Get the E-newsletter
Three years ago, Sean O'Neill, PharmD, then the medication safety officer at Children's Hospital of Philadelphia (CHOP), was frustrated that his team could not easily transfer drug libraries from old smart-infusion pumps to new pumps. He also wanted to leverage the data captured by the pumps to identify potentially unsafe medication practices. O'Neill thought creating new smart-pump software would address these problems.
So in 2013, O'Neill submitted a two-paragraph description of his idea to a contest at CHOP designed to seek innovative ideas from employees. Although O'Neill's idea did not win the contest, it did give him an opportunity to meet with leaders in CHOP's Office of Entrepreneurship and Innovation. They connected him with an outside team of software developers who built a rough version of the platform. O'Neill then tested the prototype software around the country, seeking input from potential users.
In 2016, leaders at CHOP spun off the new software company, Bainbridge Health, located in Philadelphia. The company's data analytics platform for smart pumps is already available on the market, and the library-management capability is in development.
"Most clinicians don't have business and entrepreneurship expertise, so it is incredibly important that they work with entrepreneurs or business experts to push ideas forward," says O'Neill, now the full-time chief clinical officer at Bainbridge Health. "A lot of our success has been due to the fact that we brought in the appropriate leadership from the business side and the technology side."
Bainbridge Health is just one example of how leaders at CHOP have fostered a culture of entrepreneurship and built innovative collaborations inside and outside their organization.
One of CHOP's earlier innovation success stories was the spin-off of Spark Therapeutics, a publicly traded gene therapy company founded in 2013. The company was built on more than 20 years of research at CHOP into the genetic treatment of diseases such as hemophilia.
"It dawned on us after Spark: What else were people working on that we might not be aware of?" says Patrick FitzGerald, CHOP's vice president for entrepreneurship and innovation. The desire to be more proactive in identifying good ideas from within spurred the creation of his role and the Office of Entrepreneurship and Innovation, which focuses on incubating new ideas that improve patient outcomes, reduce healthcare costs, and address chronic disease.
In addition to FitzGerald, who also teaches at the Wharton School of the University of Pennsylvania, the office's team includes an administrative director, a project coordinator, a medical device liaison, and a scientific and medical adviser. This last role is filled by Flaura Winston, MD, PhD, who also chairs the office's scientific advisory council, which vets new ideas that come from any of CHOP's 11,000 employees.
"Our role is to help incubate an idea [also known as "de-risking"] so we have a course of action for that idea moving forward," says Winston, who has a background in medicine and engineering. After the council helps to assess the potential value of an idea, the Office of Entrepreneurship and Innovation assembles a team of internal and external subject-matter experts to help shepherd the idea through the development process. Council members review each proposed project based on its impact on patients, mission fit, commercial potential, novelty, and whether it represents a critical improvement to the standard of care.
"Once ideas make it through our first pass, they go through a very iterative process of development that one would normally see in a startup incubator," Winston says. "But because this is taking place inside the hospital, we can leverage our extensive access to clinical, scientific, and regulatory expertise to ensure that the final product will be safe and effective."
Innovation at a children's hospital is particularly mission-driven, Winston believes. "We consider return on our mission to be as important as return on investment," she says. "For example, there are projects that may not return a lot of profit, but they are so important for the safety of children or improving accessibility. These are projects we would still pursue."
At CHOP, leaders also tend to view innovation in terms of how it might help not only a child but also a family.
FitzGerald says his office concentrates on four areas of innovation and entrepreneurship.
Creating start-ups. In the past 18 months, CHOP has created three spin-off companies that are not limited to the pediatric realm: Bainbridge Health; Diagnostic Driving, which designs software to promote safety on the road; and Haystack Informatics, a firm focused on protecting the privacy of patient data.
Creating licensable assets (usually devices). "We had three nurses come to us with the exact same idea to develop a better version of what is known as the 'no-no,' a peripheral IV cover," FitzGerald says. CHOP leaders are negotiating with a large medical device company to bring the product to market.
Investigating new business lines for CHOP. When a faculty member wanted to create a mothers' milk bank at CHOP, the Office of Entrepreneurship and Innovation helped her create a business plan and make the new offering a reality. FitzGerald says his team also is looking at expanding virtual reality applications for patients to more easily interact with hospital clinicians.
