Key Trends Make (Near) Real-Time Data a Must-Have for Optimizing RCM

Author: Jonathan Farr, Senior Vice President North America, EFFY

Among the various types of data that hospitals rely upon, only (near) real-time data enables hospital leaders to take action and follow up on that action to correct inefficiencies, denials and revenue leakage. In fact, key trends in hospital analytics are shifting toward (near) real-time analytics as an important step beyond problem definition:

  • Merging separate platforms in pre- and post-mergers and acquisitions analytics to generate an enterprise-level view cost effectively
  • Pushing adjusted or new data back into operational systems
  • Analyzing revenue and cost by diagnosis, and value proposition in terms of revenue divided by cost, and then divided by diagnosis
  • More accurately analyzing actual revenue variance by origin through price, volume and mix calculation, with mix being defined by patient, payer or diagnosis
  • Prescriptive analytics follows predictive analytics to actively suggest how organizations can best take action
  • Looking forward: incorporating big data in the context of the healthcare Internet of Things (IoT), predictive analytics and block chain as a distribution ledger

EFFY’s efficiency platform that overlays existing operational systems to help healthcare organizations compare massive amounts of data across their total enterprise, detect exceptions and problems, and guide interventions to improve efficiency that optimizes financial, clinical and operational performance.

(Near) Real Time, Real World Results

(Near) real-time data analytics is where hospital organizations gain the ability to define the rules and set validations to audit transactions as they occur. Sophisticated (near) real-time data analytics systems allow a hospital to use any data from any operational system to set up sophisticated alarms to detect issues immediately.

Real-world results: increased net revenue by three to four percent, with ROI multiples of between eight and ten by adding a (near) real-time data analytics platform.

EFFY makes it simple: An analyst using EFFY’s RCM audit solution built upon RAID HEALTHCARE — an end-to-end software platform used worldwide by leading healthcare systems, telecom companies, utilities, retail and other complex industries — has the reconciliation and analytical tools to rapidly respond to any alert. Instead of channeling the issue up through all of the relevant departments, which is time-consuming and demands the attention of a number of people, the analyst can simply guide an alarm to the appropriate staff to “fix,” resolving the problem quickly, and improving the bottom line.