ORGANISATIONAL AND TECHNOLOGICAL INNOVATION
- Design of services for patients and validation of their legal and economic relevance
- Creation of digital resources in the service of efficiency
- Identification of innovations and new professions within hospitals
- Cooperation and agreements between institutions and community medicine
- Accompanying Territorial Hospital regroupements
- Operational conjugation of the patient pathway on territories and in Territorial Hospital regroupements
- Ambulatory shift and creation of patient support services, from hospital to home
- Support for the design of business models
PARTNERSHIPS BETWEEN ACTORS
- Establishment of partnerships between institutions
- Establishment of partnerships with insurance providers
- Establishment of partnerships with assistants
- Establishment of partnerships with healthcare industrials
- Improvement of administrative and care service reception
- Reliability of patient care
- Reduction of administrative tasks through the digitalisation of flows with insurers
- Optimisation of the billing-recovery chain
- Deployment of the SIMPHONIE, ROC and FIDES programs
Our success stories
Reconciling the Interests of all for an optimal Hospital Agreement
Mise en place d’un conventionnement hospitalier
The Complementary Health Insurance Organisations (CHIO) were required to resume and densify their risk management policy as well as their health services strategy. In this context, a health service provider wanted to anticipate the implementation of various referencing schemes and agreements initiated by the CHIO and participate in their construction to depart from the strict economic logic.
We conducted discussions with the CHIOs and various hospital groups in order to identify the interests of each stakeholder, which ultimately lead to an agreement process. As part of our intervention, we identified the potential benefits of the network for the insured, health facilities and CHIO, we defined the principles of the convention (selection criteria, pathologies, definition and calculation of the package, etc.) as well as the operational modalities in particular related to billing flows.
More than 60 pathologies involved
More than 7 million insured people in the network
Establishments: When Union is Strength
Evaluation of the relevance of reconciling the activities of two health institutions
Two health facilities faced a transformation imperative: the first had to strengthen its activities to continue its economic recovery; the second, a military training hospital, had to evolve in accordance with the Army Health Service (SSA) transformation programme. To address these issues, both institutions planned to merge their activities. After a first ambitious but abortive project, the teams needed to remobilize around a more manageable project and to restore confidence in their guardianship, ARS and SSA.
In response to the request of the ARS, and relying on ANAP tools (Hospidiag, Ælipce), the OpusLine team analysed the strategic project and the financial situation of the institutions, validated the realism of the merger project, formalised the business plan and set up a well-argued dossier on the project. This file, rich in territorial analysis, arguments in favour of reconciliation and provisional financial elements, was presented to the hospitals’ board of directors, the ARS DG and the SSA. The merger project, thus validated, is now in progress.
3.3 million inhabitants potentially concerned
1 maternity ward to beautify, 1 emergency and resuscitation ward to maintain
6 months of study and some compromises
New Hospital, new path, new Challenge
Operational audit of the billing chain of a CHU (teaching hospital)
A CHU faced two important issues: firstly, a billing reform involving a review of all the patients’ administrative processes; on the other hand, the construction of a new centre regrouping all the short stay activities on the same site. Our goal was therefore twofold: to secure the billing chain and to define a model of operation for the medico-administrative path of the new hospital.
We first sought to understand the strengths and weaknesses of the patient’s medico-administrative pathway. For this, we listened attentively to the actors in the field and analysed the data available with the operational managers in order to objectify the diagnosis. We integrated the actors in the field and used their creativity to design several scenarios. Our conclusions convinced the General Management of the need to redefine the organisation of the medico-administrative path of the patient and to allocate the necessary resources.
The CHU thus had a clear strategy to improve short-term patient care and structure the organisation of the new hospital.
6 audits carried out on the 6 sites
7 key projects
12 months of work with the CHU teams
- Centre Hospitalier intercommunal de Poissy / Saint-Germain-en-Laye
- CHU de Nantes
- CHU de Nice
- CHRU Nancy
- Fondation Ophtalmologique Adolphe de Rothschild
- Institut Gustave Roussy
- Hôpitaux Universitaires Paris Seine-Saint-Denis
- Hôpital d’Instruction des Armées Robert Picqué
- Maison de Santé Protestante de Bordeaux-Bagatelle
- Mutualité Française