How to balance the yin and yang of academic medical centers
In Taoist philosophy, yin and yang describe two seemingly contrary halves that together make a complete whole. It aptly describes a common experience in academic medical centers: Balancing patient care with academic training and research.
At a recent advisory group meeting for Allscripts EPSiTM decision support leaders at academic medical centers, I heard some common themes:
When a resident and physician are working side by side, how do we account for the expenses associated with teaching time and other “non-billable” activities?
What are the true costs and contribution to patient care given the additional academic time and materials supporting each resident?
How do we accurately budget and account for funding sources that are established to pay for the research and teaching aspects of care?
How do we have the right financial incentives and programs in place to keep and grow relationships between academic institutions and institutions of care?
The clinical and academic responsibilities sometimes seem at odds with one another. It takes sophisticated solutions to accurately plan and track time and expense, bringing balance to these two competing forces within academic medical centers.
Most of these concepts were familiar to everyone at the advisory group, but the organizations vary widely in structures, processes and tools for modeling, planning and managing the academic aspects of care. So, it comes as no surprise that we received varying responses to how they were approaching and meeting their needs.
Client example #1 – Automating the complex management of funding sources
One client used the flexibility of EPSi to define its own business rules and calculations to manage the funding arrangements for manage the funding arrangements for a multi-specialty faculty practice. Using EPSi’s Data Extender functionality and reporting capabilities, the client: a) brings in data from different sources, and b) defines and applies their complex business rules and logic to the data. Through this approach, the client was able to accurately automate the management and oversight of its funding sources.
What’s especially impressive to me is that the client was able to do this on its own. It didn’t require programmers or consultants, but rather EPSi was easy and open enough to solve this organization’s business problem.
Client example #2 – Striking a balance between patient care and research
Another client uses EPSi to address a familiar problem: how much of a physician’s time is spent on clinical activities, and how much is spent on research/academic work? This client is using EPSi to figure out how much time and expense is going into each area. The team can track it with EPSi and set targets, creating accountability at the physician level. The client uses visibility and accuracy of the data and insights to achieve a happy balance between research and actual patient care.
Again, as in the first example, the client achieved all of it with the flexibility, openness and ease of use of EPSi capabilities.
Client example #3 – Understanding and having visibility of the true cost of care
Not surprisingly, all of the members interviewed described the different cost accounting methodologies and modeling practices used to ensure they accurately capture and apportion the often times hidden costs associated with teaching and research. Many times, the models required the automated creation of patient activities associated with the various academic teaching and research practices.
Although they were all the same from the aspect they all needed to accurately determine the true cost of care, they were equally as different in path they needed to take to get there. Each unique and intelligently designed accounting process employed by these organizations was a testament to the breadth of EPSi’s cost accounting capabilities, as well as the flexibility needed and provided by the solution.
Client example #4 – Identifying variances in care that lead to unnecessary cost and risk
In a recent case study, the University of Mississippi Medical Center (UMMC – Jackson, Mississippi, U.S.A.) described how it uses EPSi’s patient analytics for both clinical and research benefits. It found two areas with potential cost saving opportunities of $1.3 million: reducing unnecessary lab testing and identifying efficient uses of medication. You can download the full story here.
In Taoism, there is a natural balance and harmony nature, but a polarization and differentiation in perspective and reality. So too is there harmony in the needs of our academic healthcare settings, but also a natural variation in the perspective and reality for fulfilling those needs.
Given the number of different ways our academic medical center clients are successfully using EPSi, it’s ever clearer to me that the system is extremely flexible, open and easy to use. The functionalities and capabilities enable some really creative responses from our clients to common business problems.
We continue to encourage clients to share their best practices in the EPSi ClientConnect community.