Because there has been a shift from pay-forreporting to pay-for-performance, there has to be data to back up providers’ claims of quality in these areas. EHR incentive programs, Medicare reimbursements, and Medicare penalties are all reasons quality analytics are more important than ever before.
By Katie Wike, contributing editor
For small hospitals such as Hopkins County Memorial, switching to a customizable BI program can save money, end outsourcing, and aid in Meaningful Use (MU) preparation.
In 2011, only 10 percent of U.S. hospitals had adopted a health data analytics tool. By 2016, that number is expected to jump to 50 percent nationwide. Hospitals such as Hopkins County Memorial (“Memorial”) that have already installed business intelligence (BI) and analytics technology are seeing the benefits of having such tools to prepare for MU and convert raw data into useful reports. But for Memorial, a 93-bed facility servicing 30,000 residents of Hopkins County, TX and neighboring counties in Northeast TX, realizing those benefits took some time — and a revamping of its existing BI system.
Because there has been a shift from pay-forreporting to pay-for-performance, there has to be data to back up providers’ claims of quality in these areas. EHR incentive programs, Medicare reimbursements, and Medicare penalties are all reasons quality analytics are more important than ever before.
Standard Reporting Equals No Flexibility
Memorial Hospital’s BI-related problems stemmed from the reporting capabilities of its existing system. Namely, the hospital’s IT department was limited to the standard reports available through the old BI program. Using MEDITECH NPR Report Writer, there were few ways to generate reports, and staff could only choose from the software’s standard reports that only could be run based upon prebuilt selections. Furthermore, there was no easy way to edit data or change the overall results of the reports created. Once data had been entered into a standard form, hospital employees couldn’t use that data to find any other result; it only could be used to find one outcome. In addition, this situation was hindering the hospital’s ability to provide accurate reports on payroll, billing/accounts receivable, and admissions. “We were at the mercy of our standard reports,” states Brandon Gauntt, director of information services at Hopkins County Memorial.
Since Memorial was unable to create custom reports (the staff didn’t have the programming expertise), this service had to be outsourced. Doing so was not only a financial burden, it was inconvenient. Data fields still could not be modified, and a fee was incurred every time a report had to be changed. Problems also stemmed from having only one staff member trained on NPR Report Writer. Even if the system had the capabilities to create and change the reports required by the hospital, that one staff member could not handle the custom reporting workload.
Updated Reporting: Customization Is Key
BI and analytics provide reports that can influence how providers conduct their practices. Monitoring performance is vital to hospital boards and financial stakeholders as well as to patients who are looking to evaluate a facility’s care. Private insurance payors and government programs such as Medicare rely on performance data to make payments associated with quality of care. Thus, maintaining a positive reputation, staying ahead of federal regulations, and receiving pay-for-performance reimbursements are just a few of the reasons that having a capable BI and analytics system is important.
In an effort to remedy its BI problems, Memorial researched four vendors’ solutions, ultimately choosing Dimensional Insight. This company’s solution is a self-contained visualization, analysis, and reporting tool that also helps hospitals meet MU requirements and qualify for incentive payments under the HITECH Act.
Memorial installed ProDiver, a Dimensional Insight product that tied into the MEDITECH SQL server, and enabled staff to use all of their data to create reports. The Dimensional Insight-generated reports were easily changed and much simpler for staff to navigate than those of the previous system.
Gauntt explains, “We just wanted something that was user-friendly and fully customizable.” With Dimensional Insight, any piece of data brought into the software from MEDITECH can be easily incorporated into a report in what Gauntt calls “unlimited ways” and can be sorted into any field. The reports generated by Dimensional Insight can be converted to graphs and charts with the click of a button. And Memorial’s end users are benefitting from the Dimensional Insight installation as well, since the new reports do not require the programming knowledge of the previous NPR technology.
Gauntt worked with Dimensional Insight to integrate the new system with MEDITECH, which took six to eight months. The end users who would be creating reports trained for a period of two weeks with Dimensional Insight to learn to use the new reporting technology.
No More Outsourcing
Because the new Dimensional Insight technology allows users to create their own reports, there is no longer a need for Memorial to outsource this function. The hospital was paying $100/hour to outsource custom reporting before the install. Each of the reports (the hospital averaged at least 6 to 10 a year) cost Memorial approximately $1,000. Since staff members are trained on Dimensional Insight programs, the hospital saves time, and no longer needs to deal with report requests. End users are capable of building their own reports because there is no need for IT knowledge, and this, too, frees staff for other tasks.
“With BI, our users can easily produce reports that show the top number of any criteria, such as the length of service by physician or insurance, revenue by provider, or average length of stay,” says Gauntt. Keeping on top of payroll, billing, accounts receivable, and admissions through reporting maintains the hospital’s finances, too. Monitoring admissions and readmissions is especially important since it has been reported that some readmissions can cost a hospital more than $250,000.
Memorial is using ProDiver technology to test for MU requirements as well. The program is able to quickly produce detailed reports for each MU requirement (patient portal use, certified EHR technology, clinical quality measures). For example, Gauntt says a report can show the computerized physician order entry (CPOE) percentage of orders placed on each individual patient. The government requires hospitals to use CPOE for medication orders for 30 percent of unique patients requiring at least one medication. Without meeting the criteria, Memorial would not receive MU incentive payments.