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Advancing Analytics in Healthcare: Leveraging Disruptive Revenue Models

Improving Evaluation and Management Coding with Computer Assisted Coding

One of the earliest and most profound impacts of the digital revolution in the healthcare industry can be traced back to the introduction of electronic health records (EHR) in 1972. The exponential rate of technological progress in the following decades combined with the dawn of healthcare consumerism eventually led to the widespread digitalization of hospital systems.

However, hospitals were soon faced with a growing repository of data, both structured and unstructured, from a wide range of disparate sources. As hospitals realized the importance of data in a completely digital ecosystem, the abundance of data became a fruit ripe for the picking. This is where analytics comes into play. By applying the right real-time data analytics platform, hospitals can process large volumes of data quickly and automatically. This, in turn, allows hospitals to use this data to gain real-time visibility and make more informed decisions based on an elaborate business intelligence (BI) model.

Market research firm MarketsandMarkets estimates the healthcare analytics market to be valued at USD 14 billion in 2019. With a projected compounded annual growth rate (CAGR) of 28.3%, that valuation is expected to reach a staggering USD 50.5 billion by 2024. Data analytics is no longer a competitive advantage, but a necessity in the modern healthcare ecosystem.

The Way towards Actionable Business Intelligence Analytics

Al tools provides visibility into the operational performance of healthcare institutions through useful insights derived from available data. Decision makers can accurately identify gap areas and arrive at relevant solutions through extensive root cause analysis of issues.

Visualizing data can greatly improve decision-making processes by highlighting necessary and helpful business insights. By converting endless rows of numerical data into graphs, charts, and tables, visual reports can help decision makers navigate large volumes of data and directly identify pain points. Sophisticated visualization tools help healthcare institutions drill down to the nitty-gritties of business insights like total hospital costs, departmental costs, and so on using customized reporting capabilities. Similarly, these tools can be leveraged for more accurate and insightful reporting on KPIs like case mix index (CMI), denial, and account receivables.

 But the advantages of data visualization are not just top-down. Visualization is an effective way to engage front-end operation staff. Physicians, care professionals, and program heads can greatly benefit from running visualizations to arrive at well-informed strategic operational decisions and improved efficiency.

Moreover, the shift towards “fee-for-value” payment model can become a challenge for hospital revenue cycles. Data-driven insights can enable healthcare organizations better understand their existing revenue streams. Mapping that with accurate real-time value-based KPIs can not only help them guide patients towards care environments that are cost-effective, but, in due course, provide access to necessary facilities like acute care facilities. According to a global forecast by Market Research Future, the global acute care market is expected to grow at a CAGR of 7.8% in the 2017-2023 period with the US contributing 44% towards that growth.

Getting it Right: Letting KPIs do the Talking

Healthcare analytics is powerful. However, analytics are only as strong as the data that it splices. Even today, a large chunk of information in the healthcare industry, including clinical and performance data, exists in unstructured form. To make the most of analytical tools, hospitals need to convert this unstructured data to relevant structured data repositories, preferably in a healthcare enterprise data warehouse (EDW). This allows healthcare institutions cut back on costs rising from manual data management while ensuring accurate analytical reporting. Ultimately, operational transformation is the key marker of success in analytics adoption.

Maintaining structured patient data involves accurate and efficient case coding and real-time upkeep of information. This allows hospitals to successfully run analytical programs and facilitate health information management (HIM). CDI departments with insights can also help improve revenue operations. Comprehensive dashboards and reports can provide the right performance parameters with respect to financial metrics that enable more informed decisions.

The current value-based healthcare ecosystem has made payments a directly dependent function of quality of care. In this context, real-time smart analytics can help healthcare professionals better understand critical KPIs such as Denials, Patient safety indicators (PSI), CC/MCC capture rates,  severity of illness or risk of mortality (SOI/ROM) scores, and length of stay (LOS) variance.

Parameters like coder productivity, DNFB/DNFC days, CMI, the accuracy of data, number of cases re-coded, physician queries also stand to be improved through analytics exercises.

ezDI has been at the center of value-based care transformation for over a decade. Our understanding of the system and experience of working with leaders in the healthcare industry has allowed us to go beyond providing the traditional benefits of analytics to healthcare providers. As the only born-in-the-cloud​, ​ AI​-powered​, fully integrated, analytics platform on the planet, ezDI can help you navigate and breakdown your data in real-time to provide operational visibility.

Our analytics platform ezAnalytics helps healthcare providers get a better understanding of their KPIs by drilling down to the minute capability details and identifies grass-root metrics that affect the revenue cycle. By consolidating and structuring data present across a wide range of disparate sources the platform provides decision-makers with relevant contextual data.

With the industry set to witness increasing adoption of the value-based care model, healthcare CFOs need to act quickly. Transitioning to analytics tools is the only way to weather the storm that disruptive revenue models will present in the near future.

To learn more about ezDI’s AI-based mid-revenue cycle management solutions visit www.ezDI.com and to see the live product demo of our Clinical Documentation, Coding, Compliance/Auditing, Quality Measures, Encoder, and Enterprise Analytics request a live demo.

Devanshu Yadav

Devanshu Yadav

Devanshu Yadav is a corporate strategist at ezDI Inc. He works for continuous advancement in bringing ezDI’s award-winning natural language processing (NLP) technology and comprehensive medical knowledge base to the market. He is considered as a subject matter expert in an emerging Healthcare AI driven technologies for mid revenue cycle management. He has contributed to the literature of healthcare professionals by engaging in numerous publications with HFMA. He is trusted & accomplished expert in intersection of technology, HIM, CDI and Coding, with a mission to set others up for success.

Devanshu has earned his post graduate degree in Business Administration and graduate degree in Electronics engineering. He is a firm believer in the abilities of technology to change the world, making the world a better place for all of us.

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