Guided Schedulingin Centricity™

BusinessCentricity LIVEMay 1, 2015

Orlando, Florida

2

TRACK OWNERS: ZINC INSTRUCTIONSPLEASE UPDATE THE CHART TO THE RIGHT BEFORE SUBMITTING THE PRESENTATION INTO ACTIVE

• Following review and approval in Active, each presentation given by GE employees or customers at Centricity LIVE must be approved through Zinc

• Jessica Diniz will be uploading each presentation into Zinc following Active review

• Before submitting this presentation in Active for review, Track Owners must select the appropriate answer to each Legal and Regulatory question

• ALL QUESTIONS MUST BE ANSWERED

• If further substantiation is required, please email the appropriate permissions, sources, or citations to jessicadiniz@ge.com so she can upload to the Zinc Gallery

• Once the presentation is approved in Zinc, please delete this slide from the final deck before presenting at Centricity LIVE

Individual Page Use?:Yes

Are all Uses and Applications Discussed or Referenced in the Proposed Material on Label for the Product?:

Yes

Relates to a Major new Product/Services Launch?:No

Includes Product or Service Claims, Features, Benefits or similar information?:Yes – from Design History File (in Gallery)

Contains Competitive or Comparative Claims?:No

Includes Return on investment (ROI), quantifiable cost of ownership, reimbursement, or meaningful use claim or reference?:

Yes

Include References to Market / Segment Share or Market / Segment Leadership?:No

Include identifiable Patient Information / Data?:No

If Customer Names are Used, are Necessary and Appropriate Permissions in Writing and on File?:

Yes – Permission to use on File (in Gallery)

Include Customer Testimonials?:Yes – Permission to use on File (in Gallery)

If any non-GE Stock Images are Used, are Necessary and Appropriate Permissions in Writing and on File?:

N/A

Do the Proposed Materials Contain Images of GE Products?: Yes

Do all Product Images Depict the Device(s) Being Promoted in the Piece?: Yes

This is a Translation of a Previously Approved Piece in Which no Changes Have Been Made?: No

This is a Revision of a Document Previously Approved for Ad / Promo Use?: No

Patient Access 2015 |Continuing the Climb

DISCLAIMER

The content of this presentation represents the views of the author and presenters.

GE, the GE Monogram, Centricity and Imagination at Work are trademarks of General Electric Company.

Patient Access 2015 |Continuing the Climb

Agenda1. Overview of The Emory Clinic & Patient Access2. Description of Guided Scheduling

– Question Guides, Appointment Sets, Rules– Implementation Process

3. Build Process– Department Engagement– Algorithm Development– Filtering Process

4. Operational Execution– Governance Model– Standardized Question Nomenclature– Efficiencies Gained

5. Reporting– Query Development in Caché– Question/Answer Level Statistics – Algorithm Changes Based on Data

6. Lessons Learned

Patient Access 2015 |Continuing the Climb

1,700 Clinical Providers 90+ Locations 2,670,000 Annual Visits

EMORYHOSPITALS

EMORYSPECIALTY ASSOCIATES

EMORYCLINIC

EMORYHEALTHCARE

EMORY UNIVERSITYWOODRUFF HEALTH SCIENCE CENTEREMORYSCHOOL OF MEDICINE

EMORYSCHOOL OF NURSING

EMORYSCHOOL OF PUBLIC HEALTH

YERKESNATIONAL PRIMATE RESEARCH CENTER

EMORYWINSHIPCANCERINSTITUTE

280 Clinical Providers 50+ Locations 480,000 Annual Visits

6 Hospitals 1,800 Beds 70,000

Admissions

EMORYHEALTHCARE NETWORK

7 Hospitals 1,400 employed MDs 400 private practice

MDs

OUR ORGANIZATION

Patient Access 2015 |Continuing the Climb

Named one of Atlanta’s Best and

Brightest Companies to work for in 2014

MAGNET HOSPITALS:ONLY HEALTH SYSTEMIN GEORGIA to achieve this standing

HOSPITALS INUniversity Health Consortium (UHC)TOP 25 in 2012, 2013 & 2014 22

EMORY HEALTHCARE

Patient Access 2015 |Continuing the Climb

PATIENT ACCESS ORGANIZATIONAL STRUCTURE

APPOINTMENT CENTER

ACCESS OPTIMIZATION

CAPACITYMANAGEMENT

PATIENT ACCESS COMMITTEE

SECTIONPHYSICIAN CHAMPION

CLINICAL LEADEROPERATIONAL LEADER (S)

