Tuesday, 10 November 2015 08:04

Even Those in Trenches Becoming Value Experts at Virginia Medical Group

Written by Robert Fortini PNP, Tristan Williams, and Tammy Shumaker

  In the modern landscape alternative payment models in healthcare, the need to accurately measure and report the quality of the care that a health system provides has never been more crucial to its success. Health systems and providers are adapting to this landscape and anticipating the change from fee-for-service to a value-based performance (VBP) payment model in a number of ways. The new payment model requires additional efforts in collaboration, optimization, and engagement in order for providers in ambulatory practices to understand the nuances of VBP. Workflows must be adapted to capture discrete data to ensure ease and accuracy of reporting. 

At Bon Secours Virginia Medical Group (BSVMG), it has quickly become evident that in order to change these workflows, staff in the trenches must become experts. Led by the Clinical Support Services and Informatics Team, the key team members at BSVMG who assist those who provide exceptional patient care are called “super users.” These super users are embedded clinical support staff members who serve in each ambulatory practice and have enhanced knowledge of ConnectCare functionality, as well as the knowledge of how to use that functionality to meet the ever-changing requirements of pay-for-performance programs.

While any organization that has an Epic electronic health record (EHR) will recognize the term “super users,” BSVMG has developed and refined their program to create end users who function at a higher level of expectation and with greater accountability. These super users serve as the main conduit for new workflow education and level-setting, and for moving information not only into the practice, but also out of the practice. Each super user must have significant experience as a clinical staff member in an ambulatory practice. Members are recruited by leadership, with practice managers nominating clinical staff members who are proficient in Epic, with at least one year of experience in it. In addition, the nominee must exhibit strong leadership and communication skills. Once nominees are approved by a leadership selection committee, they are enrolled in super user training classes. 

This standardized training helps develop the proficiency of each super user by immersing them in a deep dive of the Epic electronic medical record system, as well as the policies and protocols that drive its use. Super users are trained in all workflow functionality, from patient check-in at the front desk through the roles of every clinical staff member with whom the patient comes in contact to the workflows of check-out. This broad education gives the super users the tools they need to help staff in all practice positions with the use of the EHR. Once training is completed, super users take a proficiency exam and become credentialed within the organization. The Bon Secours program is unique in that once the super users are back in their office, they are held accountable for delivering information to the practice. BSVMG leadership feels so strongly that this program will promote the initiatives by which it will achieve success that it has committed to compensate the super users for the additional responsibility this role brings.

To assist with this accountability, the program is led by a super user coordinator. The super user coordinator, who is a member of the CSSI department, serves as a liaison between the medical group and super users to help distribute information to the end users in the practices. With contributions by other members of the team, from the health information management (HIM) manager, the biomedical equipment manager, the clinical informatics manager, all the way up to the administrative director of the department, the super user coordinator brings to the super users the most recent data and technology available to coordinate initiative-driven education in the practices. In addition to being the conduit for information, the super user coordinator provides continuous education to each super user, helping them in their roles as educators, troubleshooters, and liaisons in their practices. Super users must interpret the information they receive at three mandatory monthly meetings into a language that practice staff can easily understand. Additionally, having the experts spread across the market allows for communication to a large number of staff members who can be reached across a large geographical area quickly and consistently. When a new workflow is created or a requirement changes for specific quality metric capture, the updates can be shared market-wide in a matter of hours to days. This nimble and comprehensive method for getting new information out to the practices has ensured that the super users are true partners with leadership in making the changes necessary to achieve and demonstrate quality measure success. 

About the Authors

Robert Fortini, PNP, the VP and chief clinical officer for Bon Secours Virginia Medical Group, Home Health and Hospice, is responsible for facilitating provider adoption of EMR, coordinating clinical transformation, and facilitating advances in population health initiatives. Robert has extensive experience in operations and clinical policy development, and experience in workflow re-engineering and CQI in ambulatory care. He recently advanced Bon Secours’ efforts in “Good Help for Life” by leading efforts in advance care planning and behavioral health integration into primary care, promoted access by the expansion into the retail clinic and Telehealth arenas, and developing a workforce equal to the task.

Tristan Williams is the super user coordinator for the BSVMG and is responsible for over 100 super users across the Virginia market. Tristan has 19 years of experience in healthcare in a variety of backgrounds. She is EpicCare Ambulatory certified and enjoys working in the electronic arena.

Tammy Shumaker is the clinical informatics manager for the BSVMG, with overall responsibility for the super user program in Virginia. An EpicCare Ambulatory certified LPN, Tammy has been a Bon Secours employee for 20 years, focusing on such areas as meaningful use, clinical workflows, and informatics utilization.

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