Congressman Experiences All-Digital Environment of Ministry Saint Clare’s Hospital

Wisconsin 7th District Congressman Sean Duffy recently visited Ministry Saint Clare’s Hospital in Weston to learn more about the facility and Ministry Health Care’s effort s to improve patient quality and safety through its use of technology.

During the nearly two-hour visit to his new hometown hospital, senior leaders and staff at Ministry Saint Clare’s introduced Congressman Duffy to one of the first fully all-digital hospitals in the country and its electronic medical record.

"It's no secret that there are many things impacting access and delivery of health care services,” said Duffy who began to call Weston home with his family in October. "Wisconsin can have a powerful voice in providing solutions to these complex issues by sharing the lessons learned from our high-quality health care providers."

The centerpiece was a tour of Ministry Saint Clare’s Intensive Care Unit (ICU) where leaders showcased how staff is partnering with Advanced ICU Care to implement a collaborative Electronic-ICU (EICU) program.

In its first five years, the EICU program at Ministry Saint Clare’s has produced impressive results that are 26 to 40-percent better than national predictions in key performance areas such as ICU mortality, length of stay and patient ventilator days.

“The real driver in our improving quality and lowering costs is the use of this technology to compliment our bedside care,” Ministry Saint Clare’s President Mary Krueger told Congressman Duffy. “We are delighted to share our story with you and describe how this implements best practices and evidence-based medical guidelines to improve our overall performance.”

Duffy also received an update from Chief Medical Officer Larry Hegland M.D., on Ministry’s efforts and related frustrations with the Recovery Audit Contracting (RAC) process. The Tax Relief and Health Care Act of 2006 made permanent the Medicare RAC program to identify improper Medicare payments - both overpayments and underpayments-in all 50 states. RACs are paid on a contingency fee basis, receiving a percentage of the improper overpayments and underpayments they collect from providers.

“While we understand the intended purpose of the RAC process is to reduce overpayments that stem from fraud or abuse, many of these cases involve routine medical necessities that could be avoided,” said Hegland. “The downstream effect is a program that costs millions for the Ministry system to manage and most of these cases are overturned on appeal.”

RACs may review the last three years of provider claims for the following types of services: hospital inpatient and outpatient, skilled nursing facility, physician, ambulance and laboratory, as well as durable medical equipment. The RACs use proprietary software programs to identify potential payment errors in such areas as duplicate payments, fiscal intermediaries' mistakes, medical necessity and coding. RACs also conduct medical record reviews.