Answers for a Healthier World

EHRs have profoundly impacted the healthcare industry. The EHR was initially seen as a way to digitize the patient’s chart and record, but by doing so EHRs have impacted the healthcare industry through the exponential increase in the amount of data that is now available to clinicians. The healthcare community is at the early-stages of trying to figure out how to use this onslaught of data to change and improve patient care. Organizations are trying to leverage the EHR as a database, not only for quality improvement and safety, but also for general population health.

Strategic planning is essential in healthcare- particularly when implementing and operationalizing an EHR. One key extension to proper strategic planning is project and portfolio management. According to the Project Management Institute, 89% of high-performing organizations value project management and 81% of high-performing organizations actively engage sponsors.  An overall Portfolio Management Framework, however, is a necessary component to effective project management since it can instill a programmatic but practical approach towards implementation and optimization initiatives. To sum it all up, portfolio management helps projects align with overall enterprise strategies.

A regulation-based, seismic change recently hit the healthcare industry. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), a Medicare payment reform, went into effect January 1, 2017. MACARA and the associated Quality Payment Program (QPP) regulation will shift the reimbursement model from a straight fee for service model to a more comprehensive value-based framework.

Understanding and optimizing the revenue cycle is not easy. There are so many activities and steps pertaining to all administrative and clinical functions within healthcare, that the ability to capture, manage, and collect patient service revenue can seem daunting. Gaining an effective capability to do so requires that healthcare providers achieve revenue cycle readiness by examining and mapping each step from patient admittance to the release of their final bill. Each step in between represents a piece that leads to a complete revenue cycle. Successful and profitable healthcare institutions often have a firm grasp on every individual step, including visibility into the revenue cycle as a whole.