Tag: care coordination

It’s a puzzle many healthcare providers are still working to solve: when over 80% of health outcomes are influenced by non-medical factors, how can health systems help their patients achieve better outcomes? From affording time off work so they can attend an appointment, to accessing healthy food, childcare or transport, your patients’ ability to engage with and benefit from health services can be heavily influenced by a host of social and economic dynamics Understanding these social determinants of health (SDOH) gives you a more complete picture of your patients’ health and life circumstances. You can anticipate their needs, coordinate their care more effectively, and ultimately give them a better healthcare experience. What’s more, harnessing the right data on SDOH leads to smarter investment and operational decisions, yielding advantages for your health system as a whole. That’s why many providers are starting to use non-medical consumer data in their care management planning. Here we look at some of the top use cases for SDOH data. 5 top use cases for data on social determinants of health     Reduce missed appointments No-shows cost providers an average of $200 each (plus a lot of wasted physician time). Often these are down to lack of access to transportation or childcare. SDOH data can help you anticipate where these challenges might occur, so you can offer additional services like a free shuttle bus or crèche. You’ll make the experience a little easier for the patient, and potentially prevent an unchecked health issue from becoming something more serious.     Save costs from preventable health events Unfortunately, life circumstances can lead to many people using health services in a way that could be avoided. Missed appointments or difficulty following a care plan can lead to escalating medical issues, entailing more treatment and readmissions. Patients might also fall back on emergency services because they can’t easily access appropriate alternatives. SDOH data helps you understand the circumstances that might lead to this kind of patient behavior. For example, if you can spot patients who may be likely to dial 911 because they have no other way to get to the health services they need, you can offer alternatives that avoid an unnecessary visit to the ED. This could help you save up to $2000 per Emergency Department visit and around $10,000 for each hospital stay (which often can’t be fully reimbursed if the patient ends up being readmitted).     Increase care plan compliance A patient’s living situation can often determine whether or not they’ll be able to stick to their care plan. For example, specific dietary advice can be a real challenge for a diabetic patient if they have a limited food budget, lack of time to shop and prepare food, or a plain lack of options of where to buy it. An SDOH needs assessment can flag this in advance so clinicians can help patients find a plan that will work for them. Similarly, pharmacies might use consumer data to help minimize abandoned prescriptions or situations where a patient fails to follow dosage directions, which is estimated to cost the industry $290 billion per year.     Save administrative and clinical time Analyzing consumer data can help your operations run more efficiently, which benefits your patients through well-coordinated care, timely information sharing and prompt referrals. Many providers are taking advantage of automated solutions for leveraging SDOH data, saving massive amounts of administrative time for care managers by pre-populating patient data and automating SDOH needs assessments. Consumer insights solutions like Experian Health’s ConsumerView analytics can optimize operational efficiencies and ensure your care managers use their time well.     Investing in relevant community health programs One of the most impactful use cases for SDOH data is to gain a richer understanding of your member base, so you can invest in the most relevant community health programs. For example, a 2018 pilot project by Atrium Health in North Carolina screened for food insecurity in older patients who may have been at risk of readmission. Emergency food services were provided where needed, and as a result, readmissions dropped by 60%. Your purchasing power can also be a force for change. The Cleveland Clinic outsourced its laundry service to Evergreen Cooperative Laundry, a local collaborative working to combat poverty. Ralph Turner, executive director of patient support services at the Cleveland Clinic says: “Establishing the foundation for people to stabilize their incomes and become part owners in a business… in itself generates health and wellbeing in our community.” Leveraging consumer data to improve patient outcomes These examples show some of the varied ways screening for social determinants of health can open the door to understanding your patients and creating truly person-centered care services. Who knows what opportunities are hidden in the SDOH data for your patient population? Are there gaps in your data? Could you combine different data sets for a fuller picture? What exactly is your consumer data telling you, and how do you turn it into meaningful management decisions? At Experian Health, we have comprehensive data assets and analytics platforms to help you answer these questions and more, and leverage consumer data most effectively.

