Ascendian Healthcare Consulting

Tuesday, February 21^st
4:00 p.m.
Jef Williams, Vice President
VNA’s Critical  Success Factors for Vendor Selection and Requirements Development

Wednesday, February 22^nd
11:00 a.m.
Shawn McKenzie, CEO
Is VNA Your ‘Secret Squirrel Decoder Ring’ for HIE?

Thursday, February 23^rd

3:00 p.m.
Jon Shoemaker, Senior Consultant
Take Control of Your Image Data & Prepare for Meaningful Use

By: Shawn McKenzie

Early in 2011, the State of California passed legislation requiring facilities utilizing computed tomography to record the procedural dose. My bet is that sweeping legislation is soon to come. Procedural dose benchmarks are being reevaluated; the ACR is engaged in facilitating the movement to capture dose and has enacted a dose registry; the Joint Commission is considering incorporating some radiation dose reporting and monitoring requirements to its accreditation process. While this activity on a national scale begins to develop, we must all ask ourselves realistically, what good comes from recording exposure from a single episode when the issue more likely to cause harm is a patient’s aggregate exposure over time?

Read the entire article as it appears in Radiology Today

Featured on Imaging Technology News

Understanding the three types of VNAs is a start for deciding which will serve your enterprise the best.

By: Jonathan Shoemaker

If your enterprise is similar to most current hospital health information technology (HIT) architecture, you have clinical/data silos everywhere. This is nothing to be ashamed of; you are normal. But in the coming age of healthcare delivery, silos must be replaced with interoperability. One key to interoperability will be an integrated medical image archive. While most consider image archiving as specific to cardiology or radiology, the fact is you have imaging elsewhere in your enterprise whether you know it or not. Determining the best archive solution is dependent on the size and scope of your imaging needs across the enterprise.

Ascendian Press Release

Ascendian Healthcare Consulting, a national healthcare IT consultancy, has engaged with the California Correctional Healthcare Services (CCHCS) to deliver services that will create a digital imaging health care IT foundation for the state's prison systems, which will increase efficiency and reduce costs.

CCHCS and Ascendian are focused on implementing solutions that will improve clinical operations statewide through new technology and streamlined processes. The overall goal was to modernize and standardize the outdated and disjointed prison health care system. A 10-year health care plan driven by three key values is now underway:

• Deploying health care technology and solutions for system wide cost reductions
• Revising existing contracts to improve vendor performance and cost containment
• Standardizing facilities and workflows to increase health care access and delivery

"The solutions Ascendian is providing are another tool to help us meet the court mandates in health care services, while also increasing efficiency and saving taxpayer dollars," said Brenda Epperly, Statewide Director, Allied Health Services at CCHCS.

Read Full Press Release

HIMSS Digital Office Newsletter features an article by Ascendian's VP, Jef Williams

Acountable care has arrived. With the final rule submitted, approved and published, we now have a good idea of the qualifications and requirements for participating in shared savings. What the final rule does not provide, however, are the logistics for how organizations will execute to the policy. We expect over the next several months more information to be gathered and shared among those planning and participating as ACOs. As organizations ramp up for this effort, it will be critical that physicians and providers play a prominent role in the process.

Historically, physicians have focused most, if not all, of their time and energy on patients. This is, after all, why they went to school. Doctors are scientists, and they are best at practicing medicine. Besides, in a Fee for Service (FFS) model, income is directly tied to patient and procedural volume. But success in building an ACO will require that forward-thinking physicians provide leadership in preparing and positioning themselves – and their practices – for success in the future.

Here are several important areas where clinical expertise will serve ACO leadership well.

Read more...

VNA Case Study as Featured in Imaging Technology News

Centura Health is the largest healthcare network in Colorado. Dedicated to delivering advanced care to more than a half million people, Centura strives for the highest quality and continuous innovation. To accomplish this, the organization needed to address its transformation and connectivity efforts across patient, people, processes and technologies — the essential ingredients when optimizing clinical performance.

