October, 2017:

Addressing Physician Burnout-It’s Not Just the EHR

Tactics for addressing Physician Burnout http://bit.ly/2xJOzX4

Epic’s Revenue Guardian

Revenue Cycle leaders return home from Epic’s campus this week with a few new tricks in their bags.  One highlight and quickly becoming a hot topic is Epic’s Revenue Guardian.  While Epic has the charge router, front and back-end automation and workqueues abound, the Revenue Guardian is a secondary check of the system to prevent lost revenue, missing charges, and target areas you know your organization needs to keep a close eye on.  (Epic also announced a new Payment Guardian expected soon.)

Simple examples Epic offers are checking contrast orders to ensure there is a contrast charge, missing observation charges, or even missing rev 391 rev codes.  Epic uses the best practice advisory functionality many organizations are familiar with to accomplish these checks.  As of a few weeks ago, there were 25 examples in Epic’s foundation system, though now we have over 100 pre-built examples to take advantage of.  Requirements to implement are to have Epic’s HB module as well as either EpicCare Ambulatory or Epic Inpatient.  Revenue Guardian checks are only for hospital accounts and hospital billing charges at this time.  While you can configure these checks to trigger a DNB, this should be carefully discussed with your revenue integrity lead and team.

Reports, workqueues and other data can be produced from these checks, with the goal of eliminating revenue leakage and improving front and back-end training where missing charges can be automated or corrected by workflow.   Putting the appropriate governance into play to support the check findings is essential to turning the data into action.  Culbert works with organizations from design, build, and revenue integrity optimization with these checks.

Director Epic Practice

MGMA 2017- Presentation : Optimizing Health Information Management

Another outstanding MGMA conference in Anaheim CA.   Proud of our speakers Elizabeth Morgenroth, CPC and Randy Jones, DHA, FACHE,FACMPE who presented:

“The Data Integrity Department: Optimizing Health Information Management”

Looking forward to MGMA 2018 in Boston!

Epic Provider Efficiency Profile (PEP)


As hundreds of organizations return home from a week of Wizardry in Verona, Wisconsin, they bring back new memories, new connections, lists of new features to explore, and a high for the potential of the newly named ‘CHR’ (Comprehensive Medical Record).

In the clinical space, conversations were abuzz around provider satisfaction, efficiency and CHR usability.  The topic was perhaps spurred by Carl Dvorak referencing supposed negative news media about provider adoption and happiness, though tempered by the notion that Epic users are among the happiest.  That said, everyone agreed there is a long road ahead.

The provider efficiency profile was highlighted as a ‘spell’ in the land of Epic wizards to help organizations develop keener insights into their clinical community.  The PEP as it’s called, provides clinician-level data about workload, system usage, specific number of tools adapted, amount of time in certain activities, time spent during specific hours of the day, and much more.  The efficiency can be determined looking in comparison to others, as well as in comparison to specific workflows (example: disposition in the ED).

The PEP must be turned on by the build team, though it can be focused on the providers or clinics you choose.  In one case study, Culbert found identifying opportunities at 5 clinics to improve specific smart tools, improve in basket training and share high efficiency provider notes with others reduced the average time after work completing and closing encounters by 30 minutes per day.  The PEP is a powerful tool for just after go-live and to continue to monitor throughout optimization cycles.


Jaffer Traish- VP Consulting-Culbert Healthcare Solutions