ADMINISTRATIONMEDICAL DIRECTOR

CHIEF NURSING OFFICEROPERATIONAL LEADER (S)

CLINICAL CALL MANAGEMENT

ALAN KRAMERDIRECTOR,

PATIENT ACCESS

SARAH KIERASST. DIRECTOR,PATIENT ACCESS

SARAH KIERASST. DIRECTOR,PATIENT ACCESS

RAJANI BINUASST. DIRECTOR,

TELEHEALTH

Patient Access 2015 |Continuing the Climb

LIVE

2007 2013 IDEAL STATE

PATIENT SATISFACTION

29TH PERCENTILE

PATIENT SATISFACTION

73RD PERCENTILE

PATIENT SATISFACTION

99TH PERCENTILE

LIVE

PATIENT SATISFACTION 75TH PERCENTILE

2015

THE IDEAL PATIENT EXPERIENCE

Patient Access 2015 |Continuing the Climb

CONTACT CENTER

175

number of budgeted Patient Access Associates and Specialists

10,323

Average number of daily calls

received3:58AVERAGE CALLHANDLE TIME

PER RN PER DAY

114CONTACTS

16 inbound calls35 outbound calls63 EeMR messages

9number of budgeted RN ADVISOR FTEs

4.5%

30 MASTER SCHEDULE BUILDS/EDITS

150 DAILY SCHEDULE AND TEMPLATE BUILDS/EDITS

CONTACT CENTER

RN ADVSIORS CAPACITY MANAGEMENT

FIRST CONTACT RESOLUTIONSCHEDULING THE RIGHT PATIENT IN THE RIGHT SLOT WITH THE RIGHT

PROVIDER

ABANDON RATE

BRAND AMBASS ADORS

Engaged with 32 of 39

departments

7number of Capacity Management Architects

SERVICE LEVEL

78% ACCESS OPTIMIZATION

-Provide

guidance on

schedule build

-Optimize clinic

flow

A DAY IN PATIENT ACCESS

Patient Access 2015 |Continuing the Climb

Agenda1. Overview of The Emory Clinic & Patient Access2. Description of Guided Scheduling

– Question Guides, Appointment Sets, Rules– Implementation Process

3. Build Process– Department Engagement– Algorithm Development– Filtering Process

4. Operational Execution– Governance Model– Standardized Question Nomenclature– Efficiencies Gained

5. Reporting– Query Development in Caché– Question/Answer Level Statistics – Algorithm Changes Based on Data

6. Lessons Learned

Patient Access 2015 |Continuing the Climb

Description of Guided Scheduling

Question Guides: Series of questions that lead to either another question, a message, or the scheduling of an appointment.

Appointment Sets: Appointment scheduling based on two or more resource dependencies.

Rules: Pop-up in Centricity Business (either hard stop or soft stop) that is generated at the department, physician, patient, or visit type level.

Patient Access 2015 |Continuing the Climb

IMPLEMENTATION PROCESS Build Wiki (Online Content Database): Remove access barriers and physician

specific preferences.

Visit Types: Providers on teams need to have the same visit types allowing for maximum flexibility in team search.

Build Question Guide: Work with physicians and staff to put together the questions that drive towards specific end-points.

MD/Admin Review: Physicians and administrative leadership must provide final approval of the protocols prior to building in Centricity Business.

Staff Training and Adoption: Work with staff to understand the importance of using the tool. If needed, require usage to help adoption.

