Running head: WK1 PROJECT NEEDS ANALYSIS

Content Review- Week One

By Lynda S Strickland
EIDT 4001-1, Walden University
Professor Susan Schnorr
July 19, 2015

WK1 PROJECT NEEDS ANALYSIS

BeaconLBS Needs Analysis Report

Overview
In October 2013, United Healthcare Group Inc (UHC) announced its partnership with
Beacon Laboratory Benefits Solutions (BeaconLBS) to administer the UHC Laboratory Benefit
Management Program. The program includes management of all outpatient lab services,
however, 79 Decision Support Tests (DST) will be subject to an Advanced Notification protocol
using the BeaconLBS stand-alone portal, integrated Electronic Medical Record (EMR), or
integrated lab ordering services.
The Laboratory Benefit Management Program was developed to help manage appropriate
utilization for outpatient laboratory services. The pilot program is limited to fully-insured
Commercial members in Florida, excluding Neighborhood Health Partnership members. .
BeaconLBS Physician Decision Support (PDS) technology helps make it easier to choose tests
and laboratories using evidence-based guidelines and industry best practices. PDS also offers a
selection of Laboratories of Choice, and a network of participating laboratories to that help to
provide consistent clinical practices and cost-efficiency.
A solution called PDS-Q, a spin-off of the Physician Decision Support (PDS) has been
partially implemented with selected larger providers based upon compliance, use of a Laboratory
of Choice (LOC), and the organizational internal concerns. PDS-Q is a retrospective system
automatically creating the advanced notification with the provider only having to finalize and
submit it. The system is being considered for an automatic launch to registered providers who are
not accessing the system or are inconsistent with its use. A learning solution is required for mass
learning without immediate contact by BeaconLBS representatives.

WK1 PROJECT NEEDS ANALYSIS

The following report identifies issues and proposed solutions with respect to overall
compliance with the United Healthcare Advanced Notification Protocol that went into full effect
November 1, 2014. A compliance rate of 80% was expected by the end of June 2015; however,
the current compliance rate teetered between 45% and 48% as of July 1, 2015.
Data Collection
Multiple data sets or series, internal BeaconLBS conversations, as well as interviews with
medical providers and staff were reviewed for this analysis. The compliance data collected is
over a time period beginning November 1, 2014 to July 4, 2015. Interview data is a collection of
conversations occurring during the same time period. The interviews are a result of first contacts,
provider registrations, training sessions, intake calls as well as follow up calls and emails.
Sources of Data
A. Provider Compliance Report: The provider compliance report data is comprised of
claims data which consists of UHC patients lab orders for the state of Florida as
provided by United Healthcare. The report is created on a monthly basis. For the purpose
of this analysis we will utilize the latest report dated July 4, 2015.
# Groups listed

# DST Ordered

# DST with AN

4755

51145

10881

Percentage with
AN
25%

Compliance Report: Fischer, A, Appendix A

The current report covers the time period of May 1 to June 30, 2015. A 60 day snapshot
provides a 25% compliance of DST being presented with the mandatory notification. The result
is 75% of lab orders being denied for non-compliance.
B. Weekly Adoption Report: The weekly adoption report is comprised of data analysis using
the averaged RVU (relative value unit) a physician or provider group orders in labs

WK1 PROJECT NEEDS ANALYSIS

within a 30 day time period. RVUs are an indication of the volume of orders from an
organization or physician. The report calculates the projected and actual RVUs, and the
percentage of orders submitted with an Advanced Notification within a weeks time
period. The report provides an overall compliance percentage beginning November 1,
2014 to current, the current week, and the last three weeks respectively.
Type of
Grouping
Provider
Groups
Individual
provider

# listed

RVU

8971

3749811

Current Week%
Compliance
38%

3030

30810

49%

July 4, 2015 Weekly Adoption Report: Chan, L & Catlett, C, CP Risk Solutions, Appendix B

When constraining on the overall adoptions according to the information from UHC there are
a total of 12,001 groups for registration. We then compared this data set to the BeaconLBS
registration data set which shows 9,299 identifiable registrations. This could indicate there are
2,702 physicians or groups remaining to be registered or duplicate listings.
C. Provider personal perspective (interview) data is a culmination of discussions and
feedback from the medical providers within the state of Florida. The provider
perspectives range from Director of Operations, Office Administrators, and nursing
personnel to front desk registration. The providers and groups range from large to small
RVU ordering habits.
Listed below is a compilation of the main reasons for non-compliance and how BeaconLBS
has attempted to resolve the issues. Several of the objections would support the need for a
performance gap assessment looking for areas of opportunity where the group could improve
(Piskurich, 2006). Addressing areas such as not enough manpower or it interrupts our work

WK1 PROJECT NEEDS ANALYSIS

flow with the provider group could encourage participation while showing empathy and support
from BeaconLBS and United Healthcare.

