CareSelect

Eliminate Waste and Control Costs

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Behind the Scenes at NDSC: Caroline Liebscher, Implementation Manager

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By implementing CareSelect®, one site saved $250,000 over a 3-month span by avoiding unnecessary testing. Caroline Liebscher, Implementation Manager, discusses actions health systems can take now prepare for a CareSelect implementation so that your organization is set up to achieve impactful results.

 

Caroline Liebscher

Implementation Manager, NDSC

While at NDSC Caroline has been a primary manager for imaging implementations, a mentor for new team members and a people manager. She currently serves as Implementation Manager leading CareSelect Lab implementations.

Each organization we work with has their own goals and priorities for their implementation, so working to make those a reality is certainly rewarding. I think my favorite moments have been when we hear from providers that they really feel like Clinical Decision Support (CDS) will make a big impact for patient care.

Tell us more about your role at NDSC. What aspects do you enjoy the most?

I have been with NDSC for almost four and a half years now, and in that time, I have had the privilege of working on several different projects. I have been a primary project manager for imaging implementations, a mentor for new team members, a people manager, and now I also head up our CareSelect Lab implementations. There are many things I enjoy about working at NDSC, but the primary one is the feeling of accomplishment that comes from helping an organization finish an implementation. Additionally, digging into data post-live and seeing how CDS can help providers and patients is exciting.

 

What has been one of your team’s greatest accomplishments at NDSC?

I think every project has its own accomplishments, so it’s hard to pick just one. Each organization we work with has their own goals and priorities for their implementation, so working to make those a reality is certainly rewarding. I think my favorite moments have been when we hear from providers that they really feel like CDS  will make a big impact for patient care.

Outside of imaging, our recent go-lives for CareSelect Lab, CareSelect Choosing Wisely, and CareSelect Blood have been wonderful to work on. Expanding my knowledge outside of the imaging realm has been an exciting change.

 

From your experience, what is most important for a customer to consider in advance of an implementation? Do you have any advice to providers help prepare for kick off?

There are many factors to a successful implementation, but one of the first that comes to mind is to come prepared with a clear definition of why you are implementing CDS, taking into consideration how CDS aligns with your organization’s mission and strategic directions. Understanding what your organization is hoping to accomplish can drive decisions we make throughout the implementation. You will have better provider adoption of the content if they understand why their use of the decision support is meaningful. It is also important to not treat CDS as a one-time project that ends at go-live, but to instead make it an ongoing operational initiative. Finally, it is essential to include clinical leaders that are passionate about the CDS solution. Their ideas and connection to the providers that will be using decision support are invaluable to the planning and execution of the implementation.

Having an idea of the project goals and who will be guiding the project are two of the key pieces for getting ready for the kick off and implementation. As part of the follow up from the kick off, the NDSC team will begin working with you on scoping decisions. Those project leaders should be involved from the beginning to make these decisions and that reason for implementing will serve as the background for many of these scoping choices.

 

What are some obstacles that arise during an implementation that an implementation team should be aware of in advance of a kick off? Do you have any advice to providers to prepare for such obstacles?

One of the biggest hurdles I have seen during implementations is clinician leadership engagement. The scoping, mapping, and provider testing processes rely on the expertise of the clinician leaders involved in the project. Without engaged leaders, the decision making can take longer than planned and testing may not be as thorough. We want to prepare as much as possible for the way ordering clinicians will use the system, and feedback during mapping and testing is crucial to that.

Defining who will be the clinician leaders prior to the kick off and discussing timelines early on will help ensure that project stays on track.

 

Can you describe an ideal implementation timeline for CareSelect Imaging to ensure PAMA compliance by the looming January 2020 deadline?

The sooner that an organization can start their implementation, the better. It’s also important to schedule your implementation ASAP since we expect demand for implementations to exceed capacity in the first half of 2019. A standard implementation typically takes three to four months to complete but can be completed in less time for some organizations. Additionally, it is ideal to have at least three months after that initial go-live to optimize a bit based on provider feedback, to complete claims testing, and to prepare your external referrers for their compliance.

 

How does implementation for CareSelect Lab differ?