Exploring vanguard technologies that are on the horizon and outside the traditional scope of medicine. One example is a dermatology application that allows parents to send secure pictures of skin ailments for evaluation by a dermatologist. The app will be launched inside CHOP in early 2017. Leaders also are exploring gamification techniques to monitor how children self-report their recovery after a serious illness or injury, Winston says.
Leaders at CHOP and Bainbridge Health offer the following advice for healthcare organizations looking to build their innovation and entrepreneurship capabilities.
Be transparent when selecting ideas to pursue. The selection process for new ideas at CHOP is agnostic and "for people from all walks of life—nursing, facilities, surgery, and so forth," FitzGerald says. "We don't want politics to be involved, so it is a very open and transparent process. Our scientific advisory council covers a large majority of disciplines at CHOP so that we can ensure ideas come from all areas of the hospital."
Look outside for expertise. "Historically, hospitals have been too insular in their approach to innovation, perhaps to protect intellectual property," FitzGerald says.
CHOP's in-house innovation team includes no software developers, designers, or prototype developers. "We prefer to look outside our walls to help us develop these ideas," FitzGerald says.
Make sure financial and operational leaders are comfortable with the ambiguity of innovation. "We cannot always put innovation into a clear work process," says Winston, who is also a professor of pediatrics at the University of Pennsylvania. Having clear guiding principles and oversight can help, but the innovation process needs to remain flexible, she says.
"The office's incubation process starts with determining the development needs—how we can support the team with a great idea to get to a solution that can improve health. Each idea, each team has a different set of needs. It is highly individualized and requires flexibility. Some teams are researchers who have limited clinical or business expertise but already have a great prototype that needs polishing and a business plan. Others are clinicians who have a clear vision for a clinical problem and how to solve it but may lack research, business, and product development skills and resources."
Seek ideas from nurses and other front-line staff, who often develop workaround solutions to solve problems. "Nurses are some of the most innovative people out there," Winston says. "If a nurse at the bedside sees a problem, he or she fixes it to help their patient. We take this innovation and turn the nurses into makers. We give them the support so they can take that workaround into the commercialization space."
Test an idea with clinicians inside and outside your organization. "Unless you are engaging clinicians in this work, you are never going to know if you're truly addressing an actual problem," O'Neill says. By testing the smart-pump software across the country, O'Neill recognized his product was marketable.
Give clinicians protected time to explore new ideas. CHOP gave O'Neill a six-month leave of absence to test his software idea and bring it to market. "You can't really flesh out these ideas for two hours a day after you have put your kids to bed," O'Neill says. "It is vitally important for organizations to provide protected time for people to innovate. We certainly wouldn't be where we are with Bainbridge now if I had not been given that opportunity."
Laura Ramos Hegwer is a freelance writer and editor based in Lake Bluff, Ill.
Interviewed for this article:
Sean O'Neill, co-founder and chief clinical officer, Bainbridge Health, Philadelphia.
president for entrepreneurship and innovation, Children’s Hospital of
Winston, MD, PhD,
chair, scientific advisory committee, Children’s Hospital of Philadelphia.
HealthTrust: Optimizing Purchased Services
Andrew Motz, assistant vice president, supply chain consulting at HealthTrust, discusses the value of a data-driven approach when procuring purchased services.
Change Healthcare: Accelerating Revenue Cycle Transformation
Jason Williams, vice president for strategy and business analytics, Change Healthcare, discusses the importance of technology and technology-enabled services in reinventing the revenue cycle.
Ensemble Health Partners: Driving Revenue Cycle Innovation
Judson Ivy, president of Ensemble Health Partners, discusses the value of revenue cycle outsourcing and the importance of selecting the right partner.
Grant Thornton: Facilitating EAM
6 Patient Revenue Cycle Metrics You Should Be Tracking (and How to Improve Your Results)
Patient financial engagement is more challenging than ever – and more critical. With patient responsibility as a percentage of revenue on the rise, providers have seen their billing-related costs and accounts receivable levels increase. If increasing collection yield and reducing costs are a priority for your organization, the metrics outlined in this presentation will provide the framework you need to understand what’s working and what’s not, in order to guide your overall patient financial engagement initiatives and optimize results.
10 Ways to Reduce Patient Statement Volume (and Reduce Costs)
No two patients are the same. Each has a very personal healthcare experience, and each has distinct financial needs and preferences that have an impact on how, when and if they chose to pay their healthcare bill. It’s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients. The need to tailor financial conversations and payment options to individual needs and preferences is critical. This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach, but take control of rising collection costs.
