Giving Data Purpose: Revenue Cycle Information Management Strategies

Information flows from myriad points along the patient care cycle. Yet, for many of today’s healthcare provider organizations, the influx of data from sources such as electronic medical records, patient accounting systems, 835 and 837 health claim transactions, budgets, and general ledgers can be a wasted opportunity. Without a solid data management strategy in place, healthcare organizations cannot make the most of the information to measure performance, target problems, implement corrections, and achieve their patient care quality and financial goals.

Healthcare providers know how important it is to have quality, reliable data that moves freely throughout the organization’s system, including in the revenue cycle. Simply having a system in place to input data into software tools, however, is not enough. Here are several leading practices successful organizations use to achieve effective information management in the revenue cycle.

Gain buy-in

Successful information management in a healthcare organization starts with having buy-in from all relevant stakeholders across the organization for a single data management strategy. Even if the organization’s data has integrity, without an agreed-upon strategy for using that information, it may not offer as much value as it could.

Managing information, therefore, goes beyond simply creating dashboards and other visuals for team members to use to assess data. It involves all leaders, from areas such as revenue cycle, clinical leadership, operations, and more, coalescing around a single strategy for measuring revenue cycle performance. When shortfalls are identified, they should be tied easily to actionable, underlying data in order to truly connect performance to operational improvements.

Unite around data elements

Making sure all team members understand the different data elements being used and why each is relevant is another important step in executing a successful information management strategy. The organization should ask questions such as whether the organization will use one source of data or multiple elements to measure revenue cycle performance.

In addition, to help achieve unity around the data elements being used, leading organizations take the following actions:

• Identify a group of cross-functional subject-matter experts from technical and operations areas of the organization to validate a data management strategy and assess data integrity.
• Create an inventory of available data elements and an inventory for the data that fuels their output.
• Identify fields or data components within data elements that may rely on manual input or human decision-making. (It’s important to understand the propensity for “noise” in underlying data and metrics tied to manual inputs.)
• Discuss data refresh frequencies for each data source, and determine their appropriateness based on reporting strategy (for example, data elements that refresh monthly may not be reliable or appropriate for use with day-to-day operational reports or feedback).
• Understand linkages among data elements and how to construct blended outputs among multiple data elements.
• During the development process of reporting, involve all stakeholders to make sure any questions or concerns are addressed early on.
• Upon development completion, create and roll out an education plan for other users to gain buy-in for and comfort with reporting. This should include frequently asked questions and “cheat sheets” for employees to reference.
• Form a committee to handle ongoing maintenance and improvements related to data management.

Improve access to information

No matter the quality and quantity of data, it is useless if the right people are unable to access it. Leading organizations are moving beyond decentralized approaches – such as using numerous spreadsheets that are passed from person to person – and embracing newer, smarter technologies. For example, organizations are using visualization tools to present data graphically and to publish information from large data sets that everyone from the C-suite to department managers and beyond can access in real time at the point of decision-making.

By using these tools in a centralized way, organizations can improve standardization and reporting integrity. This approach is not a cure-all, however. Without the right players at the table to define strategies and measurements, quality of insights may suffer.

In addition to making sure information is centrally located, organizations with successful information strategies do the following: 

• Have critical information (from electronic health records, patient accounting systems, bill scrubbers, and other tools) flow into a data warehouse.
• Use an internal analytics team to create blended data elements from many feeds that point to significant insights based on input from stakeholders across the organization, such as the finance, clinical leadership, revenue cycle, managed care, operations, and marketing departments.
• Use visualization tools and related capabilities to create and publish dashboards for users across the spectrum in the organization.
• Identify superusers or groups of superusers who can use data for custom analytics or reporting.
• Empower superusers with the right tools, education, and staff members to turn data into useful analytics and reporting.

Evolving for greater insight

All healthcare organizations have data – a lot of it. Best-in-class organizations have developed a single, effective information management strategy for measuring revenue cycle performance; have united around the number and types of data elements being used; and have allowed information to be easily accessed by significant stakeholders.

Adopting these leading practices to improve information management in the revenue cycle can go a long way in helping healthcare organizations evolve to meet the ever-changing healthcare landscape and demands for greater insights.