By Adeel Sarwar, chief technology officer, CareCloud.
Whether you’re looking for creative ways to cut costs, boost revenue, or insulate an already stretched-too-thin workforce from burnout, one thing is for certain – healthcare leaders are suffering from data-induced decision paralysis.
Here’s why.
In today’s data-centric care climate, where analytics is king, organizations are realizing the value of making financial, clinical, and administrative decisions backed by data. But are leaders equipped to leverage the flood of insights they now have at their fingertips? And if so, what does data-backed, intelligent action look like?
Purpose-Driven Intelligence
Purpose-driven business intelligence provides organizations with insights to enhance or repair a specific business area or process. For the sake of this article, we will examine how a large national healthcare organization applied purpose-driven intelligent business data to improve the health and morale of its employees.
First, They Set a Goal
By narrowing its gaze on employee health and wellness data, the large national healthcare organization used intelligent analytics to set a hyper-focused mission: boost employee participation of its onsite clinic and health benefit services.
With so much data at your fingertips, it’s easy to get overwhelmed. By honing in on one organizational element, you’ll be better positioned to drill down deep, identify trends, and establish an action plan.
Then, They Focused on Manageable Change
Once the mission was set, the organization took a deep dive into its EHR data to better understand employee utilization of its various health clinics and classes. Empowered by the numbers, the organization constructed a plan to enhance participation of benefits and services most under-utilized by its employees.
As you work on your own organizational changes, keep in mind that the data may surprise you. Trust the numbers and let them guide your decisions.
They Engaged their Staff
To drive interest and engage employees, the organization decided to launch a points-based scorecard system that awards employees for logging activity across various health clinics and services. This system encouraged employees to take advantage of onsite classes and resources and empowered leaders to identify areas of improvement within high-impact programs.
Making organizational changes can be challenging, which is why leadership and staff buy-in is critical. To do this, communicate your plan, educate and train on new processes, and then set parameters that keep everyone accountable and engaged.
Bundling errors continue to wreak havoc on hospital bottom lines in 2021, causing 34% of inpatient charge denials with an average value of $5,300 each. That’s according to an auditing and revenue integrity report analyzing more than $100 billion worth of denials and $2.5 billion in audited claims released today by Hayes, makers of MDaudit, the industry’s leading integrated auditing, billing compliance and revenue integrity platform for the nation’s premier healthcare organizations.
“Healthcare Auditing and Revenue Integrity: 2021 Benchmarking and Trends Report” shares the findings of Hayes’ review of professional and hospital claims audited in MDaudit Enterprise during the first 10 months of 2021. Internal auditors identified a significant number of concerns in the claims they reviewed, with approximately 33% of the audits resulting in “disagree” findings. The concerns centered primarily around disagreements between procedure codes and diagnoses.
Focusing on denial trends, bundling was the top category for both inpatient and outpatient charge denials – the latter of which had an average value of $585 for each denied claim. The top reason was that the benefit had been included in a previously adjudicated service or procedure. Professional services had a first-time denial rate of 15%, led by claim submission/billing errors and carrying an average value of $283 each, while COVID-19 claims continue to attract higher denial rates from both commercial and federal payers.
“With the pandemic driving projected losses over $100 billion this year, hospitals and healthcare organizations are under intense pressure to optimize revenue flow and reduce compliance risk,” said Peter Butler, CEO, Hayes. “Gaining control over denials by focusing on both auditing and training providers and coders to improve documentation is a logical first step – particularly given that 43% of rendering providers and 27% of hospital coders fail internal audits and auditors have ‘disagree’ findings about 33% of the time. Left unaddressed, this is a huge revenue and compliance risk for organizations.”
By Terri Casterton, director of product and strategy and healthcare, Bottle Rocket.
If digital expansion in healthcare was simmering before the pandemic, COVID-19 has set the need for transformation alight. Engagement tactics that were already in use before 2020, like telehealth, remote patient monitoring, and care at home, flew to the forefront of the agenda as providers were forced to close their doors.
