Population Health Analytics and the Triple Aim with Tens of Millions in Savings

Population health analytics is used widely by healthcare delivery networks that operate tens of hospitals and clinics, employ tens of thousands of staff, and serve hundreds of thousands of patients. Healthcare systems use population health analytics to achieve the Triple Aim of improving population health, patient experience, and per capita costs. Healthcare networks identify specific areas for improvement, and the results affect all the hospitals in the system. After implementing the population health analytics, networks report annual savings of tens of millions of dollars in areas associated with the highest healthcare costs, such as cardiovascular (CV) disease and stroke care. What is the strategy healthcare networks follow to achieve such impressive results?

If healthcare systems implement population health analytics, they will be able to achieve the goals of enhancing population health through compliance with clinical guidelines regarding certain serious health conditions, changing the care delivery with reduced clinical variation, testing modern processes and approaches to billing, finding new methods of effective patient care.

Healthcare organizations will manage to cut the main expense drivers in certain health system programs and receive tens of millions of dollars in savings/revenue. This will result in the general financial health of the organizations.

However, the lack of relevant analytics tools leads to clinical practice variation, supply overutilization, documentation errors, and other issues, resulting in high costs and negatively impacting patient outcomes. Healthcare networks often fail to focus on the most critical issues while attempting to tackle the overall problem all at once.

Challenges on the Way to Reach the Triple Aim in Healthcare

In their efforts to decrease medical costs, healthcare organizations face challenges related to such areas as supply costs, use of medical supplies and resources, clinical practices, and clinical documentation. Here is a more detailed list of problems that need solutions:

Issues with supply costs

• Non-labor costs exceeding revenues in multiple hospitals
• Steep growing prices of the many materials and supplies (the second largest cost source after labor) in recent years
• High costs of the specific procedures such as electrophysiology in CV programs, which influence the overall budget for specialized care management programs 
• Ordering routine diagnostic tests for prices exceeding national benchmarks
• Absence of standardized guidelines regarding the selection and use of medical supplies to reduce variables in spending
• Absence of a universal supply contract distributed among all providers within a network 
• Fragmentation of vendors and supply contracts across the healthcare network. 

Problems connected with overutilization and LOS

• Overutilization of the supplies, such as laboratory tests
• Excessive use of the medical resources, such as transfusion resources, that leads to unnecessary patient health risks and excess costs
• Unnecessarily extended inpatient stay

Clinical practice issues

• Varied procedures in care for patients suffering from serious health conditions, such as heart failure (HF)
• Lack of programs and strategies of precise ownership of care coordination and care management to handle persistent challenges especially with such conditions as HF
• Geographical and operational diversity of medical centers with the same specialization, which complicates the adoption of universal recommendations regarding practice changes

Clinical documentation challenges

• Losing millions of dollars because of inaccurate or missed documentation, that is required to support appropriate coding and billing
• Absence of analytics tools to identify missing documentation prior to patient discharge to be able to timely complete it.

General obstacles on the way to increased revenue and improved services 

• Contribution of certain diseases and health conditions, for example, CVD, to shorter life expectancy of Americans 
• Necessity to focus on the health conditions with high mortality rate, because identifying and addressing such diseases will influence the overall population health 
• Imperative to optimize care across the whole target area to stimulate meaningful change
• Significant costs for the treatment of some health problems, such as heart disease
• Unclear target areas in the particular disease treatment that need improvement primarily and uncertainty about how to address them 
• Complexity of healthcare networks that unite multiple hospitals and medical centers and demand a systemwide improvement 
• Centralized processes that shift the focus from the specific needs of individual facilities
• Differentiating between the improvements that will affect all providers and those affecting only some of them.

