Using Data Analytics to Improve Clinical Performance and Its Reimbursement Outcomes: One Hospital’s Experience

At Butler Health System, a 311-bed community hospital in Butler Pa., hospital leaders have come together to use data analytics to improve a range of patient care delivery processes and outcomes. Working with an analytics solution from Information Builders, a New York City-based business intelligence and integration company, Butler Health System clinical, IT, and financial leaders have been moving forward to focus in particular on examining and improving specific diagnostic and care delivery processes whose outcomes have financial impacts.

In all this, the leaders at Butler Health System are fortunate to have A. Thomas McGill, M.D., leading the charge. Dr. McGill, a practicing infectious diseases specialist, has been vice president of quality and safety at Butler Health for 10 years, and for the past four years, he has also been the organization’s CIO. Thus, his title and responsibilities encompass both quality improvement and IT activities and efforts at the health system. McGill spoke recently with HCI Editor-in-Chief Mark Hagland regarding the work that he is helping to lead at Butler Health. Below are excerpts from that interview.

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You have a unique perspective on all this, being both the vice president of quality and patient safety for ten years at your organization, and also, for the past four years, the hospital’s CIO. Tell me about your and your colleagues’ pursuit of clinical performance improvement through data analytics.

Certainly. Especially because of my dual titles, in our analytics work, we are focusing on a combination of quality and safety improvement, as well as on financial analytics. And our particular focus has become all the metrics for which we are held accountable by external organizations—payers and regulators. We had long been working on analyzing some metrics, but the evolving mandates coming from the Medicare program and the commercial payers have particularly spurred activity here. Medicare has all its adjustment programs, and the commercial payers have their incentive programs. For example, the healthcare-acquired conditions program under Medicare penalizes a wide range of conditions acquired while patients are being treated—some of them infections and other conditions non-infectious.

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For example, we started working on venous thromboembolism [VTE] prophylaxis early on. We looked at the actual costs of patients in the same DRG [diagnosis-related group]—looking at whether they had a clot or not. And we found that per case, patients with a clot were costing us $9,000 per case.

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