Woods Services, Inc.
Woods Services was awarded $25,000 last year in support of its three-year implementation of a new Electronic Health Record. This multi-faceted project is aligned with Woods’ strategic directions plan priority of infrastructure development, and Woods continues to seek additional funding to support the critical organizational pillar of infrastructure supporting its administrative services and systems, which are key to its ability to develop new services to meet the needs of a population with complex needs.
This project has a direct impact on the ability of Woods to provide coordinated care for people with intellectual disabilities, behavioral challenges and medical complexities across multiple types of services, departments, and external entities. Clients include 585 people who are served by Woods through campus and community-based services, as well as its five affiliate organizations that provide a range of services in PA and NJ for people with intellectual disabilities and mental health disorders. Woods serves 585 children and adults through its main campus and community-based services, and nearly 20,000 people across its network of care through its five affiliate organizations in Pennsylvania and New Jersey. The EHR enhances the quality of care for our clients and has a positive impact on performance management and revenue cycle management.
Woods has undergone a significant organizational transformation over the past year, focusing on reorganizing its integrated health services under the new Medical Center at Woods, enhancing its clinical services within the residential treatment programs for children, incorporating more evidence-based approaches and curricula in its education programs, and improving employee engagement efforts and benefits. Other programmatic improvements have also been carried out in the education programs, as well as Beechwood NeuroRehab, Woods’ brain injury program. The programmatic transformation could not be accomplished without significant investment in infrastructure improvements across the organization, including the incorporation of a new Electronic Health Record, and the technologies needed to connect this system with other electronic systems.
In addition to having a positive impact on Woods’ ability to improve the quality of care through the new services and systems developed over the past two years, these investments are key to Woods’ ability to build services within a managed care environment. The trend towards moving services beyond healthcare into managed care is a dramatic shift occurring throughout the country in health care and the long-term care sectors, and will inevitably reach services for people with developmental disabilities. Woods must be able to have effective back office systems to function and thrive in this ever-changing landscape, as well as grow new and innovative programs serving the most vulnerable populations.
Now, in year, two of implementation, the new Electronic Health Record has already been fully rolled out across all of Woods’ programs, and is scheduled to “go live” in October at Brian’s House, Woods’ affiliate organization which administers group homes and day services in the Greater Philadelphia region. Archway Programs, based in New Jersey, another Woods affiliate, will incorporate the new EHR within the next year. The grant supported equipment and technology that allows the EHR to dovetail with Woods’ other electronic systems, including the EMR that supports the Medical Center at Woods. Ultimately CareLogic, the new EHR, will have an EMR module that will replace the separate EMR currently in use that will create one clinical system of record, reduce duplicate entry, and further simplify care coordination across the services. The other major impacts of this project are on Woods’ ability to bill efficiently, which is core to the financial health and sustainability of the organization, and improved compliance as a result of the new system. Woods has over 200 funders from multiple states, requiring tracking of documents and services governed by different requirements.
The greatest achievement to date that has resulted from this project is the Patient-Centered Medical Home (PCMH) pilot. Because of the ability to retrieve and analyze data from these electronic record systems, Woods has made major strides in achieving one of the goals it set out to accomplish last year – reducing ER visits and hospitalizations among the population of people with intellectual disabilities Woods serves, who are among the highest users of these costly services. Not only are the services costly, they are also traumatic for individuals with multiple challenges that affect their coping ability. Woods worked in partnership with Keystone First, Pennsylvania’s largest Medicaid provider, to conduct a Patient-Centered Medical Home pilot that would reduce ER visits and hospitalizations for Woods’ clients who are on the Keystone First patient panel. The theory of change was that increased primary care visits and enhanced care coordination to coordinate specialty care, transitions after hospitalizations and care through external providers would reduce unnecessary ER visits and hospitalizations, and improve overall care. This theory of change was confirmed. Primary care visits increased as expected; however, inpatient costs went down 39%, total claims costs went down by 8.7%, ER costs went down 2.3%; and gaps in care were reduced by 15.6%. A proposal is being submitted this month to expand this pilot within Pennsylvania – invited by Keystone First, so that more community members with intellectual disabilities requiring complex care can be served with Woods’ health care model.
Woods is also very excited to report that it is preparing to become accredited through the Council on Accreditation, a national accrediting body. Achieving this accreditation will further facilitate Woods’ ability to develop new programs and also maintain contracts, which require such a recognition. It will also serve to strengthen the foundation for smoothly administering contracts with managed care organizations. Council on Accreditation requires organizations such as Woods to have an EHR, as well as to show that we use it to 1) improve processes and procedures, 2) improve outcomes, and 3) ensure our billing is 100% accurate, timely and compliant with all regulations, which is one of the keys to the sustainability of this project. Woods has reorganized its Performance and Quality Improvement (PQI) department and formed an interdisciplinary committee with board representation, developed a PQI policy and manual and an annual PQI plan, which outlines clinical and organizational outcomes for the coming year and indicators of progress towards these outcomes. Accreditation is anticipated to be achieved by February 2020. Woods would not be able to track progress towards outcomes without the ability to document services in an EHR and analyze data for many different purposes.
As Woods develops more community-based services, it will become more important than ever that an EHR is deployed to ensure that services are being delivered effectively, and that billing and other operations can be conducted seamlessly. An example of how the new EHR benefit program development and ensure continuity of care is in the case of its affiliate, Brian’s House, which provides group home and employment services all over the five county area of Greater Philadelphia. Brian’s House will go live with CareLogic next month. Nearly 20 clients are on the brink of graduating from Woods’ programs and have chosen to move after graduation to group homes developed and administered by Brian’s House over the next year. They will continue to receive critical health care services from the Medical Center at Woods, delivered by primary care and specialty providers who are very familiar with their health conditions and needs. Several of the clients transitioning to group homes are among the most behaviorally and medically challenged clients Woods has served over the past several years and therefore it is even more critical that program staff have real-time information at their fingertips to ensure coordination of services for clients requiring complex care. The EHR will help ensure continuity of care for these graduates.
Woods is embarking on its next strategic planning process this fall, and the EHR implementation provides an incredible foundation for the plans that will be developed over the next three years.