WHEN IT COMES TO financial and administrative workflow, hospital operations specialists say the key to success lies in understanding how machinery – both literal and figurative – can optimize productivity and minimize waste.
Judging from the current state of workflow in healthcare, however, experts say provider organizations are still climbing the learning curve.
In IT vernacular, “workflow” is a term that describes automating processes, ideally to make them more efficient. Although it refers mainly to the IT systems that handle the logistics of information movement, workflow is also a holistic concept designed to improve the collective aptitude of the organization.
The trick, experts say, is combining the right IT system with the right operational approach.
Joe Thear, vice president of product development for Reston, Va.-based QuadraMed, says “a lot of repetitive processes” hamper hospital administrative workflow, and executives need to examine how and where information circulates through the organization.
“What we’ve seen over the years is that processes go wrong at the front end and spread from there,” said Thear, pinpointing patient intake as the entry point for critical revenue cycle processes.
“So tools should be loaded upfront – accuracy at the front end ensures faster collections and reduces exposure to bad debt,” he added. “If you enable intake people to learn about why claims are denied at the back end, they can take the steps to correct things the first time. This sounds simple, but it doesn’t happen very often.”
Technologically, the system should “wrap rules and processes together” so users can detect anomalies down the line, Thear said, noting that clinical workflow systems have used this mechanism with great success.
“Clinical workflow systems have improved medication and care delivery, and the administrative side needs the same,” he said. “We are working to develop a system that is as error-proof as can be, and one that is timely and accurate so that problems can be corrected immediately instead of at the end of the month.”
Bruce Hallowell, partner with Falls Church, Va.-based CSC Consulting, approaches the workflow issue as one of “automating people instead of processes” and that “people shouldn’t be doing the computer’s work, the computer should be doing people’s work.” And while it’s an area that administrators may not have paid much attention to in the past, he recommends they promote it to the top of their priority list.
“They need to re-evaluate the process of how they do business every six months – it’s changing that fast,” he said. “And they need to understand the technology and how (it) interacts with the people who use it.”
Many financial managers are still techno-phobic about workflow systems, he said.
“Fear and a lack of understanding are at the heart of the problem,” Hallowell said. “But when people are afraid of technology in the financial area, they lack the savvy they need. They either depend on technology that is too old or they listen too much to vendors and get talked into buying systems that aren’t right for them.”
Hallowell says CFOs need to use a “value-based” approach to decision-making when it comes to workflow systems. “If there’s no value to it, why do it? It’s actually a simple solution,” he said.
There is no magic formula for evaluating and selecting the right workflow system, although familiarity with information deployment patterns can help, said Ben Tobin, senior consultant for Weymouth, Mass.-based Beacon Partners.
“You can see many good systems in any facility you go into, but the problem is they are different and they don’t talk to each other,” he said. “Some may communicate with each other on a certain level, but it’s difficult to bring all that information into a cohesive key indicator report. A billing system might track denial rates and collections, but the accounting system doesn’t tie the cash in the bank to it. There usually isn’t enough information at your fingertips to be a proactive manager.”
Although some vendors are offering enterprise-wide approaches that can collect and aggregate information from disparate domains, investing in such ambitious technology isn’t realistic, in Tobin’s view.
“There isn’t one single system out there that can serve every need,” he said. “Individual systems are added incrementally and become obsolete at different times. You have to live with the varied systems and need to have an IT team strong enough to understand what best serves the organization.”
Senior management also has a responsibility to facilitate better communications with the IT staff as well, Tobin said. Armed with clearly conveyed goals for financial and administrative workflow systems, the tech crew can best utilize its expertise to leverage results, he said.
“There is a line of demarcation between IT and operations, and it needs to come together,” Tobin said. “Operations has to lead, and IT has to serve in the supporting role. Through a well-organized joint effort, they can tie all the pieces together.”