At the 2019 Healthcare Financial Management Association (HFMA) Annual Conference, a group of senior financial and data analytics leaders from hospitals and health systems around the country gathered to discuss the challenges and opportunities in leveraging data analytics to improve utilization, clinical outcomes and financial performance. Intuitive partnered with HFMA to serve as a host for the focus group, encouraging participants to share their insights around the topic. Below are five key takeaways from the event.
1. Data governance and transparency are important foundations
To get the most out of data analytics initiatives, healthcare organizations must keep information organized and have strong governance practices to preserve data integrity and make sure it is easily presentable and usable. Governance groups should be comprised of clinical and financial leaders who meet monthly or quarterly. Once established and launched, these groups may evolve into more of a governance ecosystem. “When physicians and other clinicians are involved in decisions around the data points for benchmarking care, it fosters more engagement and confidence in the measures,” says Katie Gilfillan, director, Healthcare Finance Policy, Physician and Clinical Practice for HFMA.
Transparency at the physician and organizational level are essential to drive change. To enable greater visibility into the data, one focus group participant developed self-service dashboards for clinical, quality and finance data that are controlled by the finance team but can be customized by different users — including physicians — through selectors and filters. To access the dashboards, users must go through an orientation process, so they understand what they’re seeing. Some reports require additional training due to added complexity. Within these reports, the organization currently can get to the charge level or service-line level. It is working toward the National Provider Identifier (NPI) level as well. The health system can run reports on the top 25 physicians and can slice and dice in any way to gauge performance and costs as well as benchmark against peers.
Similarly, some of the larger systems are using data to compare cost and utilization across hospitals. Transparency between organizations is being used to create inter-hospital peer pressure, which is aimed at elevating long-term performance.
2. Data timeliness and integrity are critical concerns
Generally, providers are moving through a progressive and evolutionary process regarding data analytics, starting with the acute setting and then expanding outward toward the ambulatory and post-acute settings. Organizations are also incorporating health plan data, but progress in this area has been slower.
There are a variety of data sources, but a primary one is the electronic health record (EHR). Most organizations leverage this tool to access clinical, utilization and sometimes financial data. Health plans supply utilization data as well, however the timeliness of the information and the willingness of some health plans to share it are the hurdles many organizations face. Data integrity is also a challenge as information comes from diverse sources and is not always standardized.
To overcome these roadblocks, some organizations are starting to think outside the box. For example, one focus group participant created a statistic around robotic surgeries, identifying ways to quantify costs, analyze utilization and track time. The organization trends the data year over year, creating feedback loops to improve performance.
3. Physician training and engagement are essential
Most focus group participants agree that engaging physicians around the importance of data — especially cost data — can be difficult. The group concurs that providing some degree of education — between one and three hours —outlining the benefits of the information and how to interpret it can be helpful. Organizations found that when physicians appreciated the advantages of certain data and were presented with the right opportunities to dig into it, they were more willing to get onboard with the data analytics concept.
4. Data can reveal priorities
The group’s participants are using data to refine where they should focus improvement efforts. Some have chosen to benchmark against nationally known health systems around best practices and then use data to determine where they can assume risk. More specifically, one hospital is looking at several metrics, including the top 20 DRGs, avoidable emergency department use and long length of stay, which is defined by determining the mid-point for a DRG and then adding eight days. The hospital is working to benchmark costs in these areas to change utilization.
Another hospital has started examining small pockets in the health system, evaluating its quality metrics and where it may have poor star ratings. Still another organization is focusing on clinical data, mainly to improve quality and utilization. They have not yet integrated the financial piece or costing. The eventual goal is to determine how to cost at a patient level from EHR data. To accomplish this, the organization will need to integrate financial data to determine where to assume risk.
Analyzing length of stay and avoidable admissions data has proven helpful to one entity. It uses data to determine where there are opportunities for improvement and discern what the standard of care across the system should be. As a result of this work, the organization has decreased supplies by 7% in the first year.
5. Data should underpin strategic decisions
Making decisions without data to back them up is no longer considered strategic. In an effort to be more tactical, one health system uses data to drive decision-making in its pursuit of multiple risk-based contracts. Its goal is to engage with employer groups, but it wants to see that the system can manage costs effectively before entering in to direct-contracting arrangements.
The use of data analytics in healthcare is just starting to gain momentum. In future focus groups, participants will delve further into different opportunities to advance data use and explore ways to better operationalize information to enable forward progress.
Interested in joining the conversation about data analytics in healthcare? Contact Chuck Alsdurf, HFMA director of finance policy and operational initiatives, at [email protected] to learn more about upcoming programs.
Intuitive, maker of the da Vinci® surgical system and Ion® endoluminal system, was founded with a simple belief: Medical intervention should help people recover as quickly and completely as possible. In more than two decades working closely with care teams and hospital leaders, we’ve learned that human understanding, smart systems and instruments, and digital insights are needed to enable better outcomes. We call this Intelligent Surgery. And, with six million procedures performed by tens of thousands of surgeons worldwide, we’re more passionate than ever about innovating for minimally invasive care.