Case Study: How a large national health system deployed mobile technology to simplify query workflow for physicians

Challenge

An over 60-hospital national health system had many motivations for seeking a new physician query solution.

To begin with, the health system's inefficient query workflows were having a direct and negative financial impact. For example:

  • Significant dollars were on hold because of unanswered queries, costing the health system hundreds of thousands of dollars in interest per month.
  • Clinical documentation improvement (CDI) and coding staff spent inordinate amounts of time following-up on unanswered queries, and the cost was reduced productivity and the loss in additional charts that could be reviewed, queried on and coded during that time.
  • Most critical, low query response rates at many hospitals negatively impacted accurate quality reporting and full reimbursement.

From a technical perspective, the health system operates different EHR systems across the enterprise. Each EHR system supported its own unique query process for providers, CDI and coding staff. Therefore, there was no easy way to view or measure query activity across the enterprise. Further, CDI and coding staff tracked queries in different software systems, creating silos of information and hindering collaboration between the two groups.

Despite COVID, query workflow improved. Physicians reported high satisfaction with the easier process. CDI staff, who had been transitioned to working from home because of the pandemic, achieved even greater physician engagement and higher productivity by using the Artifact platform.

Perhaps the greatest challenge was satisfying providers. Providers were extremely unhappy about query workflow. They felt queries were time-consuming and interfered with patient care. As a result, the health system's average query response rate was less than desirable with significant room for improvement.

Lastly, an unforeseen challenge emerged. In March of 2020, the COVID-19 pandemic hit causing unprecedented upheaval for hospitals across the globe.

Solution

With various challenges and motivations, the large national health system had to find a solution that would fit their complicated environment and achieve the following goals:

  • An effective solution would need to sit across all EHRs, have a shared interface for CDI and HIM staff to collaborate on queries and be accessible to all providers across the health system.
  • Providers needed to find the technology easy and convenient so they would adopt it and become engaged in the query process.
  • Query volume, response rate and response time measures needed to be tracked accurately across the enterprise and show significant improvement to justify a financial return on improving the process.

The health system selected Artifact Health's HIPAA-compliant, cloud-based, mobile query platform because the technology checked all the boxes to be effective in their complex environment. Also, with many different EHR systems, the implementation and deployment approach would be critical to success. So, the health system valued Artifact's focus and strong commitment to customer support.

Results

The implementation kicked-off in early February of 2020 and the project team brought 20% of the health system's over 60 hospitals live on the Artifact platform right before COVID hit in mid-March. At that point, the project was paused for three months due to the pandemic.

Because of positive results from the initial group of hospitals, the health system made a decision to restart the implementation process in June, and by September all 60+ hospitals were live on Artifact.

The initial group of hospitals live on the Artifact platform before the pandemic hit demonstrated the following results:

  • Average monthly query volume climbed 36% by September due to efficiencies gained and the reduction in CDI time spent following up on unanswered queries.
  • Average physician response time was cut in half, down to less than a day. The vast majority of physician responses were coming in within the first hour from the time the query was sent.
  • Accounts on hold for these hospitals decreased by 69%.

Despite COVID, query workflow improved. Physicians reported high satisfaction with the easier process. CDI staff, who had been transitioned to working from home because of the pandemic, achieved even greater physician engagement and higher productivity by using the Artifact platform.

Summary

Without knowing it, the large national health system had proactively positioned themselves for the "new normal" setup by the pandemic:

  • They relieved providers of a time-consuming administrative task when providers need more time to care for patients.
  • They increased the productivity of hundreds of CDI and coding staff working remotely by giving them a tool that engages providers.
  • They put an effective query process in place to help financially recover from the disruption caused by the pandemic capturing proper and full reimbursement for services and reducing accounts on hold.
  • Finally, at a time when hospitals have a paramount public health responsibility to document and report patient data accurately and comprehensively, they collaborated with experts at AHIMA to provide a standardize compliant query template library to ensure high-quality, comprehensive clinical documentation.