Patient-Reported Data Collection and Return on Investment

ROI-300x300-screenDetermining ROI Metrics

The determination of when an investment recoups its costs is in many instances a fairly straightforward matter. In other instances however, it isn’t quite that simple. As the transition to value-based healthcare advances, providers are keenly looking for ways to assess the impact of patient-reported outcomes data on their bottom line.

The identification of a specific ROI metric to the cost of deploying a patient-reported outcomes data platform deployment is dependent on a number of factors that are not always easily quantifiable. Much depends upon what kind of data is being collected, the purposes for which it is being collected and both the qualitative and quantitative nature of the data.

To ensure a credible and reliable calculation of the ROI of patient-reported outcomes data collection, providers should rely upon a rigorous systematic approach for evaluation. One such methodology can be found in the work of the ROI Institute, through their “evaluation framework,”1 which categorizes results in a prescribed, logical order. This recommended sequence represents a chain of impact that can attribute and account for benefits realized. This framework consists of 5 levels of information to consider:

  1. Reaction to the program, particularly the perceived value of the program.
  2. The extent of learning such as skills, competencies, knowledge, and insights in the program.
  3. The extent of application and use of knowledge, skill, and insights acquired during the process.
  4. The program’s effect on the data such as, sales, productivity, quality, time, and costs.
  5. The ROI, the net monetary benefits compared to the cost of the program.

Patient-reported outcomes data collection offers its users a myriad of ways to generate value. For researchers, the data analysis tools provide powerful opportunities to analyze deep data sets. Practice managers are enabled to follow physician members to uncover best practices. And of course physicians can optimize their CMS reimbursement adjustment amounts by monitoring their performance scores throughout a performance year. The point is each user has a unique basis from which to evaluate and determine the overall benefit Patient-reported outcomes data collection contributes to a provider’s practice. Any valid assessment of an ROI must be tailored to the specifics of each user. Any generalized metric is clumsy at best and more than likely misleading.

Value Return to Physicians

The value of any patient-reported data collection platform to a physician must be measured by an array of considerations requiring objective and deliberate analysis. Each aspect of a physician’s practice that is impacted, whether directly or indirectly, necessarily needs to be factored into the equation. Failure to pursue such diligence in the assessment process will more than likely produce an incomplete and misleading result.

Application of the ROI Institute’s evolution framework offers a substantive foundation on which to assemble a meaningful appraisal. The framework is flexible enough to enable application to each unique practice configuration, yet establishes cumulative benchmarks that result in a succinct and useful metric. The sequential nature of the framework reinforces an approach that captures seemingly disparate variables and leverages them collectively to reveal a deeper and more nuanced valuation of deploying a patient-reported outcomes measurement system.

Data mining technology, such as OBERD’s “Mountain,” can factor prominently in generating value out of the data being collected. With it, physicians have the power to slice and dice information in a myriad of ways for infinite uses. For example, providers may measure effectiveness of care, by specific procedure as well as in aggregate. These insights, which can be generated on-demand, can empower physicians with invaluable and actionable information. No longer is a physician constrained to wait for an annual, boilerplate report.

The capacity to robustly leverage data enables insightful benchmarking for both patient and practice analysis can fortify operational best practices. By incorporating efficiencies and successful procedures revealed through tools such as Mountain, new competitive and productive gains can be realized.

A byproduct of this ability to mine data is to provide physicians the opportunity to license newly uncovered knowledge to manufacturers for research and development by the medical and pharmaceutical industries.

Patient Engagement

Patient portals and other technologies that identify and fortify patient touch-points provide opportunities to encourage patient participation in their own care. Heightened patient engagement can lead to better healthcare outcomes at a lower cost by increasing the efficiency of the healthcare system/care offered. In addition, the deployment of patient defined outcomes instruments offers to maximize clinician-patient communication by facilitating an environment that involves patients in their care leading to a better understanding of their conditions and quality outcomes.

Tracking patient reported outcomes for research purposes provides an exceptional marketing tool to showcase your advancement in medical treatments/surgical practices. OBERD’s powerful analytic tool, Mountain, offers providers a platform to analyze and mine the data you collect, and to benchmark against other data sets, global or local.

