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Healthcare is on the brink of a data revolution, moving from simply collecting and reporting, to collecting, analyzing and changing practice. It’s not enough to just have data — it’s time to put it into action, driving continuous improvements in service delivery.
As part of its effort to support better data analytics, the Centers for Medicare and Medicaid Services (CMS) has spent the last year conducting sessions and workshops with over 6,000 physicians, patients and other clinicians collaborating on parting care by sharing and building on relevant information. The extensive outreach resulted in a “near-universal vision of health information technology” centered on three priorities moving forward:
- Improved interoperability and the ability of physicians and patients to easily move and receive information from other physician’s systems;
- Increased flexibility in the Meaningful Use program;
- User-friendly technology designed around how a physician works and interacts with patients.
The goal is to encourage more flexible, efficient, outcome-oriented use of data analytics to create opportunities for better care.
What can data do for you?
If you can conceive it, you can probably measure it. The key is to examine your incoming data with a combination of creativity and analysis, in order to turn the abstract numbers into concrete actions. A recent white paper by Blue Hill Research provides a comprehensive list of approaches to data:
- Combining a patient’s medical records and genomic information to identify ways to target care, improve outcomes and lower costs.
- Monitoring patients remotely to understand indicators to potential problems, and analyzing historical data to understand outcomes and recommend care-related actions.
- Analyzing operational data to understand emergency room patient flow and equipment usage patterns, to predict and respond to bottlenecks in care.
- Analyzing electronic health records data in real time during patient treatment to identify patients at risk of readmission, and recommend further actions for high-risk patients
- Monitoring research findings and drug approvals, combined with patient records, to improve population health efforts.
- Analyzing outcomes across patient demographics (e.g. age, gender, payment types) with prescriber information such as location, education, or specialty to uncover unwarranted variations in practice.
Hospitals, health systems and physicians — in cooperation with insurers in the healthcare marketplace are applying these approaches to their patients now, with positive results. Here’s a look a three cases of success.
1. Developing care models. Blue Cross Blue Shield in Florida closely analyzed its prospective insurance marketplace customers and were able to pinpoint the variance in health issues across communities. Plans created based on this research brought together local health systems to develop new care models that would better fit communities’ needs. They used “place of delivery” care models to bring together nurses, analysts, pharmacists, social workers, and other experts into inter-disciplinary teams that focused on improving care for high-risk populations in particular communities.
2. Bridging the gap between coding and care. Mercy Hospital St. Louis refined the work of humans by optimizing EHR workflows and automating secondary diagnoses based on keywords and care patterns, then established tracking of patient care in response to these results in order to allow for continual process improvement. “As a result, Mercy has simplified and increased the accuracy of coding for specific inpatient health conditions,” notes an in-depth case study. “This information is now embedded within the clinical workflow, giving clinicians the actionable data they need to identify secondary diagnoses and provide the best of care, right from the patient bedside. It also increases the health system’s revenue through more accurate coding and improved reimbursements.”
3. Identifying gaps in care. Horizon Blue Cross Blue Shield in New Jersey used its consumer analytics to identify the uninsured markets in their area, and launch a targeted marketing strategy to reach those uninsured residents. With ad placements outdoors, on public transit, and through social media, as well as mail, digital and email outreach, it helped grow Latino membership from 8,000 to 30,000 members, thus onboarding potential patients who were previously under-served by insurance and care.
An agile future
Healthcare providers must develop nimble, flexible, responsive organizational strategies to embrace data analytics and keep up with value-based reimbursement models. Those that join CMS’s push for interoperability and that find ways to lighten the EHR load for physicians — such as by using certified medical scribes — “are likely to meet their regulatory goals, improve clinical care, and deliver high quality business services internally and to their patient customers.”