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

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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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+)

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

12. Epic research module demo

13. 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

14. 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

15. 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)

16. 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

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