Mike Noke, MBA

CMS healthcare programs are shifting from an optional data reporting submissions to mandatory electronic submissions. To meet these requirements, healthcare organizations need to align their organization’s data with evolving standards, which can require a whole-system transformation.

This is the first of three articles that stress the urgent need for healthcare systems to take an all-in approach to data and analytics, starting with the need for and benefits of high-value data.

High-value data has been standardized and can be used to identity standardized attributes across previously siloed systems. It enables: faster downstream analytics, aggregated benchmarking, novel data combinations that produce exponential value.

Organizations that make high-value data the foundation of an integrated data strategy, can supply providers, clinicians, and administrative leaders with the trusted, timely data they need to maximize reimbursement and drive informed decisions for better outcomes.

Value-based care contracts can be difficult to advance with today’s healthcare labor shortages, lower revenues, and skyrocketing operating costs. Outlined in this article are data and organizational strategies that align provider networks, incentives, and meet VBC quality and efficiency goals

Healthcare leaders must increase revenue and decrease costs without negatively impacting care quality and patient outcomes. At HAS 2022, a panel of healthcare leaders and executives shared key recommendations on leveraging data analytics to achieve this precarious balance.

Community Health Network (CHNw) did not have a standard approach to documenting patient risk for stroke or contraindications to anticoagulation. The organization needed to change workflows to ensure patients received the expected care to improve long-term outcomes. CHNw leveraged high-quality data and analytics from the Health Catalyst® Data Operating System (DOS™) platform to implement data-informed workflow changes and meaningfully improve the care provided to patients with atrial fibrillation (A-fib).

Provider burnout was a challenge for healthcare organizations before 2020’s COVID-19 pandemic, and the pressures of the global crisis exacerbated the problem. In 2022, 56 percent of critical care and 60 percent of emergency medicine physicians reported burnout. Today, however, the industry is looking to the same digital care technologies that helped hospitals navigate the pandemic to alleviate provider burnout and improve care.

Identifying and executing achievable population health goals requires insights from a vast amount of accurate but often incomplete data. Population health experts offer three key strategies to navigate complex data.

1. Start with the available accurate data. Resist the urge to wait for “perfect data.”

2. Consult clinicians early and often when selecting and executing population health initiatives. Familiarize these clinicians with data dashboards and keep dashboards user-friendly to advance success.

3. Consider the role risk stratification plays in setting goals. While high-risk patients may be a care team’s primary focus, initiatives that transcend risk levels and include initiatives for rising-risk and low-risk patients prevent care cost escalations.

Participation in the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) National Database is a key component of Johns Hopkins Medicine’s cardiothoracic surgery quality performance program. The organization leveraged ARMUS by Health Catalyst to reduce its registry data entry burden and simplify registry data management, achieving improved efficiency and data quality, reducing data cleaning, and lowering missing data rates.

A primary focus for healthcare organizations post-Covid is improving health equity for their communities. At HAS 2022, a duo of data scientists from ChristianaCare shared an analytics framework for measuring and managing equity disparities and described how they developed and applied a machine-learning-based algorithm to quantify differences in health outcomes.

The framework consists of a data layer, an analytics layer, and an interpretation and decision support layer. The data layer identifies and standardizes data structures for a list of health outcomes. The analytics layer calculates the defined metrics in an integrated, automated way. And the interpretation and decision support layer highlights how a user-centered design dashboard can support clinicians and leaders in understanding and interpreting outcomes.

HIEs can become a primary driver to healthier communities through high-value data access. Adopting a strategy that addresses emerging data use cases, data quality, and strategic partnerships will fuel long-term success and add new revenue streams from a wider range of participants.

Baylor Scott & White Quality Alliance (BSWQA) wanted to quantify the financial impact and success of its care management programs but lacked the necessary data and strategy. To evaluate its care management program, BSWQA leveraged high-quality data and analytics from its analytics platform and propensity score matching to assess performance. Now, it can evaluate the financial impact of its care management programs, calculating the true return on investment and shared savings impact.

Several healthcare leaders from hospitals and health systems across the country share their team’s best practices when implementing a data analytics platform to improve quality and operations initiatives.

The strategies shared by the leaders that yielded the most success at their organizations include encouraging collaboration between data analytics teams and process improvement teams, aligning data insights with established operational initiatives, focusing analytics initiatives on a limited number of improvement areas with the broadest potential impact, telling a story with the data to inspire meaningful change.

Carle Health sought to improve its process for ongoing professional practice evaluation (OPPE). The organization leveraged the Health Catalyst® Data Operating System (DOS™) platform to automate OPPE, allowing Carle to generate provider scorecards quickly and efficiently on demand and review providers performance regularly.

Healthcare organizations are accustomed to starting each new year with changes to billing and coding policies. However, in 2023 providers and suppliers are finding that some updates need extra clarity. Guidelines on the recent updates will help providers create consistent processes to reduce errors and reimbursement delays.

The Centers for Medicare & Medicaid Services has released its latest updates to the Clinical Modification (ICD-10-CM) system and the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS). Effective April 2023, healthcare leaders will have 42 ICD-10-CM and 34 ICD-10-PCS additions to navigate.

With healthcare spending on the rise, UnityPoint Health needed advanced analytics to support clinical decision-making when balancing population health priorities and shared savings. UnityPoint Health and UnityPoint Accountable Care formed a partnership, leveraging its analytics platform and high-value data and analytics to aid in developing the analytics support required for improving patient outcomes while decreasing costs and driving success in risk-based contracts.

Different entities within an ACO need access to the same patient information to coordinate around delivering better patient care at lower costs. Despite this clear need for data sharing, organizations face common barriers, including patient confidentiality, cumbersome processes, and legal and compliance considerations. However, ACOs can overcome these barriers with a team mindset and robust data infrastructure. A teamwork approach aligns each system’s goals more closely, ensuring the entire ACO prioritizes patients and their data as the key to better care coordination. Next, organizations need to invest in advanced technologies, including a data platform that easily aggregates and securely distributes patient information to the right people at the right time. These two changes—working together and supporting data-sharing tools—elevate ACO performance and care coordination

Research indicates that one in five readmissions could have been avoided with proper transitional care management (TCM). Given that Medicare readmission costs amount to $2.6 billion each year, decreasing readmissions through transitional care management is a priority for healthcare organizations. This article details a five-step framework that healthcare organizations can follow to set up successful TCM programs.

The framework emphasizes early, proactive care management that integrates hospital efforts with long-term care needs, home care, and other community resources. Once discharge occurs, it’s often too late to put care transition measures in place, resulting in higher readmission rates and higher healthcare costs.

Banner Health utilizes Health Catalyst's Tech-Enabled Managed Services (TEMS) for clinical chart abstraction. Clinical chart abstractors identified an opportunity to improve the number of patients undergoing thoracic surgery receiving pre-surgical pulmonary function testing (PFTs). The TEMS clinical chart abstraction team was able to immediately see the positive impact of Banner Health’s changes in its patients’ data, providing timely feedback to the organization about the effectiveness of improvement efforts.

Healthcare leaders discuss how they use digital patient engagement technology to bridge care disparities and reduce the burden of health inequity. This article shares strategies for building trust through technology and gaining organizational buy-in for a successful launch.

HIEs juggle many priorities to improve their technology platform for better data quality. When HIEs support a broader audience and address gaps in clinical pathways, they can become the preferred access point for population health analytics, quality measure reporting, and health equity strategies.

