Culbert was engaged by a large academic medical center to assess the current state of their Epic system in relation to pending ICD-10 requirements and peripherally perform an assessment centered around base functionality. Culbert evaluated clinical documentation and ordering tools such as SmartTexts, SmartSets and Preference Lists in addition to content such as the existence of specialty navigators, diagnosis groupers and decision support. By comparing and contrasting overall findings with utilization statistics and documentation deficiencies, Culbert was able to provide a clear picture and plan to prioritize and address gaps in build beneficial to both ICD-10 compliance, physician efficiency, and enhanced user acceptance. The action on this plan involved an individual assessment of departments to educate physician leadership on the scope and reason for the project, review Culbert findings, and identify necessary build to both enhance ICD-10 compliance and physician efficiency. In the early stages of this project, two immediate beneficial findings were found and are described below:
- During one specialty assessment and build process, significant content beneficial to both ICD-10 and physician efficiency was identified and delivered. With the creation of multiple highly relevant and intuitive SmartTools, physician leadership estimated that individual providers would be able to add an additional 1-2 patients per day. This was a result of reducing the time taken to identify orders and complete documentation. Utilizing a conservative estimate increasing 1 patient per day over 40 weeks and frequency of visits leading to surgery, the specialty calculated that the department would realize a ROI of approximately $1.3mm spread over their 8 providers in the first year alone. Extrapolating to 5 and 10 year outlooks shows an ROI of $6.4mm and $12.8mm respectively.
- Another benefit was taken as a very quick win. In educating a physician on Epic’s potential and illustrating the flexibility of the system, a Culbert analyst was able to demonstrate UserPhrases to a physician that frequently authored notes in a free-text manner due to a lack of documentation tools that met her approval. With the creation of a custom UserPhrase integrating existing SmartLists with her most frequently used verbiage, the provider was able to trim nearly 2.5 minutes off per visit. With this provider seeing an average of 12 patients per day, that translated into an average of 30 minutes saved per day or one additional patient. This also provided sharable content for other physicians within the specialty to review, personalize and use.