Ross Swanson, senior vice president of Corazon, a national consulting firm for healthcare specialties, explains the importance of accurate collection and intelligent use of meaningful data.
Collecting and understanding data
Most hospitals can easily collect cost data from insurance claims and other revenue cycle files. Where most hospital service lines struggle, according to Mr. Swanson, is with integrating this disparate financial data with operational efficiency data. For example, hospital service lines may not consistently track information such as the number of cases, severity of cases, staffing and turnaround time. Moreover, if hospitals are collecting this data, they may not be able to have consistent findings with the integrated financial and operational metrics, and recognize trends to make changes that will improve operations.
“When you say, ‘How are you correlating increased complexity of procedures with staffing in the procedure room’? they have a hard time doing that,” Mr. Swanson says. Creating IT infrastructure that can capture this data and organize it can help hospitals increase efficiency by staffing to patient volume more appropriately.
Ensuring accuracy
While some hospitals do track operational efficiency data in addition to cost data, it may not always be accurate. Mr. Swanson says one of the risks of inaccurate data is retrospective collection. For instance, if a staff member looks at a patient’s chart a month after the patient’s discharge and needs the physician to clarify some documentation, the physician may not remember some details of the case. Hospitals should ensure outcome data is collected in real time to avoid errors and to intervene in a negative trend quickly.
In addition, hospitals that rely on claims data need to ensure they are coding and billing correctly. Mr. Swanson cited a case where a client had reported very detailed cost per case data, but when the hospital looked into the data further, it found errors, such as missed direct costs and incorrect patient diagnosis-related group assignments on internal reports. Accurate data is essential for hospitals, not only for optimizing internal efficiency, but also for avoiding financial penalties from CMS and for maintaining a positive reputation locally and nationally.
“Public reporting entities like HealthGrades, CareChex and even information on the Hospital Compare website is compiled from a lot of repurposing from the Medicare database and claims data,” Mr. Swanson says. “If people aren’t coding and billing 100 percent accurately, it’s going to skew their quality scores.”
By investing in robust IT systems and performing methodical implementation of those systems, hospitals can ensure correct data and avoid extra costs later due to inaccurate, incomplete or mismanaged data. Data analysis capabilities are also one of the main drivers to help hospitals improve efficiency and quality.
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