Does your hospital’s clinical and financial data speak in different languages that mean different things to different people? In all probability they do. Are you doing enough to establish a logical link between the many datasets? In all possibility, you’re not because enough is never enough. Let’s understand this better.
The dynamics of the healthcare industry have shifted from ‘volume-based’ reimbursements to ‘value-based’ reimbursements, designed to drive quality of care, lower costs, and enhance the patient experience. Till 2010-12, the revenues of healthcare entities were pretty much predictable to account for which, they maintained basic financial data acquired from patients.
However, health systems are now burdened with providing ‘quality based care’ and on enhancing the quality of care based on clinical data. In 2012, data warehousing and analytics took a center stage when the Centers for Medicare and Medicaid Services (CMS) introduced its value based reimbursements programs for hospitals along with penalties for excessive readmission of Medicare patients.
To transit to ‘value-based’ care models and to improve quality and cost outcomes, healthcare systems need to identify, monitor and analyze numerous metrics that were ignored earlier under the ‘volume bases system’. These metrics include:
- Protocols: Hospitals are focused on delivering care through appropriate protocols to avoid lapses and errors. These protocols indicate quality and non-reporting leads to a penalty.
- Readmission: Hospitals keep track of the rates of readmission for every cause within a certain time period and consistently devise process improvements to lower the rates of readmission.
- Lowering turnaround time: Hospitals are now committed to improving the turnaround time for every process to be able to reduce cost and increase patient satisfaction.
- Mortality rates: Every hospital is focused on lowering their mortality rates to be able to avail financial incentives.
- Patient satisfaction: Patient satisfaction depends on every process of care ranging from admission formalities to waiting time for emergency care.
- Cost variations: Hospitals are looking for new ways to reduce variations in clinical process to make the cost structure more stable and predictable.
Most health systems face concerns when it comes to sorting, linking and retrieving the clinical and financial data stored on their servers. To be able to store and sort huge volumes of data, health systems have embraced data warehousing tools that offer the flexibility to source data from various sources such as clinical, financial, supply chain, logistics, and HR systems, in a manner that it can be leveraged by advanced analytics tools generate meaningful sights that can steer process and quality improvements.
Additionally, health systems are forming multi-disciplinary teams comprising physicians, nurses, quality improvement professionals, analysts, finance teams and technicians to initiate and drive process improvement programs. Many times the teams have a role in designing the initiatives after analyzing the data. The team is also accountable for tracking progress and measuring financial, clinical and operational outcomes.
Financial, clinical and operational outcomes are thus a function of collaboration, care coordination, process improvements, program management, all of which are integrated into AcesoCloud’s sepsis solutions.
Delivering high-quality care while still being profitable has come become an achievable reality!