COVID-19 revealed a complicated flaw in the industry: a maze of digital obstacles preventing a seamless online patient experience. Post-pandemic, patient habits still lean towards a preference for digital access: in July 2021, a McKinsey report revealed that telehealth utilization in the US has stabilized at levels 38 times higher than before COVID-19.
As everyday healthcare decisions fall upon the shoulders of increasingly digitally-adept populations, providers need to ensure a simple user experience -moving away from patient portals to more robust engagement platforms. At the forefront of every leader’s mind should be how to provide a frictionless engagement path for patients, and what digital tools are necessary to guarantee the seamless delivery of this experience.
Electronic health record (EHR) patient portals have long been an entry-point for basic transactions like viewing test results and refilling medications, but this is no longer enough. Innovators in the healthcare space are recognizing the need to move to more dynamic systems. Luckily, EHR vendors have, of late, been more willing to partner with third-party app and cloud-based developers, building integrated solutions to provide a more cohesive healthcare experience.
It’s clear that unleashing a patient-focused strategy is the way forward for healthcare providers in the wake of the pandemic. But what are the key benefits that will differentiate your company from the competition?
Get hyper-personal in the experience you deliver
EHRs can serve an enterprise, from labs to ICUs, across multiple facilities and geographies. In a world of shrinking healthcare margins, this scale can drive much-needed standardization and efficiencies. But the needs and circumstances of a real population are never contained or linear, effectively diminishing the potential of a one-size-fits-all approach.
Value continues to shift from fee-for-service to fee-for-outcome, and because of this a hyper-focus on specific segments will uncover new opportunities to drive engagement (and corresponding outcomes) on a highly specialized care journey.
Being a pharmacist is one of the most rewarding, yet challenging jobs. It requires a high level of knowledge and handwork as well as great communication skills.
You need to be personable and empathetic because you’re dealing with patients on a daily basis, but you also need to be able to prioritize your time to stay organized.
Finding a balance between all of these different factors can be difficult, but it’s definitely possible. It might take some time and experience to reach the level at which you’re comfortable owning and managing your own pharmacy, but it will be rewarding when you do eventually reach this stage.
If you’re a newly-qualified pharmacist with the hopes of one day owning your own pharmacy practice, or if you’ve recently progressed onto being a pharmacy owner after years of being a technician, here are some top tips for you. Following these tips will ensure you become a successful pharmacist-owner.
Hospital workers are burnt out. The physician shortage in the U.S. is growing increasingly dire, and COVID-19 variants are filling up intensive care units from coast to coast.
In late August, U.S. Army veteran Daniel Wilkinson made news, dying of a treatable illness outside of Houston, simply because no hospital beds were available. Parts of the country, like Louisiana, are finding themselves unable to provide ambulance services and other essential hospital functions due to case surges.
It’s times like these when our front-line workers jump into action, risking it all to manage high patient influx while delivering the highest quality care possible. As an HR worker, there are ways you can also help support your hospital staff, both professionally and personally.
Communicate to Fill Roles Efficiently and Effectively
“One-third of the physicians now working in the U.S. are expected to reach retirement age in the next decade,” and besides that, the aging American population is requiring increasing care for a growing number of chronic illnesses and ailments. The physician shortage in the U.S. isn’t going anywhere, especially in light of COVID-19 variant surges.
That means HR workers are working overtime to fill in the gaps. When physicians fall ill or are otherwise unable to work, fill-ins are also in order. Communicating with your hospital staff can help you better understand their needs. Perhaps they need a nurse who specializes in critical care, or maybe a doctor with experience in infectious diseases. Increasing the number of nurse practitioners hired may also help to fill the gap left by retiring physicians.
Quitting rates are higher than ever before, and one way to deal with the talent shortage is to liberate your talent strategy. Maintaining a database of pre-vetted, qualified applicants can help streamline the hiring process, which could otherwise take weeks or months. Recruiting culture is fast changing to allow for faster hiring and more efficient communication.
The healthcare industry deals with a significant amount of sensitive information every day, thus making healthcare organizations a prime target for cyberattacks. If stolen by cybercriminals, sensitive healthcare data could be used for identity theft, extortion, and other illegal activities. These confidential data may include patient names, dates of birth, addresses, and social security numbers.
