Clinical Program Management

The Wilshire Group is dedicated to a business and support model that will yield lasting results for your organizational initiatives.  We employ cost-effective methodologies, leveraging some of the brightest minds and most impressive people you will encounter, in order to help your programs reach their maximum potential.  We know that you set the bar high for your organization and staff, but achieving the outcomes you seek isn’t always straightforward.  Our assessments, collaborative approach, and prowess for fine-tuned project management and delivery can get you there. We pride ourselves on partnering with organizations large and small to set and accomplish goals, reach new heights, and push the boundaries of what is possible in healthcare.  We’ll make sure your clinical processes are tight, your resources are efficient, and we’ll lead you along the path to the outcomes you seek.

Our leadership team and knowledge experts have proven track records in delivering clinical projects of all types.  We don’t just work with operations, and we don’t just work with IT, we take a holistic approach with our projects, collaborating across the facility to bring technology, resources, and processes in line with goals. And with revenue integrity always at the forefront of what we do, we ensure that your clinical projects are financially sound and that you are maximizing your ROI. Here are a few of the high impact clinical areas we are experienced in leading to improved outcomes:

  • Emergency & Trauma
  • Perioperative Services
  • Labor & Delivery
  • Imaging Departments
  • Pharmacy
  • Lab & Infusion Services
  • Cancer Treatment & Research
  • Quality, Compliance, & Regulation
  • Behavioral Healt

Our Specialties:

  • ED Performance Improvement
  • Perioperative Performance Improvement
  • L&D Performance Improvement
  • Imaging Performance Improvement
  • MU & PQRS Programs
  • Provider Efficiency
  • Case Management & Care Coordination

To learn more about what we may be able to help you achieve, or to express interest in a plan tailored to your needs, contact r.sommers@thewilshiregroup.net

EMR & Clinical Systems Integration

With the landscape of healthcare continuously changing amidst technological advancement, new regulation, and the drive toward value-based care, it is more important than ever before to ensure your clinical systems are providing you and your staff with peak performance.  Whether you use Epic in full scope, or employ a network of connected systems, we are positioned to assist.  Modern computerized systems come with steep price tags, and yet we routinely see workflow and process gaps, poor/cumbersome design & configuration, failed integration points, and an assortment of other significant opportunities for improvement. Year in and year out we witness firsthand the difference systems operating at 80% vs 100% of their potential can make. Putting forth effort to achieve that last 20% not only provides a greater return on your EMR investment, but the results can be truly transformative as well. Your staff will gain efficiency and daily ease/satisfaction of work, your patients will have better experiences, information and insights will be more transparent through data, and you are likely to even direct improvements even on the balance sheet. The Wilshire Group is skilled in identifying and prioritizing the opportunities you have and the advancements you can make to your clinical information systems.  Our experts can help you to realize the benefits that last leg of work and fine-tuning of systems can yield, providing you with an incredible ROI for both the systems you have purchased and the services and assistance we provide. The Wilshire Way is forging ahead where others have stopped, and it makes all the difference.

Our Specialties:

  • Workflow Design
  • Application Configuration & Deployment
  • Charge Capture Integration & Improvement
  • Documentation Efficiency / Clicks Program
  • System Integration & Optimization
  • Community Connect & Affiliate Extensions

To learn more about what we may be able to help you achieve, or to express interest in a plan tailored to your needs, contact r.sommers@thewilshiregroup.net

Detailed Services Offerings

With the widespread deployment and use of today’s modern electronic medical records, capturing charges should be easier and more accurate than ever before.  However, the reality is that organizations all over encounter almost as much challenge as they do improvement.  Ownership and responsibility has is now diffused between clinical department leads, billing staff, and IT resources, and accuracy is often sacrificed, which is why we look to bring these groups together to identify optimal and long-term solutions. Starting with your high-volume and high-dollar areas, we employ a combination of system improvements, automation, and staff education, to help maximize net revenue capture, minimize errors & denials, reduce administrative time spent by staff, and speed up the entire bill cycle. In addition to providing tailored and specific charge capture support, we also offer pre-defined project options for all-encompassing improvement.

