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Three Steps to Prioritize Clinical Quality Improvement in Healthcare

Bobbi Brown, MBA

Senior Vice President

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.

Patient Safety Incident Reporting Functionality Reduces Barriers and Improves Care

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.

How Specialty Pharmacies Can Improve Medication Adherence and Patient Outcomes

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.

Reduce Healthcare Inequities with Patient Engagement Technology

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. 

Commercial Medical Necessity Edits are Your Key to Fewer Denials

Jennifer Bishop

Vice President, Product Content

Kristy Manrique

Director Medical Necessity

Mikki Fazzio, RHIT, CCS

Content Integrity Consultant, Principal

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.

Changes to ICD-10-PCS Codes: CMS Updates Effective October 2022

Mikki Fazzio, RHIT, CCS

Content Integrity Consultant, Principal

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.

The Future of Healthcare: Our Promise to HIEs

Dan Soule

Vice President Product Management

Vineeth Yeddula

CEO, KPI Ninja by Health Catalyst

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 HIE2. The Health Catalyst roadmap and pathways to success3. Our long-term commitment to HIE and HIE sustainability

The Top Four Examples of Quality Improvement in Healthcare

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.

The Top Seven Healthcare Outcome Measures and Three Measurement Essentials

Ann Tinker, MSN, RN

Professional Services, SVP

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. Mortality2. Readmissions3. Safety of care4. Effectiveness of care5. Patient experience6. Timeliness of care7. Efficient use of medical imagingCMS 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.

How Managing Chronic Conditions Is Streamlined with Digital Technology

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.

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