Clinical Redesign

Designing pathways to success.

As the shift from a fee-for-service payment model to one that incentivizes quality and outcomes through value-based-payments gains momentum, success will depend on coordinated redesign of clinical processes. Care delivery predicated on isolated pathways must give way to highly-integrated, patient-centric care. Doing so will help providers achieve all four dimensions of the Quadruple Aim:

• Improved patient experience
• Improved health of populations
• Reduced per capita cost of health care
• Improved physician and provider satisfaction

 

Our team assists with:

• Current state assessment
• Process gap / duplication identification (technology, data, resource utilization, provider roles and processes)
• Design and implement evidence-based clinical care models that maximize top of license work, reduce out of network leakage and improve quality:
  • Primary and specialty care co-management
  • Consensus care and referral guidelines
  • e-Consult and e-Referral

 

Our Approach

• Develop visual “blueprint” of the patient flow through the care delivery system
• Align projects and processes to facilitate identification of workflow similarities and resource utilization
• Analyze process maps to identify commonalities to encourage resource sharing and development of centralized services
• Develop future state patient flow maps for clinical pathways using evidence based practices
• Perform on-site validation analysis to validate and determine feasibility of proposed future state
• Coordinate efforts with multidisciplinary teams including clinical operations and IT to devise implementation strategies
• Facilitate “warm handoffs” of process maps to work streams to ensure continuity