Readers Write: Culling Through Mountains of Data to Achieve Meaningful Change

Culling Through Mountains of Data to Achieve Meaningful Change
By Jim Denny, CEO, Navicure

Research shows that organizations that leverage analytics are five times more likely to make faster decisions. Considering this fact, along with the mountains of data accumulated by the average healthcare organization, it’s no wonder healthcare leaders have named data analytics implementation a high priority.

Navicure’s May and June 2016 data analytics survey shows that 45 percent of the 622 survey respondents currently have an analytics solution, although 45 percent of respondents without an analytics solution are in the process of selecting or implementing one. If healthcare leaders using such solutions overwhelmingly recognize the value of data analytics, then why haven’t a larger percentage of their peers implemented a technology solution? The answer may lie in the sheer size of the opportunity afforded by analytics. The amount of data and numerous types of data can make it difficult to develop program parameters and get started. The following three steps can serve as a foundation, helping you get your analytics program off the ground quickly and efficiently:

1. Obtain organization-wide buy-in

Analytics is more than just a technology solution; it’s a data-driven approach to process improvement. With that in mind, two factors are especially important for any organization embracing analytics. First, leadership must believe in this data-driven approach. They must begin making decisions based on what the data tells them. Second, the analytics implementation should extend to staff, not just leadership. When mapping the various ways you’ll use analytics, make sure supervisors use data to pinpoint specific tasks and workflows that can be improved, and conduct training accordingly. In addition, staff should be included in the analytics strategy, using analytics to take action and correct their errors.

2. Identify your organization’s critical key performance indicators

An early-stages analytics program can benefit from starting small with the one or two KPIs deemed most critical to organizational success. By identifying KPIs that correlate to your current challenges, you can focus efforts on the areas that will yield maximum results. Some essential revenue cycle KPIs are:

• Days in A/R
• First pass rate
• Denial rates
• Rejection rates
• Charge lag
• Overall cash flow performance

More than 55 percent of survey respondents said their most important KPIs are days in A/R, and denial and rejection rates. Forty percent also rated denials as their top revenue cycle challenge, followed by patient payments and billing (37 percent). To that end, most organizations can make immediate revenue cycle management improvements by first targeting denial and rejection rates. However, if cash flow is your greatest concern, kick off your analytics program by measuring and monitoring charge lag and overall cash flow performance. Organizations should also start to include patient-specific payment KPIs as part of their active monitoring given the growing patient self-pay trend. It’s important for your organization to see the benefits of analytics, and starting with KPIs that can move the needle enables you to get quick wins.

3. Make actionable data an integral part of your strategy

Dashboards are important because they can give leadership and supervisors an easy-to-review snapshot of the above KPIs, but their effectiveness is limited without actionable data. For instance, if you’re targeting denial and rejection rates, the back office team working denials and rejections needs detailed analytics data that enables them to drill down all the way to the claim level. Only then can they begin to understand their error patterns, take action, and create change. At a more detailed level, features such as grouping and filtering can help this team even more. For instance, grouping by denial type enables a billing specialist to determine the cause and related financial impact of each category. Setting up these groups on the front end will allow her to clearly see which denials require certain types of action, thus enabling her to work more quickly while making fewer errors.

Getting the Most Out of Your Investment

The good news about analytics: It’s an investment with a high return, and it can give you both near-term and long-term results. In Navicure’s survey, nearly three quarters of respondents with analytics solutions had achieved cash flow improvement by reducing days in A/R. Fifty-six percent also increased revenue by identifying bottlenecks so they could get paid more quickly, and almost half had improved productivity by using analytics to pinpoint staff that needed training. In summary, those are black and white, irrefutable data-driven reasons to support the value of analytics in healthcare organizations.

Jim Denny is CEO of Atlanta-based Navicure.

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Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

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News 8/8/16

Top News

Mount Nittany Exchange joins the PA Patient & Provider Network (P3N), which also includes Keystone HIE and St. Luke’s University Health Network’s EVantage Health HIE. The Pennsylvania Dept. of Human Services, which oversees the P3N network, anticipates onboarding ClinicalConnect HIE and HealthShare Exchange of Southeastern Pennsylvania by the end of the summer.

HIStalk Practice Announcements and Requests

Thanks to these renewing HIStalk Practice sponsors. Click a logo for more information. Contact Lorre if you’re interested in learning about sponsorship benefits.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketcham, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Announcements and Implementations

Meridian Medical Management’s PrecisionBI division develops an ACO module for Allscripts TouchWorks Reporting users, enabling them to identify eligible patients and aggregate data in a tailored quality reporting database.