The Queen’s Health System recognized that suicidality was increasing, with many patients presenting to the emergency department (ED) for help in a time of crisis. The organization needed a data-informed strategy to create a systemwide suicide prevention plan. It established a team to implement several best practices based on data from its analytics platform, including suicide risk screening. As a result of these data-informed improvements, Queen’s has meaningfully improved patient safety and outcomes for patients at risk of suicide.

Life sciences organizations develop meaningful digital therapeutics (DTx) that reach rural communities, treat common chronic diseases, and connect patients to providers through technology that supports clinical journeys. This article shares how incorporating digital engagement tools drives the continuous use of DTx for equitable healthcare.

Learn how automated patient engagement technology can be deployed to help providers optimize heart failure treatment while lessening the care team burden at each phase of the patient’s journey, including:

Healthcare organizations are facing a double-sided labor crisis: a severe labor shortage and rising labor costs. Learn how they can optimize their use of current resources and gain detailed insight into operations and pinpoint interventions aimed to decrease expenses.

The healthcare worker shortage is heading toward a deficit in the millions. Healthcare organizations need a short- and long-term action plan. Learn how to create the right action plan to achieve your long-term goals while realizing immediate impacts.

U.S. health systems will have a projected deficit of 200,000-450,000 RNs by 2025. Meanwhile, hospital labor costs have reached almost 50% of an organization’s overall expenses. Now more than ever, leaders need a data-driven labor management strategy that ensures the most cost-effective, high-quality care.

Community Health Network (CHNw) had the vision to transform into an analytics-informed organization, but it faced challenges in making that vision a reality. The organization needed an enterprise analytics partner that would provide high-value data and analytics, and that had value realization at the core of its mission. CHNw selected Health Catalyst as its analytics partner, leveraging the Health Catalyst® Data Operating System (DOS™) platform and a robust suite of analytics applications to transform into an analytics-informed organization and improve care efficiencies and the health in the community it serves.

Skim highlights of the HAS 22 healthcare analytics event organized around the theme, “Embracing the Human Side of Healthcare Analytics.” This easy-to-digest infographic highlights the summit’s award winners and top data insights.

In order to reduce unwarranted care variation for patients with heart failure, healthcare providers should consider five critical elements of care standardization including systematized population health, patient activation, outpatient care protocols, acute decompensation management, and streamlined care transitions. 

When unwarranted care variation is eliminated, organizations will see a higher rate of evidence-based care that helps reduce morbidity, mortality, and total cost of care. 

As part of its pursuit of “zero harm,” Banner Health established a strategic initiative to improve the inpatient mortality observed versus expected (O/E) ratio. However, limited access to high-quality mortality data impeded improvement efforts. Banner Health utilized its data and analytics platform and Health Catalyst's Tech-Enabled Managed Services (TEMS) registered nurse clinical chart abstractors to develop and implement new processes to leverage the data behind a mortality index for all its locations. Banner Health improved the accuracy of its clinical documentation, mortality O/E ratio, and external benchmarks.

What does the Current Procedural Terminology (CPT®) code set look like for 2023? New additions, deletions, and revisions take effect on January 1.

As healthcare organizations across the country face labor shortages, limited resources, and growing expenses, it’s never been more important to deploy valuable resources where they’ll be most impactful. Learn how predictive risk stratification helps organizations pinpoint their most vulnerable patients.

Even in a data-driven healthcare ecosystem, analytic insights alone won’t sufficiently drive outcomes. Instead, the content behind these numbers, the data story, fuels real transformation. The Healthcare Analytics Summit 2022 explored the human side of data and the people and communities behind the healthcare outcomes.

HIEs will learn how becoming DAV certified, or aligning with a Certified Data Partner, can expand revenue opportunities and reduce the time commitment required of health plans and providers for HEDIS quality measure reporting. 

Healthcare organizations that build a data and analytics platform instead of buying frequently underestimate the complexity and total cost of ownership, and the problems get worse as the software ages. INTEGRIS Health was challenged to scale up or produce the desired results using its homegrown data and analytics platform. The organization decided to optimize a modern data and analytics platform that would meet its needs now and, in the future, while delivering significant cost savings.

Treating heart failure is complex and because of that, variation in care is common. Eliminating unwarranted variation is an important factor in delivering successful treatment of HF; however, without access to comprehensive data and clinically proven strategies, it's very difficult to achieve. This first installment on reducing care variations explores the six key advantages of leveraging a sophisticated technology platform to improve care. 

Rural communities experience a higher prevalence of chronic conditions and often face significant barriers to accessing healthcare. Leveraging text-based patient engagement technology can alleviate many of those barriers through personalized communication pathways, remote physiologic monitoring, and bi-directional messaging, keeping rural communities conveniently and safely connected to care. 

Learn how to support health equity with patient engagement technology. Help patients attain their full health potential every step of the way by:

Self-service analytics can empower healthcare organizations to better leverage business intelligence, enabling non-expert users to explore data sets, create custom reports and dashboards, and share valuable insights. However, without the right foundation, self-service analytics won’t reach its potential. Four pillars for success include the following: 
1. A data-centric culture.
2. Data literacy.
3. Leadership support.
4. A defined business goal.

Bleeding complications occur in up to 16 percent of all patients undergoing percutaneous coronary intervention (PCI). Community Health Network (CHNw) identified one area where it didn’t perform as well as expected for post-PCI bleeding and found ways to improve through risk-adjusted quality metrics, interdisciplinary teams, analytics, and clinical chart abstractors from Health Catalyst. CHNw’s data-informed improvement efforts are delivering the desired results.

Heart failure treatment is complex and requires ongoing attention. To ensure organizations are delivering optimal treatment to prevent disease, slow progression, and improve outcomes there are seven key strategies across the continuum of care to deliver guideline-directed medical therapy and engage patients in their care.

Value-based reforms and technology trends are reshaping healthcare. From the rapid adoption of new technologies, including the widespread adoption of electronic health record systems, to emerging value-based payment models, industry trends are creating an opportunity for Health Information Exchanges (HIE) to demonstrate the unique value they bring to the healthcare ecosystem. In this case study, learn how KPI Ninja’s technology helped the Wisconsin Statewide Health Information Network (WISHIN) meet urgent pandemic needs posed by Wisconsin’s Division of Public Health (WI DPH) and how these same capabilities continue to support value creation with other HIE participants and use cases.

For healthcare providers facing growing competition and growing expectations from patients, a robust patient engagement strategy is essential. There are five key factors that healthcare leaders must consider in order to be successful.

Healthcare today is often episodic, and patients’ conditions may develop or worsen needlessly for those facing barriers such as access to care, medications, healthy food, and other needs. The ongoing healthcare provider shortage also leads to delayed care and poor outcomes. Learn how patient engagement technology can help!

This white paper reviews the stages of value-based contracting, including the difficult lessons learned by early clinically integrated systems, the new dynamics that drive VBC success, and the key interventions that impact contracts. The paper also explains how, by leveraging a framework based on a thorough understanding of five population health management (PHM) competencies, health systems can drive effective clinical and financial outcomes across the value-based care continuum. 

Day 1 of HAS 22 may have looked like a hard act to follow, but Day 2 did not disappoint! From early risers for the fun run/walk to a full day of keynotes, featured speakers, breakout sessions, and more, summit attendees learned new ways to look at data and analytics, how we relate to information and each other, and new perspectives for making the healthcare ecosystem–and world at large–a better place.

