Clinical Redesign

Project Management Backgroud Image
 

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

  COPE Health Solutions played an integral role in the successful implementation and use of a new referral system and specialty care process…bringing expertise and experience from the field in a collaborative effort to make eConsult the success it is today.  

   -- Sajid Ahmed, Former Director for Health Information Technology and Innovation, L.A. Care Health Plan

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