Successfully Implement a New Computer System
With everyone on board using creative resolution, the transition doesn’t have to be daunting.
By Lynda Vining, CPC
Recently, an academic facility installed a new computer system. It included a massive, shared electronic medical record, which incorporated electronic patient scheduling, fiscal management, and revenue cycle. Here’s how the transition was made successful.
Start with Training
Training began with all staff — from scheduling to registration, charge entry, follow-up, payments, and adjustment posting. Many business group managers and information support staff attended classes, as well, and some were certified to work in the system. Each staff member was given a manual/notebook, with a chapter for every class. We could write notes and add sections to the book, as necessary. A few of the staff became “super users,” and helped to teach others.
Innovative Ways to Learn and Share Information
In addition to structured lessons in class, we were set loose on “the playground,” an area within the new system that allowed us to create and experiment with “dummy” names and accounts. This gave us hands-on experience adding and correcting charges, adding and making changes to insurance information, etc. All entries were temporary: Anything keyed in was erased when we logged off.
During training classes and in our work areas, large sheets of poster paper were hung from the wall. Each sheet was a “parking lot.” If you had questions or scenarios, or needed to know how to deal with certain things, you would “park” your question on the poster paper. The answers were published each week. The collected questions and answers were compiled into a “most frequently asked questions” document, and were placed on our “infonet” (internal computer network or intranet)”
We also published “Tips and Tricks” on the infonet, which feature diagrams and screen prints detailing how to do certain things. We can print these pages and add them to our manuals. We even have a direct email to the cash department, called “Cash Questions,” to help us.
Following training, we were all required to pass a proficiency test.
Load Before Going Live, then Verify
Prior to going live, we printed appointments for three months to be loaded into the new system. We had a “super registration weekend” to load all this information (demographics, billing information, etc.) into the system. When the patients presented for the appointments, we verified (and in some cases, updated) the information.
There are three types of records in the system:
- Patient Record: The patient record includes patient demographics, medical record numbers, the primary care physician, clinical information, and the patient chart.
- Coverage Record: The coverage record contains the subscriber identification number, the member number, the group number effective date, and the claims address.
- Guarantor Record: The guarantor record contains the address for billing statements, charges, payments, adjustments, and the person ultimately responsible for the bill (e.g., the patient, parent, workers compensation, contract, grants, guardian, employer, or any entity responsible for the bill or any special handling of the claims for reimbursement).
We all learned new lingo, too. For example, in our old system we had “cases,” and everything pertaining to the episode of care was billed in a case; we now have guarantor accounts. We previously used financial status codes for insurance carriers; we now have coverage records. And where we used to have work files, we now have work queues.
On the go live date, when our charges were keyed for the first time, super users, identified with brightly colored vests, were located all over the floor to help with any problems.
Success Relies on Continuous Effort
The hospital went live three months after our professional billing department, and our super users were there to assist in the residents’ clinics when patients presented for appointments. We also assisted in adding insurance billing information. We continue to provide feedback to our staff and the hospital staff.
Implementing a new computer system was a large undertaking, and many dedicated employees devoted long hours to training. We did encounter some problems during the rollout, but we also had good communication between the professional billing staff, the hospital clinic staff, and our help desk staff. Planning and teamwork made the conversion a success.
Lynda Vining, CPC, works at the University of Florida Jacksonville Physicians, Inc. She is the team lead for the Department of Obstetrics and Gynecology Business Group. Vining has over 40 years of experience in billing and coding for obstetrics and gynecology. She is an active member of the Orange Park, Fla., local chapter.