The Healthcare Analytics Summit is back in person! After two years of a virtual experience, presenters and audiences are together again in Salt Lake City for HAS 22. This year’s theme, “Embracing the Human Side of Healthcare Analytics,” puts the focus on the patient, team collaboration, visual data storytelling, and much more.

The Centers for Medicare & Medicaid Services (CMS) has released updates to its International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) system diagnosis codes for fiscal year (FY) 2023. ICD-10-CM codes, which will increase from 72,750 to 73,639, impact all provider types in both the inpatient and outpatient settings. The updates are effective beginning October 1, 2022. Some of the additions for 2023 include the following:

1. Certain infectious and parasitic diseases.
2. Endocrine, nutritional, and metabolic diseases.
3. Mental, behavioral, and neurodevelopmental disorders.
4. Diseases of the nervous system.
5. Diseases of the digestive system.

Reporting quality measures costs healthcare organizations billions annually. To help reduce costs associated with reporting efforts, WISHIN partnered with KPI Ninja, an NCQA Data Aggregator Validation (DAV) Certified Data Partner, to validate WISHIN healthcare provider and practice participant data streams for its own DAV certification. As a result, several WISHIN health plan participants looked to WISHIN to shortcut the Healthcare Effectiveness Data and Information Set (HEDIS) “chart chase” and acquire primary source verified supplemental data to streamline data collection efforts, ensure data integrity, and reduce costs.

Decision makers continually need more data and analytics to support their decisions, but IT and BI resources don't always keep pace, which can lead analytics teams to feel overwhelmed with the number of requests. MultiCare Health System experienced significant growth, resulting in increased demand that threatened its analytics team’s efficiency and morale. The organization recognized it needed to transform its analytics solution and processes.

Today’s healthcare leaders want their organizations to be data driven. However, many leaders incorrectly interpret data and analytic visualizations. Without accurate interpretation of analytics, healthcare leaders don’t have real data-driven insight to know how to strategically improve and measure wins and losses. 

Concerningly, only 4% of analysts, department leaders, executives, and board members can correctly identify the following four pivotal pieces of information in a line chart:

1. Baseline performance.
2. Extreme historical points.
3. Persistent shifts in performance.
4. Forecasted performance in six months.

Is your organization’s leadership part of the 4% that can correctly identify these four points in data presented over time? If not, your data and analytics may be doing more harm than good.

To cut costs, healthcare leaders are looking at their greatest operating expense—labor management. However, with outdated labor management systems, decision makers rely on retrospective, incomplete data to forecast staffing volumes and patient support needs. Limited workforce insight can result in misaligned staffing or worse, jeopardizing patient care due to lack of labor support. With the Health Catalyst PowerLabor™ application, part of the Financial Empowerment Suite™, decision makers have access to a comprehensive view of labor data by organization, department, team, and job role. Timely insight into current and future hospital needs allows leaders to staff to patient volume, control escalating labor expenses, and ensure optimal resources for excellent patient care.

In an effort to extend its medication refill processing services to a broader group of physicians in multiple regions and specialties, St. Joseph Heritage Healthcare utilized Health Catalyst Embedded Refills, freeing up physicians to spend more time with patients and enabling technicians to take a more proactive role in closing care gaps associated with medication refills.

Valley Medical Group sought to consistently create capacity for its medical assistants to practice to the top of their license and spend more time with patients before every provider visit. The organization implemented the Health Catalyst Embedded Refills application to automate, standardize, and delegate much of the refill process.

Healthcare organizations today have access to so much data from across their systems that they may struggle to know where to focus quality improvement efforts. An analytic framework and a stepwise process ensures organizations have broad data access and can identify the most significant opportunities for impact. With a strategic, data-informed approach to clinical quality improvement, health systems can consume fewer resources, discover cost savings, and improve ROI and the quality of care. 
Three steps comprise an effective quality improvement process:

1. Adopt a healthcare-specific, open, scalable data platform.
2. Identify improvement priorities using the 80-20 rule.
3. Gain consensus from clinical teams on specific projects and goals.

Swedish Health Services utilized the Twistle by Health Catalyst patient engagement software to deploy a communication pathway that guides patients throughout their colonoscopy experience.

Credena Health sought to minimize telephone calls and voice message management associated with refill coordination and delivery scheduling to improve the patient experience by allowing patients to respond to messages at their convenience. The organization utilized Twistle by Health Catalyst to deliver refill reminders, automate patient follow-up in the absence of initial response, and gather ideal delivery parameters for their medications.

For organizations that are striving to improve patient safety, incident reports are a valuable tool for safety leaders to identify and investigate conditions that may lead to errors or cause harm. Historically, incident reporting has involved complicated forms and a lack of transparency which can discourage employees from reporting events. The newest module in Health Catalyst’s Patient Safety Monitor application, Voluntary Event Reporting, provides an easy-to-use application that is convenient, efficient, productive, and informative. Voluntary Event Reporting offers game-changing support for organizations dedicated to nurturing a safety culture and leveraging reliable data and analytics for better outcomes by ensuring your teams have what they need to report events, follow up, learn, and improve.

Clinical leaders at ChristianaCare sought to improve early detection of postpartum hypertension by overcoming low attendance for follow-up office visits. The team implemented a text-based remote monitoring program which has successfully reduced post-partum hypertension-related readmissions and eliminated long-standing racial disparity.

Healthcare organizations continue to navigate the complicated shift from fee-for-service reimbursement models to value-based care.

To successfully make that transition, population health management (PHM) is an essential tool to bridge gaps in care, reach underserved communities, and improve the health of at-risk populations.

Specialty pharmacies serve patients who are managing medical conditions that often require complex therapies. These entities can implement patient engagement technology to improve medication adherence and patient outcomes in the following ways:

1. Streamline the process for getting a patient started on treatment.
2. Deliver educational resources and medication adherence reminders.
3. Automate refill and delivery notifications to create staff efficiencies.
4. Increase patient satisfaction, retention, and patient outcomes.

Guy’s and St Thomas’ NHS Foundation Trust began COVID-19 vaccination based upon defined priorities and the National Health Service (NHS) guidelines, prioritizing calling patients over the age of 80 who had an upcoming outpatient appointment. By utilizing its data platform and analytics applications to improve the COVID-19 vaccination call process, the organization was able to manage its COVID-19 vaccination efforts effectively.

Social determinants of health can have a serious negative impact on health outcomes. While these determinants like race and zip code are complex to address, simple text-based outreach can be an effective way to connect disadvantaged people with information, services, and assistance that can help bridge many gaps in care.  

Leverage consistent, proactive communication to ensure that patients have accurate, useful information and have the tools they need to stay engaged in their healthcare. 

Healthcare organizations risk losing more than $200 billion annually to denied claims. Of this loss, medical necessity denials account for $2.5 billion. In response, providers need a mid-revenue management solution that includes healthcare claims management, such as medical necessity edits (MNEs), and ensures claims fall within acceptable standards. Accounting for MNEs for a broad range of commercial insurances in addition to Medicare and state Medicaid MNEs, the Vitalware® by Health Catalyst medical necessity tool offers a comprehensive, timely, and accurate solution to help organizations avoid lost compensation and revenue delays.

