How to Make an Impact in the First 100 Days as a New CIO

Starting as a new healthcare CIO, you quickly need to get beyond the optimistic view of your new information technology domain gleaned during your interview process. Wise CIOs take a page from corporate and national leaders and arrive on day one with a plan for how to reach day 100 with a deep awareness of the IT organization you manage, a solid plan with broad acceptance to achieve the corporate strategic goals, and some quick wins already delivered to your stakeholders.

Why 100 Days?

Three months is generally regarded as a reasonable “honeymoon” period for a senior executive to absorb their new organizational environment and be ready to deliver results. The additional ten days provides a measure of extra time to secure buy-in from your stakeholders and communicate your plans broadly to the organization.

How Should You Organize This 100-day Orientation to the New Job?

  1. Devote time and attention to determine the strengths, weaknesses, opportunities and threats of your IT organization. Document current state and incorporate the subjective impressions of your employees and your superiors.
  2. There will be urgent and highly visible issues that require action within a critically short timeline. Determine what you can postpone for deeper analysis and identify actions that can quickly resolve users’ pain points in less than 100 days.
  3. Build your initial IT strategic plan to address the gaps between the current state of IT and a desired future state vision driven by the needs and strategic goals of your organization. Develop alternative approaches to achieve this vision including clear costs and benefits, communicated effectively to the management team.

First 30 Days: Face-to-Face Engagement is the Key Activity in This Timeframe

  • Meet with key members of (non-IT) management. Start with senior executives and medical staff leadership. Ensure that you understand their role in the organization, how they interact with IT, what some of their recent requests have been to IT and how these have been resolved. How can IT help them achieve their strategic vision? What would they consider their most urgent or repetitive IT needs? Prepare questions that are tuned to the individual’s role but also listen to what they want to share. Find out which people in their line of report you should follow-up with.
  • Meet with IT staff, beginning with managers and supervisors. In addition to your regular management and section meetings, meet one-on-one. Seek out issues they wrestle with, whether it involves systems, processes, or people. Review recent performance evaluations, specifically if any behavior or skill gaps are not being properly documented.
  • Become familiar with the organization’s strategic and tactical plans currently in place. Evaluate plans that exist in terms of concurrence with overall organizational goals.

60 Days: Assess Your Systems and Infrastructure Environment While Continuing to Fill in Information About Staff and Shareholder Needs

  • Perform or engage a complete technology assessment
    • Network infrastructure, databases, workstations, data center capacity, etc
  • Evaluate service delivery levels
    • Help desk performance, systems reliability, implementation history, service level agreement review, etc
  • Review budgets (planned vs. actual performance)
  • Develop fast action plans for the urgent, simple issues and begin implementation

90 Days: Transition From SWOT Assessment to Tactical Plan Development

  • Test your perceptions of enterprise SWOT findings with other senior managers
  • Draw up a desired state of IT to meet the enterprise’s current and anticipated needs
  • Prepare a comprehensive gap analysis between the desired state and the current IT assessment
  • Prepare alternatives to address the gaps utilizing peer group, department staff, and expert input. Develop implementation detail around these alternatives
  • Review a draft of the gap summary and tactical plans with senior management including budget costs, KPIs, and benefits expected
  • Review execution of the fast action projects (be sure they are on-track for completion and user goals are being met)

Final 10 Days: Polishing the IT Strategic Plan and Communication

  • Develop an executive summary, describe the evaluation and planning process
  • Define an IT architecture blueprint with guiding principles for future decisions
  • Present tactical alternatives with narrative of the pros/cons of each item in terms of cost, time, and impact on business strategy
  • Describe implementation requirements, including the timeline to accomplish the alternative recommendations
  • Propose realignment of staff to accomplish tasks and define when these changes would need to occur
  • Detail changes to service levels and service delivery


Congratulations! You have arrived at day 100 with your research completed and the tools in hand to be successful in your first year as a new CIO. Now it is time to execute on the IT strategic plan, deploy and motivate IT staff to meet your goals, and monitor progress on meeting your users’ needs.

