Becker's Hospital Review

45 Executive Briefing Cerner's health information technologies connect people, information and systems at more than 25,000 provider facilities world- wide. Recognized for innovation, Cerner solutions assist clinicians in making care decisions and enable organizations to manage the health of populations. The company also offers an integrated clinical and financial system to help health care organizations manage revenue, as well as a wide range of services to support clients' clinical, financial and operational needs. Cerner's mission is to contribute to the systemic improvement of health care delivery and the health of communities. Nasdaq: CERN. For more information about Cerner, visit cerner.com, read our blog at blogs.cerner.com, connect with us on Twitter at twitter.com/cern- er and on Facebook at facebook.com/cerner. 2. Increase cash on hand. Another way organizations can minimize financial disruption is to augment cash reserves and enhance revenue cycle perfor- mance prior to conversion. Initially, some organizations may struggle with cash collections after transitioning between patient accounting systems, per Ju- lie Kay, vice president of revenue cycle services at Cerner. This can happen when an organization begins to focus on complet- ing work in the new system and inadvertently lets legacy A/R work slide, which can lead organizations to suffer a cash crunch or issue with their reserves. "You have to set the expectation that there is going to be a short-term decline in cash unless certain steps are taken to pro- tect cash flow and prevent billing delays," Ms. Kay said. To mit- igate financial risk during conversion, Ms. Kay recommended organizations optimize revenue cycle processes and take steps to increase cash on hand. Working down days in A/R, reducing DNFB to around four days and enhancing charge capture pro- cesses are effective ways organizations can create a financial cushion to mitigate any dip during the conversion. "Having a very rigorous project plan in place is important, not just for converting, but also for managing and maintaining accounts re- ceivable and knowing how many days of cash on hand you need should something happen during implementation," Ms. Kay said. 3. Counter productivity issues by adding support staff. Enlisting the support of a third-party to augment revenue cycle staff can be invaluable during a conversion, when hospital re- sources are stretched thin, Mr. Koons said. Some organizations choose to outsource all legacy A/R work during a conversion so internal staff can focus entirely on stand- ing up the new system. This abrupt transition, although intend- ed to help staff learn the new system more quickly, can end up overwhelming employees and harming office morale. Gradually introducing staff to new workflows while they wind- down legacy A/R can help employees feel more comfortable and confident with change. "Internal staff's expertise is in the legacy system," Ms. Kay said, meaning internal employees are often the most productive and efficient at working the legacy system. As a result, organizations that gradually shift workflows may see a less marked impact on productivity levels as employ- ees gain competence in the new system. To further ensure productivity remains consistent during con- version, health systems should enlist supplemental office support. "We've partnered with Cerner's RevWorks for sup- plemental staffing, known as transition services, to bridge our productivity gap during conversion and ensure performance remains consistent while our internal staff gain efficiency on the Cerner system," Mr. Koons said. Specifically, RevWorks' team of experts focuses on refining work processes in the Cerner system as employees work down legacy accounts. By setting up and smoothing out processes in the platform before the office fully converts, RevWorks ensures the transition is as seamless as possible. Cerner's team also plays an important role in helping staff learn best practices in the new system. "RevWorks teams work side- by-side with [hospital] staff to help them both understand new workflows and learn how to use the system at its full capacity," Ms. Kay said. For instance, as hospitals undergo a software con- version, hospital IT and revenue cycle staff may have a general idea of how to use the new system to complete a particular task, but they may not know system best practices. Cerner experts can recommend alternative workflows that take full advantage of the IT system's efficiencies. Although an IT vendor is likely to have unmatched knowledge of its product, value-added resellers, consultants and other business education and training companies are also worth con- sidering for employee training and support services, according to Mr. Koons. "[Centra] also partnered with a company to build the training content and curriculum for staff system conversion," he said. 4. Engage staff in the conversion process. System conversions present as many cultural challenges as they do technical difficulties. People are creatures of habit, which can lead to resistance to change among employees. It is no differ- ent in a field as disciplined and regimented as medicine, where healthcare professionals are often uncomfortable with aban- doning ingrained practices in favor of new, unfamiliar ones. The importance of anticipating and addressing cultural chal- lenges during a PAS implementation cannot be understated. "Change is very uncomfortable and awkward for staff," Mr. Koons said. "We want frequent communication to the organiza- tion and inclusion as much as we can from a high level down to alleviate any fears that the change will be overwhelming." Knowing that a patient accounting system implementation will cause complications for staff, an organization's implementation teams must find ways to boost morale. To foster a culture of change among revenue cycle employees, Centra presented the conversion as an enterprisewide movement for improved connection and unity. "We called Cerner 'Unison,' or the 'Unison Project' to generate ex- citement among staff," Mr. Koons said. "We've held a number of events to kickoff the 'Unison Project' and scheduled town halls where we've demonstrated the system to employees in advance." Conclusion The fact that change has become a near constant in healthcare does not make navigating transformation any easier for em- ployees or administrators. Engaged and effective leadership and a well-established implementation management team are key to leading an organization through times of instability. "Hospital leaders tend to become fixated on the technical con- version," Ms. Kay said. "But Centra is doing a fantastic job of preparing their organization for change on all fronts, from em- ployee engagement to executive leadership. They understand the culture of their staff, their physicians, their community — and that's what makes a difference." n

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