Solving Urgent Needs
Hospitals & Hospital Systems
Hospitals and hospital systems have urgent needs for strategic technology that solves the challenges in the evolving healthcare environment that are not provided by patient-centric electronic medical records that are tactical.
Boards and C-level executives are in charge of providing optimal value to patients and payers with optimal outcomes for most administrative functions with little or no information, much less insight, that control value-driven care.
Hospitals and hospital systems must increasingly demonstrate optimal clinical outcomes for transparency that require optimal operational and financial outcomes. The relationship of performance measurement with outcomes, analyzed by scientific metrics that matter and calibrated to patient-specific predictive risk factors is essential, yet not provided by existing EMRs, clinical integration and revenue cycle management vendors.
Optimal Clinical Processes
Optimal clinical processes begin with evidence-based guidelines, but hospitals urgently need to track outcomes using scientific metrics calibrated by patient-specific predictive factors resulting from clinical, operational and financial performance. Experience-based clinical processes are needed to continuously improve outcomes with real-practice performance rather than relying on published textbooks and articles. Key performance indicators (KPIs) must be identified as clinically valid performance metrics.
Joint Commission Standards require Focused & Ongoing Professional Practice Evaluation (FPPE-OPPE). Hospitals urgently need to credential practitioners based on published performance and outcomes metrics from organized medicine to achieve optimal clinical performance and outcomes while mitigating liability exposure from negligent credentialing.
Hospital-Owned Physician Practices
Practice management for hospital-owned physician practices and groups creates the same urgent need physicians have for their own private practices. PQRS compliance and use of performance and outcomes metrics, with process data systems and dashboards are the strength of QualOptima, as well as QualVal Solutions for bundled technology with outsources or supportive practice management solutions. Hospital are recognizing the strategic value of measuring performance and outcomes beyond PQRS for patient management, not simply practice management.
Physician Contracted Practices
Hospital contracting with physician practices, such as emergency medicine, anesthesiology, radiology, pathology, and hospital medicine urgently needs to include incentives and disincentives for performance and outcomes. Combinations of productivity measurement with clinical performance and outcomes measurement is vital to outsourced contracting, especially where outsourced practices maintain their own peer review data.
Real-Time Patient Management
Real-time use of performance and outcomes data from precise scientific metrics is the logical next step in hospital operations and patient management. The AMA expert in development and use of these metrics for concurrent quality measurement with patient management, Eric Schneider, M.D., recently co-authored a significant article advocating such technology in the New England Journal of Medicine. This technology is the solution to patient management mirroring the air traffic control model extensively discussed in the Institute of Medicine.
Hospital urgently need to market based on transparent reporting of outcomes data, not the recent phenomenon of marketing essentially contracted favorable quality and outcomes results. Studies in the medical literature report technology methods capable of analyzing specific hospital services, such as obstetrics delivery complication rates (determining that low performing hospitals have a five-times greater maternal complication rate than high-performing hospitals). Equally urgent, hospitals need to use patient outcomes, correlated with patient-specific risk factors, to retain patient loyalty and to attract new patients.
The central theme of the Institute of Medicine, in the quest for improved patient safety, clinical quality and outcomes, is for hospitals to become learning organizations. Analytics of the past focused exclusively on claims data, clinical integration, and revenue-cycle management have not delivered the information urgently needed by hospitals to become learning organizations.
External Clinical Auditing
Hospital boards of trustees have clearly established processes and consultants to externally analyze financial performance and outcomes. Clinical auditing for boards are equally important to comply with regulations and responsibilities to validate internal analysis and reporting.
Tracking Strategic Plans
Hospitals and their boards of trustees spend millions of dollars on strategic plans yet do not have the strategic data analytics to track clinical progress and improved patient outcomes to monitor those plans.
- Physicians & Physician Groups
- Accountable Care Organizations
- Health Insurance Companies
- Medical Malpractice Companies
- Medical Device Manufacturers
- Pharmaceutical Companies
- Covernmental Entities