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Healthcare BI and Analytics including Master Data Management, Targeted Analytics, Governance, Enterprise Data Strategy, and Data Assessment

Managing a Patient Experience Program with PressGaney

Greg Seeman, Lead Technical Consultant at Perficient, has been working closely with ProHealth Care in Waukesha, WI to bring their data warehouse online and integrate reporting within a Microsoft SharePoint  2013 BI system.

This would be the 2nd phase of this year-long project. On deck was the task of improving workflow through the Patient Experience program. The Patient Experience program is an internal program common to any healthcare system that focuses on patient satisfaction and quality. Surveys are a key component of the data gathering processes many healthcare institutions use to manage patient experience.

In his post, Greg explains the solution used to manage their data overload where they were spending countless hours downloading reports, creating spreadsheets and number crunching. You can read his full post here.

Healthcare Benchmarking – Part 1 of 2

I am an avid sports junkie. I literally wake up and fall asleep watching SportsCenter. Last month, while watching the NBA Finals (Go Spurs!), I concluded that sports and healthcare have a lot in common. Sport, is a “physical activity that is governed by a set of rules or customs and often engaged in competitively1.” If we simply swap out the words physical activity for medical practice(s) in the aforementioned definition, we would be describing today’s healthcare organization, no?

For me, the parallel of the two industries really lies in their competitive nature-seeking to be the best. The whole premise of sports is to encourage competition, to be the world’s best Healthcare Benchmarking - Part 1 of 2player, team, or country. Similarly, the healthcare industry encourages competition by seeking the best physician, practice, health system, equipment, outcomes, cost and efficiencies. However, you cannot be the best unless you know what “best” means. What is the threshold you are comparing yourself to in order to be called the best? What are the weaknesses that are holding you back from being the best?  What is the benchmark for best?

In sports it is a little easier to identify. For example, after six titles, five Most Valuable Player awards and 10 scoring titles, Michael Jordan is considered to be the best player of all time. He is the benchmark of greatness in the sport of basketball-he is what all other players aspire to be and what they evaluate themselves against. Unfortunately, in healthcare it is not as easy, as these types of statistics are not as readily available. However, in recent years, in an effort to help define and understand “best”, more and more healthcare organizations are finding value in benchmarking as a tool to assess their current thresholds and a way to improve their process and overall performance in an attempt to be the best.

In this blog post, you will be provided a general overview of benchmarking. In the next blog post we will take a closer look at the actual process of benchmarking. Read the rest of this post »

ACA’s Quality Rating System – An opportunity to gain market share

Starting in 2015 all issuers of Qualified Health Plans (QHPs) on the Healthcare Marketplace will need to provide Quality Rating System (QRS) measurements that will be aggregated and scored to provide consumers with a star rating for each product offered.

How many stars will you have?

How many stars will you have?

Although there are still details to be worked out by CMS, the required measures for the 2015 beta test are in place. All issuers that wish to continue providing QHPs on the Marketplace will need to provide the required measures. There are two different sets of measures included in the beta specifications.

The first is a set of clinical quality measurements that are mostly taken from the current NCQA HEDIS accreditation process. Many issuers already collect the data for these measures; especially, if they are meeting the requirement to be accredited for the Marketplace today and are using NCQA for that process.

The second is set of measures derived from an enrollee satisfaction survey (ESS) that needs to be performed by an accredited third party survey vendor. Most of the questions in the ESS are drawn from CAHPS. The survey processes requires that a sample of data is drawn, audited by a third party and provided to the survey vendor. The vendor then performs the survey and reports the results to CMS. Questions focus on rating an enrollee’s satisfaction with a plan over a six month period.

While the QRS initiative driven by the ACA attempts to provide transparency, it also creates a competitive market that will force issuers to look at ways to increase the quality of care and enrollee satisfaction to deliver better scores. The prize? For consumers, better products. For issuers, a larger share of the market.

Want to participate and win? Then you need a solution that not only provides the required measures, but also provides insight and the ability to drive quality improvements. This can be accomplished with a well thought out solution architecture that provides processes for delivering the measures and the means for analyzing data to drive improvements.

