8. Analytics tools are key to gauging the success of a CDI program
Although an improved case mix index may indicate that a CDI program is working, that metric is not sufficient as an evaluation tool because it fluctuates, Oliva said. Examining a range of clinical, financial and operational indicators is vital. Oliva cited four, in addition to case mix index:
- Physician engagement and response rate
- Retrospective coding queries to physicians
- Expected mortality
- Case coverage (through enhanced clinical documentation specialist productivity and efficiency)
“You really need to get these things on a monthly basis,” Oliva said. “Even more important, can you get down to the individual physicians? You’ve got five orthopedic surgeons, for example, and only one of them isn’t answering the clarifications. Well, you’re not going to bother with the other four. But you have to know that.”
9. Organizations must overcome various barriers to effectively use analytics
In an interactive workshop to conclude the cohort, audience members shared various obstacles that their organizations have faced in utilizing analytics. One is inconsistency of sourcing and methodology, which can limit the ability to aggregate information. Also, lack of transparency may cause dissension. “For every data set we’ve shown on a board, you’ve got somebody in that room who challenges that number and how believable that number is,” an audience member said. “It’s very important to address that barrier up front.” In addition, lack of communication between the business team and the IT team can create a gap between the goal of an analytics project and the implementation.
10. Results of an analytics program should be communicated the right way
When using analytics to affect physician behavior, such as in the context of CDI or cost of care, administrative leaders should remember their audience. “Here’s one thing I know about physicians: Most of them haven’t failed at anything in their entire life,” Oliva said. “So, if you walk up to a physician and say, ‘You’re performing below average compared to your peers,’ they’ll get defensive. If you stick with the product, you explain the rules on how the methods are collected, you may have a better chance. But it takes that kind of work.” Physician champions can be effective in initiating changes, but they should never be used as “the stick,” Oliva said. Instead, “let them be peer colleagues.”
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From our sponsor: How analytics can enhance the healthcare provider experience
Michael Clark, senior vice president and general manager for provider solutions with Nuance, offers insight on some of the main points from the Business Intelligence, Data Management and Analytics cohort at HFMA’s 2019 Annual Conference.
What are the biggest challenges for healthcare providers today in trying to make effective use of analytics?
There’s one challenge that rises to the top, and it’s one that came up several times in our conversations with cohort panelists: creating a data-driven culture. As with any behavioral change, it disrupts the usual day-to-day workflow and requires a lot of reminding and reinforcing with operational leaders who lacked access to this data previously.
Stephen Morgan, MD, from Carilion Clinic summarized it best when he said 80% of the work is changing the people and culture, 15% is changing and improving process and 5% is the technology.
As panelists discussed in detail during the cohort, how can providers use data analytics to optimize electronic health record (EHR) operations?
Analytics can drive the evolution of workflow design and the operational processes around the system, including those that cost time and dollars and cause user frustration. It can also drive targeted optimization for users that need support, be it retraining or personalization, in order to get them home and at the dinner table on time.
This type of optimization can have positive downstream clinical impacts, too. As Stephanie Lahr, MD, from Regional Health shared, their organization was able to drive down hemoglobin A1C in their diabetic population by addressing workflows and standard processes to manage these patients through data that wasn’t previously available.
What are the implications of enhanced EHR use for provider satisfaction and physician burnout?
As Christopher Holland from Partners Healthcare outlined, optimizing the EHR has compounding benefits for quality, financial and safety measures — saving time, reducing burnout and ultimately creating happier providers.
From a quality standpoint, dashboards and metrics can help providers more easily identify patient needs across the continuum. Financially, it opens provider capacity to see patients and provides the CFO with operational data to demonstrate technology ROI. And most importantly, it’s combating physician fatigue and improving patient safety by giving providers the tools to finish their work during clinic hours.
How can data analytics and AI improve clinical documentation?
Data and analytics solutions are particularly effective at analyzing multiple streams of siloed data — coming from EHRs, medical devices and remote-patient monitoring systems — to identify health patterns in patient populations where opportunities for personalized interventions didn’t exist before, which enhances not only the quality of care that the patient receives but also the quality and integrity of data itself.
It can also call attention to administrative errors from incomplete or inaccurate documentation before the documentation is submitted, ensuring appropriate and timely reimbursement.
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The Business Intelligence, Data Management and Analytics cohort at HFMA’s 2019 Annual Conference included the following sessions and speakers:
Using Analytics to Optimize the EHR (panel discussion)
- Christopher Holland, HCMBA, user experience manager, clinical strategy and innovation, Partners HealthCare, Boston
- Stephanie Lahr, MD, CHCIO, chief information officer and chief medical information officer, Regional Health, Rapid City, S.D.
- Stephen Morgan, MD, senior vice president and chief medical information officer, health analytics and clinical informatics, Carilion Clinic, Roanoke, Va.
- Michael Clark, senior vice president and general manager, Nuance Communications, Inc.
Using AI-Powered Documentation to Prioritize Patient Encounters
- Tom Stafford, vice president and chief information officer, Halifax Health, Daytona Beach, Fla.
- Anthony Oliva, DO, vice president and chief medical officer, Nuance Communications, Inc.
Using Analytics to Improve Documentation Performance (interactive workshop)
- Anthony Oliva, DO, vice president and chief medical officer, Nuance Communications, Inc.