First, is one I think everyone will be excited about — CareSelect Lab does not require a structured reason-for-exam for the decision support calculation. Instead, the CareSelect Lab content from Mayo Clinic utilizes chart data such as prior lab test results, diagnoses, etc. to determine if the selected test being ordered is appropriate or not.

Because CareSelect Lab does not require an adjustment to the provider workflow, we recommend capturing lab CDS data behind the scenes for around 90 days to evaluate the current state and determine where user interventions can provide the greatest benefit. Our goal is to provide valuable guidance to the clinicians without overwhelming them with alerts.

 

After Go-Live, how is CareSelect continuously optimized to meet the specific demands of each health system and ensure the most up-to-date clinical guidelines?

Once your organization is live with CareSelect, the NDSC team will work with your project team and leadership to address any content or system feedback from the ordering professionals, review usage reports, and discuss any additional communication or training that should occur. Analyzing reports of how the providers are using the content in their day-to-day practice provides insights into any additional adjustments we can make to optimize the system. This can include things like adjusting the indications that are considered common for an exam or adding additional synonyms for certain indications.

As I mentioned above, we should treat CDS as an ongoing operational initiative. In addition to the initial optimization work we will do in the first few months post-live, the NDSC Customer Success team will work with your organization to regularly review data and do content upgrades approximately once a year to ensure you stay up to date with the current recommendations from the medical societies.

 

With a successful implementation, how can CareSelect impact health systems in terms of waste reduction, patient care improvement and cost savings? Do you have any specific examples from a recent implementation?

We see subjective examples of savings and improvement to patient care from the implementation of decision support every day. When we look at the usage data or receive feedback from ordering providers and radiologists, we see cases where clinicians were able to order the right exam for the patient the first time, avoiding unnecessary testing. Additionally, a good objective example comes from one of our sites that calculated significant savings for the hospital (around $250,000 over a 3-month span) from avoiding unnecessary imaging.

ACR Bulletin: CDS Deadline Moves Forward Under CMS

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The PAMA requirement has been reconfirmed for referring providers to consult AUC for advanced diagnostic imaging services starting Jan. 1, 2020. Following the implementation dates and guidelines for Appropriate Use Criteria (AUC) is both important and confusing. Here are the most current mandates to maintain your reimbursement status.

Behind the Scenes at NDSC: An Interview with Jamie Kelly, Account Executive

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CareSelect™ Blood marries NDSC’s seamless approach to integrated CDS with Mayo Clinic’s transfusion and PBM expertise. Jamie Kelly provides insight about how this newly launched solution will impact patient blood management for both patients and providers. 

 

Jamie Kelly

Account Executive, NDSC

Jamie joined NDSC in January of this year, with a background rooted in health IT from the ambulatory EHR field. She serves as an Account Executive and collaborates with the NDSC and Mayo Clinic teams to help advance NDSC’s newly launched CareSelect™ Blood product.

Approximately 50% of transfusions aren’t clinically indicated. In addition to wasting resources, these unindicated transfusions cost billions of dollars for health systems and can cause adverse reactions for the patient. Reducing blood use saves health systems, patients, and insurance carriers money. More importantly, it reduces the length of hospital stays for patients, mitigates waste and saves lives.

What is your role at NDSC and what aspects do you enjoy the most?

In addition to selling CareSelect solutions, I have taken on the role of collaborating with the NDSC and Mayo Clinic teams to help advance NDSC’s newly launched CareSelect™ Blood product.  This entails being the product expert, knowing the field of patient blood management and ensuring that the platform’s capabilities are properly communicated.

My favorite part about being on the NDSC sales team is the collaborative and supportive team effort. We all work together and help one another with no questions asked, and we have fun doing it!

 

What are you most excited about for your team this year?

I am most excited about bringing CareSelect Blood to market. It’s always both a thrill and a challenge when you have a new product to sell. The fact that this solution is different than anything else NDSC currently has on the market makes it that much more exciting. CareSelect Blood represents the expanded relationship between NDSC and Mayo Clinic, marrying our technology with their operational consulting.

 

Why is patient blood management (PBM) important to you?

