Patients and Families First governs all operations at Hospice of Palm Beach County. The impact of this on clinical services is clear, but what is the role for Information Technology and Accounting in supporting this practice? Managing patient records and billing for over 1,100 patients and their families every day, in a variety of settings throughout the entire county, with different levels of care by many different disciplines and payer sources, is challenging. Not unlike other organizations or companies, Hospice of Palm Beach Countys rapid growth created the need for additional systems that either were or could be configured to be interactive, and provide real-time patient care and financial information.
Hospice of Palm Beach Countys solution was HEART Hospice Executive Activity Reporting Technique – a comprehensive strategic plan which focused on automation, streamlining, accuracy and timeliness not only for present needs, but also for future growth and development. Input from every area was considered in developing the plan and the implementation strategy. Consideration was given to managing ongoing business activities with minimal disruptions to all involved. “Buy or Build?” – the ever present IT dilemma. The need for a comprehensive patient data system, specific to hospice and palliative care, prompted Hospice of Palm Beach County to co-develop LATIS, the first of its kind web-based system to provide readily available data to multiple users, accessible from wherever the users are. For clinical staff, this dramatically reduced paperwork and redundancy, thus allowing more direct patient care time. For management, it provided the ability to generate real-time information and specific reports needed to assess business operations. Phase II was modifying how we use Dynamics, Microsofts General Ledger software, which serves as the hub for gathering data from all of our other systems. The challenge was to create a sophisticated chart of accounts to handle present needs, provide drill-down information for end users, and handle growth. Integration with LATIS was first done in a test environment with 60,000 records in a month. Careful planning resulted in only 2,700 exceptions the first pass, decreasing to 150 after revisions and now, fully operational, only a few per month. Revenue is recorded daily by patient, location, payer source and level of care. When the middleware implementation is completed Phase III – the General Ledger will receive information from LATIS, and software programs for Human Resources, Scheduling, Pharmacy, Resource Development, Purchasing, Durable Medical Equipment and other off shoot systems. This total integration of information will meet the goals established for IT and Accounting in HEART. The advantages are many. Information is only entered once and then is automatically populated to other systems. These systems provide the means to be in regulatory compliance even with constantly changing criteria with regards to billing. Processes are automated, requiring less data entry resulting in more information, less mistakes and built in checks and balance systems from Accounting to Pharmacy. Financials are up- to-date with monthly closings possible within a few days of month-end. Assigning a dedicated team manager to oversee the project has been of benefit for smooth transitions. According to Warren Blanchard, CFO of Spectrum Health, Inc., the parent company of Hospice of Palm Beach County, “The key to success for Hospice of Palm Beach County has been good planning and communication. Explaining why changes are being made, the advantages and the ultimate outcomes will help to lessen employees resistance to change. Planning allows for future modifications as needed as opposed to starting over due to outgrowing a system.”
