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Linking Clinical And Financial Data: The Key To Real Quality And Cost Out

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Since accountable care took the healthcare industry by a storm in 2010, health systems have had to move from their predictable revenue streams based on volume to a model that includes quality measures. While the switch will ultimately improve both quality and cost outcomes, health systems now need the capability of tracking and analyzing the data from both clinical and financial systems. A late-binding enterprise data warehouse provides the flexible architecture that makes it possible to liberate both kinds of data to link it together to provide a full picture of trends and opportunities.

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  • REALLY GREAT ARTICLE,DR.RAJENDRAKUMAR BIDARI
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Linking Clinical And Financial Data: The Key To Real Quality And Cost Out

  1. 1. Linking Clinical and Financial Data: The Key to Real Quality and Cost Outcomes By Bobbi Brown © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  2. 2. Linking Clinical and Financial Data Health systems weren’t concerned with achieving high-value care until accountable care took the industry by a storm in 2010. Health systems had a predictable revenue stream from the fee-for-service payment model. Patient volumes their revenue. © 2014 Health Catalyst www.healthcatalyst.com On my desk there is a copy of “Show Me the Money.” As a finance person I embrace its concepts of achieving high value results because it’s applicable to today’s healthcare environment. Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  3. 3. Metrics for Value-based Purchasing © 2014 Health Catalyst www.healthcatalyst.com While the switch to value-based purchasing will ultimately improve both quality and cost outcomes, health systems now need the capability of tracking and analyzing many other metrics before they can comply with the government’s new mandates. These metrics include: Throughput Quality Readmissions Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Mortality rates Patient Satisfaction Cost per Episode of Care
  4. 4. Metrics for Value-based Purchasing Throughput The time it takes to complete a process, such as shortening the average wait time in the ER or reducing the time between cases in the OR, now translates directly into money and greatly affects quality. © 2014 Health Catalyst www.healthcatalyst.com Improving throughput will benefit the organization by reducing cost and increasing patient satisfaction. Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  5. 5. Metrics for Value-based Purchasing Quality With value-based purchasing, hospitals are required to assess and report measures of quality relative to defined benchmarks. If hospitals don’t report their quality metrics, they’ll receive a penalty, further impacting their bottom line. © 2014 Health Catalyst www.healthcatalyst.com Were patients given discharge instructions? Did the care manager schedule follow-up visits? How many falls occurred in the hospital? How many hospital-acquired infections? Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  6. 6. Metrics for Value-based Purchasing Readmissions Quality will also be assessed based on the rates of readmissions for all causes within a certain time period for specific patient populations. © 2014 Health Catalyst www.healthcatalyst.com For example, what are the rates of heart failure, pneumonia and AMI readmissions within a 30- and 90-day period? Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  7. 7. Metrics for Value-based Purchasing Mortality Rates What are the hospital’s mortality rates for pneumonia, heart failure and acute myocardial infarction (AMI) among its patient populations? © 2014 Health Catalyst www.healthcatalyst.com High mortality rates in pneumonia, health failure and AMI will result in loss of incentives beginning in 2014. Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  8. 8. Metrics for Value-based Purchasing Patient Satisfaction Patient satisfaction is now tied directly to payment models. © 2014 Health Catalyst www.healthcatalyst.com How satisfied are patients with their care experience? Was the room satisfactory? Was the family comfortable? Would they recommend the hospital? Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  9. 9. Metrics for Value-based Purchasing Cost Per Episode of Care Containing costs is now more important than ever as value-based purchasing systems strive to keep treatment consistent and expend-itures © 2014 Health Catalyst www.healthcatalyst.com appropriate and predictable. Reducing clinical process with variations will improve the cost structure. Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  10. 10. Metrics for Value-based Purchasing © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  11. 11. Clinical & Financial Data Challenges As though health systems weren’t already dealing with enough concerns with all of the new metrics they need to capture and analyze, there’s one more challenge they’re dealing with — accessing linked clinical and financial data from within their systems to provide the right metrics in this new world of value-based reimbursement. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  12. 12. Clinical & Financial Data Challenges But the two data systems were not integrated because there wasn’t a need. Today, data from both clinical and financial systems can be leveraged to drive concrete, timely quality improvements while also lowering costs. © 2014 Health Catalyst www.healthcatalyst.com Traditionally, health systems housed their financial and clinical data in separate systems. Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  13. 13. © 2014 Health Catalyst www.healthcatalyst.com Achieving High Value Results Achieving high value results for health systems is achievable. The organization must understand where it is in relation to clinical quality measures and financial costs associated with delivering care. The right tools and teams are necessary to liberate clinical and financial data and link it together to provide a full picture of trends and opportunities. Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  14. 14. © 2014 Health Catalyst www.healthcatalyst.com Achieving High Value Results Enterprise data warehouse A late-bindingTM enterprise data warehouse (EDW) provides the ability to aggregate data from a wide variety of sources allowing a sophisticated analytics system to leverage the data and drive timely quality improvements. Late-binding brings the data together just-in-time. Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  15. 15. © 2014 Health Catalyst www.healthcatalyst.com Achieving High Value Results Multi-disciplinary teams In addition to the EDW, permanent multi-disciplinary teams of frontline staff can help drive sustainable improvement. The team constantly monitors to ensure they’re focused on sustaining quality and financial improvements as well as clinical and operational outcomes. Once data and best practices reveal improvement they work to gain buy-in from the clinicians. Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  16. 16. © 2014 Health Catalyst www.healthcatalyst.com Achieving High Value Results The “aha” moment By using easy-to-use dashboards along with a late-binding data warehouse, then clinicians can visualize their own progress. The “Aha!” moment comes when they can see how the clinical decision they made two days ago affected the bottom line today. Example: A provider focused on appendectomy as a key opportunity for quality and financial improvement. Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  17. 17. © 2014 Health Catalyst www.healthcatalyst.com Late-Binding™ EDW The Key to Linking Clinical and Financial Data Quality and cost improve-ments require intelligent use of linked financial and clinical data coupled with multi-disciplinary teams who are driving process improvements. The Late-Binding™ Data Warehouse offers the ideal type of enterprise data warehouse architecture for healthcare because of its flexibility to bind data late or just in time. Late BindingTM Data Warehouse Data Acquisition and Storage Source Mart Designer IDEA Source Marts: EMR, Patient, Billing, Costing, General Ledger, Patient satisfaction Source Marts: Clinic EMR, Professional, Billing, Time Card, HR, AR, Supply Chain, Claims Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Source Marts: Additional Source Marts as necessary Catalyst Analytics Platform Atlas EDW Console Security and Auditing Meta-Data Engine Advanced Analytics Data Marts Content Repositories SAM Designer
  18. 18. Surviving Value-Based Purchasing: Connecting Clinical and Financial Data for the Best ROI Bobbi Brown, VP Financial Engagement How to Drive ROI in Your Healthcare Improvement Projects (a free, on-demand webinar, transcript, and slides) Bobbi Brown, VP Financial Engagement and Leslie Falk, VP Executive Engagement © 2014 Health Catalyst www.healthcatalyst.com More about this topic Both Financial and Clinical Data Are Required for Meaningful Population Health Management (white paper) Bobbi Brown, VP Financial Engagement and Luke Skelley, Vice President 5 Ways to Improve Hospital Revenue Cycle Management Bobbi Brown, VP Financial Engagement The Key to Transitioning from Fee-for-Service to Value-Based Reimbursement Bobbi Brown, VP Financial Engagement and Jared Crapo, VP Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  19. 19. © 2014 Health Catalyst www.healthcatalyst.com For more information: Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
  20. 20. Other Clinical Quality Improvement Resources © 2013 Health Catalyst www.healthcatalyst.com Click to read additional information at www.healthcatalyst.com Bobbi Brown is Vice President of Financial Engagement for Health Catalyst, a data warehousing and analytics company based in Salt Lake City. Ms. Brown started her healthcare career at Intermountain Healthcare supporting clinical integration efforts before moving to Sutter Health and, later, Kaiser Permanente, where she served as Vice President of Financial Planning and Performance. Ms. Brown holds an MBA from the Thunderbird School of Global Management as well as a BA in Spanish and Education from Misericordia University. She regularly writes and teaches on finance-related healthcare topics.

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