February, 2013:

GE Centricity Practice Solution (CPS) v11


With the announcement of Centricity Practice Solution (CPS) v11 on January 24, 2013, GE Healthcare makes a strong positive statement as they continue to develop and improve one of their core software offerings.   CPS v11 is the release that is ICD-10 compliant and GE has done a lot of work to make the transition from ICD-9 to ICD-10 easy for the physician.  GE has added a predictive search engine to the problem section of the system which allows searching by full description, abbreviation or by code and will display both the ICD-9 and ICD-10 codes when there is a match.  GE has also changed the workflow for problem entry so that the number of clicks needed to add a problem has been reduced from 4 to 1 which will be welcome news to the many physicians who count their clicks.  The focus on ease of use for the physician community is the right strategy for gaining the trust of a group of users that is dealing with change due to the various stages of Meaningful Use, among other demands on physician time.

Feedback from GE’s early adopter group indicates that the upgrade to v11 is straightforward from either v9.5 or v10 with no significant issues reported.  Some additional work is required for the upgrade from v9.5 but it is more than manageable.  This should be welcome news to organizations that have not yet upgraded to v10.

GE CPS clients can now include the upgrade to v11 in their ICD-10 planning and leverage the content to help educate their physicians on the demands of ICD-10.  By coming to market with a solution a full 20 months before the ICD-10 deadline, GE gives their clients ample opportunity to effectively manage the process and be ready in advance of the October 1, 2014 deadline.

How to Proactively Collect Patient Pay Balances

A particular strength of Culbert is assisting both Physician Practices and Health Care Systems proactively collect patient balances prior to visits or admissions.  The creation of a centralized pre-registration unit will accomplish the following:

  • Communicate directly with patients to verify insurance and educate the patient on their financial responsibility.
  • Assist patients in potential means to assist with their financial obligations (Indigent care, Prepayment discounts, etc).
  • Create a pre-registration process for checking eligibility electronically.
  • Coordinate with the hospital/practices, I.S. and Billing to improve the revenue cycle.
  • Assist the practice/hospital registration areas by developing procedures, and communication around collecting the patient’s portion of the bill when they come in for services.
  • Work with registration areas regarding errors so that information that interfaces to claims is correct and produces a clean claim the first time.
  • It costs healthcare facilities approximately $5 – $7 per statement sent to patients for co-pays, deductibles and co-insurance’s that could have been collected up front.
  • Creation of this new service line, there should be a reduction in edits, re-bills and patient collection efforts.  


There are many advantages to this new revenue cycle model. The health system gains the economies of scale inherent in centralizing and specializing. Patients get a new service where someone can advise them about their insurance benefits and let them know before their appointment what they will be responsible to pay. By proactively understanding insurance, processes and systems can be put in place to ensure that reimbursement is received sooner in the revenue cycle.




Scheduling Optimization Using Allscripts PM

Physicians usually prefer to set-up their scheduling templates in ways that help manage patient flow and their own workload.  Allscripts PM Software is readily customizable to accommodate such preferences – for example, by defining what time-slots are available for certain appointment types or by restricting the number of new patients or physicals in a day.  The first step in optimizing schedules is always to clarify the physicians’ productivity expectations, goals and rationale.  The next step is to consider how best to structure the schedule to maximize utilization while facilitating patient access – especially urgent appointments for primary care and new patients for specialists.

To design the optimal schedule, it is helpful to have an understanding of demand vs. capacity, as well as utilization trends.  Given the unpredictable nature of health care, 90% is a reasonable target for most physicians and 85% for mid-level providers, based on our empirical experience working with clients.  It is better to adopt an “open access” approach – allowing patients to book any appointment type at any time.  Otherwise, physicians risk having more unused slots and managers waste more time micro-managing schedules, especially when there are cancellations on short-notice.

Large medical groups face an extra challenge:  how to strike a balance between enabling flexibility for physicians while maintaining an overall system that is efficient, error-proof, and manageable for the lead administrator and central IT support staff.  In our consulting view, Allscripts PM has the functionality to work well – as long as the administrator plans the scheduling set-up process properly, following clear organizational standards to simplify and streamline options.  This management discipline is crucial if there is a centralized scheduling staff.  And if the system is not designed right at the start, it’s twice as hard to redesign later!


Healthcare Supply Chain Management

In this time of changing reimbursements, many medical groups are looking toward improvements in workflows to maintain or improve bottom line.  One area where many groups have been able to uncover significant cost savings is supply chain management. 

At the core of supply chain management is the procurement process.  In its most basic form, the procurement process provides a means to purchase equipment and supplies needed in a hospital, practice or clinic.  In its more advanced forms, this process provides for significant cost savings and controls through effective contract negotiations with GPOs and distributors, active management of inventory levels, and process efficiencies gained through technology-based process improvements. 

An example of the potential savings to be achieved is a recent engagement undertaken by Culbert’s Revenue Cycle Team.  In this engagement, Culbert was asked to (1) evaluate current supply chain workflows, (2) evaluate the current technology in use, and (3) identify areas of potential savings.  The initial assessment identified significant workflow breakdowns that were resulting in the loss of potential volume discounts as well as lower TIER pricing.  At the client’s request, Culbert prepared and issued an RFP to three major GPO’s/Distributors in order to determine a better, more cost effective solution.   Once the responses were received, Culbert successfully negotiated on behalf of the client – gaining access to new contracts estimated to achieve a 20% savings over historical spend rates.  To date, performance continues to meet or exceed initial estimates.

Another finding of the assessment was that the current technology was antiquated.  Missing were many technology improvements designed to improve overall process efficiency (ie. No ability to punch-out to vendor sites).  Culbert identified the product of choice, negotiated contract terms, and led system/workflow design sessions on behalf of the client.