Cases of data breaches continue to put high-sensitive patient information at risk. Moreover, cyberattacks resulted in at least one data breach in 91% of healthcare organizations six years ago. And, just last year, more than 50% of all healthcare vendors exposed Protected Health Information (PHI) due to data breaches.
To protect healthcare data, organizations should take a proactive approach. This would mean implementing healthcare security practices not limited to the list below.
Updating Or Replacing Outdated Infrastructure or Hardware
They say the only permanent thing in this world is change. Technology isn’t an exception. One of the various ways that healthcare organizations could reduce the risk of data breaches is to update their IT infrastructure. They have to ensure the latest security patches are available and installed.
However, the need to update IT infrastructure can be costly. Installing it requires distinct knowledge from professionals. Therefore, healthcare organizations must ensure they have the budget and the right people on board to carry out the process. They may do so by working with Dallas managed services provider (MSP) or the nearest IT company that will take care of all the required updates.
Backing Up Data
A ransomware cyberattack uses malware to limit or prevent users from accessing a system. Users could only regain access after a ransom is paid. It tells us one thing – data breaches can also compromise data availability and integrity.
This is why cybersecurity experts highly recommend frequent offsite data backups. It’s the practice of protecting data by copying it from a primary to a secondary location. Most established IT companies provide this for their clients as part of their service.
Surgeries are primary income-generating activities in hospitals and health care facilities. As such, efficiency is crucial in the operating room (OR), where time equates to money as well as someone’s life.
Numerous procedures are done in operating rooms to remove tumors or replace faulty body parts daily. And while carrying them out allows surgeons to upgrade their skills, such improvement must be matched by technologies to make surgical procedures and their outcomes better overall.
Ultimately, the operating room staff must have all the resources to minimize errors and downtime while improving patient experience. Below are a few of the emerging innovations that enhance efficiency in the OR.
Technologically Advanced Surgical Cameras
With cutting-edge imaging technology, doctors can operate with surgical precision. Advanced surgical cameras are capable of not only providing three-dimensional views but also capturing high-definition images. Ultra-small in size, they can be inserted into any body cavity, helping surgeons reach any internal area. Once inside, these cameras create an accurate map of the patient’s body.
Additionally, there are surgical headlights that do more than illuminate the surgical site. Others come with video recording capabilities such as BFW’s LED surgical headlight system to facilitate minimally invasive surgical procedures.
Hybrid Operating Rooms
As the name suggests, a hybrid operating room is a traditional operating room equipped with the latest technologies and imaging systems, including computed tomography (CT) scanners, magnetic resonance imaging (MRI) machines, and the like. This type of operating room also comes with modern surgical tools for minimally invasive procedures.
A hybrid OR procedure involves far more precise and efficient methods than those carried out in standard operating rooms. Setting up and maintaining one can be costly, though, with estimates reaching several million dollars.
Life insurance is something that healthcare providers would rather not deal with. After all, it is only slightly related to the medical field, in that most insurers require a person to undergo a medical before approving their application. However, that could soon change.
If you need a refresher on life insurance, this article from Lemonade Insurance does a great job at explaining what life insurance covers. For people who do not have dependents, this information may not be something they know. Even those who do have dependents don’t always know how much insurance they should get, or whether they even really need life insurance.
The idea that technology will impact life insurance might sound strange, but it is already happening. Here’s how it will impact healthcare providers.
Bundling errors continue to wreak havoc on hospital bottom lines in 2021, causing 34% of inpatient charge denials with an average value of $5,300 each. That’s according to an auditing and revenue integrity report analyzing more than $100 billion worth of denials and $2.5 billion in audited claims released today by 
Being a pharmacist is one of the most rewarding, yet challenging jobs. It requires a high level of knowledge and handwork as well as great communication skills.
By Adrian Johansen, freelance writer; 
The healthcare industry deals with a significant amount of sensitive information every day, thus making healthcare organizations a prime target for cyberattacks. If stolen by cybercriminals, sensitive healthcare data could be used for identity theft, extortion, and other illegal activities. These confidential data may include patient names, dates of birth, addresses, and social security numbers.