From the Consultant’s Corner 4/4/14

Three Factors for Success in Using Informatics

As the healthcare industry continues to experience a growing demand for reporting and analytics, organizations will be required to focus on healthcare informatics. Defined as the science of how to use data, information and knowledge to improve human health and delivery of healthcare services, informatics is more than just data reporting. It encompasses business intelligence, data analysis, and analytics as well.

Historically, data reporting was a lesser priority because healthcare organizations did not know how best to leverage data across business and clinical applications. Now, as healthcare leaders begin to understand how to use data and reports to drive performance and outcomes, informatics is moving to the top of the chart with both clinical and business implications. For example, instead of just identifying patients with diabetes, informatics determines whether specific services have been provided and pinpoints care gaps. On the business side, rather than looking at schedule availability, informatics reviews provider productivity expectations and identifies opportunities to standardize and consolidate visit types and provider schedules.

Why focus on informatics

As healthcare leaders define ROI for large investments in new technology, informatics should be at the center. In my experience, although expanding EHR installations and capabilities provides access to more information, the focus has been on implementing technology rather than using the information. The only way to obtain true ROI is to use the captured data for proactively managing patient care and financial operations.

Government regulations also steer the focus to informatics. While Meaningful Use Stages 1 and 2 require technology to be implemented, they also demand that physicians and hospitals become meaningful users. The ICD-10 conversion requires reporting and capturing clinical data in a discreet fashion and understanding what it means from coding, billing and downstream reimbursement perspectives. To comply with these regulations, organizations must understand and respond to the data.

Value-based reimbursement methodologies are another driver for informatics, as accountable care measures of both quality and cost impact how the organization is paid. For instance, organizations no longer are paid to see a patient 10 times with no health improvement; instead, they are reimbursed for keeping him or her healthy. These opportunities require the organization to marry financial and clinical information in a fully integrated manner.

Three factors for success

Leveraging informatics effectively across an organization requires more than EHR technology; it comes down to strategic decisions made by key executives during and beyond implementation. I believe these three factors help organizations realize the true potential of the data and use it to improve operational performance and patient outcomes.

1. Clearly define success metrics.

Without clear goals, no organization can improve performance, regardless of how many reports are run. It’s important to use leader-defined metrics to create reports and deliverables that measure progress and performance against certain key indicators, keeping in mind that information should be published with an operational rather than technical focus. Additionally, leadership should communicate the overall goal of educating and informing end users on what to do with the data, knowledge, and information provided by informatics.

2. Create a customer service culture.

This operational focus for informatics requires a cultural shift in ownership, moving informatics from IT to operational units, such as the revenue cycle or clinical informatics group. Design the informatics effort based on operational requirements, ensuring information is delivered when and where it is needed in the workflow. As a liaison between the technical focus and those using the information, operationally-driven informatics teams should partner with clinical and business managers to understand needs. In my opinion, organizations that allow IT to drive informatics projects will struggle.

3. Set expectations for report development and dissemination.

Resources are not always sufficient to support the increasing reporting demands in healthcare. One way to mitigate this is by implementing service level agreements to prioritize report requests and establish turnaround times. Define the escalation path when resources are not sufficient to meet the organization’s reporting needs.

Moving beyond technology

EHR use alone will not improve care. Rather, the collective knowledge and data captured in the EHR will impact quality and outcomes through informatics. Beyond simply generating reports, informatics supports clinical and business goals by providing the necessary information to the right decision maker in a manner he or she can understand and use to promote health and improve delivery of healthcare services.

Brad Boyd is vice president of sales and marketing for Culbert Healthcare Solutions.