Community Health Center
Case Study


  • Background
    • As lowest cost primary health providers, US Community Health Centers (CHCs) are growing rapidly and are under substantial strain to increase efficiency while providing better access and better outcomes
    • Traditionally, CHCs have not dedicated significant funds for automation and enterprise performance improvement efforts
    • Substantial government funding has been made available for automation initiatives
  • The Problem
    • A California Federally Qualified Health Center (FQHC) required a means to standardize data, processes and workflows to improve efficiency while preparing for their implementation of an Electronic Health Record (EHR) system, which typically causes a loss of throughput and therefore revenue
    • Key problems for the organization included patient access, revenue cycle management, patient waiting times, data quality, data visibility, scheduling, and provider productivity
    • Initial areas of focus: operations, finance, capacity & demand and patient scheduling
  • Approaches
    • Consulting-led problem-oriented operational review, including departmental and enterprise analysis of processes and systems
    • Chief executive-sponsored inter-departmental process improvement sessions
    • Presentation of clear solutions with staff consensus and buy-in
    • Enterprise and departmental process development
    • Prototyping and rapid application development to support new processes
    • Data quality improvement
    • Systems integration
    • Predictive modeling
  • Solutions
    • Implemented an organization-wide data quality improvement program concurrently encompassing processes, systems, and staff education
    • Developed a near-real-time enterprise performance improvement system pulling information from various systems of record
    • Provided graphical business intelligence system available on management and staff desktops to provide immediate visibility into current state and historical trend analysis
    • Provided billing staff with up-to-the-minute graphical insight into accounts receivable to identify charge capture deficiencies and take corrective action
    • Provided scheduling staff with predictive solutions to better match capacity and demand and increase overall provider utilization
    • Eliminated lengthy manual creation and analysis of paper-based reports through the development of systems-generated exception management alerts
    • Created a performance data warehouse to accurately record operational, financial and capacity metrics gathered as a result of process monitoring
  • Results To Date
    • Data quality improved dramatically whereby key operational and financial reports went from unreliable and retrospective to accurate and real-time
    • Over $400,000 in unbilled revenue identified that was investigated and captured
    • Means identified to increase annual retained surplus by more than seven times while increasing net margins from 2.1% to 13.2%
    • Enabled better decision making by executive leaders due to objective, accurate real-time visibility into operations and finance
    • Organization better prepared for EHR implementation and integration

Case Study Details

  • Why TWHS?
    • Our team has developed medical management systems used by health plans to manage care for over 60 million Americans
    • Our team has over 100 years of combined experience in international health care operations and information technology
    • Proven innovation with visually-driven performance improvement systems design, development and deployment
    • Constant advocacy of proactive management, operations and business automation to identify and solve problems before they become an organizational threat
    • Substantial experience with systems integration and real-time query optimization with third-party systems
    • Data quality improvement experience
    • Rapid business process and application development methodology and technologies
    • Experience with business-critical timelines where failure is not an option

Products and Services Used