Healthcare Embraces the Cloud

Liza Sisler, Director at Perficient, recently wrote a blog post about the incredible growth of cloud based services by healthcare organizations:

 “Nearly all cloud adopters plan to expand their cloud services; areas for growth include archived data, disaster recovery and hosting operational applications and data”.   

“The top three reasons for adopting cloud services include lower maintenance costs, speed of deployment and lack of internal staffing resources. The survey shows a positive growth outlook for cloud services as almost all healthcare organizations currently using cloud services plan to expand their use of these tools.”

With healthcare organizations traditionally being slower to adopt cloud based options due to security concerns, this study shows the changing landscape for payers and providers. You can read the full blog post and view an infographic on cloud adoption in healthcare here.

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Patients Shopping for Quality and Value

Data from a recent study by the Employee Benefit Research Institute shows that individuals enrolled in high-deductible health plans are more likely to behave like consumers and seek data on price and quality before receiving care.1 This, combined with the effects of the Affordable Care Act, where trends are reflecting that more than 80% of individuals enrolled in exchange plans chose high cost sharing plans, are turning patients into consumers.2

Patients shopping for quality and valueThe high-deductible health plans are reinforcing the need to provide accurate pricing and quality data to patient shoppers as well as the need for provider organizations to understand service line margin to be able to adjust their service offerings accordingly.

My colleague Melody Smith Jones, @MelSmithJones, recently wrote about this in her blog post, What the Market Says You Need in Your Patient Portal.

“The forward-thinking strategists in healthcare organizations nationwide should have their sites on the marketplace horizon.”

I invite you to read Melody’s entire blog for more about what features the market is demanding, but I would like to focus on the last item in her list: “Integration of clinical and financial data”… Read the rest of this post »

Understanding the Value of Care – It’s Not a Guessing Game

Robert S. Kaplan, PhD, writes about improving the “value of care” in this month’s HFMA magazine.

“Existing cost measurement systems in healthcare are inadequate. They typically use inaccurate and arbitrary cost allocations and provide little transparency to guide clinician and staff driven efforts to reduce costs and improve processes to enhance outcomes.

They also fail to focus on the correct unit of analysis: patients being treated for specific medical conditions over complete episodes of care.Untitled design

Unless the sector can implement better cost measurement and management systems, the promise of value-based care will remain unfulfilled.”

He goes on to write about the virtues of using Time Driven Activity Based Costing (TDABC) in healthcare by directly attributing all resources to the organizations outputs of services (therbligs). The full article can be viewed at HFMA.org.

Recently Cleveland Clinic partnered with Kaplan to take on this daunting task. During the pilot, accurate cost data was used to help leaders understand profitability by service line, and better support clinical teams in driving efficiency. The pilot project was setup to determine whether TDABC costing and relative value unit (RVU) based costing would produce materially different results. The results uncovered significant enhancements in clinical and administrative processes for the procedures studied and reduction in expense related to direct administrative and support processes for two types of heart valve procedures. Read the rest of this post »

The “Secret Sauce” for Financial Transparency

Assembling the data needed to achieve financial transparency is both a technical and political challenge. My recent BLOG In Managing Finance at Hospitals, the Proof is in the Data discusses this in detail. I thought I’d take a moment now to discuss some of the software that combines clinical and financial data for cost management to elaborate on the “secret sauce”.

The Perficient High Performance Costing Expressway combines the power of Oracle’s OLAP engine, Essbase, via the Hyperion Profitability & Cost Management (HPCM) application, along with Oracle’s leading healthcare data model to allocate and store data.

Our goal with the Perficient High Performance Costing Expressway is to accelerate the implementation of these solutions by defining the commonly used data element inputs into a standard interface formats that can be easily consumed into the HPCM application. This data will seamlessly flow from Oracle PeopleSoft General Ledger, via the adapters available for the Hyperion platform, or the Oracle Health Care Data Model within the data warehouse, if employed, since both the source and target data mappings can be predefined. For data sources that are not sourced from either location, Perficient will work with the client to connect the source data needed into the standard interface format. The diagram below provides a high level view of the overall process for consuming data into the model.