Blood is a finite and costly resource. Even so, blood transfusions are one of the top five overused medical interventions nationwide. CareSelect Blood is a much-needed solution to help guide appropriate use. Approximately 50% of transfusions aren’t clinically indicated. In addition to wasting resources, these unindicated transfusions cost billions of dollars for health systems and can cause adverse reactions for the patient. Reducing blood use saves health systems, patients, and insurance carriers money. More importantly, it reduces the length of hospital stays for patients, mitigates waste and saves lives.

 

Can you explain the current landscape of patient blood management?

PBM is a well-documented and validated approach for health systems to improve profitability as well as patient outcomes. However, most health systems have only scratched the service in their PBM efforts. Red Blood Cells (RBCs) are an easy place to start, but that can’t be the end. There is so much more that can be done that is often overlooked. One in 10 hospitalizations still has a transfusion associated with it, and we see an opportunity for that number to be reduced.

 

Why is there a need for a Clinical Decision Support (CDS) solution, such as CareSelect Blood?

While we know a successful PBM program must start with education and understanding, the power comes with the ability to impact change – and then to measure that impact – at the point of care. CareSelect Blood marries NDSC’s seamless approach to integrated CDS with Mayo Clinic’s transfusion and PBM expertise. This unique solution removes the barriers often presented by over-burdened IT departments, and helps put the required organizational structure and governance in place.

 

Can you elaborate on the components of CareSelect Blood and how they were developed?

This comes back to our partner, Mayo Clinic. After working with one another to develop CareSelect Lab, we saw patient blood management as the clear next step in our partnership. We knew that, in true Mayo Clinic fashion, any PBM program they could create would go above and beyond anything available on the market today. Mayo Clinic pushed past market standards like hemoglobin thresholds and blood unit limitations to tackle a much more comprehensive set of pervasive issues across all blood products and blood management. We couldn’t be happier with the 100 plus rules they’ve authored in combination with the end-to-end consulting that will operationalize the program.

It’s also important to note Mayo Clinic’s condition-driven approach. Blanket alerts aren’t firing across the organization. They are tailored to the setting and even the individual patient. This creates a targeted and meaningful approach to help guide providers.

 

What aspect of NDSC’s CareSelect Blood do you find most valuable and why?

It’s hard to pinpoint a specific rule, module or program aspect. I find the value stems from the fully integrated program that is tailored via customized engagement for every client.

 

Are there tangible examples of the benefits of implementing CareSelect Blood into an EHR?

Mayo Clinic Hospital – Rochester saw a $5.3 million reduction in one year across all blood products, and that was just in purchase price alone. As a nation, we spend upwards of $6 billion annually on blood, creating a huge opportunity to cut back. When reviewing the potential in the market, we are confident our clients can realize a 20-30% reduction in overall blood product use, with aggressive health systems achieving up to a 50% reduction.

 

Looking forward, can we expect CareSelect Blood to evolve as the needs in PBM change?

Absolutely. If there is one thing we can count on in healthcare, it’s constant change. CareSelect expanded from CareSelect Imaging to now include Lab and Blood solutions. We already have other solutions in the works, and our existing offerings will continue to progress and develop as the industry necessitates.

 

Outside of your professional life, what do you do for fun?

I live with my husband, Matt and black lab, Henry. Outside of work, I am a trained yoga instructor and an untrained dog whisperer. I also love to travel, watch way too much true crime TV, and brunch like it’s a sport.

Survey: Patient Clinical Outcomes Shortchanged by Prior Authorization

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CHICAGO – More than nine in 10 physicians (92 percent) say that prior authorizations programs have a negative impact on patient clinical outcomes, according to a new physician survey released today by the American Medical Association (AMA). The survey results further bolster a growing recognition across the entire health sector that prior authorization programs must be reformed.

“Under prior authorization programs, health insurance companies make it harder to prescribe an increasing number of medications or medical services until the treating doctor has submitted documentation justifying the recommended treatment,” said AMA Chair-elect Jack Resneck Jr., M.D. “In practice, insurers  eventually authorize most requests, but the process can be a lengthy administrative nightmare of recurring paperwork, multiple phone calls and bureaucratic battles that can delay or disrupt a patient’s access to vital care. In my own practice, insurers are now requiring prior authorization even for generic medications, which has exponentially increased the daily paperwork burden.”