In a recent healthcare information technology survey, more than 40 percent of chief information officers identified patient matching as healthcare’s top IT concern. And though a quarter of the respondents admitted it wasn’t a current priority for their organizations, they did say that it very much should be. There’s no shortage of reasons why, but the most pressing is the need to reduce medical errors, which account for over 250,000 deaths in the United States every single year. Case in point: Seventeen percent of CIOs acknowledged that errors in matching data with the right medical identities have led directly to adverse outcomes for patients. The numbers speak for themselves: Healthcare organizations must find more effective ways to manage the data within their networks. That begins with building a robust medical database that not only hoses data, but also knows how to match it with the proper patients. How robust EMPIs streamline workflows An enterprise master patient index (EMPI) is a database that can help you clean up your data and eliminate duplicate and inaccurate records. It uses algorithms to match exact data elements among disparate records, as well as elements that fall within an acceptable range of possible compatibility. Using technology that can apply an algorithm of probabilistic and referential matching methodologies will allow healthcare organizations to expand beyond the limitations of conventional single methodology matching, as both probabilistic and referential matching techniques provide a higher degree of likeliness. The system assigns these data points to unique identities that follow patients throughout the organization. Any new data generated within the network is also attached to this identity, meaning physicians, specialists, pharmacists, and other members of the patient’s care team can access and update it as needed. EMPI support tools and unique patient identities are building blocks toward creating a healthcare ecosystem that’s truly interoperable. According to an April 2018 survey by Black Book, hospitals with an EMPI report “consistently correct patient identification at an overall average 93 percent of registrations and 85 percent of externally shared records among non-networked providers.” Unfortunately, not all healthcare systems possess the IT infrastructure to support these programs. And as long as some organizations fail to integrate similar platforms, providers won’t reap the benefits of industry-wide interoperability — and patients will continue to suffer. Whether it’s a frustrating billing mix-up, privacy breach, or a detrimental (or even fatal) misdiagnosis, many errors can be successfully prevented with an EMPI. Filling in the holes The goal of such a system should be to standardize data entry and access within each healthcare organization, as well as across the entire industry. Such a network could protect, govern, and match unique patient identities across every discipline and every aspect of their care continuum. But in order for the system to achieve these goals, you need to be sure you’re feeding it relevant, recent patient information. To ensure you have enough patient data to build an EMPI that accurately matches profiles, ask yourself these questions: 1. What kind of medical care have my patients received before this visit? When patients enter a new hospital, they’re given a brand-new identity, or patient number, that’s only relevant to that healthcare system. The identity you assign them within your own organization doesn’t provide any insight about what they’ve experienced before their current visit — and that’s the crux of the matter. When patient information is siloed within a specific system, you have no view of the patient’s medical history. But when it’s shared across systems and fed into a more dynamic and interoperable data management system, patients will ultimately receive better care. 2. Who are my patients when they’re not “patients”? It’s important to understand who patients are when they’re not in the hospital. Yes, they’re husbands and wives, mothers and fathers, brothers and sisters. But some could be physically fit, while others haven’t seen the inside of a gym in years. Some might get regular checkups, but others cannot afford to see a physician regularly. All of these traits factor into your patients’ identities. With a comprehensive EMPI, you can tie them together to understand the environmental and socioeconomic factors that influence your patients’ health. You can then identify what social determinants of health need to be addressed or could potentially influence the efficacy of certain treatments. 3. Can we identify patients without a picture ID? Biometrics such as fingerprints and iris scans are more secure forms of identification than a photo ID. They’ll not only make it easier to identify patients, but will also offer heightened security against fraud. That being said, even biometric identification isn’t 100 percent secure unless it’s part of a database, such as the EMPI, that accurately matches patient identities with relevant medical data. Accepting that the healthcare industry needs better data management and patient-matching strategies is the first step to realizing those goals. EMPIs have shown organizations the value in universal patient identities. Now, they simply need comprehensive databases that are robust enough to keep patient identities consistent across the entire healthcare ecosystem.