Patient Access 2015 |Continuing the Climb

EMORY CLINIC TRACKERSection Wiki Status Guided Scheduling Status

Targeted GSGo-Live Date

Visit Type Change

Ortho, Sports & Spine Complete Complete 8/31/2014 Complete

Gastroenterology In Use Complete 10/8/2014  Complete

Surgery - General Surgery In Use Complete 10/8/2014  Complete

Surgery - Plastic Surgery In Use Complete 11/13/2014 Complete

Rheumatology In Use Complete 11/20/2014  Complete

Anesthesiology – Pain In Progress Complete 12/3/2014  Complete

Endocrinology In Use Complete 12/11/2014  Complete

Nephrology In Use Complete 12/11/2014 Complete

Pulmonary In Use Complete 12/11/2014 Complete

Surgery – Oral In Use Complete 12/19/2014 Complete

Sleep Center In Progress Complete 1/28/2015 Complete

Surgery - Bariatric Surgery In Progress Complete 2/05/2015 Complete

Hematology In Use Complete 2/12/14 Complete

Dermatology In Use Complete 2/21/2015 Complete

Urology In Use Complete 3/16/2015 Complete

Surgery - Vascular Surgery In Use Built in test environment Late April Complete

Primary Care In Use MD/Admin Review Late April Complete 

Cardiology In Progress Initial question guide build TBD TBD

Infectious Disease In Progress Initial question guide build TBD TBD

Otolaryngology In Use Initial question guide build TBD Complete

Neurosurgery In Use Initial question guide build TBD TBD

Surgery - Surgical Oncology In Use Initial question guide build TBD TBD 

Gynecology & Obstetrics In Use Beginning in Late January TBD Complete

Ophthalmology In Use Beginning in Late January TBD Complete

CT Surgery Complete Not Started TBD  

Interventional Radiology In Use Not Started TBD  

Neurology In Use Not Started TBD Complete

Radiation Oncology In Progress Not Started TBD  

Patient Access 2015 |Continuing the Climb

Agenda1. Overview of The Emory Clinic & Patient Access2. Description of Guided Scheduling

– Question Guides, Appointment Sets, Rules– Implementation Process

3. Build Process– Department Engagement– Algorithm Development– Filtering Process

4. Operational Execution– Governance Model– Standardized Question Nomenclature– Efficiencies Gained

5. Reporting– Query Development in Caché– Question/Answer Level Statistics – Algorithm Changes Based on Data

6. Lessons Learned

Patient Access 2015 |Continuing the Climb

BUILD PROCESS Department Engagement: Have the right people in the room

who know all of the details about scheduling.– Physician, Resident/Fellow, Nurse, Technician, Secretary, Appointment

Scheduler

Algorithm Development: Use previously billed ICD-9 codes to drive decision tree branches.

Filtering: Each question should remove or narrow at least one of the following options:– Urgent triage, physician team, visit type

Patient Access 2015 |Continuing the Climb

SPINE SCHEDULING PROTOCOL

Patient Access 2015 |Continuing the Climb

DISPLAY WITHIN CENTRICITY BUSINESS

Patient Access 2015 |Continuing the Climb

Agenda1. Overview of The Emory Clinic & Patient Access2. Description of Guided Scheduling

– Question Guides, Appointment Sets, Rules– Implementation Process

3. Build Process– Department Engagement– Algorithm Development– Filtering Process

4. Operational Execution– Governance Model– Standardized Question Nomenclature– Efficiencies Gained

5. Reporting– Query Development in Caché– Question/Answer Level Statistics – Algorithm Changes Based on Data

6. Lessons Learned

Patient Access 2015 |Continuing the Climb

OPERATIONAL EXECUTION

Governance Model: Initial sign-off required from all physicians. All changes must be approved by the Medical Director and Administrator. Access Optimization team controls build and edits.

Standardized Question Nomenclature: All questions labeled in standard format with no repeat questions. Questions phrased as they would be asked to patient.

Efficiencies Gained: Staff can schedule across specialties (multidisciplinary scheduling). Required usage of guide for all staff. Scheduling errors have nearly disappeared.

Patient Access 2015 |Continuing the Climb

STANDARDIZED QUESTION NOMENCLATUREItem # Short Name Questions and Answers

Question 1 GEN SURG LOC 4 Where is it located?