Issue

Resolve

Not integrated with EMR

Currently integrated with several and more

on the way-BLBS portal should only be an
interim method for providers using an
integrated (Pending) EMR or Lab Ordering
System
UHC and BeaconLBS has been
communicating since October 2013Administrative changes could be the causelack of internal communication within
Provider Organization
The PDS takes on average 1-3 minutes
PDS-Q takes on average 30 seconds to 1
minute
This is a mandatory policy implemented by
UHC. The design is to ensure affordable lab
care and compliance with UHC policy
We can work with offices to define and
outline workflow
Individual conversations refer to upper
management
The BeaconLBS logo in on the back of the
card
Verification processes identify patients
BeaconLBS can run a patient report
A certified MA or Medical Records Technician
and, RN, LVN, PA, are highly credentialed and
trained I abstracting medical records. All
Q&A are designed to be answered from
information that should already be in the
records to support the lab order

I did not know about it

Not enough man power

We follow guidelines so it is duplicate

work
It interrupts our workflow
Other contractual issues with UHC
Unable to identify patients

Medical Assistants are unable to answer

the Q&A

Personal communications July 2015

D. A performance gap assessment takes a look at what the performance should be and what
it is now (Piskurich, 2006). An individual client performance gap will assist BeaconLBS
with specific training needs or solutions by provider organizations. A Provider
Performance Gap Analysis has been performed and included for a group being considered

WK1 PROJECT NEEDS ANALYSIS

for the PDS-Q application. This is an example only of the information required in
addition to discussion and is not complete. The organization was interviewed,
information was discussed and followed by activation and training in the proper operation
of PDS-Q.
Strengths and Weaknesses
It is to be noted there flaws in the data.
The first flaw is the numbers of organizations or providers still requiring registration as
physicians in the individual provider section of the Weekly Adoption Report could in actuality
belong to a group. The Compliance Report also designates 333 line items to the group affiliates
column comprising of 94 groups. This would suggest a clean-up of the organizations would
provide accurate data.
A second flaw is the possibility of duplicate registrations in the BeaconLBS Physician Portal.
Mass registrations by BeaconLBS for groups occurred while individual physician offices have
also self registered. The total registered groups could be less than the data suggests.
A third flaw is the number of physicians in compliance. The Adoption report lists 2,911
physicians/organizations with no expected RVUs and no expected compliance percentages. If
these are considered in the mean calculation they should be removed.
Conclusions
After reviewing all available data, there appears to be additional issues that could affect
identification of those requiring activation and training of the PDS-Q system.
1. Conflicting statistical data
a. The exact number of provider groups or independent physician groups unknown
due to the possibility of duplication in the data
2. Criteria for selection of PDS-Q activation is compromised by item 1
3. Provider resistance is easily overcome but must be accomplished
4. Provider Performance Gap Analysis is vital in overcoming provider resistance-

WK1 PROJECT NEEDS ANALYSIS

a. It is currently unknown where all data is obtained to create the reports or who
internally populates the required data
Recommendations
BeaconLBS is requesting a training solution to improve overall performance or compliance of
the UHC Laboratory Benefit Management Program. The training solution must be
comprehensive and robust to facilitate mass distribution. Instructional design is mainly
concerned with skills/knowledge deficits as they directly affect training (Piskurich, 2006). It is
not to say that additional factors can not influence performance such as negativity about the
BeaconLBS product by management within a provider group. Communication and training will
attempt to resolve the negative aspects of compliance.
Non-Training Needs
1. Consolidating providers to their respective groups in the Compliance Report and Weekly
Adoption Report will:
a. Strengthen the provider organizational RVU data and overall compliance data
b. Assist in proper identification groups for PDS-Q review
c. Prevent multiple contacts by multiple BeaconLBS staff
d. Streamline and prioritize outreach by RVU data and registered groups
2. Consolidating self-registered physicians in the PDS Portal with their respective groups
will:
a. Clean the data sets and allow for proper future implementation of PDS-Q.
Training Needs
1. Create a PDF User document welcoming and explaining how to access and use the PDSQ. If the user is new to the system additional training may be desired and accomplished
by:
a. Insert a training demonstration video or link inside the PDF document rather than
posting it online since the PDS-Q will only be available to specific groups
2. Creating an explanatory email or document outlining the specifics of the United
Healthcare Laboratory Benefit Program will:
a. Explain the ramifications of non-compliance such as claims denial and fee
schedule
b. Meet objections head on
c. Strengthens verbal outreach communications
3. Provide needed access and training to BeaconLBS staff to create a personalized Physician
Performance Gap Analysis as this should be part of the outreach to potential PDS-Q users

