Dashboards and Key Performance Indicators: The Pulse of the Practice

From sole-practitioner private practices to vast hospital-employed physician groups, there is an ever-increasing focus on developing and tracking a few simple, diagnostic key performance indicators. From group to group, these indicators may vary depending on the organization's structure and goals, but any well-defined metric of physician productivity and financial performance should allow physicians and management to: (1) develop attainable goals; (2) strengthen communication and trust; (3) gain proactive feedback by enabling proper goal tracking; (4) forecast future performance; and (5) coach physicians and managers in order to reach those attainable goals.

The measurement, organization and presentation of these performance indicators into defined reports are often referred to as provider dashboards. Dashboards must provide a concise presentation of the KPIs, identify trends for practice managers and suggest actionable intelligence for administration. Upon review with leadership, dashboards should make it clear to the provider and manager alike areas that may need improvement as well as proficiencies that can be maintained. Are providers on track to meet production goals? How do they compare against national benchmarks? Are reimbursements lower this year than prior years? Dashboards can be used to answer any such question. Perhaps most importantly, they provide an opportunity for discussion between administrator and physician, along with the requisite information for each to assess his or her performance and determine how best to work towards sustainable financial health while continuing to provide high-quality patient care.

Determining key indicators: Custom solutions for individual practices

Not all physician groups operate in the same fashion. For example, some providers in large hospital-employed practices are compensated on the production of work relative value units, whereas those in the private practice setting are more obviously concerned with net collections. Some groups track internal quality initiatives whereas others may be looking to monitor electronic health record meaningful use goals. It is important when building any dashboards to begin with key performance indicators that are meaningful to a specific practice. It is important that the key performance indicators for a given dashboard be customized to an individual physician/group or entire system.

Building dashboard templates: Keeping it simple

Dashboards are not detailed financial reports — they are concise snapshots of practices and providers that convey actionable information quickly to a leadership team. For this reason, dashboards should be kept as simple and concise as possible; keeping dashboards under two pages in length whenever possible can help focus the reports with the most important aspects of a group. In addition to the customized key performance indicators discussed above, key performance indicators from at least three distinct areas should typically be included: (1) financial and productivity information; (2) revenue cycle data including payor and accounts receivable data; and (3) case profile information. The financial and productivity information captures raw performance, in terms of both patients seen and dollars generated. The revenue cycle and payor analysis identifies patient mix, reimbursement trends and any revenue cycle issues the practice may be confronting. The case profile data allows a practice to understand the importance of new patients to a practice's health, along with providing information on coding trends within the group. In addition to building these dashboards for each provider in a group, it is useful to provide dashboard "roll-ups" that combine the data of similar specialists, departments, cost centers, or even an entire employed group. These roll-ups allow providers to see how they compare against others in their group while allowing administrators to identify practice-wide trends in a timely fashion.

Incorporating benchmarks and budgets

Whether internally constructed or using nationally published data, performance benchmarks can help both the provider and the administrator set reasonable goals and timely monitoring. Whatever benchmark sources a practice may be using can be incorporated into a dashboard, both at the provider level as well as in the "roll-up" dashboards. Sometimes the best benchmark for success comes in the form of an internally constructed financial budgeting.

Data connections: Building the bridge

As discussed above, dashboards are useful tools for all sorts of groups, from the smallest independent practices to large hospital-employed groups with hundreds of employed providers across a wide array of specialties. Just as each group will have its own customized dashboard, so too will each have its own data storage, billing system and IT infrastructure. It is important to work with groups to customize and extract the data used for their individual dashboards. This can entail anything from canned reports from a remotely hosted billing system to direct database access to live data that can allow electronic dashboards with up-to-the-second data. Whatever a practice's needs and capabilities, it is important to establish consistent and timely access to a reliable data source. Working directly with a group's reporting and IT personnel to build these connections from the ground up and set-up helps to ensure that dashboards are consistently populated with timely and actionable metrics.

Timely production and meaningful monitoring

Analytics and key performance indicators are only valuable when they are packaged and presented in a timely manner. While dashboards are typically produced on a monthly basis, the frequency of production should be determined by the group. Whether producing daily "flash reports" to identify micro-trends or quarterly dashboards to assess larger picture concerns, it is important to build and deliver the dashboards as promptly as possible. The more current the data, the more actionable the intelligence derived from it; it is important to work with a practice to minimize the delay between receiving data and producing the dashboards.

From data to dialogue

More than anything, dashboards engender open and honest conversation between a provider and his or her leadership team. At a private practice, this can come in the form of a practice manager or even the physicians themselves examining data from a new perspective. At larger systems, dashboards can provide an administrator and physician the necessary tools and information to meet for a monthly review of goals and performance. Regardless of the setting, well-built and monitored dashboards with meaningful key performance indicators can help any practice build the teamwork and paths of communication that are necessary to deliver better patient care and build sustainable financial performance. We've learned that like any data, dashboards can be a first step to improvement, but rarely are they the last. More often than not, dashboards provide a way to begin a conversation — about changing behavior or monitoring and tracking performance goals or aligning a practice's financial and clinical performance.  

As professional reimbursements continue to trend downward throughout the country, conversations like these are becoming more and more necessary: providing quality care depends now more than ever on the financial health of a practice. A well-informed practice with strong channels of communication is more likely than most to be able to negotiate the hurdles ahead.  

Well-built dashboards with meaningful key performance indicators can provide a great first step toward creating a more well-informed, prepared and flexible group, for whatever challenges may lie ahead.

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