By the Numbers: Using Data for Optimal Service Line Management

Adjust font size: A A A | Printer-friendly version

March 21, 2007

Effective service line management depends on thoughtful decisions about which services to grow and how to grow them given ever-changing market position and varying degrees of profitability. Providing service line decision makers with the right information, when they need it, and in a format that is easy to use is key for managing all aspects of service line planning and delivery. These aspects range from business and clinical strategic initiatives, such as whether to expand a facility or a specialty within the service line, to operational issues, such as how to staff appropriately or remove throughput barriers.

A new HFMA report, sponsored by MedAssets, offers some guidance on the types of reports that will be most useful for service line process improvements. Although the advice is applicable to all service lines, these examples focus specifically on the cardiac area simply because the stakes for this line of business are great due to its importance to most hospitals—often bringing in anywhere from 20 percent to 40 percent of an organization's revenue—and because of the high volumes, costs, and competition typically involved.

The following highlights typical performance reporting needs.

Cardiac Service Line Managers

As the gatekeeper of information, the cardiac service line manager plays a pivotal role in the decision-making process. Consequently, the manager needs to have a handle on all categories of data on a regular basis. Particularly important are financial data regarding volumes and payment. These data generally come from patient medical records and the financial information system and should be reviewed at least quarterly or monthly for service lines with high volume.

Changes to diagnosis-related group assignments in the cardiology service line have made these data particularly important, says Jeanne Jenkins, vice president of clinical services for Aspen Healthcare Metrics. Length of stay data are also important for the cardiac service line manager to review on a quarterly basis, Jenkins says, and compare with external benchmarking data. If the average LOS is longer than desired, determining whether a delay lies before or after the actual procedure has been performed is helpful in trying to correct it. "Breaking out the data and even looking at the data by day of the week can actually give you more insight into what's happening in the hospital," Jenkins says.

On a quarterly to semiannual basis the service line manager will want to review data on additional procedures performed during a primary procedure. For example, Jenkins says, it is standard practice in some hospitals to perform a renal arteriogram during cardiac catheterization surgery. The additional procedure offers no additional payment. Instead, a review of data will show it adds cost and time to the procedure and increases patient health risks associated with greater exposure to contrast media. Data associated with clinical quality, such as rates of surgical site infections or post-operative hemorrhage, can be equally important for cardiac service line managers because they play into the program's goal of providing certain standards of care.

Clinical data can also point to operational inefficiencies. Service line managers may periodically review these data to find areas where costs can be reduced without compromising care.

Decision Support Personnel

Decision support personnel should make sure that the data they pass along are reliable, consistent throughout the organization, and updated regularly—as often as every two weeks.

Cost data are particularly important to keep updated. In a typical year, for instance, there might be five new pacemakers that come on the market. If the coding and payment data for these pacemakers are not current, then the service line manager may not be basing decisions on the true costs of the procedure, supplies, or equipment, Jenkins explains. This, of course, can lead to bad decision making. Identifying high-cost procedures and regularly reviewing their detailed components of cost can help in eliminating these situations.

Decision support staff may also draw data from outside sources. For a cardiac service line, typical sources would include the American College of Cardiology or state programs that offer data on clinical outcomes. Such data would be used to benchmark a program's performance against similar programs.

Using Data Effectively

No matter how accurate the source or how frequent the distribution, data must be meaningful to be effective. Users should clearly understand how the data can be used to drive the kinds of decisions that will lead to an improved service line.

SOURCE: By the Numbers: Using Data for Optimal Service Line Management - HFMA Resource Library

Additional Resources