DexCom adds portal-based messaging capabilities to its Clarity diabetes management software, part of its G5 mobile continuous glucose monitoring system.

Ontario-based startup Strategic Leverage develops an online tool to help physicians understand and manage their online reputations.

Acquisitions, Funding, Business, and Stock

The Institute of Healthcare Design Thinking, a healthcare marketing, communications and strategy collaborative, will relocate from Chattanooga, TN to Cleveland this fall in an effort to take advantage of the Ohio capitol’s “thriving healthcare, business, and design ecosystem.” The institute was founded last year as a part of Lift1428, a Chattanooga-based healthcare marketing and design firm. Perhaps it will end up renting a room at the HIMSS Innovation Center, which touts itself as a “physical and virtual, state-of-the-art, testing, exhibition, and conference facility that offers real-time demonstration of healthcare technologies.”

Telemedicine

This article looks at the South Korea’s lack of love for telemedicine, currently prohibited under the country’s Medical Act. From data security issues to a widespread belief that the development and adoption of telemedicine technologies will create a digital divide between the haves and the have-nots, the fate of telemedicine in one of the most technologically enthusiastic countries in the world seems uncertain at best. The country’s first and only telemedicine pilot program has been plagued by issues related to data mismanagement including improper or lack of encryption, use of vulnerable passwords, and anxiety over last year’s North Korean cyberattack on a medical institution.

Government and Politics

Kentucky’s proposed Medicaid reform includes offering beneficiaries a $500 incentive to transition out of the $1,000-deductible program and join a commercial health plan for at least 18 months. “As participants roll off of public assistance, they will be prepared to make smart health care choices, which will have a positive effect on the free market,” explains Amanda Stamper, press secretary. “Naturally, as more and more Kentuckians become consumers, quality will increase and costs will decrease in the health care market, as we see happen in all free markets.”

HHS celebrates National Health Center Week. I’d love to see an infographic that focused on how many have adopted healthcare technologies, and how that adoption has impacted patient satisfaction and quality scores.

My #firstsevenjobs would read as follows:

Sat babies
Shelved books
Adult swim
Scheduled life savers
Tea pourer
Flagpole paster
Textile coverer

Feel free to share yours in an equally cryptic and brief manner via the comments section below.

Other

Kinsa donates its smart thermometer and app to Olympians in an effort to help track the spread of illnesses like the Zika Virus. The new location-based Olympic Village Group feature anonymously collects data from users in the Olympic Village, and then reports common symptoms and an overall health grade for the area. The app also offers an anonymous message board so that users can chat about sicknesses and symptoms.

For all its healthcare bells and whistles, Quartz contributor Mike Murphy calls the Apple Watch “the most anxiety-inducing device” he’s ever owned thanks to a heart condition and predilection to constantly check the device for incoming messages. “The watch is strapped to you,” he writes. “The internet never leaves you alone, is symbiotically tied to you, is physically closer to you than some of your appendages. It’s always there, always tapping you. It’s a reminder that a worry is like a notification, which left unchecked, can consume you. For me, it was the heart rate, and a fear that I was neglecting my mortality, the duty to my parents and the doctors who saved my life when I was two years old by not ensuring that I was doing all I could to keep on living. The heart monitor and the watch itself made me feel like a bad son and lazy person and not a hard-enough worker with the constant reminders that I wasn’t moving enough, answering enough messages, or being present.” After a particularly nerve-wracking visit to the physician’s office, Murphy’s physician recommended that he take a vacation without Internet-connected devices, exercise more, and relax – advice I think we should all take to heart in this hyper-connected world of instant digital gratification.

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

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Population Health Management Weekly Wrap Up 8/7/16

Lisa Casasanta (Boehringer-Ingelheim Pharmaceuticals) joins Mercy Medical Center and the Sisters of Providence Health System (MA) as vice president of population health.

Nabil Chehade, MD (HealthSpan Physicians and the Ohio Permanente Medical Group) (OH) joins MetroHealth System as SVP of population health.

Lumeris names Ray Wolf (Redirect Health) SVP of architecture and innovation, and appoints Joseph Gifford, MD (Providence Health and Services) SVP of provider markets.

Cerner reports in its earnings call that its HealtheIntent population health management solution has been purchased by more than 100 clients, and that it sold two PHM deals of over $5 million.

