Jim Denny, Founder and Chief Executive Officer, Navicure
When describing the amount of revenue cycle data available to healthcare organizations, many providers use words like “massive” and “daunting.” The reality is that providers have access to more data than ever before, yet they often don’t know what to do with it. There are literally hundreds of revenue cycle metrics that healthcare organizations can collect, resulting in a volume of information that if not managed well can be overwhelming.
The key to getting the most out of revenue cycle data is making it actionable, and that is where data analytics come in.
A relatively new idea for healthcare
Data analytics, sometimes known as business intelligence, involves examining raw data to identify patterns, discover risk points, uncover opportunities and draw conclusions. Although other industries have been using data analytics for years, healthcare is somewhat new to this world, especially when applying the concept to the revenue cycle.
Recent results of a national survey of healthcare organizations, conducted by Porter Research and Navicure, found only 45 percent of survey participants used a data analytics and reporting solution to analyze their revenue cycle. Of those that didn’t have a solution or were not looking for one, 36 percent didn’t think they needed it, and nearly 50 percent didn’t have the necessary time, budget or resources to employ such a solution. Those organizations using a data analytics solution place value on revenue cycle analytics. According to the survey, 73 percent of respondents viewed revenue cycle data analytics to be a top priority.
The hacking business has hit retail establishments, financial institutions, and now, more than ever, healthcare. It can get overwhelming when you see headlines of healthcare organizations getting attacked with ransomware, malware, viruses, loss of patient records, and all sorts of cybersecurity breaches.
The potential solutions and vendor options to protect your organization can cost a lot of money and can be overwhelmingly technical. What can you do? While it’s not possible to have absolutely perfect cybersecurity, here are 5 simple ways that can help you keep patient data safe.
1. Keep calm and assess the risk.
Don’t overreact. Doing an internal risk assessment is an essential step in looking at the likelihood and impact of potential threats. Identify what your organization has that’s valuable, vulnerable, and exposed. Make a list and then look at what probability or likelihood each has to an attack. If something were to happen, assess what financial, social, and economic impact it may have. For each risk area you identify, determine if you will mitigate (buy a control), transfer (buy cyber insurance for the gap), avoid (remove the vulnerability), or accept (perhaps it’s not cost effective to prevent).
The United States population stands at 323 million and has a net gain of one person every 12 seconds. And, as insurance coverage increases, more people than ever before are seeking health care services. Estimates show that 20 million people have gained health coverage because of the Affordable Care Act within the last few years, placing new demands on our healthcare system.
Unfortunately, the number of healthcare professionals is not increasing at the same rate as demand for services. It means we, as physicians, have to be more effective in how we manage our patients.
Analytics is a powerful tool for clinicians to use to navigate the rising tide of patients. We can customize analytics to provider, organization, geography, diagnosis or any number of attributes for a community of patients. Because, when we can key in on patients who are most at risk or who need the most help, we can align our priorities and resources to optimize care for them.
For clinical trials, the road to results is often long and tedious – not to mention costly and resource intensive. Four digital health technologies are now poised to enhance and streamline the clinical trial process. Whether enabling more comprehensive monitoring, increasing the frequency of data collection, or growing the pool of potential participants, digital tools can help researchers reduce costs while improving efficiency and outcomes.
Wearable fitness devices
“Wearables” are small electronic devices that are light enough to be worn or carried. Through sophisticated technology (multi-axis accelerometers), they monitor things like steps, active minutes, heart rate, sleep and so on. In the near future, they will also provide measures and insights for stress levels and blood pressure.
There are two types of wearables found in clinical trials – consumer-grade and clinical-grade. Consumer-grade are the devices with which most people are familiar – Fitbit and Apple Watch, for example. They are relatively inexpensive and easy for people to use, so they tend to fit seamlessly into participants’ daily lives. That said, the data they generate is not yet considered clinically valid, and thus can only be used in an exploratory fashion during a clinical trial.
Conversely, researchers can employ specialized clinical-grade wearables, commonly known as actigraphs, to gather primary and secondary data. Although these devices resemble their consumer-grade counterparts, they have gone through the FDA 510(k) pathway and yielded validated data. As such, regulators consider them to be reliable enough to support safety and/or efficacy claims.
Carolyn Scott, Registered Nurse, M.Ed., Master of Health Administration, Senior Vice President and Chief Customer Officer, PeraHealth
Written by: Carolyn Scott
As healthcare transitions from fee-for-service to value-based care, there is an emphasis on lowering costs and improving outcomes. In the midst of this transition, care teams are currently equipped with outdated tools that drive a reactive, “let’s fix it,” mentality. However, reaching these goals requires shifting the way care is delivered by being more proactive and patient-centered. This isn’t a new concept, but it’s something we’ve yet to achieve. How can we make this happen? By combining existing information in electronic health records (EHRs), vital signs, lab results, and nursing data with predictive analytics to help care teams attain this proactive mindset.
Nursing assessments have long been considered a standard nursing practice; however, combining them with the advent of clinical analytics makes them a far more powerful tool. For example, the insights generated by predictive analytics can allow care teams to determine a patient’s risk of a serious health event, with time to proactively intervene earlier. By leveraging analytics, we can transform the way we provide care.