MIPS Compliance

The determination of any unambiguous ROI regarding MIPS compliance relies upon several factors that presently are premature to firmly assess and are simply not available. No reliable computations can be made until CMS has aggregated Composite Performance Scores (CPS) of all physicians participating in MIPS performance year one, 2017. All scores achieved during this initial year will be used to determine a “CPS Threshold” against which providers will be compared in order to assign reimbursement adjustments that will affect payment year one amounts in 2019. Until that threshold is published, it is simply impossible to identify express ROI expectations.

That said, close monitoring of CMS communications are beginning to reveal benefits through the thoughtful and strategic usage of patient-reported data measurement for the collection, analysis and reporting of patient-reported outcomes data.

CMS has published guidelines to demonstrate how reimbursement will work through the Quality Payment Program (QPP) but has yet to provide specific monetary values. The program has allocated $833 million dollars yearly for the next 5 years that will be distributed based on eligible clinician merit with a focus on quality outcomes, which is reflected in one’s CPS.  The better one’s CPS, the higher the probability that positive reimbursement adjustment will follow. Beyond the funding set aside to incentivize performance merit, here is an additional $500 million dollars available annually for the next 5 years reserved for those with an overall composite score of 70 points or above.

OBERD continues to closely monitor CMS announcements and regulatory developments. As each iteration of QPP rules are revealed, OBERD will continue to refine its products to optimize results for its customers.

Reinforcing a Practice’s Marketing Message

The publication of CMS’s Physician Compare website, by publishing clinician measure scores, allows patient to embody the role of a consumer in shopping around for the best healthcare and for providers that demonstrate higher quality outcomes. CMS has further advanced the promotion of provider score transparency by empowering qualified clinical data registries (QCDR) to supplement Physician Compare website information with enriched content that will further empower patients to see additional information about providers and their practice. OBERD, as a CMS-approved QCDR, is developing multi-modality scorecards to showcase a provider’s best qualities, identify top performers, identify best practices and establish additional practice marketing opportunities.

Summary

As the transition from a fee-for-service to a value-based care system continues to evolve and accelerate, the ability to efficiently and economically collect, analyze and communicate patient-outcomes data will be foundational to a provider’s success. Evidence-based healthcare decisions will rely on leveraging a patient’s involvement in their own healthcare. By increasing the role of a patient to communicate on their own individual situation and progress, that patient is afforded a more active role, which promotes better patient experience and satisfaction. Better performance scores directly impact reimbursement computation.

Of the ROI Institute’s five point evaluation framework mentioned earlier, it needs to be underscored that the first three elements address subjects that do not lend themselves to quantifiable measurement. The perceived value derived from acquired knowledge, skills and insights precludes the value received in the application of those newly realized observations. Application of the new knowledge in turn can directly impact and drive a provider’s best practice.

The ROI evaluation framework begins to address quantifiable activities in step four only after the first three steps of the process are accomplished. These activities, such as sales, productivity and costs can only be accurately assessed in the context of framework steps 1-3. The ROI Institute’s framework requires that all four steps are necessary, a condition precedent, before any actual ROI, the net monetary benefit compared to cost, can be accurately assembled.

OBERD understands that providers desire to be free from the routine task of data collection. Providers can now harness exceptional new methods to gather information from their patients, learn from them and to apply those insights towards that patient’s care. A healthcare provider should be able to practice medicine, and not have to monitor every single regulatory change. OBERD is set up to do just that. Be assured that OBERD will continue to advance solutions that address the latest in compensation strategies that generate optimized benefit to its customers.

As seen in OBERD’s Insights Blog.

Learn how you can take your value-based care to new levels with our new outcomes solution in partnership with OBERD.

