Magazine Article | March 25, 2013

Data Analytics Makes Healthcare More Intelligent

Source: Health IT Outcomes

Compiled by Cindy Dubin, contributing editor

As a key way to improve operating efficiency, ensure quality care, and contain costs, Wheaton Franciscan Healthcare uses data analytics technology to ensure valuable information isn’t sucked into software “black holes.”

While business intelligence/data analytics has been widely adopted by CIOs in a variety of industries, adoption in the healthcare arena is still far from widespread. According to a report from Frost & Sullivan, conducted on behalf of the U.S. Hospital Health Data Analytics Market, many hospitals lack the appropriate tools and capabilities needed to turn clinical data into insight. In fact, the use of advanced health data analytics in U.S. hospitals was at only a 10% adoption rate in 2011.

But, adoption of advanced health data analytics is expected to increase significantly over the next five years, according to the report, with a 50% adoption rate expected by 2016. The surge will come as a result of the increased use of EHRs. Hospitals will focus on building their capabilities in advanced analytics, as traditional tools to providing patient care, measuring quality, and containing costs become inefficient.

Data analytics will prove their value in analyzing revenue, staff performance, and operational efficiency. These tools include progressive real-time and predictive techniques, often provided by Web-based systems that aggregate disparate data across diverse care settings.

These are among the many reasons why Wheaton Franciscan Healthcare, with corporate services offices in Glendale, WI and Wheaton, IL, adopted a data analytics solution. Wheaton Franciscan Healthcare is an integrated healthcare system in southeast Wisconsin, providing nearly one-quarter of the healthcare delivered in that region, and is affiliated with more than 1,300 physicians. The organization also has hospitals and medical groups in Iowa and Illinois. Michelle Jones, director of patient financial services and patient access, recently talked with Health IT Outcomes about how Wheaton uses data analytics to the benefit of its organization.

Q: What was the impetus for leveraging data analytics tools?

Jones: We were looking for tools to use in the business office that would help us measure our success more proactively than we had been able to previously with our disparate billing systems. Our billing systems had many “pathways” to follow when running reports, and if not run in a certain way, accounts would be missed. With the data analytics platform we implemented from MedeAnalytics, we don’t have that problem anymore.

The other reason we were looking into data analytics was that when we could not run our own reports out of our billing department, we had to depend on our IT department, and that could take time. We now obtain the information ourselves and use it to run our business.

Reporting previously was an issue, and we usually had to wait until month-end to find out how our accounts receivable was performing. Using MedeAnalytics, we are able to work proactively instead of reactively.

Q: How does your data analytics solution work, and what type of information is it allowing you to analyze?

Jones: MedeAnalytics is delivered using a Softwareas- a-Service (SaaS) model. It is a web-hosted, managed analytics platform that collects, aggregates, cleanses, and normalizes data and then presents instant views into financial, operational, and clinical performance. We can view — refreshed every other day (only because of our systems, not MedeAnalytics) — dashboards that provide clear insight into how the organization is performing.

We still use our billing system, which is our system of record. MedeAnalytics is an add-on to our current system. We feed reports from our current billing system into MedeAnalytics, and we are then able to analyze and manipulate the numbers. We can look at different metrics in real time.

For instance, from a business office standpoint, we can see how much we write off daily vs. previously having to wait until month-end to see how much was written off. We can see how much cash we have collected each day. We can see where we are with our accounts receivable and what’s over 90 days or 180 days. Previously, this information was only available to us toward the end of the month or after the month. This way we can be more proactive in the work that we do and affect outcomes rather than always being reactive.

Q: What did the implementation process entail?

Jones: We began implementation with the hospital sites for billing. There were weekly meetings to determine our key performance indicators (KPIs) and how we would transfer the information from our legacy systems into MedeAnalytics. On the medical group side, it was pretty similar. And on the front end, we did implement some of MedeAnalytics’ real-time eligibility tools and estimation tools in the patient access area. We also used RQA (registration quality analytics), which we are now in the process of updating. Wheaton Franciscan Healthcare is upgrading to PAI 13 which is the patient access suite of real-time tools. This will enhance our registration process by providing us with workflows for the registrars that will encompass eligibility, quality analytics, estimations for hospital services, authorizations, etc. Having information correct on the front end helps the total patient experience by making the billing on the back end much cleaner and transparent to the patient.

Q: What benefits have been realized from leveraging data analytics?

Jones: We are much more proactive in the business office. If the KPIs show lower or higher numbers during the month (i.e., low cash collections or an increase in older accounts) we are able to dig in and analyze why and work proactively to try to increase the numbers before the end of the month. If we see that our write-offs are higher than normal, we can analyze and inform the finance department proactively instead of being surprised at the end of the month. Again it is working proactively rather than reactively.

One of the ways that accounts receivable is measured is by how many accounts/dollars are aging over-90-days-old and higher. Since implementing data analytics technology, Wheaton Franciscan Healthcare dropped its over-90- days-old accounts receivable by at least 6% and has kept its over-360-days accounts receivable at 2% or less.

Q: What are your plans for expanding the use of data analytics?

Jones: We are upgrading to PAI 13, which is MedeAnalytics’ real-time patient access tool. This will be a 10-month implementation in Illinois, Iowa, and Wisconsin. This will give us more robust eligibility information, estimation information, quality, and productivity. It is a workflow system for the front end. The registrar will know right away if mistakes were made on the admission and will be able to correct them right away instead of the bill being denied because wrong information caused rework. They’ll see buttons on the screen that will turn from red to green as tasks are performed. We want to make sure we have everything we need from a patient on the front end of the process, so that billing is seamless. We chose MedeAnalytics to assist us in making it a clean process.

We just recently finished implementing the denials workflow module in MedeAnalytics. This will assist us in reporting insurance denials and keeping track of appeals won and lost. It will help us discover the root cause of denials so we can work on stopping them from happening.

Q: What best practices would you recommend to other healthcare facilities looking to leverage data analytics?

Jones: If you have disparate systems that do not talk to each other, it’s wonderful to use MedeAnalytics. We have both our medical group and our hospital information within the system, which helps us run reports from a global standpoint. If you are looking to operate your business more proactively than reactively, this is a perfect tool. It is an excellent tool for running reports and analyzing data, and you never have to worry about missing/losing information. The MedeAnalytics team is excellent to work with — great resources and great customer service. As far as I am concerned, you cannot go wrong in choosing this product.