The speed and scale of the current challenges and demands experienced by today’s healthcare organizations are unprecedented. The creation of ever-increasing amounts of data, coupled with the application of new advances in treatment, diagnosis and analytics, means that healthcare is on the brink of some major developments. The promise of analytics lies in its ability to transform healthcare into a truly data-driven culture.
While privacy and security risks are challenges to using big data, the potential positives outweigh the negatives. Healthcare data is considered the most complex and disconnected set of any industry, but successfully exploiting these opportunities provides huge returns not only financially, but also for the quality of care.
“The trend to see and use information as an asset is still in the ‘early adoption’ phase, making doing so a competitive differentiator for leading organizations. But even where information leaders have embraced this idea, there’s an array of challenges to transform the idea of value into a reality that benefits the organization. Information has economic value that organizations can ‘turn into money’ in two ways: selling, bartering or licensing it; and by using it to reduce costs or increase revenue. Yet most information and business leaders lack the experience and tools to monetize information,” asserts the Gartner report, “Seven Steps to Monetizing Your Information Assets,” published October 15, 2015.
Kevin Fitzpatrick, Chief Executive Officer, CancerLinQ
The field of oncology has been filled with pioneers dedicated to furthering research and science in search of a cure for cancer. Many of those pioneers in medical oncology have been members of the nonprofit American Society of Clinical Oncology (ASCO), including Sidney Farber, MD; Kanti R. Rai, MD; and Janet D. Rowley, MD. These physicians dedicated their lives to improving the quality of care for patients with cancer. This commitment to quality and the quest for knowledge is still alive today in CancerLinQ, a health information technology (HIT) platform that will harness Big Data to deliver high-quality care to patients with cancer that is being compiled by CancerLinQ, a wholly owned nonprofit subsidiary of ASCO.
This rapid learning system for oncology data brings together a network of members of and practitioners in the field of oncology who contribute to the care of cancer patients everywhere and provides users with access to data from potentially millions of cancer patients to help inform decisions about patient care. In effect, CancerLinQ is the evolutionary next step in ASCO’s rich 50-plus-year history of being the world’s leading professional organization for physicians and oncology professionals caring for people with cancer.
Thank you for giving me the best possible care over the last 11 months. For the price I paid out of pocket plus with insurance, I cannot imagine how you keep the lights on. From everything I read, I’m spending less than most who have this kind of problem and getting a better outcome. During my treatment, you took time to carefully tailor my medications to account for my allergies and walk me through the emotional and physically strenuous steps of multiple surgeries and rehabilitation. With all of this and your great bedside manner, it’s no surprise that your patient satisfaction scores are so high.
During my recent visits, I’ve noticed less cars in your parking lot and fewer patients in your waiting room. In my last visit, I saw a sign that your practice is moving in a few months. You told me that you and your partners would love to stay in the current location, but patient volume had dropped to a financially unsustainable low. Unfortunately, your new office will be too far for me, so I am extremely motivated to figure out how to help you stay put.
Here’s the deal: I want to see if I can help you increase the volume of patients that are coming to your practice. To do this, there are three big questions to answer. First, who do patients see if they don’t see you? Second, who is referring those patients to your competition? And third, who is referring your current patients to you?
Joe Warbington, Director Market Development for Healthcare, Qlik
Emergency departments around the world are under tremendous pressure to reduce patient waiting times and drive clinical effectiveness in all areas. The ED in most hospitals is a fast paced, high pressure environment where no two days are the same and where an increasing demand has led to significant focus on quality and performance. Given this backdrop, data and analytics may not seem like an obvious solution, but the evidence of the impact these programs are having is undeniable.
At the North East Georgia Medical Center, Dr. Mohac Davè, the ED Medical Director has been working with Qlik in their ED for over 2 years, specifically targeting performance, patient experience and patient safety. The ED manages 115,000 patients per year and one of the early findings showed that contrary to popular belief, arrival patterns are actually extremely predictable. “We now know with some certainty that Mondays, especially afternoons and evening, are going to be the highest volume day.” Dr. Davè goes on to say that, “Qlik has allowed us to take this knowledge and provide staffing to demand.”
Patients do what they want. If they don’t want to take medicine, they won’t fill the prescription. If they don’t want to come in for a preventive check-up, they just won’t show up. If a friend recommends a doctor, they may not even say good-bye to the old doc before trying the new one. Even though provider network design may promote a smaller, more focused contingent of practitioners, patients can still easily go to practitioners outside of those networks. With these and the many other factors outside of the control of clinicians, it’s incumbent upon healthcare providers to ensure that every patient interaction is one that helps attract and retain them and that the information driving those interactions is complete and accurate.
Accurate and complete patient profiles
One way to impact patient interactions and the completeness of information available to clinicians is to ensure you’ve got accurate patient demographic profiles. Whether matching a presenting patient to their existing medical record or matching a medical document sent from one care setting to another, patient demographics fuel this process. Patient demographics impact much more though.
Want to create a bad patient experience? Pull the medical record for a similar-sounding patient and start administering medicine only to find mid-course that the patient has an allergy to that med. Send a blood specimen to a lab with missing patient identifiers only to never receive the results and have to call back the patient and redraw the specimen. Tell your patient that their Social Security Number was stolen by an identity thief. Want to contact that patient for post-discharge follow-up or to get that patient experience survey filled out? It won’t be a snap if you don’t have an accurate and complete patient demographic profile.