7 Tips for Reducing Stress While On Call

  1. coc-blogMake sure you know your schedule- No one likes surprises. So make sure you know when you are on call.  If there are conflicts take care of them with enough time to get someone to cover for you.  Ideally you want the schedule made far in advance with easy access to view it on a shared calendar.  Many practices use google calendar or something similar.
  2. Don’t make big plans- Depending on your practice, being on call may be extremely busy or pretty slow. However, you need to be available for urgent and emergent patient issues that arise.  Trying to make it to a concert or take a family vacation while you are covering your practice after hours is a recipe for disaster.  You may be setting yourself up for medical liability and certainly making it difficult to enjoy your time off. Instead, swap calls with a partner or develop a relationship with a friendly competitor in your area to help cross-cover your practices.
  3. Ensure that patients can get through easily- At the beginning of call review the process that patients take to reach you. For some it may be checking that your phones are being forwarded properly and the call center knows your contact preferences. Ideally they should have your cell phone, home phone and email. Make sure they know how you want to be contacted.
  4. Try not to get angry or grumpy- It’s not always easy to sound enthusiastic when you get awoken in the middle of the night or disturbed during dinner to speak to a patient for an issue that doesn’t seem very important. Try to remember that the patient is not as knowledgeable as you are about health issues and wouldn’t be bothering you unless they were very concerned. Even if the call turns out to be non-urgent be sure to be polite and reassure the patient; you will both sleep better if the tone is pleasant.
  5. Educate your patients- Tell your patients to call if they are having difficulties or have questions about their care; try to be specific about the type of symptoms to look for.  This is especially important for patients who have had recent surgery or are taking new medications. By explaining what serious post-operative symptoms or potential medication side effects may be will reduce potential problems for you and the patient.
  6. Have a process to document calls- Your job is not done when you are finished speaking to the patient. Find an easy and reliable way to document the call and your recommendations. Some practices have a voicemail system that they call into to tell staff members about patients that called. You can also keep notes and fax back to the office.  We don’t suggest email or texting your office staff since this is likely to be in violation of HIPAA regulations. The easiest way to document is with an app based on-call service which allows for immediate documentation that is sent to the office staff as well as into your EHR.
  7. Designate staff to follow up after hour issues- No matter how you document the calls you need to designate someone in your office to handle the follow-up and charting of after hours calls. Ideally that person gets in early so they can call patients that need urgent appointments.  Make sure you have a way to track which calls were reviewed and charted by your staff.  Signature and time/date stamp is helpful.

We invite you to learn more about solving on call challenges as well as other pain points your medical practice may be facing and we look forward to speaking with you.

rheeDavid Rhee, M.D. – Retinal Specialist and Co-Founder of Connect On Call

David graduated from Harvard University with a BA in Biology, and obtained his MD from UC-San Diego. He then completed a residency in ophthalmology at Tufts University and a vitreoretinal Surgery Fellowship at Wills Eye Hospital in Philadelphia. David has a keen interest in the Android platform and other open source platforms and designed the wireframe layout of the mobile web app for ConnectOnCall.

The True Cost of Patient Registration Errors

The true cost of patient registration is hard to analyze because most providers and hospitals have convinced themselves they need to handle patient registration, instead of the patient handling it themselves. Therefore, the cost for patient registration can’t be improved and constantly increases based on new industry standards, such as meaningful use questions and ever-increasing staff costs. The result of this attitude and approach is that patient registration often takes more time than necessary. If the patient is unable to control his or her data during the registration process, lengthy wait times and increased dissatisfaction occur—costing providers both time and money.

Patients, on average, spend about 20 minutes in waiting rooms of healthcare organizations. When these organizations don’t focus on streamlining the patient check-in process, patient throughput suffers. Staffing expenses increase because staff must take time to clarify patient data or fill in missing pieces at the point of service. In addition, the potential for denied claims is higher due to a lack of data verification, raising overall collection costs.Impatiently-Waiting

Today, just 5 to 10 percent of healthcare organizations offer self-service solutions for patient registration and check-in. This is a missed opportunity to improve patient satisfaction, reduce costs and increase revenue. There are three benefits of self-service check-in technologies healthcare leaders should consider.

Speed. At Montgomery Cancer Center in Montgomery, Alabama, an electronic patient check-in solution decreased patient check-in time to just 41 seconds. Putting the registration process in the hands of patients not only provides them with the ability to manage their experience, but also limits check-in time simply by eliminating a visit to the front desk. This increases patient throughput and ensures that the time staff does spend with patients is of higher value.

Consider the airport registration process. When passengers fly, the last place they want to go to is a desk staffed by an airline employee. Instead, the first stop is to a kiosk or a mobile application with built-in technology that recognizes individuals with the touch of a few buttons, thanks to information they have been able to input in advance.

