Electronic Health Records Project

Charge of the LSU Health System EHR Executive Steering Committee (ESC)

The ESC is responsible to set overall strategic and operational EHR project goals to ensure alignment with the clinical and financial goals and objectives of the LSU Health System. The ESC is responsible for ensuring consistent implementation of standard processes and best practices across the health system of ten state public hospitals. Project goals and decisions affecting strategic direction and consistency of design, deployment, implementation, support and/or maintenance within the project are communicated and supported by the ESC to the health system hospitals and the EHR project organizational structure. The ESC is responsible for resolution of critical issues that cannot be otherwise resolved at lower levels of the project organization. Decisions regarding scope, timeline, project processes, and budget will be approved by the ESC.

Vision:

LSU Health System envisions patient and family centered medical care delivered through health system-wide coordination of access to services, quality care and cost efficiency across the care delivery continuum, independent of location, and supported by integrated clinical and business process and advanced information management.

• Patients, families and caregivers have the information required to navigate the LSU Health System.
• Patients, families and caregivers receive timely and appropriate information and services.
• Caregivers identify the appropriate care needs of patients and families.
• Caregivers deliver safe, appropriate, efficient and effective care to patients and families.
• Caregivers provide ongoing care management to ensure maximum effectiveness of and satisfaction with care provided.
• Reliable and valid clinical, functional, satisfaction, safety and cost outcomes data is stored, retrieved, analyzed and made available to caregivers in a timely manner.
• One-stop scheduling and registration.
• One-time collection of patient financial and clinical information.
• Patient eligibility and financial obligation is known.
• Charges are driven by documentation at point of care.
• Easily understandable and accurate bills are created in a timely manner.
• Immediate answers to patient financial inquiries can be provided. Key strategic objectives
• A system that reflects the vision of one patient, one record.
• Standardized work processes across the organization.
• Project to be led and owned by functional groups (not IT).
• Use of standardized (non-custom) software from the chosen vendor.
• Use of best practices where appropriate.

Guiding principles:

• A common clinical terminology will be utilized.
• Adoption of CPOE (> 99%) in order to achieve the considerable benefits tied to this goal.
• Design for a paperless environment.
• Bar coding for patient identification.
• Patient’s available information will be compiled prior to registration.
• All patients will be registered using a centralized or decentralized model, as appropriate.
• Adequate and appropriate hardware (workstations, printers, peripherals, and network connectivity) will be available.
• There will be one Charge Master and Service Master across all hospitals (common descriptions, charge, codes, and methodology).
• There will be one guarantor statement across all facilities for technical services and one guarantor statement for all professional services
• Guarantor information obtained at one facility will be “trusted” by other facilities until re-verified using accepted standards

Clinical design guidelines:

• Design will support new forms of interdisciplinary collaboration and communication to coordinate and realize the highest possible standards of patient-centered care.
• Clinical decision support tools will be applied throughout the health system to guide real-time clinical decision making.
• Unnecessary variations in care will be minimized through common processes and replication. Common care standards (e.g., processes, documentation tools, order sets, care plans and drug protocols) will be adopted across all sites as much as possible.
• Patient information will be shared across the continuum of care .
• Clinicians will view information in a manner that improves workflow required to deliver discipline-specific care.
• Clinical documentation will be multidisciplinary with a patient-focused approach that eliminates the need for most paper tools.
• Clinicians will document at the time care is provided.
• “Charting by exception” will be the standard documentation practice.
• One point of data gathering with multiple points of data sharing to eliminate duplication of data collection/validation across caregivers.

Revenue cycle design guidelines:

• Scheduled patients will be pre-verified to collect as much demographic and payor information as possible.
• Scheduled patients will be pre-registered if such practice accelerates the check-in process.
• Insurance eligibility/ benefits will be verified prior to service.
• Clinic scheduling for patients will be available 24 hours a day, seven days a week.
• Appointment reminders will be given to predetermined patient types, based on site criteria.
• Patient instructions will be linked to scheduling so that appropriate information is provided to patients in advance of their visit.
• Information about financial options/obligations, service location, and parking will be provided to patients prior to service.
• Co-pays will be requested at the time of service.
• The clinician will be responsible for complete and accurate documentation of visits, services performed, and the patient’s disease/condition at the time of service.
• Charging will occur at the time service is delivered and documented.
• Coding and data entry will be completed within 24 hours of discharge or the last date service was provided.
• Coding and documentation will adhere to hospital policies and procedures for coding and documentation compliance.
• Utilization will be appropriately monitored based on contractual requirements.
• All utilization monitoring will be a derivative of documentation.
• 100 percent of all claims will be error-free.
• Compliance editing/monitoring will be automated, and upstream processes will be designed to eliminate the need for downstream edits (e.g., charges outside the date of service, research account holds, PT/OT/Speech Authorization holds, onset date hold, missing authorization/missing certification hold, Medicare therapy visit count, interim bills, missing room charges, 72 hour and “same day” rule charge transfer).
• The benefits of HIPAA standard transactions will be realized in the design, especially eligibility 270/271, insurance claims 837, remittance 835, and claims status 276/277.