Executive Consultant-Culbert Healthcare Solutions


Leveraging Best Practices to Optimize Your Enterprise Reporting Strategy

Data and reporting have become an integral aspect of healthcare operations from both a clinical and non-clinical perspective. With the widespread onset of EHR platforms, clinicians now have access to powerful data sets that serve as catalysts for better clinical decision-making. Hospital operators are also able to take a deeper dive into potential clinical inefficiencies and make better business decisions, which ultimately helps improve the organization’s bottom line. With the plethora of reporting solutions and reporting tools at the stakeholder’s fingertips, how can an organization leverage enterprise reporting best practices to ensure that key personnel have access to the right data at the right time?

 Many EHR platforms offer a set of canned reporting solutions out of the box upon installation; however, these reports may not be as robust as needed leading to new report requests. Leveraging the implementation of a structured report request process will help ensure your stakeholders receive a reporting solution that meets their needs in a timely manner. Often, report requests are received in the form of an email with minimal information provided, thus failing to provide the report developer with adequate information to begin development. Consider creating a user-friendly and fillable .pdf form using questions written in non-technical terms that can be distributed to stakeholders and utilized as a discovery document for your reporting solution.

 Defining roles and responsibilities of your reporting staff can also assist in ensuring that your reporting solution is delivered in a timely manner. For example, a reporting coordinator can triage report requests as they are received and provide useful input so that the request is assigned to a developer with an appropriate skillset. Alternatively, if your organization utilizes a service desk platform, report requests can be assigned to a pool of developers and categorized based on the classification of the request (Eg: Inpatient, Ambulatory, Revenue Cycle). Lastly, leveraging the knowledge of your application analysts to assist in report request triage and initial discovery can prove to be of great assistance to report developers as they move forward with report development. Often, the application analysts are better versed in the specific data sets and can interpret the request with the correct context. The coupling of their expertise with the report developer’s technical knowledge can drastically improve turnaround times while mitigating the likelihood of errant data in a report.

 Creating an organized and user-friendly manner for distributing various reporting solutions is an integral step in the optimization of your enterprise reporting strategy. This process often requires analysis of your current user and security build to ensure that the proper groups of users have access to view and run reports related to their job function. Additionally, leveraging metadata to ensure that reports are properly categorized will provide greater accuracy in search results should stakeholders query your reporting library.

 Lastly, development of curriculum and training on various reporting tools for your stakeholders will tie together several of the critical elements of a successful enterprise reporting strategy. As we move in to the next year, many EHR platforms and organizations are placing a strategic focus on putting the power of the data in the hands of the stakeholder. For this to come to fruition with long-lasting effect, a clearly defined education and training initiative should be considered as you move forward with optimization of your current-state reporting strategy.


EHR Capture of Outpatient Evaluation and Management Services

Electronic health records (EHRs) have now been implemented in the vast majority of physician practices in the United States. As a certified coder, auditor and physician educator I’ve been actively involved in this process for years.  Healthcare is without question evolutionary.  But the implementation of EHRs is one of healthcare’s greatest revolutions affecting both the clinical and business aspects of medicine.  As an example, let’s take a look at how EHR implementation has affected outpatient Evaluation and Management (E/M) services.

E/M documentation, coding, charge capture, audit and the related follow up education have all been deeply affected by the implementation of EHRs. Healthcare continues to shift away from inpatient to outpatient services and payment methodology continues to shift from fee-for-service to risk and quality of care based reimbursement.  Additionally, physician practices are being incorporated into facilities.  Given these circumstances it is important to appreciate history as we consider the future so that we are poised to address change effectively.

Not so long ago a physician would see a patient, document the encounter by hand-written note or dictation and enter procedure and diagnosis codes onto a hard-copy “superbill”. A qualified (hopefully!) medical coder reviewed documentation and physician coding for each encounter.  Ideally, coders and physicians collaborated to address any documentation and physician coding discrepancies and finally a compliant claim would be generated.