Reduce Patient Balances Sent to Collection Agencies: Approaching New Problems with New Approaches
This white paper, written by Apex Vice President of Solutions and Services, Carrie Romandine, discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle. Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs, but it will maximize the amount collected before sending to collections. Further, targeted messaging should be applied across all points of patient interaction (i.e. point of service, customer service, patient statements) and analyzed regularly for maximized results.
The Future of Online Patient Billing Portals
This white paper, written by Apex President Patrick Maurer, discusses methods to increase patient adoption of online payments. Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections. This white paper shows why patient-centric approaches to online payment portals are important complements to traditional provider-centric approaches.
Payment Portals Can Improve Self-Pay Collections and Support Meaningful Use
Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs. This article, written by Apex Founder and CEO Brian Kueppers, explores a number of strategies to create synergy between patient billing, online payment portals and electronic health record (EHR) software to realize a high ROI in speed to payment, patient satisfaction and portal adoption for meaningful use.
Large Health System Drives 10% UP (Patient Payments) and 10% DOWN (Billing-related Costs)
Faced with a rising tide of bad debt, a large Southeastern healthcare system was seeing a sharp decline in net patient revenues. The need to improve collections was dire. By integrating critical tools and processes, the health system was able to increase online payments and improve its financial position. Taking a holistic approach increased overall collection yield by 10% while costs came down because the number of statements sent to patients fell by 10%, which equated to a $1.3M annualized improvement in patient cash over a six-month period. This case study explains how.
ICD-10: Managing Performance
With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus.
Clarity Drives Collections
Read how Gwinnett Medical Center provides clear connections to financial information, offers multiple payment options for patients, and gives onsite staff the ability to collect payments at multiple points throughout the care process.
Orlando Health Gains Insight into Denials, Reduces A/R Days with RelayAnalytics Acuity
Read how Orlando Health was able to perform deeper dives into claims data to help the health system see claim rejections more quickly–even on the front end–and reduce A/R days.
Revenue Cycle Payment Clarity
To maintain fiscal fitness and boost patient satisfaction and loyalty, healthcare providers need visibility into when and how much they will be paid–by whom–and the ability to better navigate obstacles to payment. They need payment clarity. This whitepaper illuminates this concept that is winning fans at forward-thinking hospitals.
Streamlining the Patient Billing Process
Financial services staff are always looking for ways to improve the verification, billing and collections processes, and Munson Healthcare is no different. Read about how they streamlined the billing process to produce cleaner bills on the front end and helped financial services staff collect more than $1 million in additional upfront annual revenue in one year.
Wallace Thomson Hospital Automates to Maximize Limited Resources
Effective revenue cycle management can be a challenge for any hospital, but for smaller providers it is even tougher. Read how Wallace Thomson identified unreimbursed procedures, streamlined claims management, and improved its ability to determine charity eligibility.
7 Steps for Building and Funding Sustainability Projects
Before launching an energy-efficiency initiative, it’s important to build a solid business case and understand the funding options and potential incentives that are available. Healthcare leaders should consider taking the steps outlined in the whitepaper to ease the process of gaining approval, piloting, implementing, and supporting sustainability projects. You will find that investing in sustainability and energy efficiency helps hospitals add cash to their bottom line. Discover how hospitals and health systems have various options for funding energy-efficient and renewable-energy initiatives, depending on their current financial structure and strategy.
Key Capital Considerations for Mergers and Acquisitions
Health care is a dynamic mergers and acquisitions market with numerous hospitals and health systems contemplating or pursuing formal arrangements with other entities. These relationships often pose a strategic benefit, such as enhancing competencies across the continuum, facilitating economies of scale, or giving the participants a competitive advantage in a crowded market. Underpinning any profitable acquisition is a robust capital planning strategy that ensures an organization reserves sufficient funds and efficiently onboards partners that advance the enterprise mission and values.
Key Capital Considerations for Mergers and Acquisitions
The success of healthcare mergers, acquisitions, and other affiliations is predicated in part on available capital, and the need for and sources of funding are considerations present throughout the partnering process, from choosing a partner to evaluating an arrangement’s capital needs to selecting an integration model to finding the right money source to finance the deal. This whitepaper offers several strategies that health system leaders have used to assess and manage capital needs for their growing networks.
