Dr. Jonathan Nasser, MD and Scott T. Hines, MD on Crystal Run says it’s all about the data.
When organizations use data strategically, it can mean the difference between clarity and confusion; progress and stagnation; improvement and status quo. At Crystal Run Healthcare, data informs everything we do—from delivering appropriate patient care and enhancing quality to streamlining operations. While it would take several blog posts to describe all the ways our organization uses data, here are three examples where we find data-driven processes particularly valuable given the current focus on population health management initiatives.
1. Identifying high-risk patients
Effectively managing population health is necessary for survival in today’s value-based world. Key to success is mining data to stratify your population, identifying at-risk patients, and proactively transitioning them into appropriate care. At Crystal Run, we analyze billing data, pulled from our EHR and matched to the master patient index, to spot high utilizers. These are individuals who we see frequently, have diagnoses that if poorly managed lead to hospital admissions (congestive heart failure and COPD, for example), and/or have critical test results, such as diabetic patients with an elevated A1C.
Once we identify these high-risk patients, we try to anticipate and respond to their care needs using diverse interventions. For instance, if a patient’s condition is less critical, we may just reach out to make an appointment with their primary care physician or implement a standardized treatment protocol to jumpstart therapy. For more complex patients, we may assign a care manager who regularly reviews the patient’s record, assesses risk factors, coordinates care, and ensures compliance and follow-up. By matching high-touch interventions with individuals at greater risk, we improve patient care and more effectively allocate our resources.
2. Reducing practice variation
Crystal Run also uses data to drill down into how our providers deliver patient care for specific conditions to make sure we’re engaging in best practices organization-wide. We recently began leveraging existing technologies to analyze physician performance to better inform care decisions. By examining charges per patient per year by diagnosis and specialty, we have created a window into how we treat certain diseases. When there is large charge variation between physicians, we dig deeper and look for reasons behind the disparity.
At the start of the program, we found that providers were not following best practices for standardized care, which was not optimal service utilization. By bringing physicians together to refine best practice guidelines (for example, standardized protocols when caring for diabetes patients presenting with high blood sugar) and set expectations that every doctor follows the guidelines, we can ensure patients receive a certain level of care across the organization. Not only does this improve population health, but it also has a financial impact because it minimizes variation, saves money due to eliminating unnecessary and redundant services, and allows us to better anticipate costs and utilization.
3. Expanding operations
Data also plays an essential role in structuring operations. For instance, before we recruit new specialists or open new practice sites, we review data to track usage patterns, looking at where patients travel to visit the doctor and what types of treatment they seek at specific locations. If we discover that one practice sees a large number of prenatal patients, then we may consider bringing on an additional OB/GYN to ease workload and enhance care delivery. Similarly, if a lot of patients are traveling a great distance to see the doctor, we might think about opening a new practice in a centralized location.
While these are just three ways we use data, the opportunities for leveraging information are practically limitless. As healthcare continues to evolve and our ability to collect and analyze large volumes of information grows, those organizations that fully commit to using data to drive performance will position themselves well for long-term success.
MD and Chief Quality Officer, Medical Director Medical Specialties, Department of Endocrinology, Crystal Run Healthcare