Bowtie Confidential: 5 Steps to Managing Change in Healthcare 4/15/12

It’s interesting. When one mentions the word “change,” it puts the listener on the defensive. If you use the words “modify,” “improve” or “alter,” it does not create the same stress level. Perhaps we should call change management “improvement management.”

Nevertheless, change is paramount in healthcare right now, and managing it is not easy. I have found that there are five areas of focus for successful change management: communication, sponsorship, coaching, education, and understanding resistance.

1. Communication is important because it mitigates surprise, which is very stressful. To communicate well, healthcare leaders and project managers should create a communication plan with milestones and a timeline. Many of our clients have been successful using tools such as town hall sessions, newsletters, e-mails, social media, etc.

2. Sponsorship is a critical change management tool. If there is not strong leadership behind the change, resistance will keep it from happening. Sponsorship for change begins at the highest leadership level. It is imperative that as management, we become positive change agents so that our staff members receive the direction that they need.

3. Coaching provides hands-on help to move from A to B. As management/change agents, we are de facto coaches. It is effective to have senior leadership coach management, who can then coach their staff members. These activities build trust and acceptance of change, predominantly because they facilitate the behavior change.

4. Education is similar to coaching, but does not have to be 1:1. It builds knowledge and ability, which are antidotes to resistance. While it is important to provide functional knowledge transfer, it is also important to talk about change management coping techniques. For example, it is important to let staff know the reason that the change is happening and what is in it for them.

5. Understanding resistance helps deflect the defensiveness around change, which facilitates moving ahead. Understand why there will be resistance. People are used to doing their job one way and are concerned about how the change will impact their work and their experience of work. Planning is an important component to change management. When people know ahead of time (again, try to eliminate any surprises), there will be less resistance than if it is forced into place in a hurry. Bring on the naysayers and ask them to be part of the process. Their point of view will be helpful in planning and design. Also, develop appropriate committees and messengers that can communicate to the organization at different and varying levels.

The goal is to become an organization in which change is OK. These five components should be part of any change and should be an everyday theme for the organization. This will build trust and will take time. Yet as trust is established and change is experienced as making things better, more people will become change agents. A healthcare organization’s ability to flex and adapt to change will become a competitive advantage as well.

Rob Drewniak is vice president, strategic and advisory services, for Hayes Management Consulting.

News 4/12/12

Preliminary results from a New Jersey Patient-Centered Medical Home (PCMH) study indicate the model is resulting in improved quality measures and lower costs. Patients participating in the PCMH model had better HbA1c measures and higher rates of breast and cervical cancer screenings. Costs per member were 10% lower than non-participants and lower rates  for ER visits, hospital admissions, and hospital readmissions.

Entrada and NextGen partner to integrate Entrada’s clinical documentation technology with NextGen Ambulatory EHR and PM.

MZI Healthcare enters into a services agreement with Emdeon to offer Emdeon Payment Integrity Solutions and Emdeon Payment Management Solutions to users of MZI Healthcare’s EZ-CAP product.

Emdeon, by the way, reports Q4 revenue of $283.9 million, up 3% from a year ago. Net loss for the quarter was $70.8 million compared to the previous year’s net income of $15 million. Emdeon, which went private last year, says the loss was “primarily due to costs and expenses, including increased interest expense.”

Culicchia Neurological Clinic (LA) selects SRS EHR and Patient Portal for its 17 providers.

GE Healthcare IT announces the availability of Centricity EDI Services 5.4, GE’s eligibility, claim, and remittance clearinghouse. The new release includes support for HIPAA 5010 and stronger analytics.

Practice Fusion announces new functionality for its EHR, including enhanced navigation, clinical messaging, prescription eligibility and formulary information, and tools to delete signed documents. Hmm…I thought it wasn’t a good idea to delete signed documents in an EHR.

Kareo launches a Resource Center that includes webinars, white papers, and educational videos.

E-mail Inga.

News 4/10/12

HHS proposes a one year delay for ICD-10 compliance, pushing the deadline to October 1, 2014 and giving providers and other covered entities more time to prepare and test their systems with the new code sets. HHS also issues a rule requiring all health insurance plans be numerically tagged with a unique health plan identifier; HHS says the proposed identifier change would save providers and health plans up to $4.6 billion over the next ten years.

Allscripts releases Wand, a native iPad app that extends functionality of its Professional and Enterprise EHR solutions.

The 200-member IPA of Nassau/Suffolk Counties (NY) announces a purchase agreement to implement Greenway’s PrimeSUITE EHR/PM solution.

Greenway, by the way, is one of the official sponsors for golfer Jason Dufner, who finished 24th at last weekend’s Masters Golf Tournament.

The AMA names HP its preferred provider for technology products purchased through the organization’s Member Value Program.

Premier Healthcare Alliance adds MedPlus to its ambulatory EMR software agreement portfolio.

Asheville Radiology Associates (NC) contracts with Zotec Partners to handle the billing operations for its 42 physician practice.

Physician offices are expected to add 760,000 new jobs between 2010 and 2020, an increase of nearly 33%. The healthcare sector as a whole is predicted to employ 4.2 million by 2020.

CMS publishes a full set of proposed Clinical Quality Measures for 2014 as part of the proposed Stage 2 EHR rule. The measures for EPs are in their own table and include detailed information on each measure, plus  links to the National Quality Forum website.

