With the completion of Meaningful Use Stage 2, healthcare operators are generating comprehensive digital clinical information for the first time. The Office of Management and Budget (OMB) projected that investments in physician order communications, comprehensive charting and other IT modernization would improve individual patient outcomes, reduce medical error risk, slow healthcare spending and produce other benefits. – It is unlikely that any tangible financial return on this investment by providers will result savings to offset ongoing maintenance and support costs. It sure seems like a case of hospitals and physician practices taking one for the rest of the team.
All this data can enable hospitals and practices to have unprecedented transparency into patient characteristics, order patterns, medication selection, coupled with patient outcomes at very detailed levels. As this data pool builds, we should expect to discover optimal, personalized medications, testing protocols, and therapy practices for conditions seen and treated in large numbers. Health analytics tools enable leaders to recognize possible opportunities to manage medication formularies, reducing drug supply costs while maintaining or even improving quality of outcomes. Analysis of diagnostic test order practice can uncover opportunities to avoid unnecessary, ineffective and redundant testing. Analyzing therapy and medication plans for both effectiveness and costs for cases that produced best patient outcomes helps optimize medical care.
These “health analytic feedback loops” can drive change to clinical tool configuration, clinical content, purchasing decisions, clinical practices, treatment plan templates, order content and other elements of operations. Providers can realize material financial returns; improved patient outcomes; and more accessible, efficient clinical operations. Improved overall performance can make pay-for-performance programs and accountable care organization (ACO) participation possible.
Big clinical data and analytics can also facilitate medical and clinical staff adoption of improving practices. Physician and other clinical staff performance measurement can be used to educate and inform caregivers of any personal variation from standard and best practices. Cookbook medicine does not replace sound judgement based on an intimate understanding of individual patients, but decision- or choice-based on personal preference or habit must be avoided. Patient safety is enhanced when teams perform complex clinical procedures or tasks in a consistent, well-supported manner. Continuous, analytic-driven refinement of workflows, supply decisions, and treatment plans to reduce variation, leverage training, and engage tool support are needed for success. Reliable individual, team, and house-wide practices assure high standards of clinical quality of care are achieved and maintained.
Robust performance metrics, shared openly but carefully, can build pride, confidence and community standing. Such programs communicate to all stakeholders: employees, medical staff, community leaders and citizens that leadership is committed to building and sustaining a healthy, sound hospital everyone should confidently rely on.
In summary, hospitals should:
- Architect clinical data at the point of entry to be readily analyzed for effectiveness, efficiency, and accountability.
- Capture and combine with other relevant data sources to provide the broadest, most essential foundation for analysis.
- Apply health analytics tools to answer some practical questions:
o What works best?
o How to enhance efficiency and pace of care?
o Is there a best order of therapy, testing, patient care that avoids conflicts, maximizes patient benefits and can organize the patient’s experience of care?
- Establish multidisciplinary teams to evaluate analytical findings, break down current practices and establish improvements.
- Apply health analytics to measure compliance with new standards individually and collectively. Track impact on outcomes: patient care metrics, readmission rates, costs, and margins. The fact is that clinical quality can only be sustained at financially sound facilities, so the clinical staff cannot avoid responsibility for financial performance.
Look at EVERYTHING! Do so objectively and with your data – big local data and health analytics can make hospital management more effective than intuition. Healthcare practices become objectively outcome driven and not subjective. Apply your tools to look inward to drive success outwardly. Prove the OMB wrong. Get a return on your Meaningful Use investment.
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