Centura understands that by mastering clinical image data across its care network it will enable clinical improvements, optimize electronic medical record (EMR) investments and drive the organization's interoperability strategy. The key requirements necessary for Centura to adequately consider a VNA solution:

- A roadmap for the single/unified environment to store and disseminate image data while addressing the legacy individual cardiology systems currently in operation at the 13 hospital locations

- Recommendations to enhance interoperability and operational efficiencies of imaging beyond radiology and cardiology for referring physicians across all enterprise departments

- Best Practices to harness and streamline clinical image data to improve clinical decision support and clinical cost-effectiveness

The roadmap and recommendations will allow Centura to unify cardiology and other clinical systems to the overarching IT strategy of connectivity and interoperability. In addition, the organization is developing a Cardiovascular Information System (CVIS) initiative, to consolidate the multiple siloed systems supporting the cardiology services lines. Ultimately, Centura is building a healthcare architecture for the future financial and operational health of the organization. With the help of Ascendian's expertise, Centura is equipped with the required information that will ensure the best possible solution is delivered.

Is it finally time to smash data walls between providers? Can health care afford not to?

HIT Exchange Magazine features an interview with Ascendian CEO - Shawn McKenzie

Few hospitals have not made budgetary commitments to healthcare IT. However, the rationale behind IT investments has always been somewhat scattershot. Five to seven years ago, it was sometimes driven by a notion that IT investment was the right thing to do, based on then-nascent evidence about improved quality and safety. Others thought it was a way to get ahead of the competition. Some simply wanted to be first.

Featured in HIMSS Digital Office November 2011 Edition

By Neil Singh and Hjalmer Danielson, Ascendian Healthcare Consulting
Hjalmer Danielson is a member of the HIMSS Digital Office Taskforce

Throughout the course of Meaningful Use (MU) implementations, significant time, energy and money will be invested on successful initiatives. An equivalent investment will be made on failed MU efforts as well. Regardless of your current health IT transformation toward MU, by incorporating a planned MU pilot, your organization can learn from its successes and benefits to an incremental roll-out approach.

Effectively embracing pilot programs can both decrease the risk of your capitalization of the investment and leverage best practices for future health IT investments and implementations. Unlike Alaska's "bridge to nowhere" project, pilot programs have proven to be a foundation for any large scale investment, as they provide greater understanding, repeatability and a methodology for deploying solutions across the organization.

When planning your MU pilot programs, consider these critical questions for a successful implementation:

• Which MU requirements will you choose to implement?
• Will you incorporate Eligible Physician (EP) MU certification as well?
• How will existing IT investments be leveraged in the MU effort?
• What procedures and workflows will need modification?
• How will you quantify MU benefits and achieve stakeholder buy-in?
• How will your current MU implementation affect Stages 2 and 3 MU requirements?

For a robust pilot program, consider these four points:

Identify Realistic Goals and create a schedule that can be achieved within a reasonable timeframe. An MU pilot program allows for experimentation and learning, but it's important to stay on task. The pilot will be a valuable validation of your strategy, which will then foster organizational buy-in. Goals for the effort must be clearly articulated and documented and it's important to clearly understand and communicate tasks involved throughout the initiative. Document, develop and update the roll-out blueprint and best practices so they can be re-used.

Create a Cross-Functional MU Team that will ensure cooperation and coordination across your entire enterprise. Hold regular team meetings and updates to expose any lessons learned, or other project risks that, if uncorrected, will delay MU deployment. Practice good resource management by choosing team members based on their abilities and their availability to participate outside of their daily commitments. Determine if outside assistance is required for program management, vendor selection and deployment.

Determining the Appropriate Pilot approach is essential to the greater enterprise goal. Controlled and phased roll-out will ensure implementation success for the enterprise. Identify and develop MU cheerleaders within your organization who are best equipped to support and advocate your MU initiative. Being a highly visible investment project, you must understand the underlying opinions and political complications that exist with MU implementation and discuss them thoroughly.

Quantifying the Results and Benefits of the complete MU pilot to the organization is tangible proof of the investment. Create a method for capturing, managing and communicating implementation data and projects milestones. Compiling and communicating pilot information is an important justification and essential for the next phases in MU initiative and incentives.

Secure your investments in MU with a pilot program. Learn and use the information generated to leverage MU throughout your enterprise implementation. What will your MU pilot look like? Save time, money and resources; invest in a program that will guarantee a success beyond the meaningful use implementation.

Jonathan Shoemaker was Featured on HIMSS News

Perspective On: EHRs' Achilles Heel in Pursuit of Interoperability

There is a climate of frenetic activity surrounding today's EHR market that is masking some obvious issues. The positive aspect of the activity is that the process of EHR determination, selection and installation will create thousands of jobs and a supporting infrastructure in healthcare that currently did not exist. The future challenges will emerge when all of these new digital silos must talk to each other as required in Phase 2 of meaningful use. It is the very selling point of these systems – simple communication and usability – which become the Achilles heel of these EHRs.

