Fellowships | FUSE CORPS
Improving Patient Access to Healthcare Services
Department of Health Services
Los Angeles, CA

“Improving Patient Access to Healthcare Services” 
Los Angeles County Department of Health Services 
Los Angeles, CA 

PROJECT CONTEXT

The Los Angeles County Department of Health Services (DHS) is the second largest municipal healthcare system in the nation. It has an annual operating budget of over $4 billion and 670,000 unique patients a year, most of them low income. As a result, any changes to the county’s healthcare system can have a profound effect on the health and wellbeing of millions of people. 

Most recently, the Affordable Care Act (ACA) has transformed the face of health coverage for L.A. County’s most vulnerable. Since 2014, an additional 1.2 million county residents have signed up for Medicaid, accounting for a third of all Medicaid expansion enrollees in California. Another 300,000 residents now receive subsidized healthcare under the ACA, while 145,000 people who qualify for neither programs now have coverage through My Health L.A., giving them access to primary care services at one of DHS’ 70 partner clinics. Regardless of potential future efforts to repeal and replace the Affordable Care Act, DHS is committed to providing the best possible care and acknowledges that any potential changes will require innovative adaptations by DHS to ensure that it is a Provider of Choice of LA County residents. 

In response, DHS has been working to streamline and improve the quality of its patient services. In 2015 DHS rolled out an electronic health records system covering the entire network of 4 hospitals and 21 health centers. To continue this comprehensive reform, DHS is seeking to reorganize the way patients access healthcare within the system and transform the process into one that is not only efficient and high quality, but also compassionate, respectful, and focused on the needs and experience of the patients. 

Historically DHS patients have struggled to gain access to outpatient services in particular, and patients have repeatedly reported a poor overall experience with the registration process. A lack of coordination and a broken patient intake service has also cost the county time and money. For example, until recently each of DHS’ dozens of hospitals and health centers have independently operated their own patient access services. In the past year, DHS has undergone a thorough restructuring of this system, and today all 500 staff who deal with patient intake and registration are now housed under the newly created Patient Access Unit (PAC). 

Now that the dust has settled on restructuring, L.A. County DHS will partner with FUSE Corps to host an executive-level Fellow for one year to assist the Director and staff of the nascent Patient Access Unit develop a comprehensive registration, scheduling and financial screening work flow and continuous system evaluation protocol. The Fellow will assist in the process of standardizing and improving the patient experience to ensure that the agency best serves patients both in theory and in practice. The job is a challenging one, and the stakes are high: DHS is investing significant resources into creating a new “one-stop shop” approach for registering and scheduling patients, and it needs the right kind of evaluation and analysis to make sure those resources are deployed efficiently and effectively. 

PROJECT SUMMARY

The following provides a general overview of the proposed fellowship project. This project summary and the potential deliverables that follow will be collaboratively revisited by the host agency, the Fellow, and FUSE staff during the first month of the project, after which a revised scope of work will be developed and agreed upon by the Fellow and the host agency. 

Starting in October 2017, it is proposed that the fellow will lead an evaluation of these restructuring efforts thus far, identify areas of weakness, and develop the measuring system needed to ensure these changes have the desired overall result: getting people the care they need as quickly and as professionally as possible. 

While it may be helpful for the fellow to have some experience or familiarity with health care systems, customer service, or the logistics of call centers, the most important qualities for this role include a sense of curiosity, a readiness to dig deep, an ability to evaluate large systems made up of many moving parts, as well as the willingness to make on-site visits to DHS’ vast network of care centers. The fellow should also be comfortable working with large data sets, which they will use to help determine baseline indicators and benchmarks for ongoing evaluations. 

By the end of the year, the fellow will deliver a list of detailed recommendations for future and ongoing improvements to the new patient access structure and with staff begin implementation of the new patient access system. 

POTENTIAL DELIVERABLES 
 
  • Conduct a current state analysis and identify internal and external best practices – The fellow will seek to fully understand current processes in the PACs, including the problems staff encounter in registering patients, scheduling their visits, and verifying their insurance coverage. The fellow will analyze all available information on patient access, including eHR (ORCHID) systems data, existing process maps, and interview data from on-site evaluations. The fellow will visit at least six PAC locations geographically dispersed throughout the county to gain first-hand knowledge of how they function and to meet with PAC Directors and staff members. The fellow will also review best practices at other patient scheduling and healthcare customer service systems throughout the country.  
  • Conduct stakeholder interviews and provide analysis of current system – The fellow will conduct interviews with all relevant stakeholders, including patients, medical staff, and PAC staff, with a view to understanding their concerns in addition to underscoring the importance of implementing new business practices. The fellow will provide an assessment of the gaps between the theory of patient service delivery embraced by the new system and its day-to-day practice. Throughout, the fellow should work to promote a strong sense of unity, collaboration, and mission. 
  • Establish a PAC data “Dashboard” –The fellow will identify key performance indicators (KPIs), and establishing the system for gathering, aggregating, reporting, and displaying data. They will quantify and develop a system for measuring the ongoing success of the new patient access system and which provides management with the information it needs to make informed policy and management decisions.
  • Establish new system goals and implementation plan – Armed with the necessary evaluations and data, the fellow will play a key role in establishing goals for improvement. These goals may include research, project planning, policy development, and partnership development. Ultimately the fellow will develop a comprehensive registration, scheduling and financial screening work flow and system evaluations, generating a detailed proposal with specific recommendations and implementation plans to address each goal. 

KEY STAKEHOLDERS
 
  • Dr. Christina Ghaly, Chief Operations Officer, Department of Health Services 
  • Shari Doi-Hatcher, Director, Office of Patient Access, Department of Health Services 

QUALIFICATIONS
 
  • At least 15 years of professional experience in systems architecture, systems management or general management with an emphasis on call center or customer service management. Previous experience in healthcare systems a plus. 
  • Superior critical thinking and analytical skills. Ability to get up to speed quickly about the integration and application of multiple technologies to improve the lives of residents across diverse populations. 
  • Experience with process improvement tools and workflow mapping visualizations. 
  • Ability to analyze large data sets and synthesize complex information into clear and concise summaries and recommendations. 
  • Ability to identify best practices, understand data and evidence and use it to support a business case, and make a persuasive argument to support recommendations.
  • Strong record of success engaging a variety of cross-sector stakeholders and managing cross- functional teams.
  • Ability to relate to a variety of diverse audiences and varying interests with strong emotional intelligence and empathy. Able to connect and collaborate across a variety of disciplines.
  • Exceptional written and verbal communication skills with ease in public presentations. 
  • Self-motivated, goal-oriented, entrepreneurial leader who is an independent worker, resourceful in creating novel solutions to complex problems, persistent in obtaining information, and able to create direction and movement within potentially ambiguous environments.
  • Flexibility, adaptability, persistence, humility, inclusivity, and sensitivity to cultural differences. Support and understanding the strength of diversity, and the need for solutions to support all regardless of race, religion, gender, immigration status, or ethnicity. 

TO APPLY 

Click the link below to upload a resume and complete the online application questions in lieu of a cover letter. The application process will allow you to indicate interest in more than one fellowship opportunity. You only need to submit one application. Interested candidates are encouraged to apply as soon as possible, as selections will be made on a rolling basis and specific opportunities may close quickly. 

This role offers the opportunity to work full time for 12 months as an independent contractor of FUSE Corps with an annual stipend of $90,000 paid through monthly installments. 

The FUSE Fellowship is an equal opportunity program with a core value of incorporating diverse perspectives. We strongly encourage candidates from all backgrounds to apply.

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APPLY: Improving Patient Access to Healthcare Services


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