Healthcare organizations are turning to data analytics to improve clinical and financial outcomes. Physicians and analysts can identify patient trends and develop more cost-effective ways to treat those populations by analyzing large amounts of data. However, when organizations focus on the big picture, they risk missing more immediate concerns: the patients themselves.
The challenge for healthcare providers is determining how to better understand the needs of the patient population while also being alert and responsive to individual patients.
"What the patients want from us is that, when you show up, you get what you need, not what a national predictive model might think you need," says Cynthia Barnard, vice president of quality at Northwestern Memorial HealthCare (NMH). "However, we're also obligated to keep our eye on those bigger-picture issues, both financially and as a responsible steward of resources."
Northwestern Memorial Hospital is currently testing a new method for preventing readmissions that balances treatment based on general populations with treatment based on individual needs.
Pradeep Sama, the hospital's director of analytics, and his team designed a predictive model that generates a daily risk assessment score for every patient. The model includes about 24 risk variables, which were selected by a review of existing medical literature, conversations with clinicians and the clinical data from EHRs.
By focusing on specific risk areas, Sama's team helps troubleshoot possible contingencies involved in maintaining wellness after discharge. The team's assessment shows that additional care may include patient psychiatric consultations, training on medication adherence or implementation of in-home caregivers.
The goal of the predictive model is to better understand how to use limited resources in a way that is tailored to individual patient needs. The challenge is working out a way to incorporate "non-hospital" data into an analytics solution.
If your care facility is struggling with limited resources due to challenges occurring in the revenue cycle, it may be time to outsource receivables management. This will allow administrators to diminish backlogs of outstanding claims and focus on higher priorities. Reach out to Professional Medical Services to learn more about our financial solutions for healthcare organizations.