Peconic Bay Medical Center in Riverhead, New York, is the Eastern hub of Northwell Health, the largest healthcare organization in New York State.

THE PROBLEM

The medical center needed to address an acute revenue cycle problem with its hospitalist group that was dramatically affecting the organization’s ability to run its hospitalist program. It was using an offshore billing and coding entity that caused significant delays in submitting charges and did not capture levels of care correctly. The delay, along with the disconnected nature of the service, created a non-transparent process, leaving the physicians in the dark over how they were performing financially.

In this environment, provider engagement was not great and staffing needs were hard to meet, both of which contributed to patient satisfaction staying stagnant at a dismal 10%.

PROPOSAL

Peconic Bay Medical Center approached pMD, a vendor of mobile communication, data capture and care navigation platforms.

The vendor proposed three key areas to address with its software: increasing revenue, efficiency and communication. From a revenue standpoint, the vendor’s mobile charge-capture software would allow Peconic Bay Medical Center to completely replace its offshore billing and coding entity with an in-house team. The medical center could increase accuracy, reduce the number of lost or missing charges, and significantly improve charge lag, all of which were affecting profitability, said Dr. Jean Cacciabaudo, medical director at Peconic Bay Medical Center.

“The mobile app would enable our providers to capture charges right on their device at the point of patient care, decreasing the time between point-of-care and when those charges make it through to claims,” she explained.

"The access to real-time charges, along with the ability to track and trend their results, has enabled the physicians to be highly engaged in the process and see the increased profits firsthand."

Dr. Jean Cacciabaudo, Peconic Bay Medical Center

The platform’s secure messaging features were also included in the charge-capture product. Providers would already be using their phones to capture charges and they could also use the app to communicate without worrying about including personal health information.

The vendor also offered to build an interface with the medical center’s hospital system free of charge in order to save providers time and further reduce the chance of billing errors.

“To ensure a smooth transition, pMD would bring a team on-site to implement and train everyone, including one-on-one training with all providers,” Cacciabaudo said. “They could get us up and running quickly to start generating additional revenue right away and allow us to replace our existing vendor without significant downtime.”

MARKETPLACE

There are various vendors of mobile charge-capture and related technologies on the health IT market, such as Claimocity, HybridChart, Ingenious Med, MedAptus, MDTech, MGSI, PatientKeeper and pMD.

MEETING THE CHALLENGE

After conducting a full analysis of the hospitalist workflow, pMD trained providers to capture their charges in seconds at the point of care on the mobile application. “The vendor’s platform is very intuitive and easy to use,” Cacciabaudo said. “Much easier than other systems I’ve personally used.”

Peconic Bay Medical Center also created an in-house billing department and used the vendor’s real-time secure messaging tools for communication between the billing department and the providers. It also is important to note that at this time the medical center partnered with Northwell and implemented a relative value units (RVU) compensation program for physicians, sparking additional interest from providers in their own productivity.

The vendor worked closely with the hospital IT team to build an advanced integration with Cerner, the hospital’s EHR. Patients are automatically added to the provider’s census list in pMD as they are admitted, which saves time for the hospitalists and reduces the chance of billing errors.

“The physicians took to pMD right away, noting the program was actually much easier than anticipated, and it did not take long for them to realize the added value,” Cacciabaudo said. “They appreciate the transparency and immediacy of the new pMD-driven process, and the billing team was able to reduce charge lag significantly. Instant improvement.”

The caregivers at Peconic Bay Medical Center are significantly happier these days and say the new technology has played an important role, she added. Transitioning away from an environment with limited information transparency and inadequate staffing has made a tremendous difference for both providers and administrative staff, she noted.

“The access to real-time charges, along with the ability to track and trend their results, has enabled the physicians to be highly engaged in the process and see the increased profits firsthand,” she said.

With the newfound financial success, Peconic Bay Medical Center was able to hire more full-time doctors. Reducing the dependency on part-time and locum physicians to fill scheduling holes has created a much more cohesive and consistent coverage rotation, meaning more familiar faces for patients and staff.

“Overall, implementing the technology has created a cascading effect; the increase in provider engagement and communication led to better financial results, which helped us stabilize and expand our workforce, making our doctors happy, ultimately resulting in the huge increase in patient satisfaction,” she said.

RESULTS

Since implementing the new technology, the medical center has seen a tremendous increase in workflow efficiency. It now is able to staff appropriately, and since doctors are equipped with real-time information to gauge how they are doing, they have become much more engaged with billing. Overall, the medical center has seen:

• 490% increase in patient satisfaction
• 26.7% (more than $800,000) increase in hospitalist revenue
• 13.5% (more than 4,000) increase in charge codes captured

“Based on these positive results achieved with our hospitalist and palliative care groups, we expanded the pMD rollout to eight additional specialties consisting of more than 75 providers,” Cacciabaudo said.

“We have since been able to replicate that success with other specialties in the hospital and in our affiliated medical group, such as our colorectal surgery, OB/GYN, neonatology, gastroenterology, general surgery, orthopedic surgery, pediatrics and behavioral health groups.”

Before the new technology, physicians received zero feedback on how they were doing and, to be frank, they really did not care, said Dr. Ken Mayer, head of the Peconic Bay Medical Center hospitalist program.

“Once we completed our chart note, someone else was responsible for the billing, and there was seemingly no impact on us,” he said.

“But since implementing pMD, we have seen a tremendous increase in workflow efficiency. We are now able to staff appropriately, and since doctors are equipped with real-time information to gauge how they are doing, they have become much more engaged with billing.

“Changes can always be perceived as more work, but the new technology worked closely with our IT department to ensure there was as little burden to the providers as possible,” he added.

ADVICE FOR OTHERS

“Without happy physicians, it is hard to expect to have happy patients,” Cacciabaudo advised. “My recommendation to other organizations is to invest in technology that improves provider efficiency. Visibility is key. If providers are equipped with real-time information to track how they are doing, they will become much more engaged with their billing.”

Further, it is important to find a vendor that will assess how their technology can fit into a provider organization’s workflow, not the other way around, she added.

“The ability to interface with other systems already in use, such as your EHR, practice management system or answering service, cannot be understated,” she concluded. “If everything is siloed, the number of systems you have to manage can quickly become overwhelming.”

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com
Healthcare IT News is a HIMSS Media publication.