Unity Health Care - Davies Community Health Organization Award
Return on Investment
Unity Health Care, Incorporated is a Federally Qualified Health Center, serving nearly 95,000 underserved residents in 30 sites throughout the District of Columbia. In 2009, Unity implemented an electronic health record (EHR). Before implementing EHR, patient scheduling was done at each site because there was no practical way to communicate enterprise wide providers’ schedules that changed moment-to-moment.
Implementing an EHR allowed Unity to revamp processes for handling patient scheduling and therefore increase patients’ access to care. We have seen a 21% increase in overall provider productivity since 2012. (see Chart 1) Because of this increase in productivity, we have realized $12.2 million dollars in additional revenue. No show rates, near 36% in 2009, have fallen to 28% in 2012.
Unity Health Care, Incorporated is a Federally Qualified Health Center, serving nearly 95,000 underserved residents in 30 sites throughout the District of Columbia. In 2009, Unity implemented an electronic health record (EHR). The EHR has enabled us to expand the role of Medical Assistants (MAs), creating more efficient work teams, while providing better quality of care for patients. The District has high rates of tobacco use, especially amongst our majority patient population, African Americans, where the smoking rate 23.3%.
The EHR has enabled us to enlist MAs to screen patients for tobacco use, an activity previously the sole responsibility of providers. MAs are now documenting tobacco use on most patients and providers have more time to focus efforts on assessment and treatment.
Workflow Analysis & Improvement
Prior to implementation of our EHR, we had an inefficient paper based process for handling claims. Our goal was to develop a system that would utilize the EHR to resolve outstanding claims efficiently, decreasing the amount of time required to process claims. In this intervention, the EHR is being used as a collaborative tool. It is allowing two groups who previously did not directly work together, providers and medical claims processors, to merge their processes, resulting in clean, quickly submitted claims.
Three years after implementation, the number of days of revenue in accounts receivables has declined 28%. This has made available $1.3 million of cash for operations that would not be available without this improvement.
Governance & Change Management
However, during the early phase of the EHR implementation, the organization was struggling due to the lack of a solid plan, effective governance and sufficient resources to succeed. In 18 months Unity was able to transform from having so little governance that there was a risk of failing the implementation, to a robust, dynamic governance structure that is adept at maintaining the integrity of the EHR. Teams working on the EHR have gone from dysfunctional to being a model for other teams and projects.
Currently, about 230 providers and a total of 900 employees use the system throughout 30 sites.