Accountable Care Organizations Analytics
In ACOs, a model of care where competing healthcare organizations must work together and share data to lower costs and co-ordinate care, the use of data analytics is essential to the success
of participating providers.
Annemarie Wendicke, MPH, CHDA, senior business analyst,
population health and management at Hawaii Health Partners,
sees this every day in her hospital, which is part of an ACO. The
data Wendicke works with on a daily basis is pulled from the
EHR vendor used across all of the hospitals, physician clinics,
laboratories, imaging centers, ambulatory centers, EDs, and
specialty clinics, and is constantly being analyzed to look for efficiencies and ways to improve care.
“Our IT department has done a great job of giving us a direct
link from the database where the data is stored directly into [the
data visualization software] QlikView and so we can visualize
large amounts of data quickly. We look at hospital encounter
data as well as DRGs associated with different diagnoses codes,
trends, and patterns,” Wendicke says.
This software has been integrated into the dashboards physicians use so that at any time they can look at their practice’s encounter data to find out, for example, which of their
patients have outstanding cancer screenings, which ones
need to be reminded to have their blood pressure checked,
or which women need to be seen for prenatal monitoring.
The dashboards are also used in finance committee meetings
where physicians and finance officers might want to find out
how many readmissions a given facility had over a certain
time period. The dashboard has the ability to let them drill
down and look at these kinds of rates by encounter, DRG, diagnosis code, or physician.
One project where data analytics has been particularly helpful is in one hospital’s effort to reduce admissions associated
with pre-term labor. During a retrospective review of ED medical records the hospital found that many pregnant women
were presenting at EDs in the evenings—after OB/GYN practices closed for the day—under the mistaken belief that they
were in labor. In most cases they were admitted overnight and
discharged in the morning by their physician. The work group
then took these findings and developed an educational campaign as well as criteria for admission that was integrated into
the clinical decision support programs in ED EHRs. If women
didn’t meet criteria for admission, they were advised to call
their doctor first thing in the morning.
Wendicke is working with healthcare professionals of all
different backgrounds, including IT, HIM, data scientists, and
project managers, but she acknowledges her biology degree
has helped her understanding of the more clinical applications of her work. Having knowledge of data visualization
programs like Tableau and programming languages such as
SQL helps, too. These are skills HIM professionals can pick
up with certifications and on-the-job training.
“One of the things that’s required in our department is to
have some experience with quality measures and clinical outcomes. They should also be able to present data in a useful or
meaningful way for a variety of audiences,” Wendicke says.
Cancer Registry Analytics
While some HIM professionals have heeded AHIMA’s advice to
gain data analytics skills through certifications, workshops, and
additional classes, others are being introduced to it on the job,
which reflects the inextricable link between the two disciplines.
Work on cancer registries and registries for other diseases has
always been the domain of HIM professionals, and now that
the data collected on these registries are being used for more
purposes, familiarity with data analytics has become essential
to doing the job.
Pam Moats, BA, RHIT, CTR, cancer registry manager at West
Virginia University Medicine’s Cancer Institute, has been working on her facility’s cancer registry for 27 years. She has learned
the analytics and informatics applications on the job, but it’s the
HIM background she possesses that has really been invaluable
in this job.
“You could not do this job if you didn’t know anatomy, physi-
ology, and medical terminology—and every year it just gets
more and more complex,” Moats says. “You have to know where
to look in the medical record to pull out what you need. You
have to have insight, too, not only the disease process but the
treatment process. We have to know, for example, how stage 1
breast cancer would be treated.”
Her job includes running and writing administrative reports,
marketing reports, and quality improvement studies, as well as
using informatics to look for migration patterns in where their
patients are coming from and how far they have to travel. Reg-
istrars also collect information from every patient that’s been
treated by the center in order to track survival rates and com-
plication rates, as well as concurrent abstracting and preparing
patient data for cancer researchers and clinical trials. Moats
says new hires for cancer registrars are required to have at least
an associate’s degree in HIM and be certified in cancer registry.
Moats has worked as a registrar for so long that she’s seen
this HIM specialty transition from a completely paper-based
system to one that’s now entirely electronic, where informatics skills are a must. Since all the work related to registries is
electronic, much of the registry workforce works remotely—
a reality Moats says she never could have imagined when
she started in the field. “It’s a great profession—a great job,”
Moats says. ¢
Mary Butler ( firstname.lastname@example.org) is associate editor at the Journal of
Quiz ID: Q1818909 | EXPIRATION DATE: OCTOBER 1, 2019
HIM Domain Area: Management Development
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