Oracle Data Mart

Read the rest of this post »

Squeezed Reimbursement. Eroding Margins. Smarter Consumers.

We have all witnessed the great impact healthcare reform has had on the healthcare industry. The landscape is changing so quickly it can be overwhelming for everyone involved. The new environment is more competitive and complex than ever and consumers are now in the driver’s seat. I say consumers because lets face it healthcare patients aren’t patients anymore, they are consumers and we must treat them that way.Squeezed Reimbursement. Eroding Margins. Smarter Consumers.

With information at their fingertips, healthcare consumers are utilizing their retail experience, tapping all of their resources and doing their research before making decisions about their care. Healthcare organizations are in a tough spot, reimbursement is being squeezed, margins are eroding and consumers are smarter. Organizations have two options – raise their costs and put a band-aid over the gushing wound or take steps to truly understand their costs and fix them.

Lets look at the first option – raising their costs. Keep in mind healthcare consumers are smarter, they are “shopping” around to find the best deals and they understand a procedure that costs more doesn’t necessarily mean the outcome will be better. In the competitive healthcare industry raising costs will result in lost market share, probably not the best option for healthcare organizations that want to be around long-term.

The second option – understanding costs. More times than not healthcare organizations do not understand their costs. Much like healthcare consumers, organizations have access to mountains of data but often times their information is located in disconnected silos making it very challenging to connect the dots. Understanding costs requires healthcare organizations to leverage clinical and financial data to make data-driven business decisions. Read the rest of this post »

Following the Money Trail: Understanding the True Cost of Care

Healthcare leaders are challenged to understand the true costs associated with providing care. If you ask caregivers to determine their current workflow, they don’t really know where the patient and family go before or after each step of their care so the total care pathway is not in their purview. This is a well-known challenge for implementing clinical effectiveness improvements whether it comes to improving care or lowering cost. I’ve worked on multiple committees in the hospital environment designed to lower costs for current patients and/or provide transparency on expected charges to consumers (future patients). One tactic that we used to achieve transparency was to shadow the caregivers to gather information about the care process to define each step and duration of the care pathway. We were able to compare this data to retrospective analysis of patient populations to “test” our Following the Money Trail: Understanding the True Cost of Caredata.

It would have been even more powerful to feed this data into a Time-Driven Activity Based Costing (TDABC) Model to determine not only the forecasted charges but also the “true cost” of care by modeling how much is being spent on consumables, personnel and space/equipment during the care pathway. Coupling TDABC with a time based study to pinpoint the best places to reduce cost and measure to make sure that the change is actually an improvement, creates a collaborative environment for handling cost reductions and avoids the traditional approach of having to implement top-down, across the board budget cuts.

Join  our team of industry experts for a webinar. “Leveraging Clinical and Financial Data to Identify Cost Savings, Improve Profitability and Improve Decision-Making” on June 17, 2014 from 2:00 to 3:00 CST. Using a case study discussing multiple scenarios for activity based costing for Pediatric Care Transitions, this webinar will explore how the Perficient High Performance Costing Expressway extracts clinical cost data, consolidates and allocates across the system to discover true patient costs.

The Perficient High Performance Costing Expressway delivers solutions that work for the people who need them at the right time and for the right cost. Perficient experts will be on hand in booth #1159 at HFMA National Institute 2014, #ANI2014. Join us there to view a demo of the Perficient High Performance Costing Expressway and hear our BIG IDEAS!

Follow me on twitter @teriemc

View my recent blogs:

Elevating the Role of Finance within the Hospital

Enterprise Warehouses: The Gift that Keeps on Giving

Balancing clinical effectiveness with profitability

 

Information Is Your Competitive Advantage

Information has always been available to us, but never before has there been so much at our finger tips, coming at us so quickly from many different sources. We can no longer continue managing our enterprise information the same way we have for the last 30 years, it is not sufficient. With that I would like to welcome you to the new generation of information management.Information is Your Competitive Advantage

Information is only useful to us if we can access it, understand it and can compare it to what we already know. Healthcare organizations rely on information to make smarter, faster and more impactful business decisions. Business leaders want access to many different kinds of information, but the problem is that information is often stored in separate, disconnected silos making it challenging to use the data strategically to generate business intelligence. Instead, often times, business leaders make decisions on intuition rather than hard data.