Today most physicians document E/M encounters and assign codes using EHRs. Most EHRs include a billing interface that generates claims automatically based on coding assigned by the physician. At best, a qualified coder spot checks for documentation and code assignment discrepancy, but the expectation is that physicians document comprehensively and assign codes accurately.  Of course, a well-run practice also has an audit schedule in place, with effective follow-up education, as part of its compliance plan.  Ideally coders and physicians work collaboratively toward compliance and revenue maximization but even the most robust audit schedule reviews only of fraction of encounters for which claims are generated.  Clearly, much is expected of physicians.  There is no longer a coder acting as a “filter” through which documentation and coding passed prior to claim submission.  For this reason it is imperative that physicians have a deep understanding of documentation/coding guidelines and the technological knowledge that allows them to use the EHR most effectively.

Most EHRs have tools that prompt physicians to capture E/M key components and their elements. However, E/M compliance and revenue maximization still requires that physicians:

  • Know the E/M guidelines
  • Understand that medical necessity must drive the level of E/M service
  • Know how to appropriately score E/M services and assign procedure codes
  • Know how to use the EHR effectively to document only accurate, applicable and meaningful content

Of course all but the last bullet were important considerations prior EHR implementation.

Another issue emerging related to outpatient E/M services is diagnosis coding. While accuracy is important, historically diagnosis code assignment for E/M services has not been a reimbursement consideration.  However as physician payment models shift from fee-for-service to risk and quality of care reimbursement, it is essential that documentation and coding include more robust information related to illness severity and comorbid conditions.  Of course the adoption of ICD-10 allows for capture of greater diagnostic detail but along with this detail come more complex code assignment guidelines.

Since the implementation of the Diagnosis Related Group (DRG) payment methodology for inpatient services in the 1980s, clinical documentation improvement (CDI) efforts have been established to optimize capture of illness severity and comorbidities.  One of the advantages to facilities incorporating physician practices is that these institutions have clinical documentation optimization experience.  Still, outpatient healthcare has its own unique set of guidelines that must be learned by CDI specialists and then taught to physicians.  It is also important to note that, while physicians are expected acquire documentation skills that optimize inpatient code assignment, they are not required to actually assign the codes.  As the importance of diagnosis code assignment increases for outpatient services it will be interesting to see where responsibility for code assignment falls.

Healthcare is continually evolving. The EHR itself influences some aspects of this evolution while assisting with other aspects of it.  Innovation and flexibility have always been and will remain key to a successful healthcare delivery system.


Translating EHR Training Into Improved Revenue Cycle Metrics

Technology continues to drive mankind forward in ways unheard of from when the great millennium occurred in 2000! Who would have thought that we would be tied to our smart phones, performing a myriad of functions that once took precious hours of our time? Now, we do online banking, book air travel, hotels, rental cars, and many other daily tasks regardless of where we are!

These same technological advances have, in so many ways, impacted the healthcare industry too. And, arguably, the largest invention has been the creation of the Electronic Health Record (EHR). So, it stands to reason that most of the healthcare institutions have either implemented, or are in the process of implementing the latest and greatest EHR system for clinicians to record, track and share critical medical record information regarding their patients.

The installation of EHR systems may run into the millions of dollars. Often, they are integrated, or interfaced with Billing Accounts Receivable (BAR) systems to provide the tools needed for submitting claims cleanly, and in a timely fashion, for prompt payment. After all, as the saying goes, it truly is all about the Benjamins; it is about healthcare institutions having the funds necessary to succeed and to carry out their Mission Statements.

So, if State of the Art EHR and Billing systems are in place to optimize patient care and outcomes, and if they are designed to bring in a steady stream of required cash to run the institution, how is it that so many healthcare institutions have less than desirable revenue cycle metrics to show for all of the financial investment in the implementation of an EHR system?

