Case Study

Electronic Health Record System Implementation for Bay Area Hospital


A 300-bed, publicly-owned hospital in the San Francisco Bay Area began implementing a certified electronic health record system (EHR) in June of 2011, with a projected launch date in 2013. With costs projected to be in the tens of millions of dollars, the Hospital transitioned some internal labor to track the spending and financial reporting process for the project. After four months, the internal resource was unable to gather the data or provide the reports necessary for the project manager to assess and evaluate progress comparative to budget. Because HFS had successfully worked with the hospital in the past, it was hired to complete the project.


HFS placed a full-time accountant with 25 years of financial and reimbursement experience in the project accountant position. The accountant identified the various sources of data and insured they were being captured, researched the cause of the budget variances, interviewed the project manager and developed reports for presentation to the hospital CEO and Steering Committee.


Within two months of HFS’s involvement, reporting accuracy was validated and auditable. From our analyses, the Hospital was able make informed decisions about:

  • The use of contract labor instead of internal labor (shrinking labor pool with other area hospitals implementing the same system)
  • Correct coding and policy errors
  • Consulting its auditors on the appropriate handling of non-productive time

In addition, the HFS consultant was able to register the Hospital at both the federal and state levels to receive incentive payments offered by CMS and DHCS. While Medicare requires full implementation and a 90-day demonstration of "meaningful use," the state requires only that you demonstrate adoption, implementation or upgrade (AIU) to certified EHR technology in order to receive its incentive payment. For this Hospital, that meant over $1M received before the project went live. HFS was also able to provide important labor detail to the Hospital’s reimbursement director to insure proper reporting of wage index on the annual Medicare cost report, a key statistic in determining reimbursement rates from Medicare.


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