Jef Williams and Shawn McKenzie were featured in HealthImaging.Com after speaking at AHRA 2011 on ACO's

AHRA: Rads need to carve a role in ACOs

DALLAS–The accountable care organization(ACO) is an unknown for most physicians and administrators, partially because the government has not yet defined final ACO rules. However, radiology practices can and should begin to prepare for the transition to the ACO model. In fact, the push to ACOs provides an opportunity for radiology practices to re-imagine their businesses, said Jef Williams and Shawn McKenzie, both of Ascendian Healthcare Consulting, during a presentation Aug. 16 at the annual meeting of AHRA.

Jonthan Shoemaker was featured in ADVANCE for Imaging and Radiation Oncology.

Defining Vendor Neutral Archives

Imaging has all but completed its rush to implement Picture Archival and Communication Systems (PACS). These last ten years have seen an industry-wide transformation from film-based to digital imaging workflow. A similar transformation is now gaining momentum within Cardiovascular Services with Cardiovascular Information Systems (CVIS).  These information systems can provide significant improvements to clinical workflow, data capture and availability, and ultimately improved patient care and outcomes. There are however new challenges with managing information in the digital age.  Disparate systems need to be integrated or interfaced to ensure data is shared across departments and these bring costs associated with the build and management of interoperability. In addition, information systems have a lifecycle and need to be replaced due to technological, functional or business requirement changes. Replacement efforts bring new challenges and costs associated with data migration and the typical payment for service to both the legacy and replacement vendors.  These costs can vary widely depending on the quality and extent of the migration.

Vendors have historically used the constraints of cost and effort as a way to hold on to customers. The unspoken strategy is to keep data locked within a system making it difficult to achieve either interoperability or conduct migration. Too often customers evaluate the associated costs and effort to complete these initiatives and determine the easiest path is to stay with a legacy vendor in the face of shifting clinical requirements.

There have been, however, significant technical developments and solutions that provide a better way to store, archive, and maintain data outside of the vendor-specific solution. One solution that has gained significant traction in the industry is Vendor Neutral Archiving (VNA).  VNA's provide the technology and architecture to allow for centralized data archiving and access for multiple systems and vendors.

Jef Williams and Shawn Mckenzie were recently featured on AHRA.org.

The original article can be found at ACO's: How do we Prepare?

ACO's: How do we prepare?

By Jef Williams, MBA, PMP and Shawn McKenzie, MPA, CRA, RT, CRT

June 2011–It is no secret that much ambiguity remains around the structure, reimbursement model, and reporting requirements of Accountable Care Organizations (ACOs). That ambiguity, however, has not slowed the momentum we see with most organizations moving to become certified. While many questions remain unanswered, there are several things we are sure of. ACOs will include and affect the following:

• Primary care providers (PCPs) who provide service aggregately to at least 5000 Medicare beneficiaries
• Contracted specialists and hospitals (affiliated or otherwise)
• Reporting requirements that measure quality of care and cost at patient and episode level
• Commitment to operate for a minimum of 3 years
• The ability to receive and distribute CMS payments (and potentially shared savings returns) to all participants of the ACO

Diagnostic imaging (DI), as a service provider along the entire continuum of care, stands to be impacted most significantly by the potentially drastic changes that will accompany participation in an ACO. The current operation, technical, and administrative (business) model adopted by nearly all DI departments will undergo major shifts. The challenge for directors and managers in this time of uncertainty is to prepare for the future in an environment where the specifics for that future are unclear. While this may prohibit your ability to establish a detailed imaging strategy for the next 5 years related to ACO participation, there are steps you can take to poise your organization for success.

Operational Readiness
One of the foundational elements of the ACO model is shared risk. In the current fee-for-service model, your department and the radiology staff are rewarded for volume and operational efficiency. Within an ACO, the payment structure, whether it be capitation or bundled payments, will drive the fiscal rewards directly tied to better outcomes, fewer studies, and collaborative decision making regarding most appropriate exam types.

In order to prepare your staff and radiology group for these changes, it is important that you begin discussions now to build trust and discuss the potential changes to workflow, the definition of efficiency, and roles and responsibilities both within the department as well as to the entire ACO organization.