During the many system implementation projects that I have led across the country, the single most neglected component of a complex system implementation is End-User Training. Although institutions will invest millions today to ensure that they have the latest and greatest software available for its end-users, tomorrow (after the system installation) they will attempt to minimize costs with a meager training curriculum. In some cases, training is a minimal consideration at best, offering a series of online tutorials; in other cases, training may be a couple of hour sessions for a given application. Often, trainers are limited in their knowledge of the software, or even worse, have no operational background to marry operational tasks with the new system.

In particular, clinicians who ought to become experts on EHR software, are often given minimal instructions regarding the many bells and whistles of a system that contains many wonderful tools for precise, complex clinical data gathering. By the time clinicians grasp the basics on how the EHR works, they are, easily, overwhelmed by the new system and have little time or patience to understand that part of the patient’s record keeping entails the ordering or charging for services rendered. This is where the rubber hits the road, or in many cases, the tires skid along and never connect to the road!

Recently, I was asked to evaluate the revenue cycle performance for an institution that had implemented a new hospital billing and EHR system. The billing and EHR System were designed to interface seamlessly with an existing providers’ BAR system. Unfortunately, the implementation team did not perform a thorough assessment of existing tasks that included the charge entry process. Under the old charge entry process, providers would manually complete encounter forms, submit them to a coding unit (where validation and manual entry were performed) before going through the remainder of the revenue cycle process. Under the new system, provider orders (charge entry data) were generated from the new EHR application into charge work-queues for designated end-users to review.

The training offered to the clinicians who generated the orders (charges) was inadequate. It did not take into account that providers were used to having support staff (coders/billers) complete the charge entry process. As a result, providers didn’t understand how to:

  1. Open an encounter, enter supporting clinical documentation and close the encounter for the system to continue the path of sending those encounters into work queues for review
  2. Link critical, required documentation to orders
  3. Complete and send encounters without creating duplicate orders.

At the receiving end, the coders and billers were not adequately trained to work their designated charge router queues. The results:

  1. Aged accounts receivable over 90 days reached a whopping 30% of the total AR. Prior to the implementation, it was closer to 20%.
  2. Days in Accounts Receivable were around 40 days. Prior to the implementation, this metric hovered in the low-to-mid 30s range.

The moral of this story is: The Best Implementation fails without a proper assessment of current workflows in order to design an adequate training curriculum.  All stakeholders should be proactive, performing their due diligence, identifying the knowledge base required for a successful implementation, and developing a comprehensive training program to meet end-users and institutional needs.

Today, clinicians are being asked to perform many tasks that once were delegated to support staff. Let’s make sure we give them a fighting chance!





Improving Provider Efficiency and Satisfaction through EHR Optimization

The system has been “live” now for many months or even years, millions of dollars have been invested in the system, and the physicians have attended their training on how to use the system. Yet their struggles continue long past the initial learning curve; charts not getting closed/completed for days, physicians working late hours to deal with notes, letters, follow-up results, phone calls and the list goes on. What is the solution to help your providers?

A system optimization plan may be the answer to help solve these issues and probably many more. Optimization should be a proactive venture as it is not “break-fix” or implementation of features not included with the initial system roll-out.  So, just what is optimization?  Basically, it is the act, process or methodology of making something (i.e. design, system or decisions) as fully perfect, functional or effective as possible.

There are many ways to go about the optimization and multiple tools to assist with the process. An organization should identify a few (approximately 3-4) clinics that would act as a good pilot for the project.  Workflow re-evaluation is an extremely important part of this undertaking.  Have your optimization team member focus on each step of the process from patient check in all the way through check out. Look for unnecessary steps being done.  Are there any bottle necks preventing patients from getting into an exam in a timely manner?  If there is information needed from the patient, send it to the patient thru MyChart and have it completed prior to the visit.   Are there any functions being done by the clinician that could be done by the nursing staff?  Is there anything being printed that can be eliminated?  Are those lab requisitions for the in-house lab really necessary?  Work with the providers to find out what part of the system or visit is slowing them down.  Are they having trouble placing orders, finding lab or imaging results or is the slow-down with the note creation, or is it just that never ending in-basket.