Employer-focused care management company Telligen acquires corporate wellness program company Total Well-being for an undisclosed sum. Total Well-Being President and Founder Colleen Reilly will assume the role of Telligen’s vice president of employee well-being.

Pathway Health will add Virtual Health’s population health management technologies, including predictive analytics, risk stratification, clinical analysis, and workflow management, to its line of consulting services for the post acute-care market.

Sponsor Updates

• Healthwise and Intelligent Medical Objects will exhibit at the Allscripts Client Experience August 9-11 in Las Vegas.
• Nordic will sponsor the Collaboration of Revenue Cycle Epic Users Conference August 10-12 in Portland.
• GE Healthcare President and CEO John Flannery continues his LinkedIn series on “The Top 10 Reasons Transformation is the New Normal for Healthcare.”

Blog Posts

• Preparing for Epic implementation: Your go-live playbook [podcast] (Nordic)
• The next generation of Healthcare IT solutions must create value for the clinician (NVoq)

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

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News 8/4/16

Top News

Athenahealth works with providers in its network to determine hotspots for likely Zika Virus diagnoses. The company has so far identified 1,800 residents of a Miami neighborhood dealing with Zika-carrying mosquitoes – the majority of which are patients at Borinquen Health Care Center. The company is working with the FQHC and several other providers in the area to reach out to at-risk patients for testing. It also plans to update patient health records with CDC guidelines on Zika so that physicians can better educate their patients. As of August 3, six cases of locally acquired mosquito-borne cases of the virus have been reported to the CDC; over 1,800 travel-related cases have been documented.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketcham, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Announcements and Implementations

Quest Diagnostics develops an EHR-friendly digital dementia assessment tool to help physicians diagnose and care for patients with cognitive dysfunction.

Wake Radiology (NC) implements PM imaging technology from Vital Images across its 20 outpatient offices.

Optum subsidiary OptumCare signs a 10-year agreement with Allscripts to supply the company’s TouchWorks technology bundle its physician practice network.

Acquisitions, Funding, Business, and Stock

The US Patent and Trademark Office awards physician dictation software vendor InfraWare a patent for its “System And Method For Analyzing Verbal Records of Dictation Using Extracted Verbal Features.” New features include periods, commas, numbered list identification, and identifiers for medication lists that will help accelerate the creation of health records from physician dictation.

ElationEMR raises $15 million in Series B financing and rebrands to Elation Health. The San Francisco-based company was started in 2010 by brother and sister team Conan and Kyna Fong while working at their father’s primary care practice, who at the time time was not a fan of EHRs (though he is now a dedicated client). You can read my 2014 interview with CEO and co-founder Kyna Fong here.

Multi-industry accounting and consulting company Wipfli acquires HFS Consultants and its marketing division for an undisclosed sum.

Telemedicine

Teladoc attributes its failure to meet Q2 revenue expectations to increases direct-to-consumer advertising costs and the delayed implementation of two clients, who’ve purchased rolls outs to early 2017. Q2 results: $26.5 million in revenue; a 45-percent increase in membership to 15.4 million, and 199,106 visits.

Iagnosis, developer of DermatologistOnCall, reports 75 percent year-over-year growth in its number of online patient visits, and a 70-percent growth in its provider network. I’m not sure what that’s worth given that the company hasn’t released hard numbers.

Dictum Health integrates Eprosystem’s EproMedical EHR into its telemedicine platform.

People

Jeff Fields (CMF Associates) joins Rite Aid subsidiary and population health management company Health Dialog as CFO. He will also take on a similar role at RediClinic, which operates 52 clinics inside Rite Aid stores.

Eric Heflin (The Sequoia Project) joins the IHE USA Board of Directors.

Josh Weiner (Summit Partners) joins Solutionreach as chief growth officer.

Zelis Healthcare appoints Charles Garner (MedAssets) CFO and chief administrative officer, and Matthew Hintz (ComplexCare Solutions) as chief HR officer. The company rebranded last month to bring together four companies – Premier Healthcare Exchange, Stratose, Pay-Plus Solutions, and GlobalCare – that make up its revenue cycle services for providers and payers.

Government and Politics

CMS hosts its second annual IT conference in Baltimore. Speakers, the majority of which were CMS employees, largely focused on internal systems powering Medicaid and Blue Button

HHS awards $8.6 million in funding to help 246 health centers in 41 states improve care quality and patient and provider experience via Patient-Centered Medical Home programs. The selected health centers will use the funding to achieve, expand, and optimize PCHM recognition. Sixty-five percent of centers already have some form of recognition.