As healthcare in the United States shifts toward a more value-based model, reducing readmission rates has become one of the biggest challenges healthcare organizations now face. Last year, approximately half of all hospitals in the country collectively lost more than $500 million in reimbursements because they had not learned to overcome this roadblock. In most cases, the difficulty doesn’t stem from provider inadequacy, but rather from the inability to effectively coordinate patient care among multiple providers and departments. From treatment specifics and aftercare instructions to prescriptions and follow-up visits, there are plenty of cracks in the communication pavement for important details to fall through. Here's the unavoidable fact: Suboptimal care coordination results in higher readmission costs to hospitals, even for patients with highly treatable conditions. In turn, providers lose much of their profitability, which further hinders their efforts to improve quality of care. Two key (and often missing) factors in care coordination are advanced IT strategies and patient engagement. The only connection among inpatient, outpatient, and long-term care teams is the patients treated in each. Therefore, providers should make it easy for patients to be proactive in their own healthcare. In large part, that requires technology that allows all patients and their care teams to communicate easily and securely, at any time and across any device. Modernizing healthcare communication while reducing hospital readmissions If healthcare providers could simply call or instant message each other with details about patients’ medical conditions, then coordinating care wouldn’t be as strenuous. Without a secure platform, however, healthcare providers might leave sensitive patient health information out in the open for anyone to steal. That liability would be multiplied among numerous physician groups, specialists, skilled nurses, home health aides, and more, possibly affecting several cities and states. All of that is in addition to hazards created by patients who log into public Wi-Fi networks and carelessly leave their mobile devices unattended. There are a lot of elements to consider, but providing a safe and convenient communication platform for patients and their healthcare teams eliminates most security concerns. With a care coordination platform, communication is protected across a broad provider spectrum, no matter what device is used. For example, after a patient is released from the hospital, the Care Coordination Manager generates and delivers real-time messages to members within the patient’s care continuum. These messages, which include discharge details, a checklist for contacting the patient, and schedules for future visits, are automated and delivered within a closed-loop system for optimal safekeeping. Better coordination equals fewer readmissions Closing communication gaps between patients and care teams is a big factor in reducing hospital readmission rates. With this in mind, as a rule-driven platform, the Care Coordination Manager automatically sends email or texts to patients and caregivers about meaningful events. By doing so, patients and their teams stay on the same page at all times with notices for completed test results, newly prescribed medications, and schedule or treatment adjustments. With the platform's two-way, real-time communication capabilities, patients can also ask questions and receive answers about their conditions almost immediately. This helps keep patients informed and engaged, and it encourages them to seek self-care solutions rather than visit the hospital repeatedly for minor concerns. In addition, different providers on the team can easily request information from each other. The Care Coordination Manager is unique and requires virtually no additional training for doctors and staff to utilize. The platform offers all of the benefits of secure, automated communication without the time-consuming catch-up training that often comes with implementing new systems and processes. Of its many advantages, however, the most significant is that the Care Coordination Manager patches up the cracks in care coordination and communication where important patient care information often gets lost. When patients and their healthcare teams can connect and discuss sensitive health information without the worry of security and efficiency, the better care becomes. As a result, organizations can reduce readmission rates across the board, which equally benefits patients and healthcare institutions, all while keeping the main goal of providing quality care top of mind.

Your organization would make a great participant in our Universal Patient Network. We’ve developed a unique solution leveraging Experian’s demographic data to establish a universal patient identifier, which has higher match performance than standard industry tools. We would like to offer YOU an opportunity to leverage our Universal Identity Manager (UIM) Batch product at NO CHARGE.* What you give: Patient demographic data in a secure file/message What you get: File with Universal Patient Identifier (UPI) and identified duplicates (at your specific frequency) How you benefit: Information exchange, care coordination, patient safety, operational efficiency and financial savings Your organization can address duplicate issues and be at the forefront of promoting a universal patient identifier. Contact Experian Health today to learn more! Visit www.experian.com/umpi, email experianhealth@experian.com or call 1 888 661 5657.   *Offer is limited to Experian Health’s UIM Batch Process product and shall remain open for such time as Experian Health may decide.