In a recent case study, Bronx-Lebanon Hospital Center describes how it uses Allscripts Staff Augmentation to complete more than 100 IT projects each year. Automating clinical processes helped Bronx-Lebanon attain nearly full compliance with core measures and keep up with ever-changing state and Federal requirements.
Bronx-Lebanon is the largest voluntary, not-for-profit healthcare system serving the South and Central Bronx in New York City. About 90% of Bronx-Lebanon’s patient population receives Medicaid, the U.S. government’s healthcare funding assistance for people with low incomes.
Bronx-Lebanon implemented its first Sunrise by Allscripts™ solution in 2008, and Allscripts became a trusted partner for the organization. Bronx-Lebanon began using Allscripts Staff Augmentation Services as a core and integrated part of the IT Clinical Team immediately upon beginning implementation activities.
Projects range from utilization management tools, clinical documentation, billing workflows and more. “Right now I have 20 projects on my list to comply with regulations from several different entities,” said Robert Leviton, MD, MPH, FACEP, Bronx-Lebanon Chief Medical Information Officer and Physician Advisor.
Achieving nearly full compliance with core measures
Bronx-Lebanon relies on Staff Augmentation Services to meet dozens of core measures. With the help of protocols and tools from the IT team, Bronx-Lebanon is nearly fully compliant.
“Staff Augmentation enables us to deliver literally hundreds of projects to help us attain nearly full compliance with core measures,” Dr. Leviton said. “They all generate tremendous revenue.” Here are a few examples:
1. 30-day readmission tool.
To avoid unnecessary readmissions, the Staff Augmentation team developed a tool to comply with the Centers for Medicare and Medicaid Services (CMS) 30-day readmission rules. Now the system automatically looks at the last discharge date of each patient, calculates length of time and alerts the physician if it’s less than 30 days.
The tool provides patient data to help the physician assess if there is any way to prevent the readmission, or admit the patient as an outpatient for observation. Not only that, but it captures the physicians reasoning for admitting or not admitting the patient, which helps Bronx-Lebanon comply with potential future audits.
2. Length of Stay (LOS) observation service.
Physicians must reassess patients every 8 hours with a note. A new tool from the Staff Augmentation team helps remind doctors with colorized alerts. If the note is not completed within the parameters, the system alerts the Utilization Management department to follow up with the physician. These alerts continue until discharge.
3. Monitoring anti-coagulant prescriptions.
There are certain instructions for each anti-coagulant medication. Staff Augmentation developed a tool to help monitor when a physician writes a prescription for Warfarin or aspirin, for example. When the physician completes the discharge process, the system automatically places information about anti-coagulants into the complete set of discharge instructions.
According to Dr. Leviton there are many other examples, ranging from pediatric sepsis protocols for the State of New York to Joint Commission standards to Federal rules for attestation. At any given time there are several dozen projects underway with the Staff Augmentation team.
Teamwork is key to success
“We don’t just email a request for a new protocol. Instead, we have a conversation about what we need and why,” Dr. Leviton said. “This approach leads to a magnificent solution…I am simply delighted to work with this team.”
Editor’s Note: Bronx-Lebanon Hospital Center and Allscripts Healthcare have entered into a consulting agreement pursuant to which Bronx-Lebanon Hospital Center and certain hospital employees provide consulting services to Allscripts. The terms of this arrangement were reviewed and approved by Bronx-Lebanon Hospital Center in accordance with its conflict of interest policy. Allscripts did not compensate Dr. Leviton or BLHC to participate in this case study or blog post.