As provider organizations adapt to the new realities of healthcare delivery in the US, the need has never been greater for an integrated view of not only the care delivery enterprise but also the interdependencies between the financial and clinical operations.
As we wrap up NHIT Week, I’d like to offer some perspective on how healthcare in America is evolving and how health IT will move it forward. Our market is undergoing unprecedented change in how we manage and pay for care, and technology will drive this transition and help us all realize its benefits.
Clinical analytics only make a difference if they change the way we care for patients, which is easier said than done. Retrospective run charts of even well-designed performance metrics can lose all value if they are left on the table of a quality council meeting. Unfortunately, this is the fate of a lot of analytic information after debates rage about the source of data and the believability of the analysis. Too often, analytic information is presented with no means for the consumer of that information to evaluate what they are seeing and to commit to taking action. Analytics can only play an important role when they inform patient workflow.
Within the Healthcare Finance community it is often said: “No Margin, No Mission”, which acknowledges that although many providers bear a non-profit status, the role of healthy financial performance is still important. Without it, the organization cannot carry out its mission of providing high quality clinical care to the community it serves.
CDI: Clinical Documentation Improvements (CDI) refers to how healthcare providers optimize the specificity, accuracy, and completeness of their clinical documentation. CDI has always been important, but with healthcare reform driving the transition to value-based care, CDI is at a critical juncture for financial, compliance, and patient care concerns.
With the scheduling of patients being the “front door” of patient care, the process of improving patient access and scheduling has become a quality measure hospitals across the country have escalated to a high priority initiative.
More and more, healthcare is becoming a consumer-driven environment. Thanks to provisions found in the Affordable Care Act (ACA), the industry is shifting from volume-based to value-based models of reimbursement. And with the establishment of the health exchanges, patients are being given even more choices when it comes to selecting coverage that most suits their budget and needs. Additionally, websites offering ratings of facilities and individual physicians are giving healthcare a consumer feel to match other industries.
A large quantity of digital ink has been devoted to the topic of analytics in healthcare – specifically clinical analytics with the ability to predict and possibly improve outcomes. And rightfully so, considering the transition from volume-based to value-based reimbursement models and penalties for the readmission of patients with certain diagnoses. But with the majority of coverage on these aspects of healthcare reform aimed at the payers and providers that must adapt, one key stakeholder is often not considered: the patient.
Recently, Health Management Technology hosted a roundtable discussion featuring David Fletcher, Streamline’s director of solution development, as part of the publication’s newly launched Exclusive Conference Call Series. Centered on Big Data Analytics, the conversation also featured Dr. Stephen Ober, chief medical officer of Emdeon, and Bimal Naik, chief client officer of CitiusTech.
Healthcare organizations have been working with large amounts of data for many years, and while the term big data is generating a buzz within the industry, the concept is far from new. Due to the rise in the prevalence and variety of healthcare IT systems put to use in hospitals, however, the sheer quantity of information being produced is reaching new heights.