A decade ago, healthcare financial analytics were nearly the exclusive province of… financial analysts. These sophisticated experts were comfortable using their skills to make structured queries, chiefly into financial databases, and to produce reports that shed some light on past performance. Typically, these reports were requested by business users – typically CFOs – who would use them to fine-tune their financial models. They were useful for long-range planning, but since they were largely confined to the financial arena, they had little impact on care delivery itself.
Fast-forward ten years, and all that has changed dramatically. Today’s analytics span financial, operational, clinical and patient-centric activities, and have a number of new capabilities that have converged to improve outcomes across the enterprise.
In no particular order of importance, these advanced capabilities are:
- Advanced visualizations – make important anomalies, outliers, problems, and opportunities clearly visible
- Streaming intelligence – updated and distributed to users in near real-time
- IoT integration – the ability to enhance EHRs with data gathered from wearables, charts updated by nurses on duty, and data from other medical devices
- Predictive capabilities – give managers the ability to shape events instead of reacting to them
- UIs with consumer-app friendliness – let users with limited technical skills conduct sophisticated queries through intuitive user interface design that guides users to see and react to defects
- Role-based personalization – presents the most useful insights to the most appropriate users at the right level of detail
Positive financial outcomes are just the first step
The benefits of these new capabilities start with improved financial outcomes, then ripple outward from there. If an analytics point solution can help an enterprise overturn millions in overturned claims, that’s found money that helps fulfill the mission. To put it simply, one overturned denial = three new wheelchairs.
Once analytics prove themselves as revenue accelerators, it is easy to see how the insights they provide can be used to explore important questions everywhere, such as, “Can we optimize pharmacy purchasing by eliminating redundant shipping?” Or “How do we improve the registration process so patients can have a better experience starting at the admission desk? Or “Would our community be better served if we created a new COE in orthopedics or pediatrics?
These are all questions than can be easily asked of today’s analytics, and answered clearly. This is especially true when Big Data is leveraged to create comprehensive longitudinal health records for each patient. A few leading enterprises have already taken this important step. When the great majority of enterprises have done the same, then care delivery will be truly consistent and portable for each patient, from one provider to the next. But until that future date, analytics offers a number of capabilities that are affecting patients positively, in the here and now.
Five new capabilities that didn’t exist a decade ago
Mobile health apps. Wearables, such as fitbits, make an important contribution to the health of large populations, but they are just the tip of a larger iceberg. For example, a wireless glucometer for diabetes patients uploads their glucose readings to a HIPAA-secure server, where it is combined with other data, such as daily exercise, calorie intake, and medication adherence. This creates a complete picture that helps each patient better manage his or her condition. With patient permission, clinicians and caregivers also have access to this data, so they can send messages of encouragement, or intervene when necessary. Just as importantly, information from large patient populations can be aggregated, and displayed by advanced visualizations that can help caregivers refine best practices.
Integrated nursing productivity analytics. For years, nursing productivity was tracked by time & attendance software that reported on past activities. But new analytics solutions can report productivity by the hour instead of by the day, match time with units of service, and ensure the best mix of premium and productive hours. Beyond more effective resource utilization, they can measure patient satisfaction, and even lead to improved HCAHPS and other patient satisfaction scores.
Integrated physician contribution margin metrics. In the past, it was difficult to see the total contribution that each physician made because the data was stored in separate silos. But today’s analytics make it possible to understand the totality of each physician’s work. In large enterprises, this goes far beyond counting the revenue each physician contributes to the mission of the enterprise. Since different physicians often take varying approaches towards the same Dx codes, it’s possible to see which treatments are the most effective. Besides measuring simple cost, these analytics can also compare lengths of stay, readmission rates, patient satisfaction, and other metrics, so they are continually informing and upgrading a dynamic set of best practices. The implications for Accountable Care Organizations are profound.
Patient-friendly billing. Typically, patient satisfaction ratings fall by more than 30 per cent from post-discharge through the billing process. (Several sources estimate that patient dissatisfaction with billing can be as high as 80 percent.) The effects of patient dissatisfaction on revenue capture are well known. But the effect on future patient behavior can be even more important. When patients avoid seeking care because their last experience was unpleasant and frustrating, their health can suffer. Conversely, patients who are satisfied with the billing are five times more likely to recommend it to friends and family. Fortunately, today’s analytics are making major progress towards patient-friendly billing. It’s unlikely that a hospital bill will ever be as simple as a Thank You note. But with clearer, friendlier billing, patients have a more positive experience, which benefits all parties involved.
Better patient engagement, from pre-admission through post-discharge. Probably the largest benefit of modern analytics is its ability to present the big picture, so providers can make significant improvements at nearly every touchpoint in the patient experience, from shortened wait times at admission to the most effective treatment; from appropriate nursing care to friendlier, more intuitive billing.
All these benefits have been made possible because today’s analytics and reporting have migrated from the back office to the center of attention. At the best providers, they have literally spread everywhere: from the admissions clerk, to every physician; from the Board of Directors, to the billing clerk, to the nursing shift supervisor. Significant as these changes are, they are just the beginning. Expect to see even more in the future.
Best of all, providers who have not democratized their analytics to this degree don’t have to wait two years while their IT Departments try to build effective solutions from scratch. There are already vendors who can implement and deploy effective solutions within only 90 days.