CareCloud CEO Albert Santalo was one of a handful of business leaders invited to the White House to take part in last week’s signing of the Jumpstart Our Business Startup (JOBS) Act. Santalo later appeared on PBS Newshour and shared his impressions of the legislation and its potential impact on CareCloud and more established HIT vendors:

It makes healthcare technology companies which have been around for in some cases 40 years, have to become more competitive because now companies like us can access public capital much earlier.

E-mail Inga.

More news: HIStalk, HIStalk Mobile.

DOCtalk by Dr. Gregg 4/9/12

EHSD-Resolving RFP

Since I first broke the news about Allscripts’ sunsetting of my current EHR (Peak Practice) about a year and a half ago, I have developed a severe case of a newly defined malady: EHR Hunt Stress Disorder (EHSD). I am worn down, drug out, and generally pooped. I can’t figure anymore re: local host versus cloud versus disruptor / innovator versus corporate clout versus Quippe-able versus app-able versus templates versus NLP versus digital pens versus etc., etc., etc. I just can’t. I’m done.

I have seen a slew of systems — some great, some not so much. I’ve seen apps and clouds and cool tech. I’ve even had some had offers to work with some vendors. But, in trying to decide, I think I have run headlong into The Paradox of Choice wall. Too many options have led me to the paralyzingly dissatisfactional funk of EHSD. Can’t find that “just right” one.

To fight my current dis-ease, I need a differentiator. To help me try to alleviate the doldrums inherent in EHSD, I’m putting out a Request For Proposal for a new trench grunt-friendly, EHSD-resolving EHR BFF.

Here’s the deal on what I seek:

• I want a system that works reasonably well. It doesn’t have to do everything or look just exactly as I’d prefer…yet. (I’m experienced with the “let’s get from here to there” thing.)
• I want a company that wants someone who will contribute to their development and success.
• A must-have: a company that actually continues to care about small grunt-type clients after the check has cleared.
• I’d like a company that “gets” the future, but respects history.
• I need a company/system I can trust.
• It’s nothing personal, but I’m not looking to make you the next millionaire. I’m a small town solo pediatrician, pretty much the bottom feeders on the medical pay scale. I need a system that has a cost low enough with value high enough to actually deliver that ROI you all promise.

2. Transfer of data from my current EHR

• A must-have

3. Continuation of my current lab interface to Nationwide Children’s Hospital

• Not a deal breaker. Ohio will soon have this connectivity enabled via its HIE, CliniSync.

4. Practice Management compatible with an outside billing company

• Another must-have. I use an outside billing company (who accesses my current EHR) to whom I am exquisitely loyal. They have done some great things for me and are wonderful people. I adore them. (Not to mention that they have my AR turning every 19 days and 93% of all outstanding balances are less than 60 days.)

5. Submissions deadline

• Tomorrow (no matter what day you’re reading this).

6. Disclaimer

• All EHR vendors are eligible (except one).

Seriously, I’m tired of my EHSD. I’m looking to get EHR-healthy again. Whether we’ve spoken before or not, please submit your non-formal RFP (or questions) to doc@madisonpediatric.com.

(I’m sorta, kinda, not kidding.)

From the EHSD-weary trenches…

“Reality is the leading cause of stress amongst those in touch with it.” – Lily Tomlin

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, directs the Pediatric Office of the Future exhibit for the American Academy of Pediatrics, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

News 4/5/12

CMS extends the deadline to April 30th for Eligible Professionals to submit eligibility appeals under Medicare’s EHR incentive program for the 2011 payment year. The eligibility appeal allows a provider to show that all the requirements for the Medicare EHR incentive program were met and that the provider should have received a payment but could not because of circumstances outside of the provider’s control.

Kokua Kalihi Valley Comprehensive Family Services (HI), a 16-provider FQHC, names e-MDs its vendor of choice for EHR and PM.

Billing and PM service provider Asterino & Associates merges with billing and EMR company Doctor Solutions. The combined entity will be called Asterino & Associates.

The 330 physician DuPage Medical Group (IL) selects Humedica MinedShare to provide clinical benchmarking and analytics from its Epic EMR.

The National Quality Forum endorses new measures associated with care costs for asthma, chronic obstructive pulmonary disease, hip/knee replacement, and pneumonia, as well as 14 quality measures on perinatal care and 12 on renal care.

The HITR nursing technology blog is running a Bodacious Scrubs contest through April 25. Winner receives a $100 AMEX gift card (and at least 15 minute of fashion fame.)

Professional services firm Syndicus forms a strategic alliance with SOAPware to promote and sell SOAPware’s hosted EHR solution.

EHR and RCM provider MTBC acquires billing company GlobalNet Solutions.

The Miami Herald talks with CareCloud CEO Albert Santalo about the potential impact of the soon-to-be-passed JOBS Act, which aims to reduce bureaucracy and make it easier for private companies to find investors early and go public.  Santalo says that an IPO is a “realistic possibility” for CareCloud and the new legislation, which includes looser regulatory provisions for for “emerging growth” companies, would allow CareCloud to go public sooner than later. Our interview with Santalo can be found here.

SuccessEHS becomes the first ambulatory EHR vendor to demonstrate successful connection with South Carolina’s Health Information Exchange.

E-mail Inga.

More news: HIStalk, HIStalk Mobile.