Big Data enters the Emergency Room to provide enhanced quality of care, reduce medical staff’s stress, and accurately capture the medical practices productivity/patient revenue.
Chances are you’ll wind up in the emergency room at some point—if only for some stitches or, like me, when you mistakenly think the palpitations of your heart signal a heart attack. For many, the hospital emergency department is their primary care doctor. The highly trained medical professionals who work in emergency medicine attend to a variety of medical situations. Emergency Department (ED) physicians who staff the emergency room ensure that all moving parts glide together in a manner conducive to the health of their patient, the hospital, and their practice.
A team of ED physicians from ConsensioHealth Inc, software developers, data analytic specialists, and members of the revenue cycle management (RCM) team from Technosoft Corporation, collaborated to create a secure online platform that would whisk together data streams from electronic medical records (EMR), billing data, and provider (ED doctors) schedule data into one platform to serve up the cream of business intelligence. The Chantilly Deep Analysis tool that they were creating would scoop up shift-specific and site-specific real time data that would help the doctors assess and improve the group’s practice performance.
“If we want to see how productive physician X is at site Y on a certain day during a certain shift we can get the data in real time. We can drill down and look at, for example, billed amount per patient and per hour, by group and by provider (doctor),” says Dr. Cory Wilson co-founder ConsensioHealth Inc.
What excites the doctors is the advanced analytics capability of the tool, the use of machine learning to improve business intelligence and answer questions that would be very difficult to answer without the machine’s help. “It is a complex product that provides actionable intelligence,” says Dr. Eric Adar of Emergency Medicine Specialist physician group and co-founder of ConsensioHealth Inc.
Chantilly solution includes the “cash prediction” and the “anomaly detection” algorithms. The “cash prediction algorithm” – takes the historical information about census data, CPT code data and makes predictions on cash flow. The “anomaly detection module” looks at the level of service provided by a provider (physicians or advanced practice providers) and identifies the outliers. These features help the practice direct its efforts on aligning operational/financial and clinical staff to improve the financial performance of the organization.
The goal is to pick up trends before humans can and to shift gears using proactive alerting. For instance, if Dr. X’s productivity falls below a certain threshold a red flag is raised. If a payor stops paying, it alerts the appropriate manager to dig deeper. If the revenue does not meet the expected benchmark the contracts data is churned to see the cause.
Staffing is always a delicate dance in ED. If a facility has an unexpected rush of patients the staffing can be adjusted. “Right now hourly census numbers are there, but they are not readily available, nor are they augmented by acuity,” says Dr. Wilson.
The data scientists ensure that the root cause of any anomaly would be presented to the ED physician practice in a scientific and user friendly manner. “Enterprise centric reporting solutions are used by hospitals but they may not cover the critical business needs the physicians may have,” said Setu Patel Vice President Technosoft Corporation. “This will improve wait times, communications, clinical outcome and patient experience. Doctors share that goal.”
Chantilly provides a way for physicians to reduce complications, and achieve sustainable improvements in their performance through better use of data. Chantilly has a profiling feature that enables doctors to determine their own performance and metrics, and review their own performance against that of their peers, using objective and reliable indicators. A unique feature is the ability to measure provider stress. Analysis of various data points results in optimal staffing models.
Obamacare promises accountability from healthcare, and accountability on patient outcomes rather than the usual fee-for-service model. There is a shift towards payment based on the value of care provided rather than the volume of treatment. How can physicians keep their finger on the pulse of their practice’s performance to ensure their practice’s health? Chantilly is a next generation advanced analytics solution created and used by Emergency Room doctors to receive real time alerts and predictive models to improve their own, the site’s, as well as the practice’s performance. Physicians draw on multiple data sets to create analytical models. This helps them improve quality and cost of delivering care.
“We have learnt from what has worked and what has not worked for us while running a number of EDs over the last 30 years and we have being doing it on a moderately large scale. There are definitely efficiencies that we can help emergency departments like ours avail. Additionally, the key principles are easily applicable to all physician practice environments. Even though it has been designed for the ED practice it would be highly valued by other doctors who are looking for similar efficiencies,” says Dr. Eric Adar.