Blood products are in high demand but often low in inventory, creating the need for healthcare organizations to ensure effective patient blood management. Community Health Network (CHNw) wanted to improve the effectiveness of patient blood management but lacked the data and analytics to drive meaningful change. Gathering the necessary data took valuable time, and, when obtained, it often had quality issues that made it difficult to reconcile. The organization utilized its data platform and a robust suite of analytics applications to provide high-value data, analytics, and insights. CHNw’s data-informed patient blood management has decreased unnecessary transfusions and improved the management of this costly, limited resource.

Changes to the ICD-10-PCS codes for the fiscal year 2023 include 64 deleted codes, 331 new procedure codes, and no revisions. The updates, which take effect on October 1, 2022, bring the total of ICD-10-PCS codes to 78,496. Health system leaders can prepare for the new round of procedure codes by taking inventory of the areas and interventions impacted, including the following:

1. Medical and surgical.
2. Administrative.
3. Extracorporeal or systemic assistance and performance.
4. New technology.

CMS will publish these codes in the 2023 ICD-10-PCS codebook, but they’re available for review now within Vitalware® by Health Catalyst products.

Being paid appropriately is vital to success, and charge capture processes are critical to maintaining a health system’s financial well-being. Blessing Health System (Blessing) recognized its charge capture process wasn’t keeping pace and lacked the flexibility to adapt quickly—and as a result, revenue was lost. To improve financial performance, Blessing implemented the VitalIntegrity™ application to provide quick, fully customizable rules management, advanced reporting and analytics, and auditing processes. Utilizing the application, Blessing has improved revenue integrity and clinical documentation.

Health Information Exchanges (HIEs) are critical to the movement of patient data across systems and technical barriers — connecting payers, providers, and patients — making these exchanges the epicenter of many healthcare communities. Health Catalyst is committed to the long-term success of HIEs and will continue to invest in infrastructure, people, and processes to support healthcare community growth. Our position and action plan for connected communities and strong population health and value-based care initiatives include the following:

1. Our vision for HIE
2. The Health Catalyst roadmap and pathways to success
3. Our long-term commitment to HIE and HIE sustainability

In order to thrive in an increasingly challenging healthcare environment, undertaking quality improvement projects is more important than ever for healthcare systems’ continued survival. However, health systems need to tackle the right projects at the right time to maximize the impact to their organization.

This article shares clinical, financial, and operational examples of quality improvement in healthcare that may help others as they tackle improvement projects. Some examples shared include:

• Pharmacist-led Medication Therapy Management (MTM) reduces total cost of care.
• Optimizing sepsis care improves early recognition and outcomes.
• Boosting readiness and change competencies successfully reduces clinical variation.
• Systematic, data-driven approach lowers length of stay (LOS) and improves care coordination.

Healthcare outcomes improvement can’t happen without effective outcomes measurement. Given the healthcare industry’s administrative and regulatory complexities, and the fact that health systems measure and report on hundreds of outcomes annually, this article adds much-needed clarity by reviewing the top seven outcome measures, including definitions, important nuances, and real-life examples. The top seven categories of outcome measures are:

1. Mortality
2. Readmissions
3. Safety of care
4. Effectiveness of care
5. Patient experience
6. Timeliness of care
7. Efficient use of medical imaging

CMS used these seven outcome measures to calculate overall hospital quality and arrive at its 2018 hospital star ratings. This article also reiterates the importance of outcomes measurement, clarifies how outcome measures are defined and prioritized, and recommends three essentials for successful outcomes measurement.

Read the top customer success stories of data-informed improvement in the following areas: cost, revenue, clinical operation, and population health.

Chronic conditions across the United States are prevalent and continue to rise. Managing one or more chronic diseases can be very challenging for patients who may be overwhelmed or confused about their care plan and may not have access to the resources they need. At the same time, care teams are overburdened, making it difficult to provide the support these patients require to stay as healthy as possible. A new approach to chronic condition management leverages technology to enable organizations to scale high-quality care, identify gaps in care, provide personalized support, and monitor patients on an ongoing basis. Such streamlined management will result in better outcomes, reduced costs, and more satisfied patients.

WakeMed Health & Hospitals (WakeMed), a leading provider of health services in North Carolina, identified it could improve the consistency and ease of patient access, but it lacked the actionable data needed to make improvements. WakeMed elected to use its data and analytics platform to obtain the information required to analyze patient access and improve the patient experience. Utilizing its data and analytics platform and analytics applications, WakeMed can now visualize patient access data to draw more accurate and consistent conclusions and quickly identify performance changes.

Managing and retaining a talented workforce represents approximately 60 percent of hospital costs. In a rapidly evolving healthcare environment, hospitals and health systems are under tremendous pressure to improve efficiency and reduce healthcare costs, making it critical to accurately monitor and adjust labor resources.

In an effort to improve staffing efficiency, Hawai‘i Pacific Health (HPH) sought to realign its staffing practices to better manage and predict its labor needs. Although the health system had a culture of flexing staffing to fit volume, it based staffing decisions on latent, retrospective data, resulting in less accurate planning than it desired. Utilizing its data platform, HPH was able to forecast its workforce needs and effectively manage staff schedules—two changes that led to significant cost savings.

Healthcare technology continues to evolve, often significantly impacting the delivery of care and therefore reporting and coverage for providers. In response, the American Medical Association (AMA) has developed CPT Category III codes to report emerging technology, services, procedures, and service paradigms. New Category III codes for 2022 take effect on July 1. While these codes don’t guarantee coverage for a particular procedure, providers must assign them as appropriate for accurate data collection. The AMA will publish the new codes in the 2023 CPT codebook, but healthcare leaders can access them now within Vitalware® by Health Catalyst products.

The Centers for Medicare & Medicaid Services (CMS) uses the Merit-based Incentive Payment System (MIPS) to incentivize healthcare organizations with payments to provide excellent care. Baptist Health Care was challenged to identify opportunities to improve its MIPS scores due to the limited control of the MIPS monitoring and reporting tool it used. Baptist needed actionable, high-value data and analytics that would allow it to accelerate MIPS performance and receive incentive payments. By implementing the Health Catalyst MeasureAble™ application, Baptist was able to accurately calculate performance and improve the organization’s MIPS scores.

As information once held closely by providers becomes available to health plans, employers, and consumers, old hierarchies are disintegrating. “The democratization of health care,” as the National Academy of Medicine has labeled it, brings with it new roles and rules that challenge health systems to successfully combine high-tech analytics with sophisticated high-touch outreach. As complex clinical care information spreads outside conventional professional channels, it will disrupt traditional roles of providers, payers, patients, and others. To thrive in this new environment, provides will need to understand how roles and interactions are evolving and how new kinds of rules will govern them. To do this, analytics that allow sophisticated measurement and management will be key to surviving and prospering in an era of artificial intelligence and distributed data.

Facing constant change and dwindling profit margins, healthcare organizations consistently rely on financial management in response to market changes. While a financial focus is crucial for survival, healthcare leaders should realize the power of clinicians as change agents in driving meaningful clinical improvement and curbing rising costs. Providers’ dedication to delivering first-class care and eagerness to continually discover the most effective care delivery methods—powered by analytic insight—is the foundation of clinical improvement. This powerful combination of clinical passion and relevant data is key to successfully surviving and thriving in an ever-changing industry, in which financial rewards depend on patient outcomes.

Allina Health had previously realized significant reductions in readmissions, but it desired to uncover additional ways to further reduce readmissions. The organization leveraged its data and analytics platform to effectively identify the factors influencing care transitions to determine specific improvement opportunities and evaluate the impact of interventions on outcomes.