WK1 PROJECT NEEDS ANALYSIS

BeaconLBS as administrators for United Healthcares Laboratory Benefit Management

Program has created a retrospective advanced notification add-in system as a solution to a 48%
overall compliance by providers. Providers within the state of Florida are resistant to the
mandatory protocol citing reasons such as: lack of EMR integration, ability to identify patients,
as well as time and manpower. Discussions are underway to release the retrospective system
known as PDS-Q to specific providers. A training need is required to address a large volume of
users in an efficient and explanatory manner through email communication. As such a solution is
being presented by creating a user guide with a video insert. The user guide will be attached to an
introductory and congratulatory email explaining the program, its benefits, and ramifications of
non-compliance. The email could also identify that BeaconLBS has heard their concerns and is
launching the retrospective program to assist in their listed concerns. I would further recommend
that communication is personalized to communicate commitment and personalized care.

WK1 PROJECT NEEDS ANALYSIS

References:
Chan, L & Catlett, C. (2015). BeaconLBS Weekly Adoption Report, CP Risk Solutions
Fisher, A. (2015). BeaconLBS Provider Compliance Report, BeaconLBS and United Healthcare
Piskurich, G. M. (2006). Rapid instructional design: Learning ID fast and right (2nd ed.). San
Francisco, CA: Pfeiffer.

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Appendix A
Abstract PDF from the Compliance Report- click to expand

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Appendix B
Example PDF of the Weekly Adoption Report-click to expand

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Appendix C
Example PDF Provider Performance Gap Analysis- click to expand

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Appendix D
Main Provider Interview Responses concerning lack of adoption.
Conversations were generated through phone and email correspondence to BeaconLBS
representatives.
Issue

Resolve

Not integrated with EMR

Currently integrated with several and more

on the way-BLBS portal should only be an
interim method for providers using an
integrated (Pending) EMR or Lab Ordering
System
UHC and BeaconLBS has been
communicating since October 2013Administrative changes could be the causelack of internal communication within
Provider Organization
The PDS takes on average 1-3 minutes
PDS-Q takes on average 30 seconds to 1
minute
This is a mandatory policy implemented by
UHC. The design is to ensure affordable lab
care and compliance with UHC policy
We can work with offices to define and
outline workflow
Individual conversations refer to upper
management
The BeaconLBS logo in on the back of the
card
Verification processes identify patients
BeaconLBS can run a patient report
A certified MA or Medical Records Technician
and, RN, LVN, PA, are highly credentialed and
trained I abstracting medical records. All
Q&A are designed to be answered from
information that should already be in the
records to support the lab order

I did not know about it

Not enough man power

We follow guidelines so it is duplicate

work
It interrupts our workflow
Other contractual issues with UHC
Unable to identify patients

Medical Assistants are unable to answer

the Q&A

WK1 PROJECT NEEDS ANALYSIS

18

Capstone Project (EIDT-4001)

AECT Standards 1-5

Criterion

/(Standard)

Unacceptable

Acceptable

Target

Needs Analysis

Evidence shows that:

Evidence shows that:

Evidence shows that:

(AECT 5.1)

Report does not include

one or more required
components.

Report includes general

description of client, the
task not being
performed and a
summary of the causes
of the problem.

Report includes full description

of client, the task not being
performed and a summary of
the causes of the problem.

Report includes general

description of the target
performance and the
recommended training
solution.

Report includes a full description

of the target performance and
the recommended training
solution.

Graded in Week 1

Report is supported by Learning

Resources and additional
research.