Taylor Potoczak, Director of Enterprise Risk Insurance at Cleveland Clinic, and Anooja Cannon, Senior Healthcare Market Strategy Lead at Origami Risk, recently explored this topic in a webinar titled "Navigating Complexity: Tactics and Tools for Effective Healthcare Risk Management." Their insightful discussion, part of PSQH's Healthcare Risk Management Week (June 17-21, 2024), shed light on Cleveland Clinic's journey to enhance their risk management operations and claims management processes through the implementation of new software tools. The organization's experience offers valuable lessons for healthcare risk managers considering new risk management, claims management, and patient safety and quality solutions.

Identifying Needs and Goals

Before implementing new claims management and risk management software, Cleveland Clinic identified several key areas for improvement:

1. Enhanced integration capabilities
2. Increased data visibility
3. Greater system flexibility
4. Streamlined workflows

These goals were driven by a vision for a more robust and responsive system. They sought a solution that would allow them to manage their claims more effectively, gain deeper insights from their data, adapt quickly to changing needs, and streamline their day-to-day operations.

Securing Leadership Support and Stakeholder Buy-In

A critical factor in Cleveland Clinic's successful implementation of new claims management software was securing unwavering support from senior leadership. Potoczak emphasized the importance of obtaining buy-in from the executive director, chief financial officer, and the board of directors of their captive insurance company.

Additionally, Potoczak and her team prioritized incorporating the voice of end-users throughout the process. By involving those who use the system daily, they ensured that the final product would meet real-world needs and promote user adoption.

Phased Implementation Approach

Cleveland Clinic adopted a phased approach to implementing their new claims management system:

Phase 1 – With their existing vendor's contract nearing expiration, Cleveland Clinic prioritized building a like-for-like system for professional liability and general liability claims. This initial phase focused on essential functionalities and critical reports, ensuring a smooth transition and uninterrupted operations.

Phase 2 – Enhancing the system by building dashboards, creating interfaces with other systems, developing import templates, and expanding to additional coverage lines. This phased approach allowed Cleveland Clinic to meet critical deadlines while also enabling thoughtful design and incorporation of user feedback throughout the process.

Key Features and Benefits

The new system brought several significant improvements:

1. Improved Integration – Interfaces with HR (Workday) and electronic medical records (Epic) systems streamlined data flow and reduced manual entry.
2. Enhanced Data Visibility – Custom dashboards and sophisticated reports provide real-time access to critical data, enabling more informed decision-making.
3. Increased Flexibility – The ability to quickly add or modify system elements allows the organization to adapt to changing needs efficiently.
4. Streamlined Workflows – End-users now perform tasks with about half the clicks and time spent previously, significantly improving efficiency.

Potoczak shared that these improvements have resulted in substantial time savings. For example, preparing institute-specific claims trend reports now takes minutes instead of hours, saving over 100 hours annually for her team alone.

Overcoming Implementation Challenges

While the benefits were clear, the implementation process wasn't without challenges. Potoczak offered several pieces of advice for organizations undertaking similar projects:

1. Clearly define your end goals and relay them to your implementation team.
2. Identify and collaborate with IT contacts early in the process.
3. Designate a single point of contact to interface between end-users and the implementation team.
4. Work with your team to shift responsibilities during the implementation process, allowing key personnel to focus on the project.
5. Provide ongoing support for end-users beyond initial training, such as implementing monthly user group meetings.

Expanding to Clinical Risk Management

Building on their success with claims management, Cleveland Clinic is now expanding their use of the system for the support of their clinical risk management program and processes. This expansion promises to bring event data capture, reporting, and root cause analysis (RCA) into one unified system, further streamlining processes and enhancing data accessibility.

Key Takeaways for Healthcare Organizations

Cleveland Clinic's experience offers several valuable lessons for other healthcare organizations looking to enhance their risk management practices through new technology:

1. Secure strong leadership support throughout the process.
2. Consider a phased implementation approach, tailoring it to your organization's specific timelines and needs. This allows for a smooth transition, minimizes disruption, and provides opportunities for continuous improvement.
3. Prioritize integration capabilities with existing systems to maximize efficiency.
4. Focus on improving data visibility and reporting to enable data-driven decision making.
5. Invest in flexible systems that can adapt to changing organizational needs.
6. Engage stakeholders, including end-users, throughout the process to ensure the system meets their needs.
7. Consider scalability when selecting a risk management solution to support future growth and expansion.

Enhancing Patient Safety, Risk Management, and Claims Processes Through Technology

As healthcare continues to evolve, so too must patient safety, risk management, and claims management strategies and processes. The technology supporting those efforts must be capable of keeping pace. Cleveland Clinic's journey demonstrates that by embracing advanced software solutions, focusing on user needs, and prioritizing data integration and visibility, healthcare organizations can significantly enhance their efforts and realize improved outcomes.

For healthcare leaders considering new risk management technology, Cleveland Clinic's experience offers valuable insights. By learning from their approach and implementing these key lessons, organizations can select and implement tools that effectively support their risk management programs, ultimately leading to improved patient safety, operational efficiency, and organizational resilience.

"Navigating Complexity: Tactics and Tools for Effective Healthcare Risk Management" is available for viewing here.

To learn more about how Origami Risk can help support your risk management, claims management, and patient safety and quality programs, contact us.