Epic Research Module Presentation to Clinical Research Professionals

1. Epic Research ModulePresentation 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 • 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. Training continued Other Training

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, 137-4512 (Physician Billing/Epic research module) • Jody Whitish and Brendan O’Connor, 137-4588 (Epic Research Module Design/Testing) • Judy Smith, x3172 (Training)