A group of providers joined GHX at the recent AHRMM conference for discussion about the challenges facing supply chain to deliver quality data to clinical teams and how to interface this data for charge reconciliation and billing. A growing item master, subsequent data management and maintenance, and clinician frustration were among the primary concerns discussed.
There are foundational challenges that supply chain is currently facing, specifically in the connection of item master data to the EHR. What has been considered best practice for item master/data management is now being questioned with the increased use of EHR technology. Current thinking is that in attempt to both increase accuracy in patient records and reduce missed charges, more is better. As a result, the item master is growing and imposing a significant impact on workflow, maintenance, etc.
What we always considered best practice for item master management
The item master supports requisitioning with routinely used supplies, but the challenge has always been to include the right mix of items while also maintaining a manageable size. There will always be a need to solve for inventory that falls outside of routinely used supplies, but this is typically where the line is drawn — now the line is moving. The number of clinical/procedural supplies that need documentation at the point of use is growing the item master by association. What was typical — 40,000-50,000 items routinely used and maintained in the item master — is now more like 100,000 or more. The management of this drastic increase in volume is not sustainable for most organizations given the frequency of contract price changes, and it is not uncommon that supply chain now be asked to maintain data where it may not have the skill set to support — such as HCPCS, implant flags, etc.
Supply chain works diligently to get the data in the item master but clinicians search efforts are frequently unsuccessful, with the primary driver typically due to the description. Descriptions change or one attribute is missing or unclear, leading to confusion and frustration on the part of the clinician.
The result is manual documentation of items that end up as miscellaneous charges and one-time supplies — certainly not ideal. However, the truly disconcerting piece of this puzzle is that we are asking the clinician to stop mid-procedure and perform a clerical task. No one is satisfied with this process.
The discussion group at AHRMM generally agreed that there is tension between the clinicians and supply chain on this matter but essentially this problem needs to be solved in supply chain/ data management. This is a fundamental industry challenge.
How do we fix it? How do we get the right data to the EHR and in the charge master? Obviously it starts with good quality data in the item master. We are struggling with how to get the data at the center of the universe to our clinical teams, accessible at the point of use when they need it and finally, how do we interface for charging and billing?
This is a supply chain problem to solve but like most robust solutions, it will require buy-in cross-functionally in addition to technology. The end goal, to provide a more complete patient record and support the financial health of the hospital, is worth the effort. Accurate data found at the point in time when needed is imperative in a value-based healthcare model.