Technical Readiness
ACOs will be joined together by way of information technology (IT). Without the technological functions provided with well built and implemented clinical information systems, the ability to share, as well as report and track patient data, will be overwhelming to the point of impossible. Your service line systems, along with other business or clinical applications integrated or interfaced to your department, will need to provide the following minimal functionality:

• Image sharing across care providers (including those captured by disparate PACS)
• Patient reporting across entire ACO
• Decision support for CPOE
• Cost reporting at patient/episode level

The challenges of technical interoperability within an ACO developed within affiliated providers or an integrated delivery network (IDN) will be difficult. For those pursuing an ACO model with providers and organizations that are non-affiliated and using disparate systems, it is critical that technical discussions be ongoing from the beginning. While technical in nature, this discussion must include IT staff, but steadfastly be driven by clinical stakeholders and leadership. Outcomes, workflow, patient information, and interoperability are under the purview of clinicians. The dangers of relinquishing leadership to IT in this area will create significant department operational challenges later.

Administrative Readiness
Preparing your business, department, or organization for participation in an ACO is perhaps the most difficult to address. Without a clear path to reimbursement models, community benchmarks, shared savings allocations, or even the potential change in relationship with your radiology group makes business and strategic planning difficult. One important thing to do in lieu of specific business planning is to prepare your organization for change. Change management, often overlooked, can be the ingredient that either makes or breaks your transition to an ACO. Preparing your staff for eventual workflow changes and fostering your relationship with radiologists may be one of the most important things you do while you move toward ACO certification. Eventually you will have to incorporate budgeting, cost analysis, informatics reporting, and other structural efforts, but until you know what those look like, they will be difficult to codify.

Serve by Leading
The ACO model is coming in one form or another. Perhaps the greatest risk to imaging will be the commoditization of services, which will drive down the value, revenue, and likely morale of your business. The best way you can ensure medical imaging remains an important, valuable component of the patient care continuum is providing leadership to those who are developing the specifics for your ACO. Including your chief radiologist in those discussions can be beneficial in helping tell the story of the value you bring to patient outcomes and the benefit of consultative services to their PCPs.

Whether the ACO model is viable and ultimately sustainable is yet to be determined. Most organizations, however, are moving toward certification.  Whether you are poised for success in a new model will be largely determined by your leadership. Engage now and begin preparing your organization. Those who don’t will be left at a significant disadvantage.

Learn more about ACOs during the 2011 Annual Meeting! Click here for related session information.

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Shawn McKenzie serves as president and CEO of Ascendian Healthcare Consulting in Sacramento, CA and is a co-presenter at the 2011 AHRA Annual Meeting & Exposition. He can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Jeff Williams serves as vice president of Ascendian Healthcare Consulting in Sacramento, CA and is a co-presenter at the 2011 AHRA Annual Meeting & Exposition. He can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Shawn McKenzie discusses today's trends in healthcare information technology with MedicExchange at HiMSS 2011.

HIT Exchange Media recently spoke with Ascendian Healthcare Consulting President and CEO Shawn McKenzie on how funds from the government are being spent on the adoption of electronic health records.

Two members of the Ascendian executive team, Shawn McKenzie and Jef Williams, have been selected to speak at this year's AHRA Annual Meeting and Exposition in Washington D.C. Their presentation takes place on August 24^th from 8:00am-9:30am and is titled "Succession Planning that Makes Sense Fiscally and Strategically."

Shawn McKenzie, President & CEO of Ascendian Healthcare Consulting, has been appointed to a leadership position with one of the Sacramento region's most influential economic development organizations. Known as SARTA, the Sacramento Area Regional Technology Alliance was established in 2001 to support entrepreneurial programs, companies and technology investment throughout Sacramento and the surrounding area.

McKenzie Stephenson, Inc. announced today that they have officially changed their name to Ascendian Healthcare Consulting. Located in Sacramento, CA, the firm provides healthcare professionals worldwide with a variety of information technology and operations consulting solutions. Ascendian will continue to serve independent delivery networks, acute care hospitals, diagnostic imaging centers, correctional institutions and physicians groups with the same superior level of service healthcare leaders have come to expect from the firm.

Ascendian Healthcare Consulting, formerly McKenzie Stephenson, Inc., was awarded the contract with the Federal Receiver overseeing the healthcare remediation for the California Department of Corrections and Rehabilitation Diagnostic Imaging Services. The contract marks a significant achievement for the company and conveys the confidence that the CDCR has in Ascendian's ability to execute efficiently and within budget parameters.