Epic Research Module Presentation to Clinical Research Professionals June 29, 2009

Agenda Background Current Process Epic Research Module Training Preview Research Discounting Update

Background Goal: One uniform electronic medical records system (Epic) Ambulatory EMR rolled out in 95% of divisions HOT: November, 2009 Urology: TBD Phase I inpatient EMR rolled out 2008 Epic Physician Billing Clinical Pilots: Neonatology, Pulmonary Medicine live Remainder of areas: 9/1/09 Emergency Dept: 9/9/09 Phase II inpatient orders/documentation – roll out 1/10/10 Other ancillary areas: PFT, EEG, Procedure Suite: TBD

Current Process for CMH Research Billing Patient registered as funded visit CMRC website created where Clinical Research Professional (CRP) enters upcoming study visit for PFS to identify study patient (not utilized by all) Date of Service: Charges entered PFS transfers Charges to Fund Account; At time of fund report distribution, monthly patient charge detail sent to PI to review Not consistently sent; not consistently reviewed

Current Process Cont.. PI or CRP notifies PFS of error in patient charges Considerable time spent between PFS, Fund accounting and division correcting charges PI or designee not consistently notifying Fund accounting of discounts necessary for each patient No consistent fee schedule that outlines discounts Fund accounting won’t always have information re: # of patients, tests, to complete discounting

Current Process for Physician Research Billing More fragmented than CMH process FORTUNATELY, most PIs direct charge a % of their effort to grant so per patient pro-fees are $0 ISSUE: Areas who should be receiving per patient reimbursement (Imaging, Cardiology, Anesthesia, etc..) are not

Hospital and Physician Billing New functionality Front end review of all research charges “before” they are sent to insurance or fund Minimizes billing errors and time spent in correcting Discounted fees schedule will be loaded so PIs/designees can see actual charge for each research item Ensures hospital and physician research charges are posted correctly

Hospital and Physician Billing cont. Allows for enhanced reporting of research charges CRP will be able to view hospital and physician patient charges by fund in Epic Go-live: 9/1/09

Hospital and Physician Billing cont. CRP responsibilities - Outpatient Review all charges within 3 business days of posting CRP will be reviewing and designating patient care vs. research fund Directors will have reports available to ensure all accounts are being closed within the 3 day requirement Charges will be in a fund “workqueue” – goal is to have more than one CRP assigned to each workqueue to ensure review with above expectation Should drastically reduce post fund review of patient charges

Hospital and Physician Billing cont. CRP responsibilities - Inpatient Continue current process Pre-admission fund coverage form to Admitting/PFS Notify PFS of charges that should be posted to research fund – need “exception” based approach-otherwise CRPs would need to review all inpatient charge line items (>100+)

Hospital and Physician Billing cont. CRP responsibilities – Ancillary Areas Continue current processes Laboratory EEG, PFT, Endoscopy, Epilepsy (until they go up on EMR)

Epic research module demo

Testing Content experts/superusers Testing: End of June/Early July Megan Domenico Dhey Delute Melissa Gentile and Fund Accounting team Majid Hussaini Carrie Kempler Harmony Maple and OSP team Johanna Mishra Lina Patel Cathy Powers Krista Tuzinkiewicz Kelly Verel And any additional volunteers Testing: End of June/Early July

Training Training to kick off week of August 10, 2009 Mandatory for all CRPs who work with patient charges Web based Basic Epic course available for those who have not worked with Epic 2-3 hours of classroom training with a training manual Playground environment Ideally, opportunity for CRP to validate their workqueue assignment

Estimated Course Length Training continued Other Training Finance Appt Schedulers POS Check In Physician/ Clinician Order Entry Estimated Course Length Setting up a research study X 30 Minutes Cadence - appt scheduling, flagging appt as research 15 Minutes Cadence - Flagging appt as research during check-in EpicCare Order Entry 1.) Basic - No Change in process 2.) Adding the RE Modifier (No Change / Reminder)

Research Discounting Update Goal – one uniform research fee schedule Majority of areas would utilize the NIH cost rate agreement Imaging – proposing NIH cost rate plus a one time setup fee and $50 per test fee Laboratory – current research fee schedule Above discounting plan still to be approved by senior leadership

Questions/Resources Sandie Bolina, x4558 (Research discounting) Lisa Lenz, 137-4512 (Physician Billing/Epic research module) Jody Whitish and Brendan O’Connor, 137-4588 (Epic Research Module Design/Testing) Judy Smith, x3172 (Training)