Clinical Trials Day, celebrated every year on May 20, recognizes the clinical research professionals who work tirelessly to improve public health and provide new treatment options to patients.

Machine learning (ML) can deliver critical insight to clinicians at the point of decision making and replace manual processes, such as reviewing a patient’s lab history. However, many clinicians don’t reap these ML benefits due to a lack of understanding and data infrastructure. To maximize the many advantages ML can bring to the bedside, organizations need to educate team members about ML and then invest in data infrastructure that supports ML capabilities. A transparent explanation of benefits can garner support and understanding that ML augments—not replaces—clinicians. With this increased understanding, leaders see the value of data integration infrastructure. A robust data platform allows organizations to aggregate data from multiple sources, ensuring ML algorithms deliver accurate insight based on comprehensive patient data.

Family Doctors and Ashley Clinic utilized remote monitoring and digital patient engagement software to better support patients with high blood pressure. These improvements have meaningfully impacted the diagnosis and management of high blood pressure for its patients.

With the healthcare industry move towards value-based payment (VBP), financial executives must navigate a shift away from volume and embrace quality care as a key driver of financial health—particularly as accountable care, quality measures, shared savings, and bundled payments gain traction. To meet this ongoing quality-cost challenge, health systems must understand their progress in clinical quality measures and costs of delivering care, as clinical quality is an increasingly significant predictor of financial outcomes. While the traditional fee-for-service environment emphasized volume, today’s VBP paradigm puts quality ahead of older metrics.

Martin’s Point Health Care desired to expand its centralized workflow for prescription renewal requests, but it could not do so without hiring additional staff. The organization utilized the Health Catalyst Embedded Refills application to process prescription renewal requests more safely and effectively, decreasing turnaround time and improving patient safety.

Former U.S. Surgeon General C. Everett Coop, MD, once said, “Drugs don’t work in patients who don’t take them.” Yet, patient adherence to prescribed medication tends to fall short of optimal. For example, according to the Centers of Disease Control & Prevention, patients don’t fill approximately 20 to 30 percent of prescriptions. The consequences for medication non-adherence can include poor quality of life, physical limitations, hospitalization, or worse, making patient compliance an integral part of quality healthcare delivery. Providers aiming to keep patients on track with their medications can look to patient engagement technology to proactively communicate critical education about therapies and the risks of non-compliance as well avoid common barriers to adherence.

After receiving consistent feedback from patients that they had inadequate expectations for recovery after joint surgeries, Providence’s Southern California region utilized a digital platform to automate patient support—ensuring patients understood the recovery process, what to anticipate regarding pain after joint surgeries, and how to manage it.

Even though medication-associated errors affect over 7 million patients and cost more than $40 billion each year, healthcare often falls short when it comes to prioritizing patient safety. For example, in October 2021, a draft of the Department of Health and Human Services Strategic Plan FY 2022–2026 didn’t include reducing preventable harm as part of its mission to improve the quality of care. Meanwhile, other complex and adaptive industries, such as aviation and nuclear, give top precedence to safety oversight and compliance. To catch up to other sectors and actively pursue patient safety improvement, healthcare needs a straightforward framework for integrating patient safety across the continuum of care—an approach involving culture, clinical analytics, and frontline adoption of best practices.

Advanced data and analytics are a good foundation for developing highly effective products for healthcare, but they’re not enough. Anne Marie Bickmore, Chief Product Officer at Health Catalyst, explains that building a product portfolio is more than a list of offerings—it starts with an immovable foundation of high-quality data and analytics. Bickmore describes four specific guidelines organizations can follow to create better products that drive sustainable improvement:

1. Build products on a strong data foundation.
2. Mind the changing healthcare landscape with a strong data foundation.
3. Take a patient-centric approach.
4. Consider a clinical perspective.

Health Catalyst is committed to supporting life sciences organizations in expediting research timelines, optimizing research design, and improving patient outcomes through access to a new source of research-grade data, rapid cohort creation, automated patient engagement, and augmented intelligence. 

Learn how Health Catalyst is helping customers to:

The unforeseen pandemic changed many industries, but according to Sadiqa Mahmood, General Manager and Senior Vice President of Life Sciences Business at Health Catalyst, COVID-19 had a particularly notable effect on the life sciences industry. With the surge in digital solutions, pharmaceutical process changes, and accelerated innovation, the life sciences are experiencing never-before-seen changes. Mahmood suggests that these pandemic-fueled transformations ignited seven positive trends within life sciences that will impact the healthcare industry, pharmaceutical companies, medical technology providers, and health systems:

1. Building partnerships.
2. Accelerating digitization.
3. Shortening vaccine development timeline.
4. Expanding the use of real-world data.
5. Scaling cloud platforms and securing data.
6. Improving supply chain.
7. Focusing on health equity.

As healthcare increasingly digitizes, organizations must prioritize the patient experience to create a seamless digital health journey. Drivers of patient experience range from the use of empathy in outreach to the technology that delivers information to a patient. Engagement software and strategies optimize patient activation when they follow the following best practices:

1. Simplify communication channels.
2. Consider the timing of communication.
3. Optimize content.
4. Determine the cadence.
5. Consider the tone.
6. Leverage data to make improvements.

Healthcare organizations across the globe have one thing in common—the desire to leverage data to improve outcomes. However, achieving this goal isn’t as easy as it sounds, according to, Jeff Selander, Senior Vice President and General Manager of Global Expansion Business at Health Catalyst. Selander says to effectively leverage data to drive systemwide improvements, organizations must democratize—or free—their data. Data democratization starts with a digital infrastructure that can support robust digital needs, such as electronic patient records and efficient patient data distribution. Once the infrastructure is in place, systems must connect digital patient records to other source systems (e.g., patient safety ancillary systems and pharmacy) for a complete picture of a patient’s health. Keeping these steps in mind, health systems are now ready to drive the greatest results for the greatest amount of people.

1. Health equity.
2. Patient safety.
3. Staffing.
4. Care delivery.
5. COVID-19 recovery.
6. Payment and payers.

Allina Health needed to ensure it had adequate staffing to meet patient needs while also managing the safety and availability of its workforce during the COVID-19 pandemic. The organization leveraged the Health Catalyst® Data Operating System (DOS™) platform, IDEA™, and COVID-19 dashboard to capture, monitor, and report critical staffing and employee health data.

As data becomes more widely available, healthcare organizations are turning to self-service analytics to empower team members to make data-informed decisions. Rather than waiting for manual reports from analytics teams, self-service analytics allows individual team members to perform queries, run reports, and dive into the data details on their own. However, this broader distribution of data also presents concerns, such as deciding who will oversee the data, who can access which data, and how to best deliver the data to end users. Leaders can address these concerns and reap the benefits of self-service analytics by focusing on answers to five common hesitations:

1. Invest in advance data platforms to standardize data.
2. Teach analytics best practices and data literacy.
3. Leverage tools to take data beyond historical analytics.
4. Shift the analytics teams’ mindset.
5. Follow data security procedures and policies.

A growing interest in data, analytics, and digitizing healthcare among organizations in the Asia-Pacific (APAC) region also brings challenges. According to Farhana Nakhooda, Senior Vice President at Health Catalyst and longstanding healthcare expert in APAC, health systems in this part of the world face many obstacles that complicate the transition to digital healthcare, including strained financial assets, sufficient clinicians, and disparities based on rural and urban areas. However challenging these barriers might be, Nakhooda provides three strategies that systems in APAC and beyond can leverage to accelerate their digital healthcare journey:

1. Promote data and analytics literacy.
2. Implement a data governance structure.
3. Invest in data protection and security.

