Transforming Change: How Technology can Create Gains and Close Gaps

By Kris Seymour, Director, Revenue Cycle Transformation and PMO, WellStar Health System

There has always been a link between healthcare and technology. At once not often spoken, is now undeniable. As technology advances, there are innovations in healthcare that are happening at a far faster rate than ever before, and in return, healthcare is an industry that is beginning to push technology to strive for a high level of excellence because of the need for medical solutions is happening at almost as rapid a rate. Along with the demands of providing care are the financial challenges that present to revenue cycle. There is a need to manage the changes in legislation to remain compliant, the changes in reimbursement to remain able to serve our communities, and the changes in the voice of the patients that are looking for an experience tailored to their needs. Technology and automation are often the answers to the question of how to keep up with the pace of innovation that the healthcare industry continues to set in both clinical and revenue cycle settings. The changes are never-ending and constantly advancing.

When healthcare systems are looking to implement change, a new system, or an initiative, the technological components of the project are the topic for discussion. Understanding how automation can create efficiencies in performance if the technology offers the features to support the operational need, and the financial impacts to optimize performance. If asked, there are not many that would disagree with the need for technology to be used to improve all segments of healthcare, and yet there is still a belief that emails, and spreadsheets are the best tools to manage and coordinate all the moving pieces involved with implementations of any kind. These are the “go to” tools used in revenue cycle to manage projects and initiatives that are dependent on the ability to meet budgetary expectations, timelines, and meet scope goals to implement a project successfully with most having significant financial implications should any of those items go off track. Having a technology or systems in place to manage changes in operation is a way that creates transparency, increases collaboration, and improves the efficiency of all implementations. Integrating technology into project and change management processes will allow for truly transformational change.

Any issues with the revenue cycle quickly impact other areas, and a lack of revenue cycle support can be detrimental.

Change is one of the few constants in healthcare. Adapting to the need of an ever-evolving industry like healthcare is the reason Revenue Cycle Management (RCM) must actively assess the effectiveness and efficiency of processes and workflow implemented on an ongoing basis. The need to stay agile is more important than ever for RCM as the healthcare industry continues to navigate unfamiliar times. COVID–19 forced a shift that has forever changed how RCM operates. The pandemic required a rapid change in process, people, and performance so that hospitals could remain open to serve the community when healthcare was needed the most. During the pressure test, no other tried and true processes failed, and process gaps were exposed.

Spreadsheets, emails, and meeting notes are all commonly used tools to manage and implement change. While these tools have their place, they are not efficient tools to drive change at a system level. Revenue cycle is the blood flow of a healthcare system. It provides essential support to other areas in the healthcare system that allows them to perform their primary functions as seamlessly as possible. Any issues with the revenue cycle  quickly impact other areas, and a lack of revenue cycle support can be detrimental. Therefore, a line of sight into initiatives through a centralized system supports the speed and provides the data needed for leaders to make informed decisions which are critical to moving the strategic vision forward. The lack of the proper systems and tools leads to gaps in communication, missed deadlines, disconnects between processes, and misallocation of funds and resources, including but not limited to the time, energy, and effort of our team members. Systems that can do more than just track tasks and send deadline reminders are inadequate. There needs to be a system in place that provides insight to leaders and puts technologies in place to connect the needed stakeholders around initiatives in centralized systems that allow for real-time updates to leaders and produces a consistent product.

There may still be a disconnect on what the concept of managing change means, why is it important to have technology in place to support it, and what impact the lack thereof can have on the success of an organization. Change management is a systematic method of approaching the evolution or transition of an organization’s goals, processes, or technologies. Change management’s purpose is to implement strategies for impacting change, controlling change, and helping team members to adapt to change. Change management is frequently used interchangeably with project management, and while there is a connection between the two, they are not the same. Change management is about the people affected by specific projects, tasks, or processes that are changing versus project management focusing on the project. The combination of the two is truly transformational or known as Transformation Management. Organizations performing at the top of the industry already see the need for transformation management and have systems in place to support the implementation of any change at a systematic level effectively and efficiently.