Operational vs. Actionable Analytics
Author: Jonathan Farr, Senior Vice President North America, EFFY

A growing number of hospital leaders understand the value of real-time data analytics vs. the limitations of operational data analytics to address and solve problems in virtually every aspect of operations.

One new platform fine-tunes an existing Revenue Cycle Management (RCM) operational system, and eliminates the need to replace any existing system, even if that system is not ideal. Costs are reduced because RAID HEALTHCARE — an end-to-end software platform used worldwide by leading healthcare systems, telecom companies, utilities, retail and other complex industries — costs less than a replacement system, and is more powerful.  

No disruption costs or need to play “catch up.”

No large upfront investment required.

By simply overlaying a real-time data analytics system, managers can quickly gain control of aggregating data, and detecting/resolving issues that impact revenue integrity, as well as clinical and operational performance, in a way that is the most cost-effective.

Real-Time Data is a Real Game-Changer

Real-time data is where hospital organizations gain the ability to define the rules and set validations. The most effective, efficient approach to data at the enterprise consolidation level stems from completely merging all data from multiple sources, so that comparable data has the same name and format.  

By merging the data, users can create the ability to answer consolidation questions, such as “What was total revenue throughout the enterprise?” From there, organizations can drill down to see all the component parts that make up that revenue number.  

Improve Your Bottom Line

Here’s an example of how real-time data analytics work: If a drug treatment is changed to one that requires pre-authorization, an alarm is sounded, so the pre-authorization can be requested.  The alarm is triggered by data originating from the pharmacy system (or module if incorporated across one large system) and matched to the third-party payer’s requirements for pre-authorization. Without this capability, payment is denied. With it, a series of 14 questions enables the organization to save millions of dollars.

An analyst, using a RCM solution built upon RAID HEALTHCARE 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 offer an integrated workflow to guide a “fix,” resolving the problem quickly, and improving the bottom line.