Providers at Truman Medical Centers (TMC) have more time to focus on patients after Cerner sustainment coaches worked with the Cerner ITWorksSM client to gain electronic health record (EHR) efficiencies. Coached providers cut their time in chart per patient by more than 20 percent while contributing to more than $1 million in regulatory reimbursements.
"As physicians, one of our main goals is spending more time with our patients," said Peminda Cabandugama, MD, endocrinologist and weight management specialist. "I think coaches helped us streamline our process, so we get to spend more time with them and thus provide better care."
Sustainment coaches provide continuous long-term services for end-users at TMC. In addition to providing optimization support, during 2017, coaches also helped with new Cerner technology implementations, regulatory support, and onboarding of about 450 physicians, advanced practice providers, residents, fellows and medical students, while still supporting more than 600 medical staff at every TMC facility.
TMC's commitment to staff satisfaction paved the way for a new standard of practice for following-up with physicians after their initial training.
"The continuous support after the onboarding process is a fabulous idea," said Monica Katamura, MD, pediatrics and internal medicine specialist. "It makes me feel like I'm not just onboarded, but there's also someone to help follow up. They check in and make sure I'm working efficiently as possible."
The sustainment coaches utilize data from Cerner's Advance and Lights On Network® to see which providers need additional support.
Time in chart per patient (total time in the EHR) fell by 33 percent.1 Also, the coaches focused on identifying documentation efficiencies. The coached providers documentation time in chart (total time spent in EHR during note documentation) fell by 38 percent.1
"Through that process, the coaches and the providers have taken steps and made huge strides," said Jeffrey Hackman, MD, FACEP, chief medical information officer and medical director of quality. "The physicians and coaches work together daily and seek each other out."
"My adoption coach has gotten to know what's important to me and she's also gotten to know where I need help," said Nasim Ahmadiyeh, MD, PhD, medical director comprehensive breast care program, breast surgical oncologist. "She's been able to customize her approach so that I am a lot more efficient in clinic."
Laura Doan, MD, FACOG, obstetrics & gynecology specialist, added implementing the documentation efficiencies, "gives me more free time at home, where I'm not spending all the time working on the computer. Instead, I can see my family or go for a bike ride. It gives me more freedom, both in the office and outside."
Sustainment coaches also help providers reach regulatory requirements. By proactively targeting providers and teaching them about tools they were not familiar with, and ensuring physicians documented in specific areas tied to the Promoting Interoperability program, coaches contributed to a significant regulatory reimbursement increase for TMC by 23 percent from 2016 to 2017.2
"Providers who engaged in sustainment coaching contributed to $1.3 million3 in reimbursement for meaningful use," Hackman said. "Meeting those requirements helped maximize our reimbursement incentive. As regulatory measures change, and new functionality becomes available, at-the-elbow support is critical to the medical staff and maximizes revenues."
TMC leaders plan to continue using sustainment coaches to assist providers. In addition to the coaching role, TMC has also added an End User Experience Specialist who focuses on proactive rounding for technology questions and needs. Both roles contribute to a first-class experience for end-users.
"I think the connection between the coaches and providers can only expand," said Hackman. "We would love to have more. As they continue to focus on efficiencies, new functionality and ongoing support and training, the need increases."
1 Comparing April 2017 to November 2018
2 Comparing 2016 reimbursement worth $1.062 million to 2017 reimbursement worth $1.3 million
3 Based on 154 attestations worth $8,500 from Medicaid