The experience in most hospitals and physician practices is often the opposite. Patient check-in is heavily dependent on staff—and breakdowns in processes occur when staff call in sick. They also occur when staff follow the same steps for each patient rather than customizing the registration process to the patient’s situation and needs. This increases the potential for error, which can lead to lost revenue.

Some hospitals and physician practices have tried to automate the registration process with the use of tablets rather than self-service platforms that verify data in real-time. However, this approach has critical flaws. For example, to receive a tablet, patients must go to the front desk, just as with traditional, manual processes, and any front-desk encounter adds time to the visit and costs hospitals and physician practices money. Every patient visit to the front-desk is an incremental cost for the hospital or physician.

Patient experience. Why is it that patients spend more time in the front office than with their physician or a nurse? It’s because front-office processes are broken. When patients spend more time than necessary dealing with a provider’s front-office processes and staff, satisfaction plummets—and there is a cost to lost patient loyalty.

One of the biggest misconceptions in healthcare is that front-office staff in physician practices and hospitals provide a personal touch to the patient encounter. But think about what this encounter typically looks like: “We have a few questions we need you to answer. Here is your paperwork [or tablet]. Please return this with your insurance card and driver’s license …” Is this really the personal touch we’re seeking to provide in healthcare?

Meanwhile, patients complain about the amount of paperwork they must complete before being seen by a physician. The personal touch they want is time spent with their physician. Anything that impedes their ability to see their physician impacts their experience.

Ideally, patients should spend two minutes or less on registration activities when they arrive for their appointment. While the amount of time spent at check in will vary by specialty, look for a self-service check-in solution that can ensure a two-minutes-or-less process.

Improved communication. So often in healthcare, it appears no one has time to truly talk with patients. Front-desk staff don’t always have the experience or time to have a meaningful conversation with patients. Nurses and technicians are under too much pressure to move patients through processes quickly. When the patient does see a physician, the backlog of patients—stemming in part from inefficient check-in processes—limits time for a meaningful encounter beyond the reason for the visit at hand.

Yet studies consistently show that the quality of patient communication has a direct impact on patient satisfaction. Effective communication is critical to the patient experience, which is now measured and tied to value-based payments. It’s also vital to understanding the patient’s total health needs and managing the patient’s health beyond a single episode of care.

A self-service check-in process opens the door to more meaningful communication with patients not just by freeing up staff time, but also by improving throughput. For example, nurses and physicians are better able to share information about additional services the patient may wish to consider. Staff can then augment these conversations by providing patients with brochures that offer greater detail about these services. Staff time also can be spent on patient follow up, making sure discharge instructions are clear and future appointments are scheduled.

Additionally, a self-service check-in solution offers real-time authentication of data and the opportunity to survey patients. Communicating financial information to patients can’t be done through the current paper process; however, when a patient uses a digital check-in solution, their data can be immediately authenticated, which allows for immediate communication of copays and remaining deductibles. Patients can also relate their experience with a staff member or physician in a post-office visit survey to actively share their suggestions for practice improvement. Not only do patients feel listened to, but their suggestions also help providers increase satisfaction and value.

Reengineering the patient registration experience is critical to eliminating front-office errors and delays that cost healthcare organizations money. It’s also essential to creating a more positive experience for patients as well as staff—a key step toward improving value.

 

gerard-white-clearwaveSRS Health guest blogger: Gerard White, President & CEO of Clearwave

With 20 years of technology leadership experience, Mr. White is responsible for successfully implementing the Clearwave Corporation vision and strategy. Mr. White co-founded the company in 2004 to carry out a vision of technology that spans the healthcare continuum through the creation of a healthcare network and a single patient identifier that allows accurate patient data to be shared regardless of what provider a patient visits.

Mr. White has extensive experience working with some of the most respected companies in the world including EDS, Security Mutual, Saturn, Lennox Industries, Continental Airlines, GTE, Alltel, Hitachi, Grant Thornton and Blue Cross Blue Shield. Both his knowledge and leadership experience provide a solid groundwork for Clearwave Corporation’s active role in revolutionizing the healthcare industry.