Make use of any and all productivity tools that may be available to you, such as Pulse or PEP – Provider Efficiency Profile. Pulse is the personal dashboard to measure how efficiently the clinicians are using the system.  It will also offer links to targeted training materials to help providers improve in particular areas (i.e. orders or note completion).  Also, the organizations project team can make use of the Pulse scores to pinpoint areas where additional build or training may be needed.

The Provider Efficiency Profile (PEP) offers invaluable information regarding provider usage in the system. You will be able to see how an individual provider compares to others in the same department or specialty in respects to number of number of new patients being seen, how much time spent in the In-Basket, time on notes, letters and orders and much more.  It will also show how much time is spent in the system when not actually seeing scheduled patients, so you can really drill down on the amount of time doing work after hours.

On a recent engagement we used all of the examples mentioned above to evaluate key areas that providers maybe struggling with throughout their day. After thorough evaluation of all information gathered  in person with a provider and a deep dive into the Pulse and PEP information we formed multiple deliverables to assist with provider efficiency among them:

  • Creation of education sessions for providers focusing on in-basket, ordering workflows and note creation
  • Development of tools to assist with workflow processes i.e. smart sets, standardized “speed” buttons for LOS, diagnosis
  • Learning home dashboards created for the providers with tips, short-cuts and how to for certain functions, links to standardized documentation (i.e. sports physical forms) as well as general help topics
  • Roll-out of synopsis for focused problems such as diabetes, hypertension, thyroid diseases and others

While the impact of a few of these have yet to be reported or assessed, there has been a great deal of positive provider feedback on the first several training sessions that were held. Almost all attending felt that the material presented will help with their speed in the office and with patient care and satisfaction.  Additional training sessions and expansion of the optimization initiative is currently being under taken.

If an ambulatory optimization project is in the works for your organization, don’t forget a little PEP will go a long way in helping your providers be more efficient with time in the system and ultimately lead to a more satisfied patient.



The CIO of the Future- Long Live the CIO

There are many articles out there that focus on the death of the CIO as a strategic position in the executive management landscape. Many pundits have suggested that today’s CIO (especially in healthcare) is mired in the technical underpinnings and has lost his/her position as a true business leader. Healthcare especially in its fast-growth, heavily regulated world has caused its CIO’s to be focused on implementation and support of costly, poorly integrated systems that don’t scale well or play well with others.

So, what does the CIO of 2020 need to be thinking about today in order to improve the impression of what the CIO is these days? What do CIO’s need to do to move healthcare to a higher state of technological maturity?

We all know the big Healthcare vendors need to come together and establish a standard framework, but while we are waiting for that to begin to take shape, we as CIO’s can drive a more flexible, scalable and cost-effective technological infrastructure and prepare for that future. Today’s infrastructure for running a modern hospital or clinic is really 5 key platforms: Voice, Data, End-user compute, your application stack, and mobile platforms.

There has been a lot of talk around cloud computing and things like IAAS, and SAAS and PAAS, but how does these play in Healthcare? Many CIO’s are apprehensive and rightfully so – there is risk. But, forward-thinking CIO’s should be looking out to 2020 and thinking more about how their patients and clinicians can interact with their organization electronically. In order to do this there will have to be a massive build-up of back-end infrastructure to support those mobile-enabled apps. With that said, the CIOs of 2020 should be thinking they need to partner with hosting and managed services providers that can bring infrastructure that is highly scalable and highly flexible to the table now.