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

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HIStalk Practice Interviews Cyber Smith, Practice Administrator

Tell us about yourself and the practice.
I am the practice administrator for a small, privately owned family practice in Arizona. We have a single location housing fewer than 10 physicians. Given that this interview focuses on our cybersecurity efforts, I’ve chosen to remain anonymous because the last thing that I want to do is draw attention to our practice. Wouldn’t it be ironic if we became a target for a cyber attack by discussing our precautions against it?

What prompted your practice to look into cybersecurity solutions?
As background, I am something of a geek. I regularly keep up with technology news and trends. A year ago, a buddy of mine shared his experience as a victim of ransomware (the $500 variety on his personal computer), so I had some awareness of this threat. But I became much more concerned with the recent news of hospitals getting attacked and being taken hostage.

As I read about the damage being done, I shared the stories with our physicians and staff. I asked everyone to be vigilant with their email, and tried to impress upon them the consequences that are possible. As I researched this topic further, I became aware of a Security Awareness Training company that offers to test your staff for free. So, a week after I warned my staff, I sent them each a bait email, based off common phishing attacks. In the first hour, three individuals had already clicked on the poisonous link. In total, five individuals clicked on the bait link – two of them were physicians. Rumors began to spread around the office, which likely prevented a couple more clicks.

Was there any pushback from physician leadership or other higher ups?
No, the owner recognized that the threat is real, and that we were obviously susceptible.

Did you look to your peers for advice on what type of vendor/solution to turn to?
KnowBe4 was recommended to us by our IT support company. I was impressed by their methodology and capability, and the price was very reasonable.

Had any of your peers already implemented such technology/services, or is your practice leading the way in this area?
I don’t personally know of any other practices in our area doing this yet. But I have heard through the grapevine of one local practice that had fallen victim to ransomware.

What type of solution did you ultimately opt for? What were the deciding factors that helped it win out?
We are already using enterprise-level virus scanning, spam blocking, and email attachment filtering. But I assume that all of the hospitals that have been hit have also had similar precautions. So, we wanted to add an employee training program with ongoing monitoring.

We ended up going with KnowBe4. They offer a Web-based training platform, and track completion of courses for each employee. they will also continue to monitor compliance through an on-going email campaign where they will repeatedly send simulated scams to all employees. Any employee who clicks the bogus link, or opens the attachment, is identified for retraining.

How receptive have your employees been to the cybersecurity tools now in place?
I was worried about complaints from our staff about a mandatory training video about this geeky stuff. However, virtually all of my staff have responded positively about the training. Some have asked if their family members can take the same training. (KnowBe4 does offer a shorter training that can be shared with family without additional cost.) And we have certainly seen our staff looking more skeptically at emails, and being more hesitant to open attachments. I believe it is working, and we will continue to monitor our staff to ensure that they don’t slip backwards.

Is your practice looking beyond ransomware to other types of cybersecurity attacks looming on the horizon?
Of course. We are worried that our three backup methods are not sufficient. We are worried about the possibility of stolen laptops, hacked Wi-Fi, spear-phishing in the guise of incoming digital medical records on CD or thumb-drive, password security, phone security, and the security of our EHR, ACO, patient portal, and the 20 insurance portals that we log into on a daily basis, each using separate credentials. And despite our efforts in all of these areas, it never feels that we have done enough.

What best practices/advice can you offer other practices that are looking into these types of solutions?
I recommend that they begin with a free test of their staff. It will help to determine how great your need is. But remember, all it takes is one individual to open a bad attachment. Even if that employee doesn’t have an email account with your practice, if they open their personal email on company equipment, you are still vulnerable.

Do you have any final thoughts?
We are becoming increasingly paranoid and frustrated by the current state of affairs. We are paranoid because medical information has become so valuable to criminals that it has made all medical practices a target. And we are frustrated that the system has not found a way to prevent the crimes of identity theft and medical billing fraud, so the strategy is to prevent all thefts. Unfortunately, our country can’t figure out a way to prevent someone from opening a line of credit with a stolen name, SSN, and DOB. So instead, all of our staff members need to be smarter than a trained, professional hacker. And in fact, all medical industry workers will need to be smarter than all of the hackers who are attacking us. It’s insanity.

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

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