Have you ever considered doing a workflow analysis on your infusion services?  

Beth Israel Lahey (BIDMC), a longstanding Medaptus partner, is transitioning seven facilities to automated infusion, with three set for implementation by June. What’s intriguing is their simultaneous migration to Epic, an uncommon move. Rather than pausing for Epic integration completion, Beth Israel Lahey is embracing a dual approach, emphasizing the importance of seamless partner collaboration with medaptus. In a candid conversation with Bob Osgood and Gary Bernklow, the subject matter experts behind this workflow analysis, we look into their insights and strategies for navigating this new transition.  

Read more on how Beth Israel Lahey is proving that third-party tech solutions need not take a backseat during Epic migrations. Could you be putting important projects on hold because of Epic integrations?  

Q: What types of things are you doing at your on-site at Lahey? Who are you meeting with there? 

Both: We met with Anna Marinilli, Manager, Practice Operations BIDMC Lank Cancer Center and Specialties, and Holly Dowling, RN, BSN, Nursing Advisor at Beth Israel Lahey Hematology and Oncology Department at BIDMC Lank Cancer Center.  

Q: What are you evaluating about their workflows and processes?  

Gary: We are evaluating to see if there are charges they aren’t capturing and to find out if we need to account for anything new at BID that we didn’t at other sites. BID has an infusion scenario that is an outlier – nurses are doing a lot of manual facility charges that aren’t IV specific but commonly done in an IV (blood infusions, scalp cooling). 

Q: What have you learned about the way they are currently billing infusion services?  

Bob: There is a lot of under-coding, rounding down on stop times, nurses coding and not fully trained on complexities of coding, and management wants to take it out of nurses’ hands. We would love to get current data for ROI, and compare their current documented actual start and stop times to after the implementation to see how much more revenue they could be generating.  

Q: What are the current workflows for billing and coding outpatient infusion services?  

Gary: A lot of paper. These staff are doing things that were done 20 years ago. Nurses see the patient, write down what they administered, scan it in, then open the application OMR (form, a stand-alone application) to document what they did and do the coding. There has been no feedback loop for 9 years, no updated training. This presents a huge issue when codes constantly change, but your staff aren’t getting updates and are instead coding from what has worked in the past.  

Q: How are you helping to audit their current processes and suggest improvements? How does this set them up for success with our automated software, Charge Infusion?  

Gary: Workflow analysis from end to end, trying to determine where the hiccups are in data or documentation.  With the new infusion migration with Epic, all nurses will have to do is scan a bag to start the infusion, enter the stop time in Epic when it is done, document injections, and then the nurse will simply document what they did.  

More than 90% of charges go straight to export for sites in pre-expansion, so this is the goal for BIDMC, and the other sites slated for implementation. The first step in helping will simply be workflow analysis. This will set them up for success with nurse buy-in, and 100% compliant IV coding, and help them realize deficiencies in the documentation process.  

Q: How did the decision come about to move to automated infusion along with Epic migration?  

Gary: BIDMC saw success at another Lahey site. The financial gains and nurse satisfaction, decreasing workloads, ROI, and simplifying of processes that are taking up time and resources.  

This means medaptus can look at your software ecosystem and workflows and improve everything at once, rather than wait for an Epic migration to be complete before moving on to the next critical software implementation. This is especially important because organizations like yours don’t want to delay the revenue savings, especially considering large EHR migrations can take anywhere from 9 to 18 months.  

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