Customer Experience and Design

In Managing Finance at Hospitals, the Proof is in the Data

ALIGN CLINICAL, QUALITY AND FINANCIAL ANALYTICS TO ENABLE VALUE-BASED CARE

Assembling data is both a technical and political challenge. I’ve been involved with multiple hospitals where the finance and clinical teams never really collaborate and therefore the lenses put on either domain is not terribly realistic. Truly merging and using the data requires clinical and financial leaders to establish trust and shared goals that promote an environment of accountability. The key to trusted data is transparency.

Profitablility and Cost ManagementCombining clinical and financial data for cost management is a popular topic given the political and economic environment. This activity generally includes these data requirements:

  • Claims data for diagnosis codes, patient demographics and encounter information and services provided; this data usually resides in the patient billing system
  • Clinical data such as labs for quality and outcomes ; this data usually resides in the EMR, EHA or other ancillary clinical systems
  • Accounting and finance data from the general ledger, budget and sub-ledger systems.

Assembling this data requires a robust technical architecture that easily stores the data relationships with contextual integrity along with the ability to resolve patient or person identity. Once the data is assembled, leaders of the organization can build disease registries to manage the cost of care for populations and to model service line profitability, analyze payer contracts and more. The most important benefit of this transformation is that the organization begins to speak a common language of accountability and front line managers begin to understand the relationships between volume drivers and departmental workload leading to increased ownership of controlling these variables. The costing step is important ensure the data as well as the transaction level calculated cost is fully accessible to decision makers. All too often we hear that “my patients are sicker than theirs” or my surgical device has better outcomes. The proof is in the data!

The Oracle Enterprise Health Analytics (EHA) platform in concert with the Oracle Hyperion Profitability & Cost Management (HPCM) solution facilitates the merging of clinical and financial data to perform costing calculations. This fully burdened cost data associated with other clinical metrics such as quality and outcomes measures answer both administrative and operational questions. Using the Oracle platform, patient volumes, outcomes and operational measures are not viewed in an independent environment but instead become dependencies to understanding case mix index, reasons for readmissions, and staffing mix (on a case level), among other things.

The Digital Essentials, Part 3
The Digital Essentials, Part 3

Developing a robust digital strategy is both a challenge and an opportunity. Part 3 of the Digital Essentials series explores five of the essential technology-driven experiences customers expect, which you may be missing or not fully utilizing.

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Perficient offers design, implementation and support capabilities for Hyperion Profitability and Cost Management (HPCM) and Oracle Enterprise Health Analytics (EHA) solutions as well as the full Oracle Hyperion EPM suite of solutions. We are a silver sponsor for the #OracleIC14 and we are looking forward to talking with you about Health Analytics and Population Health.

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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

About the Author

Terie McClintock is the Oracle Healthcare Practice Director at Perficient, Inc. where she is responsible for providing healthcare subject matter expertise to the Perficient Oracle National Business Unit while also cultivating and managing the partnership with Oracle’s Healthcare Vertical and Horizontal Business Units. Terie has more than 25 years of IT experience. Prior to joining Perficient, Terie contributed over 13 years at M.D. Anderson Cancer Center with the most recent title of Director, Data Management Services. Prior to M.D. Anderson, Terie worked for IBM as a Senior Consultant.

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