Client background
The client is a healthcare system in the southern region of the U.S. that serves more than 150,000 patients and has nearly 200 hospital beds.
The business challenge
The healthcare system encountered several critical challenges that were adversely affecting their operational efficiency and revenue generation. Key challenges faced by the client included:
- Misalignment of preference cards with supply chain management
- High procedure cancellation rates
- Inaccurate revenue tracking
A primary concern was the inconsistent maintenance of surgical preference cards, leading to significant inefficiencies during procedures. The misalignment of preference cards resulted in the incorrect accounting of necessary supplies and instruments, causing surgical delays, potential risks to patient care and missed revenue opportunities.
In addition, the client was grappling with a high rate of procedure cancellations, which not only compromised patient outcomes but also exacerbated operational inefficiencies. These cancellations were primarily due to insufficient documentation required for surgeries.
Strategy and solution
To address these challenges, Baker Tilly implemented a comprehensive strategy grounded in a structured framework aimed at enhancing operational efficiency and revenue generation. The framework included:
- Repeatable, targeted processes: Established consistent processes to address ongoing operational issues.
- Comprehensive data-driven assessment: Conducted thorough evaluations of current practices to identify gaps and opportunities for improvement.
- Collaborative process for improvement: Worked closely with the client’s teams to identify and prioritize the most impactful areas for enhancement.
- Expert remediation planning: Leveraged industry experts to develop actionable plans that drive tangible results.
- Execution of approved recommendations: Implemented the agreed-upon strategies to ensure sustained improvements.
Baker Tilly undertook a meticulous review of the procedural items, item master setup and charge description master (CDM) to ensure data accuracy and completeness. The team also verified the functionality of the Epic Procedure Pass, focusing on enhancing data integrity and streamlining documentation processes—key factors in reducing surgical cancellations and improving patient safety.
Baker Tilly also conducted a detailed assessment of the client’s preference card maintenance strategy, ensuring alignment with clinical workflows and surgeon preferences. A regular review and audit process for preference cards was established to keep supplies and implants synchronized with procedural areas, thereby preventing delays in claim submissions and further boosting operational efficiency.
Optimizing the OR Electronic Medical Record (EMR) is essential for improving the efficiency, accuracy, and overall performance of surgical services, ultimately leading to better patient outcomes, increased compliance with regulatory standards, and heightened operational efficiency. The strategic approach and effective implementation by Baker Tilly yielded significant financial and operational improvements for the client. Over the course of the optimization efforts, the client achieved over $500,000 in bottom-line benefits. Moreover, the collaboration between Baker Tilly and the client’s revenue cycle team, OR Operations and IT teams ensured that the client could sustain these improvements independently. The client is now equipped with the knowledge and tools necessary to continue optimizing their OR EMR system, leading to ongoing enhancements in operational efficiency, patient outcomes, and revenue generation.