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Data analytics: Marrying compliance and strategy

July 23, 2012
by Pamela Tabar, Associate Editor
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Accountability is no longer just a buzzword. All parties in the care chain are being asked to improve quality and share care data beyond their own walls, and the Centers for Medicare & Medicaid Services (CMS) intends to make bridging the data gaps between hospitals and long-term/post-acute care (LTPAC) facilities a regulatory responsibility soon.

Meanwhile, the LTPAC landscape has changed a lot since the previous decade: Residents are entering facilities later in life, acuity levels are rising, and baby boomer consumer expectations are about to surge through the roof. How does all this affect care delivery and a facility’s bottom line? Enter the new generation of data analytics technology.

THE NEW ROLES OF DATA ANALYTICS

Of all the LTPAC segments, nursing homes have the most data, the most standardized assessments and the most complex regulations, says Steven Littlehale,MS, GCNS-BC, chief clinical officer and executive vice president of PointRight, a predictive analytics software provider for the healthcare industry. “Yet, we’ve done relatively little to assess or utilize the information we collect.”

Under the “transitions of care” initiatives, that data will be valuable in curbing all kinds of negative things, including hospital readmissions, once the data are (1) electronic and (2) sharable. The trick, Littlehale says, is to welcome the data the LTPAC caregivers are already gathering while finding new ways to use data to benefit the residents’ health, the organization’s business relationships with local hospitals and the facility’s financial bottom line. Data analytics technology can help with both tasks.

In-house data analytics involves taking a facility’s collected data and examining it for any patterns, red flags or hidden opportunities. In the past, the analytics process was usually initiated by the organization’s finance office. The data-crunching reports were generated within its IT department and rendered as a scorecard report for the executives. Caregivers rarely heard about the impacts of the clinical and behavioral data they gathered daily, unless the outcomes were poor, that is.

“Outcomes reporting is the tip of the iceberg,” says Teresa Chase, president and CEO of American HealthTech, a provider of business operations software for LTPAC organizations. “But it’s just Generation One of analytics.”

Today’s analytics software can reach deeper across the facility to provide near-real-time results reporting. Properly employed, analytics software can catch MDS coding errors before the file is submitted, show leakages in the facility’s cost system and even provide some clinical decision-support alerts on resident care while there’s still time to do something about it.

In short, today’s analytics aren’t just for quarterly outcomes reports anymore. Now, it’s all about moving toward proactive responses to gathered data, instead of reactive ones. The proficient use of data analytics will be affecting all of these facility aspects, either now or in the near future:

FINANCIALS

Data analytics systems were originally designed to assess the positive and negative impacts of the facility’s core business and service lines, and they are still best known for that role. Now, data analytics can analyze anything from coding compliance to equipment use, and from supply purchasing history to liability costs.

As finance and operations blend together, data analytics systems are also being used to manage one of the organization’s most crucial financial aspects--its staff. Some systems can track staff skill sets and recalculate staffing needs as the resident case mix changes. “You can change your staffing models, or you can look to technology to empower the staff you already have,” says Jim Pursley, general manager of Independent Living, Intel-GE Care Innovations, which offers technology solutions for LTPAC and senior independent living.

SAFETY/RISK MANAGEMENT

Today’s LTPAC environment involves a complex balance of care delivery and documentation, among other factors. Analyzing the facility’s daily data can show where the organization can improve patient safety and close the risk holes.

With fall management and resident wandering high on LTPAC’s concern list, data analytics can be combined with motion sensors and behavior-based analytics technology inside a resident’s apartment to detect significant changes in resident movement patterns. Multifeatured pressure-sensitive pads are already on the market that can be placed on a bed or wheelchair to monitor for changes in positioning. Although originally designed to alert caregivers to a resident attempting to leave a bed or chair, some pads can detect incontinence, potential pressure spots and other things.

Some analytics-based room sensors can discern (via data gathered over a week or so) that a specific resident rarely gets out of bed during the night, establishing a “routine pattern of behavior.” If that resident later begins to get out of bed six times a night to use the bathroom, it could mean the onset of a urinary tract infection (UTI), an illness that can be treated easily if caught early.

“UTIs are a huge cause of disorientation and falls, and there are symptoms that present days before,” Care Innovation’s Pursley explains. “But once the resident falls and breaks a hip, or is on the floor with a 104° fever, you can only do so much. You’ve missed the opportunity to get ahead of emergencies before they occur.”

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