Trend Watch: Providers adapt as value-based care moves from hype to reality
Announcements from several commercial payers and the Centers for Medicare and Medicaid Services (CMS) early in 2015 around increased efforts to form value-based contracts with providers seemed to point to an impending rise in risk-based contracting. Rather than wait for disruption from the outside in, health care providers are now making inroads on collaborating with payers on various risk-based contracting models to increase the value of health care from within.
Yuma Regional Medical Center case study
Yuma Regional Medical Center (YRMC) is a not-for-profit hospital serving a population of roughly 200,000 in Yuma and the surrounding communities.
Before becoming a ZirMed client, Yuma was attempting to manually monitor hundreds of thousands of charges which led to significant charge capture leakage. Learn how Yuma & ZirMed worked together to address underlying collections issues at the front end, thus increasing Yuma’s overall bottom line.
Reforming with a New 50-Bed Acute Care Facility
Kindred Hospital Rehabilitation Services works with partners to audit the market and the facility’s role in that market to identify opportunities for improvement. This approach leads to successes; Kindred’s clinical rehab and management expertise complements our partners’ strengths. Every facility and challenge is unique, and requires a full objective analysis.
5-Minute Briefing on Revenue Integrity Through HIM WhitePaper Hospitals FS
As the critical link between patient care and reimbursement, health information enables more complete and accurate revenue capture. This 5-Minute White Paper Briefing shares how to achieve cost-effective revenue integrity by your optimizing HIM systems.
5-Minute Briefing on Accelerating Cash Flow Through HIM WhitePaper Hospitals FS
Speedier cash flow starts with better CDI and coding. This 5-Minute White Paper Briefing explains how providers can improve vital measures of technical and business performance to accelerate cash flow.
5-Minute Briefing on Reducing the Cost of RCM WhitePaper Hospitals FS
Qualified coders are getting harder to come by, and even the most seasoned professional can struggle with the complexity of ICD-10. This 5-Minute White Paper Briefing explains how partnerships can help improve coding and other key RCM operations potentially at a cost savings.
Providers Focus Too Much On Revenue Cycle Management
The point of managing your revenue cycle isn’t just to improve revenue and cash flow. It’s to do those things effectively by consistently following best practices— while spending as little time, money, and energy on them as possible.
Lucille Packard Children’s Hospital Stanford Case Study
How Lucile Packard Children’s Hospital Stanford increased payments received within 45 days by 20% and reduced paper submission claims by 70% by using ZirMed solutions.
Using Predictive Modeling To Detect Meaningful Correlations Across Claims Denials Data
The reasons claims are denied are so varied that managing denials can feel like chasing a thousand different tails. This situation is not surprising given that a hypothetical denial rate of just 5 percent translates to tens of thousands of denied claims per year for large hospitals—where real‐world denial rates often range from 12 to 22 percent. Read about how predictive modeling can detect meaningful correlations across claims denials data.
ZOLL and Emergency Mobile Health Care Case Study
Emergency Mobile Health Care (EMHC) was founded to be and remains an exclusively locally owned and operated emergency medical service organization; today EMHC serves a population of more than a million people in and around Memphis, answering 75,000 calls each year.
Maximizing Medicare Reimbursements White Paper
Since the Physician Quality Reporting Initiative (PQRI) introduction, CMS has paid more than $100 million in bonus payments to participants. However, these bonuses ended in 2015; providers who successfully meet the reporting requirements in 2016 will avoid the 2% negative payment adjustment in 2018, so now is the time to act! Included in this whitepaper are implications of increasing patient responsibility, collections best practices, and collections and internal control solutions.
Denials Deconstructed: Getting Your Claims Paid
Getting paid what your physician deserves—that’s the goal of every biller. Yet even for the best billers, achieving that success can be elusive when denials stand in the way of success, presenting challenges at every turn. Denials aren’t going away, but you can learn techniques to manage and even prevent them.Join practice management expert Elizabeth W. Woodcock, MBA, FACMPE, CPC, to: Discover methods to translate denial data into business intelligence to improve your bottom line, determine staff productivity benchmarks for billers, and recognize common mistakes in denial management.
Automation and Operational Improvement Drive Sustainable Results
Physician practices must improve organizational efficiency to compete in this era of reduced reimbursement and escalating administrative costs.
Revenue Cycle Management Resolves Migration Implementation Issues
Many healthcare organizations are pursuing next-generation health information systems solutions. Learn more about Navigant's work with University of Michigan Health System.
