president and chief innovation officer and founder of the health system's Steele Institute for Health Innovation, said in an e-mail to HealthLeaders. "In addition, working with the Geek Squad is a fundamentally different approach to a remote patient monitoring program. Instead of a patient receiving devices in the mail, the Geek Squad provides personal instruction on how to operate the device and how to communicate with the care team."
"Best Buy Health and their large supply chain and logistics capabilities offered a very promising solution for us," she added. "We’ve seen great results so far and are excited to expand the program to more use cases."
This isn't Best Buy's only partnership. Earlier this year the retailer joined forces with Atrium Health to support the North Carolina health system's Hospital at Home program. At the HIMSS conference in Chicago shortly thereafter, Chris McGhee, Current Health's co-founder and CEO, said the deal is indicative of a healthcare industry looking to be more consumer-friendly and apply some retail strategies to its platforms.
"We're fundamentally changing healthcare," he said, noting the Best Buy can pick and choose the technology needed to make the best and most reliable connections between a patient in the homes and his or her care team at a hospital. "Hospitals value that curation."
That's especially true as health systems like Geisinger expand their RPM programs to manage more patients with more health concerns. The ability to scale programs up and out and have Current Health manage the technology deployment and monitoring takes pressure off of health system executives and clinicians, giving them more time to focus on the clinical side of the program.
"Technology-enabled care-at-home programs allow us to extend their reach beyond the confines of traditional settings and bring high-quality care directly to the comfort of patients' homes," Murphy said. "These models have been shown to improve outcomes—especially readmissions—and provide more comfortable experiences and lower costs."
"Our work with Best Buy Health allows us to better cross the threshold into patients' homes and, through the Geek Squad, enable them to use RPM technology," she added. "The data shows the impact on the patient – they are getting the technology faster, adhering to their care plan better and having fewer technical issues. And they’re giving their experience high marks afterwards."
A new partnership will open primary care clinics in select YMCAs around Memphis, offering more convenient access to care for local neighborhoods as well as businesses.
A new partnership in Memphis aims to address local businesses' needs for primary care access for their employees as well as access to care in underserved neighborhoods.
Chamber Benefits, a health plan subsidiary of the Greater Memphis Chamber of Commerce, is joining forces with the YMCA of Memphis & the Mid-South and WeCare, a Florida-based provider of onsite and near-site primary care centers for businesses, to open primary care health centers in YMCAs across the greater Memphis area.
The project addresses an acute care gap in many cities: A lack of accessible primary care services for both businesses looking to get a handle on employee healthcare costs and underserved neighborhoods. Some cities have partnered with community health organizations and others to put health clinics in such sites as libraries, retail locations, and pharmacies or grocery stores.
The goal here is to improve community health as well as support local businesses. It also aims to reduce the strain on local health systems by improving access to immediate and preventive care and cutting down on unnecessary emergency room and clinic traffic.
Each 2,500-square-foot clinic will have full-time staffs that include primary care physicians and health coaches.
“This is a partnership united by its love of Memphis and desire to see greater access to primary care throughout our community,” Ted Townsend, president and CEO of the Greater Memphis Chamber, said in a press release. “ChamberCare Health Centers are designed to improve not only the health of our community but of our economy. Enrolling in this program will help small businesses, which create two out of every three jobs, provide their employees with exceptional benefits at low costs in a highly competitive jobs market.”
“This partnership perfectly aligns with our mission to support programs that build a healthy spirit, mind, and body for all," added Jerry Martin, YMCA of Memphis & the Mid-South's president and CEO. Providing access to quality healthcare, especially in areas with fewer options, enables us to broaden our services to continue to help families and individuals thrive on their journey to wellness.”
Organizers are currently deciding on three sites to open health centers, beginning in 2024. Businesses can enroll employees in the program for $40 per month per employee, while community residents can also enroll for $40 per month. Dependents are added on at no charge.
Following the opening of the first health centers, the partnership will open a new clinic in another YMCA location for every 2,000 people enrolled in the program, including dependents.
