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Top Five Features of an Effective Readmission Risk Score

Under value-based healthcare and the 2012 Hospital Readmission Reduction Program, healthcare organizations are more motivated than ever to reduce their incidence of preventable readmissions. Health systems can reduce risk of hospital readmissions by developing readmission risk scores tailored specifically to their populations. A risk model that meets the following five requirements will have significant predictive value and is most likely to achieve systemwide adoption:

  1. Identifies at-risk patients early.
  2. Separates patients relevant to the disease-specific identification method and intervention strategy from all other in-hospital patients.
  3. Uses organization-specific data to train a disease-specific model.
  4. Exceeds performance of existing models.
  5. Is developed in collaboration with domain experts.

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Ten Essential Steps for Your Readmission Reduction Program

Effective care management is essential during the first 30 days after discharge to prevent unnecessary readmission and associated costs. Care managers can follow a 10-step readmission reduction program to help patients stay on track with recovery and avoid acute care:

  1. Call the patient within two days of discharge.
  2. Assess the patient’s self-care capacity.
  3. Frontload homecare and ensure patient 'touches', if appropriate.
  4. Conduct a home safety evaluation.
  5. Order and install durable medical equipment prior to discharge.
  6. Order an emergency alert/medication reminder system and preprogram important phone numbers on patient’s phone.
  7. Implement fall prevention program, intervention, and education.
  8. Provide in-home education on new diagnoses or unmanaged chronic conditions.
  9. Connect the patient with community resources.
  10. Establish a best practice for follow-up phone calls after discharge.

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Seven Ways DOS™ Simplifies the Complexities of Healthcare IT

Health Catalyst Data Operating System (DOS) is a revolutionary architecture that addresses the digital and data problems confronting healthcare now and in the future. It is an analytics galaxy that encompasses data platforms, machine learning, analytics applications, and the fabric to stitch all these components together. DOS addresses these seven critical areas of healthcare IT:

  1. Healthcare data management and acquisition
  2. Integrating data in mergers and acquisitions
  3. Enabling a personal health record
  4. Scaling existing, homegrown data warehouses
  5. Ingesting the human health data ecosystem
  6. Providers becoming payers
  7. Extending the life and current value of EHR investments
This white paper illustrates these healthcare system needs detail and explains the attributes of DOS. Read how DOS is the right technology for tackling healthcare’s big issues, including big data, physician burnout, rising healthcare expenses, and the productivity backfire created by other healthcare technologies.

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The Top 7 Outcome Measures and 3 Measurement Essentials

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 blog adds much-needed clarity by reviewing the top seven outcome measures, including definitions, important nuances, and real-life examples:

  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 exact seven outcome measures to calculate overall hospital quality and arrive at its 2016 hospital star ratings. This blog also reiterates the importance of outcomes measurement, clarifies how outcome measures are defined and prioritized, and recommends three essentials for successful outcomes measurement:
  1. Transparency
  2. Integrated care
  3. Interoperability

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What Is a Healthcare Data Lake and Why Do You Need One? Imagine a Supermarket

Using a supermarket analogy, this article helps healthcare leaders understand what data lakes are (open reservoirs for vast amounts of data), why they’re essential (they reduce the time and resources required to map data), and how they integrate with three common analytic architectures:

  1. Early-Binding Data Warehouse
  2. Late-Binding Data Warehouse
  3. Map-Reduce Hadoop System
Data lakes are useful parts of all three platforms, but deciding which platform to integrate a data lake with depends heavily on a health system’s resources and infrastructure. Once understood and appropriately integrated with the optimal analytics platform, data lakes save health systems time, money, and resources by adding structure to data only as use cases arise.

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Five Deming Principles That Help Healthcare Process Improvement

Dr. John Haughom explains 5 key Deming processes that can be applied to healthcare process improvement. These include 1) quality improvement as the science of process management, 2) if you cannot measure it, you cannot improve it, 3) managed care means managing the processes of care (not managing physicians and nurses), 4) the importance of the right data in the right format at the right time in the right hands, and 5) engaging the “smart cogs” of healthcare.

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Hospital Revenue Cycle Management: 5 Ways to Improve

Besides improving your information systems and educating your staff on the ins and outs of managing revenue, there are many more opportunities for improvement. Here are five suggestions to help health systems improve their revenue cycle management:

  1. Trend and benchmark your healthcare data.
  2. Use DOS to Mine Your Healthcare Data.
  3. Constantly ask frontline staff for suggestions.
  4. Monitor all payer contracts.
  5. Maintain convenient and caring touch points with patients.

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The Key to Transitioning from Fee-for-Service to Value-Based Reimbursement

The shift from fee-for-service to value-based reimbursements has good and bad consequences for healthcare. While the shift will ultimately help health systems provide higher quality lower cost care, the transition may be financially disastrous for some. In addition, the shifting revenue mix from commercial payers to Medicare and Medicaid is creating its own set of challenges. There are, however, three keys to surviving the transition: 1) Effectively manage shared savings programs to maximize reimbursement. 2) Improve operating costs. 3) Increase patient volumes. With an analytics foundation, health systems will be able to meet and survive today’s healthcare challenges.

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Communication in Healthcare Culture: Eight Steps to Uphold Outcomes Improvement

Healthcare leaders looking to establish and sustain a culture of large-scale outcomes improvement must communicate their health system’s values, beliefs, and norms throughout the entire organization. Effective communication spreads understanding of outcomes improvement, ensuring broad engagement and ongoing progress toward shared goals. An eight-step strategy describes essential elements of organizational outcomes improvement communication plan:

  1. Include a communications specialist on the outcomes improvement leadership team.
  2.  Analyze the stakeholders early and often.
  3. Craft the central message around shared values.
  4. Be a constant champion.
  5. Commit to regular times and mechanisms for communication.
  6. Make sure communication flows both ways.
  7. Be transparent.
  8. Be creative.

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Healthcare Reform: Is Bipartisan Legislation Possible?

The effort to repeal and replace the ACA in 2017 failed, leaving the industry wondering if bipartisan healthcare reform is possible in today’s political climate. This article explains why it is possible, by taking a close look at why repeal and replace failed, and why the 21st Century Cures Act and MACRA have been successful. To stand a chance of being successful, proposed bipartisan healthcare legislation will most likely have one (or more) of five features:

  1. Driven by practical need rather than politics.
  2. Focuses on cost control/cost reduction.
  3. Targets areas that are expected to save money.
  4. Doesn’t involve creating new programs.
  5. Stabilizes the ACA.
There are many bipartisan healthcare legislation opportunities, from expanding the use of HSAs to innovation waivers; opportunities that won’t come to fruition unless the proposed legislation tackles practical problems.

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