Leaders at this large healthcare system identified the need for robust telehealth-based efforts in response to the COVID-19 pandemic. Using Twistle® by Health Catalyst®, a patient engagement platform, the health system rapidly expanded care capacity to meet increasing demand, continue providing necessary primary and preventative care, and keep its workforce safe.

Healthcare leaders are finding now more than ever that engaging patients will be the key to retaining them in a healthcare environment in which choice will be a determining factor in market success. The Patient Engagement Executive Handbook from Healthcare Innovation is the definitive paper on all things patient engagement and will serve as the leading resource for healthcare executives to turn to for guidance along their journey of engaging patients.

Allina Health needed to track and manage COVID-19 immunization for its workforce. The organization leveraged the Health Catalyst® Data Operating System (DOS™) platform and a robust suite of analytics applications to develop a COVID-19 immunization registry, enabling access to COVID-19 immunization data for its entire workforce.

Estimates place the in-hospital mortality for patients with COVID-19 between 15 and 25 percent, making early identification of individuals at high risk an imperative. Clinicians need reliable tools to identify individuals at the highest risk of severe deterioration. Risk-scoring tools exist for common acute conditions (such as septic, hypovolemic, or cardiogenic shock), but these methods don’t focus on COVID-19’s primary clinical impact—respiratory function. As a result, patients experiencing severe symptoms of COVID-19 may appear stable according to vital signs, such as heart rate and blood pressure, when they’re in fact critically ill. A more evolved approach to COVID-19 risk scoring focuses hypoxemia, or a below-normal blood oxygen level.

Memorial Hospital at Gulfport (Memorial) needed a partner to help decommission its legacy visualization platform and migrate its data visualizations to a new platform. The organization partnered with Health Catalyst’s Visualization Migration Services, successfully migrating to a more modern data visualization tool in just three months.

The Centers for Medicare and Medicaid Services (CMS) has long published a list of procedures that—for safety reasons—providers could only perform and receive reimbursement for in the hospital inpatient setting (the Inpatient-Only (IPO) list). However, in 2020, CMS announced a plan to phaseout the IPO list, which would have removed the inpatient requirement for certain services. More recently, a CMS ruling reversed the 2020 phaseout, thereby reinstating the IPO list. Many stakeholders consider the reversal of the phaseout a benefit to patients, providers, and hospitals in terms of improved patient safety, increased reimbursement, reduced physician burden, and more.

Integrating healthcare delivery between risk-bearing entities, such as providers and insurers, is, on the surface, an important step towards population health management and value-based goals. However, even vertically integrated units tend to function separately around patient care. As a result, patients are spread thin between receiving care, navigating insurance, and more—a situation that degrades the patient experience, thwarts optimal outcomes, and interferes with value-based goals. However, some organizations are bridging the gap between healthcare entities to improve quality and decrease costs of caring for at-risk patient populations through a sustainable, collaborative population health model. By joining forces and using analytics to drive decisions and scale programs, truly integrated risk-bearing entities put patients at the center of care, meeting their healthcare needs in a more efficient, cost-effective way.

Up to one percent of net charges in the healthcare industry are lost because of ineffective charge capture. To collect revenue for the services it rendered, this integrated health system sought to improve its charge capture performance. The organization recognized that it needed to update its technology to help it detect inefficiencies and lost revenue from poor charge capture. By implementing VitalIntegrity™, the health system improved its charge capture accuracy.

As health systems increase their focus on improving clinical performance, they rely on clinical analytics from different sources to identify opportunities for improvement. Although the process of aggregating, organizing, and deriving analytic insight from data is complex, Holly Rimmasch, Chief Clinical Officer, SVP, and General Manager of Clinical Quality Analytics at Health Catalyst, explains why it’s critical for health systems’ survival. She also takes a deep dive into the following four domains of clinical analytics, showing how healthcare organizations can take their data farther and scale long-lasting clinical improvements:

1. Data acquisition.

2. Clinical analytics usage.

3. Unrealized opportunities of clinical analytics.

4. Patient engagement.

The success of accountable care organizations (ACOs) depends on performance, which can make profitability unpredictable. Deep insight into the right data that supports the delivery of effective care management is vital for ACOs to prosper. MemorialCare needed a way to better access the numerous inputs of data so it could increase its capacity to utilize data for continuous improvement. By leveraging its analytics platform to help support the delivery of care management and prioritize resources, MemorialCare has enhanced its performance, resulting in improved patient outcomes and cost savings.

Reimbursements are a significant source of revenue for health systems. Yet, many organizations don’t receive the full reimbursement for a service rendered, even when the payer and provider have agreed on a rate. Unfortunately, keeping up with payer policy changes is difficult and most healthcare organizations don’t have a payer expert who regularly analyzes payer contracts. To protect themselves from surprise policy changes that lead to lost revenue, organizations should include three key phrases in their current and existing payer contracts:

1. “We’re not bound by payer policies unless agreed to in writing by both parties.”

2. “Once authorization is approved for a service, it cannot be subsequently denied.”

3. “Any code not in this contract will be reimbursed at a percent of charge.”

Primary care providers (PCPs) spend nearly six hours each day interacting with the EHR. Community Health Network (CHNw) was committed to ensuring patients received appropriate primary and preventative care, but burdensome documentation processes in the EHR made it difficult to improve performance and close care gaps. The organization leveraged its data platform and analytics applications to make care gaps visible to providers within their workflow, decrease the administrative burden on care teams, and improve value-based care. CHNw can now easily track and measure performance and reporting requirements.

Regardless of COVID-19 vaccine efficacy and how long it takes risk levels to fall into less threatening ranges, many effects of the pandemic are here to stay. One area that will remain fundamentally altered is the business of delivering healthcare—the strategies and ins and outs of healthcare finance. COVID-19 has fueled new delivery models and new competition, as patients and clinicians are drawn to more convenient, less costly care (e.g., virtual care) and less stressful, more productive work environments.

So, how can traditional providers adapt and thrive in this new healthcare landscape? They must start by recognizing the impending challenge as a business problem, not a technology or care problem. This means leveraging their CFOs and financial leaders to play a more collaborative role in empowering clinicians to make better decisions and operationalizing health systems’ key differentiator—data.

A low-resolution photograph doesn’t show much detail about the image’s subjects and environment. Viewers can only guess about the scene or individuals they’re observing—are they familiar faces, happy or sad, or is there something usual in the background? Low-quality healthcare data and analytics works like a subpar photo. Users can see the most basic characteristics of a patient or trend but not enough detail to make informed decisions. For example, does a patient have comorbidities putting them at greater risk, or is a facility trending towards an increase in sepsis? For better view, high-quality data and analytics bring patients and health system operations into focus, showing a clear, comprehensive picture from the patient to facility level.

Health system may have some compelling reasons for choosing to build a data platform versus partner with a healthcare analytics vendor on a commercial solution. However, while organizations may think they’re saving money, gaining control and security, and more by opting for a homegrown approach, they’ll more than likely encounter challenges, hidden costs, and limitations. In comparison to a commercial-grade, healthcare-specific platform from a vendor, build-your-own solutions fall short when it comes to domain-specific content, technical expertise, total cost of ownership, and more. Organizations that partner on a vended platform vastly improve their chances of optimizing and scaling their analytic investment over time and achieving measurable improvement.

