Ryan Williams, Clinical Systems Manager for Millennium’s Technology and Innovation Services Department, learned from the group’s Director of Quality Programs in early 2020 that multiple staff members were spending all of their time submitting quality measure data to payers for reimbursement.
“This director wanted a way to automate some of the work so her team could include data for more patients and bring our quality scores up even higher than they already were,” Williams says. “In addition to saving money not having to hire additional staff, our Medicare Advantage contracts will provide us cash incentives if we meet certain quality thresholds for the patient population assigned to us.”
Williams’ team tried developing a test project to automate submission of a single Healthcare Effectiveness Data and Information Set (HEDIS) measure, Adult BMI. “The process involved combining multiple reports pulled from our EHR and each insurance company’s website into Excel, then creating a file that could be sent to our billing system,” Williams explains.
Millennium successfully sent data for one batch of patients for a single measure to a single payer — and then shelved the project. “There were too many moving parts and things that could go wrong with a manual process like that, and we didn’t have the tools or time we needed to improve and complete it,” Williams says.
But rather than fading into the background, the problem worsened mere weeks later when COVID-19 struck the U.S., prompting company-wide budget cuts and stretching the quality team even further.
“In the wake of COVID-19, the automation project returned to the forefront,” Williams says. “Fortunately, we had acquired two new tools, Qvera and Snowflake, that allowed us to think about picking it up again.”
Snowflake, a cloud-based data warehouse, was added as an end-user feature to Millennium’s athenahealth EHR. Having EHR data ready to access through Snowflake would eliminate the need for manual manipulation of reports.
With these tools, the developers were confident they could design a custom interface that would completely automate data compilation for HEDIS measures. It was time to get building.