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Responses

 In response to your peers, offer any advice and feedback to address your peers’ progress and concerns. 

Chantel Discussion:

Hello Class,

Proposal Topic Summary:
My program proposal aims to reduce AMI readmissions at Rush University Medical Center by improving discharge planning, follow-up care, and patient education.

Resources Required for Implementation:
The successful implementation of this program requires several essential resources. Qualified personnel will include cardiologists, nurse case managers, discharge planners, pharmacists, and patient educators. We’ll also need a robust EHR to monitor patient outcomes, manage follow-up appointments, and track medication adherence. Additional technology includes remote monitoring tools like mobile apps or wearable devices and telehealth platforms for post-discharge check-ins. According to Anusharani and others 2024 regarding research, “Study has demonstrated, wearable sensors such as heart rate sensors and activity sensors, both have close to perfect accuracy of 95% and, 92% respectively” (p. 1). Funding will be necessary for staffing, technology infrastructure, training, and patient outreach initiatives.

Resource Access and Assignment Strategy:
To maximize efficiency and manage costs, we plan to leverage Rush’s existing infrastructure and EHR systems. We will assign responsibilities by integrating the program into current workflows, such as nurse case managers handling post-discharge follow-ups, and pharmacists providing bedside medication reconciliation. We also intend to utilize grant opportunities and internal quality improvement funding to support technological tools and additional staff training. Partnering with outpatient clinics and community organizations will help extend care continuity without overburdening inpatient resources.

Progress Update and Concerns:
I’ve made good progress outlining required resources and aligning them with the hospital’s existing capabilities. One concern is accurately projecting the cost and timeline for implementing new technology like remote monitoring tools. I’m also evaluating how to measure long-term impact while staying within budget. Overall, the plan is coming together, and I’m tweaking the resource plan to ensure it’s both practical and scalable.

References

Anusharani, V., Krishnan, M., Muthamizhan, T., Aijaz, M., & Guna, G. (2024). Cutting-Edge Innovations in Biomedical Sensing Technologies for Enhanced Remote Healthcare Monitoring. 
2024 International Conference on Cybernation and Computation (CYBERCOM), Cybernation and Computation (CYBERCOM), 2024 International Conference On, 683–687.

Victoria Discussion:

Hi everyone,

My proposal focuses on streamlining the prior authorization workflow for autism therapy services at a pediatric behavioral health clinic to reduce care delays, improve operational efficiency, and enhance reimbursement outcomes.

As I work through the resource allocation section of my proposal, I’ve realized that implementing this prior authorization improvement program will require a thoughtful mix of staffing and technology. We’ll need a dedicated prior authorization coordinator to manage submissions, follow-ups, and support from existing clinical and revenue cycle teams. On the technology side, I recommend we enhance our use of internal platforms like SharePoint for centralized tracking and explore automation opportunities to reduce manual workload. Leveraging health data effectively is key—especially as healthcare continues shifting toward digital transformation, where big data and AI can streamline operations and reduce administrative burdens (Liu, 2019). Financially, I plan to make the most of what we already have and use new tools over time to stay cost-effective. According to the CAQH Index, automation alone could save the industry billions annually, with prior authorization remaining one of the most time-consuming processes in healthcare (Council for Affordable Quality Healthcare, 2024). So far, I’ve mapped out the essential resources. However, I’m still weighing which automation elements to prioritize in the initial rollout to get the best return without overcomplicating things early on.

References

Council for Affordable Quality Healthcare. (2024). 
2024 CAQH index report

Liu, A. (2019). 
Transforming healthcare with big data and AI. Information Age Publishing.

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