To improve trigger-based surveillance and decrease preventable harm events that adversely impact patient safety, this healthcare organization, comprised of a specialty hospital and multiple clinics, implemented a data platform with a surveillance module, developing and implementing triggers that were the most valuable to the organization. Building an interdisciplinary team to engage in developing and validating potential triggers, the organization prioritized prompts and established a method to review each trigger’s continued impact.

Carle Health developed an inpatient addiction consult service, allocating resources to improve the quality of addiction treatment. Leveraging its data and analytics has enabled the organization to provide ready access to the data and insights required to improve the identification and treatment of patients with substance use disorders (SUD). Carle has increased its understanding of its patients’ needs and can make data-informed decisions about using resources best to improve SUD treatment and long-term outcomes

Timely access to actionable data is critical for clinical, financial, and operational improvement in healthcare. In an attempt to motivate employees with data-informed improvement, this healthcare organization utilized visual management boards, manually posting printed graphs to boards on each unit quarterly, but long delays in data availability limited its effectiveness. The manual processes for preparing data and visualizations severely limited the number of shared outcome measures. Recognizing the need to change, the organization leveraged its analytics platform and a robust suite of analytics applications to make data available to all employees and accelerate organizational improvement capacity.

Each health system takes a unique approach to financial management. No matter the organization, Dan Unger, SVP and General Manager of Financial Transformation at Health Catalyst, says that effective financial management should promote better financial decision making across the system. And even though optimal financial management is critical to healthcare operations, organizations struggle to deal with its complexities. With challenges ranging from government-set funding to newly emerging competitors in the market, health systems need to optimize their approach to financial management. Unger suggests healthcare organizations adopt three mental shifts that lead to better financial management:  

1. Identify a forward-thinking financial leader. 

2. Collaborate with clinical and operational domains. 

3. Implement activity-based costing. 

Preterm infants often undergo painful and stressful procedures that can affect their growth and development. Reducing the amount of pain and stress neonates experience can improve infants’ developmental outcomes, decrease costs, and reduce length of stay. Hawaii Pacific Health (HPH) recognized the need to decrease disruptions for patients in its neonatal intensive care unit (NICU), reducing pain-related stress and optimizing outcomes for infants born preterm. HPH leveraged its analytics platform and an analytics application to successfully identify and assess improvement opportunities.

Growing amounts of data can be overwhelming for healthcare entities to organize, manage, and distribute effectively, sometimes making data more of a burden than a benefit. However, if organizations adopt the right data mentality, they can gain insight into performance, track an intervention’s success, and improve outcomes. According to data experts, Bryan Hinton, our Chief Technology officer, and TJ Elbert, our SVP and General Manager of Data, organizations can apply five mindset changes to avoid data overload and achieve data-driven improvement:

1. Focus on data orchestration, not data computing.
2. Leverage real-time data, especially in a pandemic.
3. Prioritize data democratization over data control.
4. Use AI, if you’re not already.
5. Change current care models to fit the data.

Despite the widespread use of population health as a solution to control rising costs and poor outcomes, healthcare organizations struggle to effectively achieve population health success. A common barrier to success is lack of access to data about a system’s most impactable patients, their interventions, and how said interventions impact a patient’s health. However, health systems can overcome the following all-too-common population health mistakes by leveraging detailed data about their most impactable patients and interventions:

1. Lacking an effective solution for data-driven strategy.

2. Using delayed analytic insight to understand performance and opportunities.

3. Not tracking member-level data to measure intervention effectiveness.

Despite the widespread use of population health as a solution to control rising costs and poor outcomes, healthcare organizations struggle to effectively achieve population health success. A common barrier to success is lack of access to data about a system’s most impactable patients, their interventions, and how said interventions impact a patient’s health. However, health systems can overcome the following all-too-common population health mistakes by leveraging detailed data about their most impactable patients and interventions:

1. Lacking an effective solution for data-driven strategy.

2. Using delayed analytic insight to understand performance and opportunities.

3. Not tracking member-level data to measure intervention effectiveness.

Healthcare organizations are continually striving to decrease costs and improve profitability, and a growing number of organizations are outsourcing services to manage expenditures. Banner Health partnered with Health Catalyst to successfully smartsource clinical chart abstraction, utilizing Health Catalyst's Tech-Enabled Managed Services (TEMS). The partnership reduced costs, increased productivity, and enhanced employee proficiency and satisfaction while opening doors for team members to thrive and contribute in new roles.

In an era of technological innovation and extraordinary connectivity, why does clinical research follow a decades-old model? Clinical trials remain concentrated among leading urban medical centers with narrow patient populations, but today’s data and collaborative capabilities can support a broader, more robust reach. To that end, the new Health Catalyst Research Offering accelerates and optimizes clinical research in five groundbreaking ways:

1. Connects key players in clinical research.
2. Provides a network of healthcare provider systems, biopharmaceutical companies, and clinical research organizations.
3. Gives access to research-oriented Health Catalyst products and services.
4. Supports clinical study from planning through the active trial.
5. Maintains a national repository of clinical data.

The Comprehensive HIV/AIDS Management Program (CHAMP) at Woman’s Hospital provides case management for women with HIV and their babies. Woman’s utilized the Health Catalyst® Data Operating System (DOS™) platform and the Care Management Suite to improve care manager efficiency, automating the identification of patients eligible for CHAMP and streamlining patient enrollment in the program.

With the pandemic fueling increasing financial and clinical demands, health systems need automated tools and processes to deliver cost-effective care without compromising quality. Traditional data infrastructure that delivers delayed insights to clinicians creates additional barriers to better care. Yet, many organizations still use these fragmented systems. Now, with the Health Catalyst Embedded Care Gaps™ application, organizations can deliver relevant insight to decision makers at the point of care. With accurate, actionable insight embedded directly into the EHR, Embedded Care Gaps empowers clinicians to close gaps in patient care, maximize every patient visit, and operate at the top of their licenses. Furthermore, patients reap the benefits of closing gaps by receiving more complete care through an efficient, well-planned visit.

Community Health Network (CHNw) utilizes Health Catalyst's Tech-Enabled Managed Services (TEMS), with Health Catalyst taking ownership of the clinical chart abstraction functions. CHNw’s TEMS relationship with Health Catalyst has enabled the organization to control cost increases, improve the use of registry data, and take on more advanced quality improvement activities.

Even virtually, transporting 3,000-plus healthcare leaders and activists across three international destinations is no small feat. Add world-class data and analytics insight and inspiration from healthcare and beyond to the voyage and you have a three-day journey of a lifetime—otherwise known as the Healthcare Analytics Summit™ (HAS) 21 Virtual. The 2021 edition of healthcare’s premier analytics summit once again gathered innovators and heroes from around the globe to explore multi-domain analytics as the framework for a winning team approach to healthcare transformation.

Access to convenient care can influence a patient’s decision on where to seek treatment, subsequently affecting patient retention and revenue generation for healthcare organizations. Texas Children’s Hospital has a high patient demand for care, which increased during the pandemic. To meet the challenge, the organization sought to improve accessibility to its services while maintaining safety for its patients and staff, as well as streamline its referral process. The organization successfully utilized digital technologies and its analytics platform to quickly expand its telemedicine services during the pandemic and improve patient access.