So, why not move to the cloud? Blue sky here, think about this… Healthcare IT could be run by 3-4 key leaders who are responsible to organize 20-25 managed services contracts into a truly flexible technology framework for the organization. So let’s take a look at the 5 key technology platforms and what you can do to virtualize and commoditize these platforms and ready your organization for 2020+. Oh, and by the way, all of this is available today.

The voice and data networks are vital to any business, especially healthcare. Now that voice and data have converged, our lives have gotten easier. Gone are the days when a PBX the size of a small garage or an army of network engineers is needed to run voice and data. There are new businesses that allow you to run your voice service in the cloud, and many network VAR’s have very mature managed services organizations that can design, build, and manage your network infrastructure without having a small army of engineers on your payroll. BYOD has also changed this landscape as well, but we’ll touch on that below in the mobile platforms section.

End-User Compute (PC’s, Laptops, Printers) – In 2020, traditional PC’s and laptops may be a thing of the past (or at least on their way out). Thinking about the BYOD mentality, your employees may just bring their own tablets and smartphones to work and they join the domain and off they go. But even if you still have traditional end-user computing in 2020, there are vendors today who will design, provision to your spec, deliver to your desk, and support your end-user computing in your building.

The application stack – all of the big players offer a hosted option including Epic. Cerner has been offering this service since their days of the mainframe and Epic has just recently completed a massive Tier 3 data center to offer hosted solutions. Even if you decide not to use the app vendor as your hosting partner, you can still go to Amazon, Google, or many regional players to run your apps on their infrastructure. Even if you find an app that has to be run on your own infrastructure, your hosting partner(s) can offer up an IAAS platform that is highly scalable and flexible.

Mobile platforms are here, let’s deal with them. As everybody knows, the smartphone has become so powerful and flexible that it has completely changed the technology landscape. Everybody has one and wants to use it, but is Healthcare ready to support it – I would say a resounding “NO”. Again, the application vendors have a lot to do with it as they haven’t really embraced the small screen, but again we need to prepare for the inevitability. Other industries have come to grips with the small screen revolution and we should also for our employees and our customers.

The bottom line – there is no longer a need for massive data centers and armies of technical engineers. Remote hosting, managed services and virtualization are here now. So what does this mean for the CIO of the future? We CIO’s should be positioning healthcare IT for that future now. Remember, we are behind and it’s not just the end-user community, but the vendors in the healthcare space who haven’t moved the ball. CIO’s of the future need to be solely focused on the business. Remember those 3-4 key leaders I was talking about earlier? We are managing our services contracts with our vendors and offering highly flexible and scalable technology to our ever-changing and fast growing businesses. The CIO of the future now can focus on how technology interacts with the business and position IT for the future.



Why a Thin Line Separates EHR Optimization, EHR Replacement

Healthcare providers will have their reasons for choosing EHR replacement or EHR optimization, but a thin line may be all that separates them.

Jerrilyn Ivey-Director of Consulting Services -Culbert Healthcare Solutions shares her perspective with

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Implementing a New System or Upgrading your Existing One? Are your Goals SMART?

Director Of Consulting Services

Director Of Consulting Services

Whenever any organization decides to implement a new system or upgrade their existing system there are typically goals they are trying to achieve. Sometimes those goals are addressing specific issues, adding functionality, or meeting the expectations of the organization.

How many times have you seen where goals are identified at the beginning of the project and yet no one ever circles back to determine if those goals were met at the end of the project?  Most often this happens when the organization’s goals were not SMART goals.

For those of you whom do not recall what a SMART goal is, let’s take a look back. The “S” in SMART stands for specific. Are you goals specific enough to be definite at the end of the project? For example, an organization’s goal to reduce patient check in time is not specific enough, what is included in the check in process?  Therefore defining this goal to include those specifics can provide clarity later. So our goal turns into “reduce patient check in time to include providing the patient with necessary paperwork, completing patient update in system, and marking patient arrived”.

