At DeKalb Regional Healthcare System, a Front-End Redesign Project (FERP) is underway to meet these challenges and restructure all patient access activities relating to outpatient services. The objective of this initiative is to cost effectively enable quality patient care while ensuring customer satisfaction and optimum reimbursement. The scope of the project includes all processes related to scheduling, pre-registration, pre-certification, order processing, insurance verification, financial counseling and medical necessity.

The business model for this redesign project evolves around the development of a comprehensive Patient Access Center that will house all pre-access functions for outpatient services. This innovative new center will function in a customer service/call center environment and is scheduled to open in August of this year. Benefits of this model include enhancing customer service, providing "one stop shopping" for physicians and future physician connectivity for self scheduling, assisting in reducing administrative and eligibility denials, providing opportunities for maximizing human resources, and moving into the modern age of web-based technology.

An important component of this project has been the selection of an enterprise-wide scheduling system to support critical business tasks associated with the redesign process. After eighteen months of due diligence and evaluation, a multi-disciplinary project team comprised of clinical, technical and financial expertise selected and recommended the Tempus scheduling system as the vendor of choice to meet the needs of the health care system. This decision was based upon numerous Tempus features and enhancements, including rules-based scheduling, pop-up informational screens, appointment reminders, detailed reporting capabilities, internet connectivity for future physician self-scheduling, an integrated compliance product, and a bi-directional interface with the Siemens Invision (ADT) system. Tempus training is currently underway and "go live" in a decentralized environment is scheduled for the first week of July.

The implementation process for this project has been structured to take place in four separate phases. Phase I included the selection of technology, a review of all processes associated with access tasks, and the development of new policies and procedures linked to the redesign project. Phase II, which is currently underway, includes installing the scheduling system in a beta test environment, selecting and preparing a site for the Access Center, designing and implementing a new organizational structure, and developing measurements of success. Phase III will begin late this summer and will include relocating staff and centralizing all pre-access functions, implementation of the Tempus system in a decentralized environment, and incorporating all integrated processes associated with the project. A final component of Phase III will be shifting all scheduling activities and functionality to the Access Center for all outpatient services throughout the health care system. Finally, Phase IV will focus on future system and process enhancements, including physician self-scheduling, inpatient scheduling, and the potential for telecommuting opportunities for scheduling and other pre-access tasks.

As this project has evolved, there have been several important factors that have impacted the progress, speed and potential for success. First, developing consensus and buy-in from all stakeholders is critical. As mentioned before, having representation from clinical, financial and technical divisions is important and necessary. In addition, securing both physician and administrative representation and support is vital to a project of this magnitude. Without it, progress may be delayed and even halted until support and approval is obtained. Also, the use of outside consultants and a strong project manager is recommended to validate best practices, provide direction and over site, and guide the overall process from a project management perspective.

Other important components have included developing and following a comprehensive project plan (Microsoft project), working with the Marketing Department in developing a communication plan to address all customers/audiences, defining measurable outcomes for all project phases, and last but definitely not least……dealing with politics, politics, and more politics. Obviously, a project of this size and scope has had numerous challenges and hurdles, the biggest being the issues associated with organizational changes and the redefining/restructuring of job tasks and responsibilities. Proactively dealing with the inevitable politics associated with these changes will greatly assist in moving forward without losing the support and momentum necessary to achieve success. In other words, "walk softly and carry a big stick" and be prepared for the land mines that can, and will, appear out of nowhere.

In summary, the Front-End Redesign Project has been an exciting thrill ride, and it's not over yet. Stay tuned for a follow-up session in Savannah and another article dealing with lessons learned, outcomes and measurements of success, and of course, all details of the Tempus installation and "go live". Should be a fun summer!