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A Future-Focused Workflow: Planning Your System Conversion

“Future shock,” as defined in the 1970 book of the same name by technology writer and futurist Alvin Toffler, is “the shattering stress and disorder that we induce in individuals by subjecting them to too much change in too short a time.”

For healthcare providers, the future is now on multiple fronts. And many are experiencing their own version of future shock as they explore a change from legacy information-management and accounts-receivable platforms that rely heavily on human input to new artificial intelligence-enhanced systems capable of automating diverse tasks that span the entire patient journey and revenue cycle.

When planning a system conversion, it’s crucial to consider the full path: From choosing a technology partner to integration with existing platforms to building a workflow that’s designed for immediate effectiveness and adaptable to future changes. A system conversion involves a giant technological leap as well as a significant change in processes, but it also offers substantial benefits that range from improved patient access to increased medical coding and billing accuracy to more efficient claims processing to reduced stress on internal staff.

Backed by a comprehensive strategy that allows for inevitable complications, a system conversion can prepare a healthcare provider for the future without inducing stress and disorder on leadership and their teams.

Planning a Healthcare System Conversion

For many providers, the upgrade to a modern IT platform arrives at an inopportune time. Health organizations continue to cope with an abiding pandemic, supply chain woes are contributing to higher costs, and the widening labor shortage has left remaining staff overworked.

To help bridge the technology gap and fill the void for core AR processes, a number of providers are turning to business-process outsourcing partners who offer advanced IT solutions backed by scalable human resources teams that specialize in healthcare coding, billing and collections. Even with a knowledgeable partner, however, there are decisions leadership must make based on their organization’s particular goals and resources.

A vital early consideration for a system conversion is whether to expedite an en-masse data transfer from an existing platform to the new one or to establish a launch date — such as January 1, 2023 — by which to fulfill current accounts-receivable functions then enter all information into the new platform beginning on that date. Both approaches can leave holes in a provider’s AR information and processes, and both require careful thought regarding how data and ongoing claims are transitioned.

Regardless of whether you settle on a prompt system conversion and data transfer or a cutoff date for the switch to a new system, you will need to operate both the legacy platform and the new one for a period. Data formats have changed over time and differ between technology solutions, and data conversion to a new system is not as simple as moving files or translating data points.

Healthcare System Conversion Challenges

While a system conversion offers immediate opportunities, it takes time for new platforms to move and interpret data, and for corresponding processes to align with the new system and its automation capabilities. Even if you’re collaborating with a third-party IT and HR provider, this means that some internal resources will have to be trained for and utilize dual systems until the conversion is complete and any lingering AR issues are resolved.

Depending on the size of a provider’s in-house team and level of engagement with a partner, it may be beneficial to partition team members between the old and new systems. One group is dedicated to working on claims that begin with the new system on an established date, and the other group manages prior claims initiated through the old platform.

Another challenge from the multiple-systems perspective applies to reimbursement reconciliation. For example, if you have new service dates for a patient posted in a new system but outstanding AR data remains in the old system, it can be difficult to identify and correct discrepancies between the accounts.

Again, preparation is instrumental to a system conversion’s success. Plan for those potential AR glitches that may contribute to claim denials or processing delays.

Anticipating System Conversion Problems

One of the goals of healthcare system conversion is interoperability, which is attained partly through structured patient data. Modern healthcare IT solutions are engineered to standardize and securely store massive amounts of data, and to safely share applicable information with providers, payers and other key stakeholders.

Unfortunately, differing data formats and decades of inconsistency means not everything converts seamlessly and cleanly. Problems will arise during a system conversion, but forecasting them can minimize any adverse impacts.

Clean data, in fact, is one of the most important factors to focus on during a system conversion. So-called “dirty data” is already troublesome and costly for many providers, and while new platforms are designed for improved accuracy, consistency and automated checks, to function efficiently moving forward they depend on clean data.

Ensuring clean data entry can be time-consuming, but its benefits will reveal themselves in the long run. Clean data is essential to timely claims processing and reimbursement, electronic medical records compliance, and interoperability harmonization.

Launching a new system with clean data also prevents future data fragmentation. Data fragmentation becomes problematic when a provider tries to link incompatible softwares that are unable to communicate effectively and share necessary information on multiple platforms.

Contemporary healthcare IT solutions make requisite data accessible from a single source. If inaccurate or incomplete data is detected, a fully integrated platform can revise it across all interconnected networks.

System Conversion: A Forward-Thinking Change

Yes, the future is here. And with a sound plan to meet its demands it is nothing to fear.

Look to the future when developing a strategy for your organization’s system conversion. Determine your goals for the foreseeable future and how they may affect the implementation of a new system.

Consider cost escalations, supply chain hang-ups and staffing concerns. Assess the processes you can and want to automate.

Finally, work with an experienced, proven partner who specializes in healthcare and understands the nuances of the healthcare revenue cycle. Collaborate with a partner who has achieved measurable results for their clients and can help you evaluate your unique challenges, recognize opportunities, anticipate potential hurdles and achieve your goals.

There may not be such a thing as a perfect system conversion. But with the right partner and technology on your side, there is such a thing as a methodical and thorough transition that brings your organization into the future and prepares it for an even brighter one.