HCB News: Any other problems you tend to see in those conversions?

JM: Unfortunately, yes. Organizations often fall into the trap of building their system workflow without enough context. Think about switching systems and having to build a new charge description master (CDM), which is the comprehensive list of charges for all billable items in the hospital.


When done right, the revenue cycle team can use this forced migration to a new CDM as a catalyst to re-engage the clinical departments into reviewing their charge codes, revenue performance, and workflow rationale. They can take time to correct past charge failures and lay the groundwork for the enhancements that the new charging workflows make possible. By revisiting the CDM early, often, and consistently, an organization can build a culture of transparency, collaboration, and trust around revenue capture. Without it, charging errors and workflow obstacles become more and more ingrained.

HCB News: What are some of the underlying causes of those problems?

JM: Sometimes the causes are cultural; those are the tough cases. But others can be managed relatively easily. Many organizations are taking on much longer conversion timelines than they should be to migrate to next generation HIS platforms. If the timeline is too long, they may start to see a lack of engagement from revenue cycle operational staff. Reasons for this include the frustration of serving competing priorities when you have to both effectively manage legacy environments and foster newly live platforms. Staff may also disengage from the stress of keeping up with maintenance issues just as they have to prepare for upcoming facility conversions.

HCB News: What can institutions do upfront in the HIS planning stages to get ahead of these issues?

JM: As a foundation, they need to identify key stakeholder groups, create a collaborative communication structure, and determine key performance metrics prior to implementation. If they take care of those basic requirements, they position the organization to deal with the inevitable obstacles that arise even in a best-case scenario.

HCB News: Can you say more?

JM: Certainly. Much like how the HIS platform is integrated, the people and structure in hospital systems need to be unified as well. During the planning stages, organizations need to develop a results-driven and holistic approach—to their people, their process, and their technology—across several areas. And then they need to execute that approach.

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