How To Use Data To Improve Revenue and Outcomes

Maximizing revenue and patient satisfaction is a constant struggle in today’s healthcare environment.  Many decisions result in improving one at the expense of the other.  A recent presentation by Wise Health System at the Healthcare Financial Management Association’s ANI conference in Orlando spoke about how to accomplish both goals with a data-driven culture.

The endeavor began as an attempt for Wise Health to improve documentation around its ICD-10 initiatives.  But as Lynn Giddens-Branscum, vice president and administrative director of revenue cycle and audits for Wise Health System, began to see the benefits to their bottom line, she noticed a corresponding uptick in patient satisfaction.  As this article by Ilene MacDonald at Fierce Healthcare shows:

“Prior to the program, the revenue cycle, business office, HIM, coding and patient access was under Wise Health’s chief financial officer. The chief nursing officer oversaw nursing, case management, utilization review and discharge planners. The problem: there was little communication between clinical utilization review, revenue cycle and the hospitals and clinics. Its multiple hospital and clinic systems were not integrated, which created process problems, coding issues and audit denials.

So the organization decided to build a bridge so to speak from its case management, CDI, coding and denial management departments to its ambulatory clinics. The process involved physician education, an examination of the daily work flow, and measurement of outcomes for congestive heart failure, diabetic education and behavioral dual diagnosis. As the relationships between coders, physicians and the financial team grew stronger and the teams shared data, the system decided to use the data across the system to improve outcomes.

One initiative targeted follow-up care after discharge to patients who had congestive heart failure. Initially the organization identified patients admitted to the hospital for observation. Later, the groups expanded the analytic capability across the enterprise to include patients seen at all 18 clinic locations in order to make sure staff were following-up on care post-discharge. The organization soon began to see a drop in readmission rates specific to patients with congestive heart failure, Giddens-Branscum said, and the cardiology department decided to expand the program across all of the system’s acute cardiac facilities.

The continued collaboration among the physicians, nurses and revenue cycle also led to an unexpected result, she said: an improvement in customer service and satisfaction scores. Patients responded positively to the relationship that they developed with the transitional coordinator prior to discharge. The nurse practitioner also calls them at home to remind them about care instructions and also may send a postcard.”

Read the entire article here: Wise Health improves revenue cycle, patient satisfaction through analytics and data-driven culture

The combination of accurate data and collaboration in healthcare can lead to outstanding process improvements that increase profitability and patient satisfaction. This article gives another good example, where Wise Health used data and an open communication line between its back office functions and ambulatory clinics to drive reduced re-admissions and improved patient satisfaction.  If you believe that your hospital lacks the real-time data needed to make the right decisions, there are technologies that can help. Hospitals can turn to systems like iRISupply from Mobile Aspects to ensure they have access to high fidelity data – giving them the confidence they need to effect positive change in their organization.