Prior to joining Clearwave, Mr. White was the CEO of 1stOrder, focusing on IT consulting services and wireless application development. He holds a Bachelor of Science degree in Business Management and a Bachelor of Applied Science degree in Information Systems.

Mark Your 2017 Calendars!

To help you keep track of your year, we’ve created this 2017 quick reference calendar that you can refer to for conference dates and important holidays. Looking forward to another exciting year!

Be sure to check our website for upcoming industry hot topic SRS Webinars.

2017-calendar-infographic-FINAL-v2

Securing Your Business: Disaster recovery – do you need backup or a business continuity plan?

bouncer-blogAs an MSP specializing in healthcare and security, StratX IT Solutions is often asked,

“Is there a difference between backup and business continuity plans for disaster recovery?”

Many believe that data backup and business continuity plans are one in the same but they are not! One allows you to recover your files, and the other enables you to continue operating your practice regardless of the severity of the outage or your physical location. They are complimentary solutions and you need both in order to secure the business of your practice.

With estimates that 70% of data outages are caused by human error (eg, opening emails with viruses*) and the Gartner Group study which predicts that 25% of PCs will fail each year, asking “IF” you need a disaster recovery plan for your systems has become moot. What is critical is “HOW”.

But let’s backup for a minute (bad pun intended). Let us explain what data backup and business continuity plans are, and what StratX recommends to our clients as the most failsafe combination.

It all starts with data backup. It is the foundation for disaster recovery and business continuity – no backup means no business continuity.

But, not all backup solutions are created equal.  Remember when tape backup was the only option? Data protection is a fast-evolving market, and solutions that were put in place a decade or so ago are no longer suited to meet today’s regulatory and requirements.

What is required is a robust, viable foundation for ensuring secure, HIPAA compliant data backup and retention. Backup products fall into three (3) basic categories:

  1. Onsite backup (data stored on hardware kept physically in your office)
  2. Cloud backup (data stored on hosted hardware via the internet)
  3. Hybrid onsite-cloud backup (combines the first two categories)

Onsite backup works well when a quick restore of lost or damaged files is required. The data is onsite and, it’s fast and easy to restore to its original location. But what happens if:

  • The power goes out?
  • If the device fails?
  • Or if the equipment is stolen or fails?

You might think the cloud looks more attractive due to onsite backup’s “what ifs,” but cloud-only backup is risky too.

  • What if you lose connectivity to the internet?
  • Restores tend to be difficult and time-consuming.
  • And, after all, the cloud can fail, too.

What is a hybrid onsite-cloud solution?

  • Your data is first copied and stored on a local device and your data is also replicated in the cloud.

StratX recommends that our clients purchase and use a hybrid onsite-cloud backup solution. By using onsite backup to mitigate the risks of the cloud, and using the cloud to mitigate the risks of onsite backup your data will be available to you in case of an emergency and allow you to put your business continuity plan into action.

Furthermore, we recommend our clients use a hybrid onsite-cloud solution which gives them the ability to work virtually. The backup contains full server images (vs. only files or data) which can be restored or activated as servers in a disaster and allow you to work as if the original servers were still functioning – this is where a business continuity plan comes into play.

Business continuity, the ability to keep daily operations running, isn’t a product that you purchase per se, it’s the action plan that is designed and managed by your IT staff or vendor.

The plan lays out how you will access your server, software, applications and data when disaster strikes and also sets a timeline to achieve that access. It should also have provisions to have your IT support continually test the process before you are faced with an issue. It’s better to troubleshoot failed “test” restorations than to lose days, weeks or even months reinstalling and configuring your systems.

The only safe way to head-off downtime of your systems, regardless of the cause, is to be informed and prepared. Do you have a clearly outlined plan in place for your practice?

It’s critical that you are prepared, ask your IT staff:

  • How quickly can my business be up and running in the event of disaster?
  • Do we have documented backup, security and a business continuity plan in place which meet our regulatory requirements?
  • Is all of our critical data backed up daily, or more frequently?
  • How fast can we get our systems up and running to a pre-disaster operating state?
  • Have we done a real world test our backup and business continuity plan?

 

Jack Mortell

SRSsoft guest blogger: Jack Mortell of StratX IT Solutions

* Print our “email safety guide” for your staff. It describes the key signs they should look for to identify and avoid opening malicious emails.