Most providers aim to protect patients from unexpected and unmanageable medical bills. But on January 1, 2022, this responsibility becomes law under the No Surprises Act. The upcoming legislation targets surprise medical bills, which occur when a patient unknowingly receives care from out-of-network providers and is subject to higher charges than for in-network care. These unexpected bills degrade the patient experience and decrease the likelihood of payment for care. Surprise bills may also be more common than many consumers and providers realize—according to the Centers for Medicare and Medicaid Services, in 2016, 42.8 percent of emergency room bills resulted in out-of-network charges. With greater price transparency, the No Surprises Act seeks to protect patients but also impacts providers and facilities, ambulance services, and more, who must comply to receive timely payment and avoid penalties.

The U.S. continues to spend more on healthcare than any other country. As costs increase, healthcare organizations are exploring ways to improve care while containing costs. The University of Kansas Health System recognized it could improve performance efforts across its entire organization. By leveraging data and analytics and an adaptive problem-solving approach to drive improvement, the organization has achieved impressive results.

With an overwhelming number of healthcare terminology standards, how do industry professionals determine which ones they need to know? Terminology users can start by matching their purpose with the correct standard. Because different healthcare terminology standards fulfill distinct purposes, matching purpose to standard generally leads users to the right term for their goals. 

Terminology users can match their purpose with the correct standard by first identifying the standard’s purpose. Purposes encompass billing, clinical, laboratory, and pharmacy terminology standards:

1. Healthcare billing terminology.
2. Clinical terminology.
3. Clinical and laboratory terminology.
4. Pharmacy terminology.

Health systems increasingly turn to AI to help all team members make more informed decisions in a shorter time frame. Instead of an artificial-intelligence approach that threatens the critical role healthcare experts play in decision making, organizations should define AI as augmented intelligence. In his first podcast, Dr. Jason Jones, our Chief Analytics and Data Science Officer, explains how augmented intelligence can help health systems accelerate progress toward achieving the Quadruple Aim. The three unique opportunities augmented intelligence offers health systems include the following:

1. Augmented—not artificial—intelligence.
2. Think “change management.”
3. Address and overcome healthcare disparities.

Break free from the population health status quo of black box algorithms and shallow insights. In today’s value-based market, population health challenges demand technology that generates insights by aggregating data from all source systems, normalizing that data, and integrating clinical, financial, and operational data sets. Health systems that go beyond black box measurements by leveraging a far-reaching population health management solution transform healthcare and save millions by improving care for high-risk populations, thriving under value-based care, and reimagining care coordination.

Today’s healthcare data status quo of black boxes and shallow insights too often keeps organizations from realizing the digital era’s transformational potential. Without accessible, accurate, timely data, health systems struggle with challenges from patient outcomes and experience to profitability and, since 2020, COVID-19. Only with a commercial-grade data and analytics platform built exclusively for healthcare can organizations confidently scale analytics productivity to improve outcomes, respond to a crisis, and boost revenue.

Improving health equity is gaining traction as a healthcare delivery imperative. Yet, while equity is indivisible from healthcare quality, many initiatives targeting disparities fall short. Organizations too often rely solely on leader and stakeholder passion and perseverance without sufficiently leveraging data and analytics to understand, measure, and support equity improvement efforts. It’s time for the industry to pursue equitable care with the same resources it uses in other key dimensions, such as safety and efficacy—by leveraging data. A data-driven approach to equity opens health system’s most advanced predictive resources to equity efforts, thereby driving massive, measurable, data-informed improvement that benefits all.

Albany Med, Northeastern New York’s only academic medical center, aimed to lower its revenue losses by reducing its number of denied claims. Because of restricted access to its total data, the organization had inconsistent reports and delayed interdepartmental workflows. Albany Med sought to improve its revenue cycle process by centralizing its payer denials data, allowing it to efficiently investigate and analyze denials. Albany Med leveraged its data platform and analytics applications to consolidate payer denial data from disparate systems, enabling the organization to perform a variety of deep analyses.

Over the last decade, many health systems have found that augmented intelligence (AI) technologies have overpromised and underdelivered. The promises of AI in clinical care were grand—to ease physicians’ burdens and deliver the most relevant information at the point of decision making. However, more technology has increased the demand on providers along with clinicians’ doubt of AI’s capabilities.

Organizations can still deliver valuable AI-derived patient insight to providers at the front lines of care by taking a collaborative approach to AI that enlists clinicians in three key areas:

1. Development.
2. Implementation.
3. Results.

Almost four trillion dollars is spent on healthcare each year in the U.S., with most expenditures going to patients with chronic health conditions. Patients with chronic health conditions have a high rate of unnecessary visits to the emergency department (ED) and unplanned hospital admissions. UnityPoint Health sought to reduce costs by identifying patients with chronic health conditions at a higher risk for overutilizing healthcare services. By leveraging its analytics platform and augmented intelligence (AI), UnityPoint Health has been able to efficiently identify patients that could benefit from enrollment in its care management program.

After virtual stops in Singapore and London, HAS 21 Virtual attendees might have thought day three couldn’t top the previous two. However, global analytics travelers were wowed when Paul Horstmeier welcomed them to the Grand Dubai Hotel. Not to be outdone by its extravagant surroundings, the final day’s agenda again exceeded expectations with the likes of Amy Compton-Phillips, MD, who oversaw the care of the first known COVID-19 patient in the U.S., a robust set of breakout topics, and a special healthcare analytics edition of Jeopardy. Day three also included the much-anticipated announcement of #SockofHAS winners, results of the HAS points competition, the esteemed Flywheel Award recipient, and more. Event organizers and fans are already excited to gather again September 13-15, 2022—in person!

Day two of the Healthcare Analytics Summit™ Virtual again opened with a warm welcome from “Captain” Paul Horstmeier and his flight crew. Keynote speaker Patrice Harris, MD, MA, FAPA, former President of the American Medical Association, then took the stage to discuss common health equity challenges and solutions. Chris Chen, MD, CEO of ChenMed, followed to share how his organization has redefined value by using a fully capitated economic model. After a quick break, attendees chose between industry outlook sessions focused on health equity and population health. By lunchtime, participants were ready to explore over 30 data-centric projects at the Analytics and AI Showcases and learn about new Health Catalyst products. Attendees wrapped up an action-packed day two with Braindates, one-on-one or group networking sessions to learn more about trending topics of their choice.

From negotiating at-risk contracts to improving quality measures, population health initiatives require a flexible, adaptable data analytics platform. Learn how the most successful organizations are tackling these quality-related problems.

A fireside chat with NBA great Steve Kerr, a virtual journey to a premier international destination, a glimpse at robots changing the world, and an investigation into the parallels between motocross and healthcare analytics are just some of the experiences offered during day one of the Healthcare Analytics Summit™ (HAS) 21 Virtual. From a digital platform for the second consecutive year, HAS 21 Virtual kicked off three days of extraordinary education, inspiration, and entertainment on September 21. With experts from healthcare and beyond, attendees explored the digital trends and best practice experiences driving healthcare success in the new digital era. Additionally, two waves of breakouts offered insights into increasing revenue, decreasing cost, improving quality, and more.

Healthcare organizations continually strive to improve each patient’s experience to ensure quality care delivery and qualify for financial reimbursements. Health systems try to optimize the patient experience through traditional methods, including better access and appointment reminders. However, organizations can improve the patient journey and deliver a first-class experience by taking a different approach—by targeting the following five aspects of the billings and collections process, providers can proactively inform patients about their financial expectations and avoid surprise bills:

1. Pricing strategy.
2. Charge description master management.
3. Real-time eligibility verification.
4. Patient cost estimation.
5. Propensity to pay.