Monday, December 3, 2012

Business Intelligence and Generating Revenue in Healthcare


Business intelligence and analytics have created an atmosphere of greater decision making for businesses for many years.  Using data from the many transactions that businesses perform has been one of the most valuable tools for businesses.  Business has created teams of people to crunch numbers and this is now aided with reporting tools like MS SQL Server Reporting Service and even simple spreadsheets and graphs generated in MS Excel.  Now that health care is moving towards capturing information electronically, how can these organizations leverage these types of tools to contribute to revenue generation?

FIrst, here is a quick definition of business intelligence (BI).  BI is, according to Margaret Rouse (2006), "a broad category of applications and technologies for gathering, storing, analyzing, and providing access to data to help enterprise users make better business decisions."  This means that BI encompasses the tools that gather the data, making sure that the data is clean and abides by a set of standards.  It is the databases and data warehouses that store the data and the use of SQL to retrieve the data.  BI practices are used to analyze the data by use of spreadsheets, pivot tables, graphs and charts.  The findings are they presented on presentations, accessed through portals that house dashboards, sent through emails and a host of other ways to present the data for decision making.

According to Paul Bradley and Jeff Kaplan (2010), when it comes to the financial information system's data, health care organizations can support the revenue cycle by targeting high value claims or accounts, identifying root causes of missed charges or bad debt, enhance staff productivity, and speed up resolution of bad debt.  These are all done by predictive analytics, which identify trends and use these to make predictions to head off issues before they can begin (Bradley & Kaplan, 2010).  

On the clinical side, by leveraging BI, hospitals can "provide an efficient means for clinical results reporting" according to Healthcare Financial Management Association (2008).  This efficiency can present data that shows and measures the efficiency and effectiveness of clinical processes (HFMA, 2008).  Also by opening up the systems to physicians to input various data, this can support the physician's own billing, which turn can improve coding (HFMA, 2008).

Ferranti, Langman, Tanaka, McCall & Ahmad (2010) point out that use of BI can help support revenue generation through clinical improvement in these ways:

1. Prevention of medical errors through use of enterprise data.
2. Using data to improve the business cycle.
3. Using health analytics for emerging health issues.

As you can see BI can help to increase revenue by use of data from both the clinical information systems and from the financial information systems.  By using predictive analytics, the organization can head off billing and bad debt before it becomes a problem.  Clinical data can improve outcomes, patient safety and look towards the future so that these organizations can make better decisions which will increase revenue in the long run.

References:
Bradley, P. & Kaplan, J.  (2010 February).  Turning hospital data into dollars.  Healthcare Financial Management, 64(2), pp. 64-68.  ISSN: 0735-0732

Ferranti, M., Langman, M. K., Tanaka, D., McCall, J. & Ahmad, A.  (2010).  Bridging the gap: leveraging business intelligence tools in support of patient safety and financial effectiveness.  Journal of the American Medical Informatics Association, 17(2), pg. 136.  DOI: 10.1136/jamia.2009.002220

Healthcare Financial Management Association.  (2008 August).  Leveraging Business Intelligence for revenue improvement.  Healthcare Financial Management, 62(8), pg. 1.  ISSN: 0735-0732

Rouse, M. (2006 November).  Business Intelligence (BI).  SearchDataManagement.  Retrieved from http://searchdatamanagement.techtarget.com/definition/business-intelligence



No comments:

Post a Comment