Features of Population Health Analytics Software

To reduce costs and address variations and overuse of resources, healthcare networks need analytics to identify areas for improvement in a timely manner and work on them point by point. Population health analytics assist healthcare organizations with the following:

Clinical Practice Analysis

• Analyze the internal data in search of clinical practice variation and improvement opportunities in such areas as lab test utilization, length-of-stay (LOS) trends, community health trends, usage of intensive care unit (ICU) beds, etc.
• Detect clinical practice variation to understand which practices to change to achieve cost savings and better clinical outcomes
• Identify unrequired prolongation of inpatient stay, which leads to a decrease in LOS

Supply Chain Optimization

• Visualize the amounts of utilized resources and compare them to industry-specific benchmarks and guidelines. For example, transfusion dashboards can be implemented to monitor the proper utilization of blood and blood products 
• Analyze current supplies and identify if their routine ordering is necessary. For example, clinical research might define that some blood tests are outdated and can be cancelled, while others are excessive and can be reduced
• Share the universal supplies price file among all the network providers with the information technology system 
• Compare the bids of the supply chain vendors to select the best conditions for all the hospitals in the network

Documentation and Data Accuracy Controlling

• Review the diagnosis and find missing information regarding current patients, which makes it possible to complete the documentation deficiencies while a patient is still in hospital
• Analyze the comparable healthcare networks across the state and detect potential coding errors to be able to improve the documentation accuracy and coding for particular patient groups on time.

Benefits of Population Health Analytics

Data analytics software helps healthcare systems achieve impressive results in reducing healthcare costs and enhancing patient outcomes by improving workflows in such domains as supply chain, utilization of the supplies, clinical practice, and documentation. As reported, analytics bring them the following accomplishments:

Enhancing Patient Experience

• Healthcare networks reduce readmission rates and promote self-care among patients, such as taking medications correctly and receiving timely follow-up care, by providing comprehensive care coordination

Reducing Costs

• Better understanding a patient's condition directly lead to more accurate coding and billing practices
• By using real-time data from its enterprise data warehouse, healthcare organizations can define and influence operational issues and clinical practice variations impacting the particular care programs and costs 
• Networks receive annual savings/revenue of tens of millions of dollars in the result of their improved services. They are able to further increase their savings over the next years provided they continue the enhancement processes  
• Networks sign agreements with supply vendors about product consolidation and receive beneficial volume pricing for all providers with discounts for high-cost items
• Organizations can significantly reduce the ordering of overutilized resources and stop the routine ordering of unnecessary supplies such as lab tests, resulting in substantial savings 
• Healthcare systems are able to reduce amounts of LOS by hundreds of days, which leads to hundreds of thousands of dollars saved over several years
• Medical providers address clinical variation by using up-to-date evidence-based guidelines, provider education, and EHR notifications to significantly reduce medical resources utilization 

Improving Population Health

• Healthcare projects organized by healthcare networks and other medical institutions with an aim to improve health through changed lifestyles at a community level gain national recognition and lead to enhanced population health. 

How Belitsoft Can Help

Belitsoft is a full-cycle software development and analytics consulting company that specializes in healthcare software development. We help top healthcare data analytics companies build robust data analytics platforms.

For integrated data platforms developed to collect, store, process, and analyze large volumes of data from various sources (Electronic Medical Records, clinic management systems, laboratory systems, financial systems, etc.), we:

• Automate data processing workflows (cleansing, standardization, and normalization).
• Configure scalable data warehouses.
• Set up and implement analytical tools for creating dashboards, reports, and data visualizations.
• Ensure a high level of data security and compliance with healthcare regulations such as HIPAA.
• Integrate machine learning and AI into analytics.

We also help build specialized analytical applications like Population Health Analytics for:

• Utilizing real-time data to support a comprehensive analysis and research
• Tracking performance indicators related to lab tests, LOS, use of care units, etc. 
• Preparing detailed reports for clinical practice management.

If you're looking for expertise in data integration, data infrastructure, data platforms, HL7 interfaces, workflow engineering, cloud development (AWS, Azure, Google Cloud), hybrid or on-premises environments, as well as data analytics, we are ready to serve your needs. Contact us today to discuss your project requirements.