Partnering For Success – Provider Achieves Strength in Stability
The proper implementation of healthcare information technology systems is crucial to an organization’s financial health.
Building a Clinically-Integrated Network
As value-based payment models evolve, providers are challenged to maintain superior clinical outcomes while controlling costs.
Winning in the Post-Acute Marketplace
Read more about factors contributing to the changes in the post-acute marketplace and what it means for manufacturers, physicians, clinicians, patients, and post-acute facilities as they anticipate the transition to the second curve.
Building A Common Vision with Employed Physicians
HSG helped the physicians and executives of St. Claire Regional in Morehead, Kentucky, define their shared vision for how the group would evolve over the next decade. As well as, develop the strategic and operational priorities which refocused and accelerated the group’s evolution.
Practice Performance Improvement
The client was a nine-hospital health system with 14 clinics serving communities in a multi-state market with very limited access to care, poor economic conditions, high unemployment, and a heavy Medicare/Medicaid/uninsured payer mix. In most of these communities, the system was the sole source of care.
Though the clinics were of substantial size (they employed 98 physicians) and comprised of multiple specialists, the physicians functioned as individuals and the practices lacked any real group culture.
Clinical Integration Without Spending a Fortune
Clinical integration can be expensive, but it doesn’t have to be, as this four-step road map for developing a CIN proves. Does it have to cost millions to initiate a clinical integration strategy?
Contrary to popular belief, we have clients who have generated substantial shared savings and a significant ROI over time, without massive investments. Yes, some financial capital is required for resources the CIN providers can’t bring to the table themselves. But the size of that investment can be miniscule relative to the value it produces: improved outcomes and documentation for payers.
Adding Value to Physician Compensation
Today’s concerns about physician compensation are the result of the changing healthcare environment. The transition to value is slow, but finally becoming a reality. Proactive hospitals want to ensure that provider incentives are properly aligned with ever-increasing value-based demands.
This report focuses on the three big questions HSG receives about adding value to physician compensation; Why are organizations redesigning their provider compensation plans? What elements and parameters must be part of successful compensation plans? How are organizations implementing compensation changes?
Effective Revenue Cycle Management in Your Network
Revenue Cycle Management has become an even more complex issue with declining reimbursements, implementation of Electronic Health Records, evolving local carrier determinations (LCD), and payer credentialing [The emphasis on healthcare fraud, abuse and compliance has increased the importance of accuracy of data reporting and claims filing).
The efficiency of a medical practice’s billing operations has critical impact on the financial performance. In many cases, patient billings are the primary revenue source that pays staff salaries, provider compensation and overhead operating cost. Inefficiencies or inaccurate billing will contribute to operating losses.
Succeeding in Value-Based Care
This publication identifies and outlines the necessary characteristics of a fully-functioning clinically integrated network (CIN). What it doesn’t do is detail how hospitals and providers can participate in the value-based care environment during the development process.
One common misconception is that the CIN can’t do anything significant until it has obtained the FTC’s “clinically integrated” stamp of approval. While the network must satisfy the FTC’s definition of clinical integration before single signature contracting for FFS rates and contracts can legally start, hospitals and providers can enjoy three key benefits during the development process.
Therapy: Benefits at All Levels of Care
Nearly half of all Medicare beneficiaries treated in the hospital will need post-acute care services after discharge. For these patients, a stay in an inpatient rehabilitation facility, skilled nursing facility or other post-acute care setting comes between hospital and home.
Does Your Budgeting Process Lack Accountability?
With the proper process, tools, and feedback mechanisms in place, budgeting can be a valuable exercise for organizations while helping hold organizational leaders accountable. Having a proper monthly variance review process is one of the most critical factors in creating a more efficient and accurate budget. Monthly variance reporting puts parameters around what is to be expected during the upcoming budget entry process.
Cost Accounting: the Key to Cost Management and Profitability
Managing the cost of patient care is the top strategic priority of most hospital CFOs today. As healthcare shifts to more data-driven decision making, having clear visibility into key volume, cost and profitability measures across clinical service lines is becoming increasingly important for both long-range and tactical planning activities. In turn, the cost accounting function in healthcare provider organizations is becoming an increasingly important and strategic function. This whitepaper includes five strategies for efficient and accurate cost accounting and service line analytics and keys to overcoming the associated challenges.