These defined offerings provide you with a small team of blended resources spanning the clinical, revenue, and HIM spaces for maximum impact and results. We draw upon our strong revenue cycle backgrounds, clinical system experience, and project management finesse to bring sweeping charge capture improvement across the facility. By providing you with a mix of the exact resources and experiences you seek to gain from, employing tried-and-true principles of revenue integrity to your existing operations, and by engaging and bringing together resources from a number of key areas, we seek to maximize your net revenue capture, improve clinician engagement/accuracy on the front end, reduce edits and denials on the back end, maximize reimbursement, and help to establish a long-term program that will yield efficient billing operations for years to come. Simply put, results are maximized when revenue integrity program work combines with clinical program operations.  Collaboration is king, and when done effectively, you achieve results at both ends of the spectrum.

Whether you already have a robust Clinical Documentation Integrity (CDI) program, or scramble to keep up with regulatory, reimbursement, and clinical best practices, The Wilshire Group can progress what your systems, staff, and teams are capable of doing. We approach Clinical Documentation with a unique combination of clinical expertise and technical skill, and we believe firmly that electronic medical records, no matter their complexity, should not be cumbersome to use. Despite hefty regulatory, reimbursement, and quality-related documentation requirements, your staff need not spend all day at the computer.

There is an art to configuring computerized systems for efficiency, and at Wilshire we employ a methodology build on sound principles of design in order to streamline tools and realize gains. When paired with our top-tier application expertise, we can identify ways in which you can create an easier and more efficient system, without compromising quality. Focused on ease and consistency of use, along with attention to detail in tailoring for your requirements, we can create clear, quick, well-defined templates that result in fewer clicks, less time, and improved clarity of information. In collaboration with your clinical stakeholders, HIM/coding departments, and Epic/IT resources, we help you find the sweet spot in the Venn diagram that is complexity, customization, and standardization. We maximize the power of your data and your system while minimizing your staff’s time commitment. Whether engaging us for targeted CDI work or larger reform and improvement throughout the facility, we regularly see a potential for up to 25% reduction of clicks and time spent completing documentation requirements.

Emergency Departments are incredibly important and valuable assets, and while most acknowledge this widespread importance, that doesn’t always mean they get the attention and dedicated efforts they truly need. Whether a small regional facility or a level 1 trauma center, there are a handful of common items and metrics that every ED wishes to improve. The Wilshire Group has seasoned professionals who work hand-in-hand to improve emergency room operations and help to create safer, more dynamic and efficient process in an already chaotic, fast-paced environment. When working with ED directors, supervisors, and shift staff, we invariably find it is the attention to detail that bears fruit and creates improvement, and while your staff spend the majority of their careers immersed and attentive to that detail on a daily basis, they don’t always have the time or means to generate the improvements they would love to see.

Thankfully, for most all it takes to make strides toward becoming an elite and efficient ED is a bit of focused effort and strategy, with people who have the time, skills, and knowledge to rapidly implement a few key changes. We commonly find room for improvement in charge automation and reconciliation, along with templated notes and orders, based on volume and complexity of diagnoses. Wait times, resource allocation, and throughput efficiency can almost always be improved with strategies ranging from basic to advanced. Prevention and reduction of mortality rates for Sepsis and other high-risk conditions should already be a top priority, but there’s always more to be done. Our experts have helped clients win awards and achieve staggering improvements in this area, through early warning triggers and advanced decision support processes. That means more lives saved, fewer downstream costs, and a healthier community overall.

Perioperative services, perhaps one of your largest revenue generating areas, may not be as organized as effectively as you’d like. Culture and technology are both changing rapidly year-by-year, requiring facilities to be nimble in order to stay abreast process, resource, pricing, and supply structures. And when it comes to patient care in relation to operative processes and procedures, even minor variances and deviations can impose significant risks. Furthermore, surgical staff can be some of your most impressive but obstinate resources, so getting through and connecting with them isn’t always easy.

At Wilshire we pride ourselves on navigating these perioperative difficulties and connecting with resources on a level that makes them want to engage. By showing this group the data, sometimes even their own data, we dive straight into the heart of the matters and are able to quickly identify and show what opportunities are present and what benefits have yet to be realized. From there our project management skills tend to take over and it is a matter of mapping out changes and solutions that provide ROI to the program and betterment to staff and patients both. Frequently these items manifest in improvement to ordering continuity andn configurations, preference card updates, transition of care processes, intelligent dashboard and information display, and more efficient scheduling and charge mechanisms. When addressed as a bundle in a short period of time, relatively minor changes and improvements in these areas generate results that can quickly take your perioperative departments to “high-performing” status, with metrics to prove.

To learn more about these packages and what we can help you achieve, contact r.sommers@thewilshiregroup.net

Additional Offerings Coming Soon!

L&D Focus Package
Imaging Focus Package
Care Management / Care Coordination

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