Enterprise data management solutions instantaneously capture data from enterprise systems, cloud devices and applications and help organizations standardize and deduplicate data. This helps organizations manage their information more effectively and minimizes conflicts and organizational data issues. Organizations need enterprise data management solutions to automatically track the performance and behavior of the data stored in their systems so they can make better business decisions.

Data alone is not useful, but data that can be turned into information is your competitive advantage. Enterprise information management (EIM) enables businesses to obtain more value from their data and content, unifying what has traditionally been a dichotomy. EIM turns unstructured and structured data into information, information that drives profitable business actions, and ultimately improves quality of care and business outcomes.

Industry expert and healthcare analytics strategist, Juliet Silver explains the importance of an EIM in a recent interview.

 

Two Keys for Population Health Success

Population Health management and success will drive Healthcare for the next several years as mandated by the Affordable Care Act (ACA), Value Based Purchasing (VBP), Accountable Care Organizations (ACO) and multiple other federal and state endorsed programs. Everyone is scrambling to figure out how to achieve the Triple Aim (improved quality, lower costs and better patient satisfaction) which essentially wraps up everything with a nice little bow. But HOW can we enable Population Health and make it a win-win situation for patients, providers and payers alike? There are two key components which have to be addressed to make Population Health management a success. The first one is physician alignment and the second one is geo-specific demographic analytics.

Two Keys for Population Health SuccessLet’s examine the first, physician alignment. As Philip M Oravetz, M.D., Medical Director for Accountable Care, Ochsner Health System, wrote: “In many respects, finding the right information technology solutions is less of a challenge than re-defining the delivery of care. For us, creating a synchronized strategy to align all physicians around population management is the big challenge.”* This is certainly echoed across the country by many provider and payer organizations. Getting buy-in from the physicians who are on the front lines, both in academic and the community settings, is crucial to successful Population Health management.   Effective change management strategies must be established to ensure a positive end result. One of the most important changes should be assuring physicians that all of the additional work associated with Population Health management will not fall into their hands to complete. Teamwork, particularly allowing licensed care providers to practice to the full extent of their licenses, will enable and extend the reach of the physician to a wider population and will help streamline workflow. In addition, providing incentives and empowering these physicians with the appropriate tools and analytics will allow them to visually understand the impact of their efforts to improve care. This, in turn, reaches the center of the circle, the patient, enabling improved care and satisfaction. Read the rest of this post »

10 Benefits of Enterprise Information Management in Healthcare

This month, we completed an interview with our healthcare analytics strategist, Juliette Silver. We wanted to understand how enterprise information management strategies can specifically optimize business performance, reduce costs, mitigate risks and improve quality of care.

From the interview, I take away at least 10 major benefits to establishing and leveraging an enterprise information management strategy in healthcare settings:

EIMAn EIM strategy can:

  1. Help manage access to enterprise information in a secure, HIPAA-compliant manner.
  2. Allow healthcare professionals to turn mountains of data into real-time decisions.
  3. Help focus people, process, policies, frameworks and foundational technologies toward how to best leverage enterprise data.
  4. Set forth the framework that will be used to provide the information delivery capability,whether the information is in the form of data (structured or unstructured) or unstructured content, or a combination of both.
  5. Help an organization respond to evolving regulatory requirements and reimbursement models.
  6. Define the information management model that will be used to harmonize the delivery of both content and data specific to a healthcare organization’s goals and objectives.
  7. Ensure the delivery of information in the form of a trustworthy source that can be interpreted, used and managed consistently across the enterprise.
  8. Give a clinician or healthcare knowledge worker the access they need to the many sources or types of information from which to make decisions.
  9. Ensure information is timely, accurate, valid, verified and generally fit for purpose.
  10. Produce a more holistic view of the patient, derived from structured data stored in an electronic health record and other clinical systems, as well as unstructured information or content made available in some of the forms previously stated.

Read the full interview here.