Answers Liver or Pancreas/Colon or Rectum/Stomach or Esophagus/Gallbladder or Bile Duct/ Intestine, Bowel or Constipation/Fistula/Spleen/

Action

1.)Liver or Pancreas- Selection: Provider: Sarmiento MD, Juan Dept: 1002 / Appt: NEW / Instruction Note: No Scheduling 2.) Colon or Rectum- Action Type: 1/ attach question # 2 3.) Stomach or Esophagus- Action Type: 1/ attach question #7 4.) Gallbladder or Bile Duct- Action Type: 1/ attach question #9 5.) Intestine, Bowel or Constipation- Action Type:1/ attach question #10 6.) Fistula- Action Type: 1/ attach question 14 7.) Spleen- Selection: Dept: 1002 /Team: No Previous Surgery /Appt: NEW /Instruction Note: Two Providers

Patient Access 2015 |Continuing the Climb

Agenda1. Overview of The Emory Clinic & Patient Access2. Description of Guided Scheduling

– Question Guides, Appointment Sets, Rules– Implementation Process

3. Build Process– Department Engagement– Algorithm Development– Filtering Process

4. Operational Execution– Governance Model– Standardized Question Nomenclature– Efficiencies Gained

5. Reporting– Query Development in Caché– Question/Answer Level Statistics – Algorithm Changes Based on Data

6. Lessons Learned

Patient Access 2015 |Continuing the Climb

REPORTING Query Development in Caché: No pre-existing reporting function

for question guides. Emory worked with GE Healthcare to develop queries using Caché SQL. Queries can be edited to view data for specific departments, guides, questions and dates.

Question/Answer Level Statistics: Know how many times each question is asked and the frequency of each answer choice.

Algorithm Changes Based on Data: Determine if questions are specific enough to drive the right patient, to the right doctor, at the right time.

Patient Access 2015 |Continuing the Climb

QUERY EXAMPLE

Patient Access 2015 |Continuing the Climb

QUERY RESULTS

Patient Access 2015 |Continuing the Climb

QUESTIONS WITH RESPONSES

Patient Access 2015 |Continuing the Climb

OVERALL GUIDED SCHEDULING RESULTS Appointment Scheduled to Date using Guided

Scheduling: 32,000 Average Handle Time: 1 second decrease Errors – Orthopaedics & Spine

Metric December January February March

Appointment Type Error 19 16 1 7Incorrect Department/Provider

2 6 7 10

New Patients Scheduled 4,491 5,188 5,071 6,099Error Rate 0.5% 0.4% 0.2% 0.3%

Patient Access 2015 |Continuing the Climb

Agenda1. Overview of The Emory Clinic & Patient Access2. Description of Guided Scheduling

– Question Guides, Appointment Sets, Rules– Implementation Process

3. Build Process– Department Engagement– Algorithm Development– Filtering Process

4. Operational Execution– Governance Model– Standardized Question Nomenclature– Efficiencies Gained

5. Reporting– Query Development in Caché– Question/Answer Level Statistics – Algorithm Changes Based on Data

6. Lessons Learned

Patient Access 2015 |Continuing the Climb

LESSONS LEARNED Build questions/answers in Word prior to building in Centricity

Business. Use a standard naming convention for all question names in DBMS. Do not repeat any questions. Urgent patient triage should be incorporated into all guides as the

initial question(s). Ensure all previously billed diagnoses are accounted for in the

scheduling algorithm. Implement a standardized method for reporting potential scheduling

errors and transparent process for communicating results.

Patient Access 2015 |Continuing the Climb

Summary1. Overview of The Emory Clinic & Patient Access2. Description of Guided Scheduling

– Question Guides, Appointment Sets, Rules– Implementation Process

3. Build Process– Department Engagement– Algorithm Development– Filtering Process

4. Operational Execution– Governance Model– Standardized Question Nomenclature– Efficiencies Gained

5. Reporting– Query Development in Caché– Question/Answer Level Statistics – Algorithm Changes Based on Data

6. Lessons Learned

Patient Access 2015 |Continuing the Climb

QUESTIONS|COMMENTS

Alan Kramer, MPHDirector, Patient Access

Alan.Kramer@emoryhealthcare.org404-778-1778

Sarah KierAssistant Director, Patient AccessSarah.Kier@emoryhealthcare.org

404-778-7861

Gary GordonManager, PFS Project Office

Gary.Gordon@emoryhealthcare.org404-778-7028