The “M” stands for measureable. Is your goal measureable? Take for our patient access goal, further defining the goal to include “reduce patient check in time to include providing the patient with necessary paperwork, completing patient update in system, and marking patient arrived by 20%”, now gives the team a figure to measure when determining success. Therefore if the average check-in time was 5 minutes, the goal to reach is 4 minutes or less, on average, per patient.

The “A” stands for attainable. When setting goals at the beginning of the project we need to ensure that the goal can be obtain. Setting unrealistic expectations or figures that are not attainable may not demonstrate the success of your project. This is where the “R” in SMART comes in as well. Be realistic when setting your goals. Let’s go back to our goal above, what if we had set this goal to decrease the average check in time by 50%? Setting such a lofty goal for your team members may be defeating before they even begin and unattainable.

Finally, the “T” stands for timely. Don’t set goals too far out. Ensure that your specific, measurable, attainable, realistic goal is set within a time frame that makes most sense to determine if the project was a success.



IT Consolidation To Improve Revenue Cycle Performance

A multi-entity health system consisting of physician practice offices and ambulatory surgery centers was structured as multiple corporations working together to serve their patient population. Each organization maintained a separate database for revenue cycle operations.  This required multiple patient accounts for any surgical services provided, an account in the professional practice and one or more accounts when services were performed in the ambulatory surgery centers.  This resulted in complicated workflow for schedulers, check-in staff, charge entry staff and revenue cycle staff.  Additionally, reporting on total organizational activity required consolidation of data from multiple reports.


An analysis and work plan to consolidate the databases into a single, multi-entity database was performed. The practice management system in use supported multi-department, multi-entity with security features to segregate access and data as needed.


The professional services database was selected as the surviving database and was modified to accept and process the facility services of the ambulatory surgery centers. The changes implemented were to:

  • Utilize a new hierarchy level to separate the professional services from the facility services.
  • Establish the security settings to segregate data access between the entities to assure accurate billing in the consolidated environment.
  • Create the facility based claim formats (837i and UB04), as needed, to meet requirements for the carriers contracted that utilize these different formats.
  • Train staff impacted by these changes on the new workflows to take advantage of the new set up.
  • Establish a communication plan for the transitional period for patients with services spanning the transition as they would receive multiple bills from the ambulatory surgery centers for services based on date of service.


The effective date for the transition would be the beginning of the new fiscal year for the health system to provide the cleanest transition for reporting purposes.  This allowed for the impact of the transition and continued reporting from multiple databases to be isolated to a single year.


Improvement in business operations, patient and staff satisfaction was a direct result of this consolidation effort.

Randy Shulkin-picture

Do I Really Need an Oil Change? The Benefits of Ongoing Maintenance with you Car and Healthcare Technology


Have you ever asked yourself if you really need to perform an oil change in your car? Why do you need an oil change anyway? Well the oil lubricates the engine and carries heat away from your engine. There are thousands of engine components that work together in order to keep your car running, the oil lubricates these components. If we don’t get an oil change as recommended the oil becomes ineffective over time. That all makes sense right? Something we have all accepted and understand is a crucial part of keeping our vehicles running.

What does this have to do with health care technology?  Imagine the oil is the technology knowledge of your end users. As we all know work-arounds in the system occur from one office to the next and from one end user to the next end user. Are you one of those few organizations who conduct continuing education on the technology you have implemented? If not, liken that continuing education to the ongoing maintenance of your vehicle.

Now let’s imagine the oil is the application, such as your electronic health record or practice management system. Whenever an organization first implements their EHR or PM they are doing so with limited knowledge of what the application is capable of. Sometimes it is simply because decisions had to be made initially that limited the use of the system. Very few organizations have had the time or resources to dedicate to any amount of time towards system utilization and optimization. However now that we have meaningful use and ICD10 behind us we have reached the time where it is a great opportunity to take a step back and enhance the efficiencies of the system. Ongoing maintenance of the system is just as important as it is with the end users.

Whenever technology plays such a large role, as it does in health care these days, our priorities should include ongoing maintenance