To deliver greater value in healthcare, providers and suppliers must first be able to identify those factors that impact cost, quality and outcomes—as the adage goes, you can’t manage what you can’t measure. Historically, the clinical and operational sides of healthcare have worked in silos, making collaboration and data sharing a challenge. But as payments for care delivery are increasingly tied to quality and efficiency, the industry has begun the hard work of tearing down long-standing barriers.
Over the past 30 years, hospitals have been adopting technologies to steadily increase process automation throughout their operations in an effort to enhance efficiency and reduce costs. It began in the 1980s with the initial use of mainframes and desktop computers for electronic patient registration, continued through the late 1990s with “Best of Breed” systems, such as materials management information systems (MMIS) for order processing and inventory management, and then transitioned in the early 2000s to present day with the adoption of on-premise (“on-prem”) enterprise resource planning (ERP) systems that automated both materials management and financial operations.
Very few health systems know the true cost of a patient care procedure. Historically it is not something we have accurately captured as a healthcare industry. But as we move to value-based payment models, and seek to deliver higher quality care at a lower cost, we need to know the cost of care, including the cost of supplies used in a procedure.
A key reason why it is so hard to determine supply cost by procedure is clinicians simply can’t find products in the EHR when attempting to document their use on a patient. At Franciscan Missionaries of Our Lady Health System (FMOLHS), the item master was feeding product data to the clinical documentation systems. But because the item file contained only routinely used items, clinicians could only find the items they were looking for in the system about 40-50 percent of the time.
“How much did that procedure cost?” Simple question that is simply too difficult for providers to answer. Supply chain plays perhaps the most critical role in helping the industry get to a clear and reliable answer.
The 2017 annual survey of hospital CEOs conducted by the American College of Healthcare Executives revealed that financial challenges was their number one concern. Healthcare providers and executives are still trying to grapple with the shift of healthcare from a fee-for-service to a value-based model. As a result of this shift, there has been a marked decline in reimbursement from the government as well as private insurance groups.
Incorporating and maintaining accurate product data within one’s item master is a critical step in gaining visibility, driving purchasing accuracy and capturing revenue. Problems with item master data, whether it is related to incomplete, duplicate or missing information, is painfully felt throughout the value chain in lost savings, reduced charge capture and potential lost revenue. In clinical areas, confusing and duplicate item descriptions can leave clinicians frustrated with search efforts and manually documenting supplies which can lead to further revenue losses. Efforts to pinpoint and address the specific issues can no longer be pushed aside with hospitals already working within thin margins that are likely to get even thinner.
We rely on data every day but getting to the point of truly relevant data is a process. Relevant customer data is more than who buys from me. It is all of the information that describes the people and companies that you care about, and it is everything related to who made it, who buys it, who uses it, who holds the contract and more.
The holy grail of electronic health record (EHR) systems is to enable healthcare organizations to deliver more effective and efficient patient care. However, when the data within these EHRs is siloed within certain departments or contain inaccurate or incomplete information, it becomes nearly impossible to accurately track medical costs, reorder necessary supplies and support the industry’s mission to provide that desired level of outstanding patient care.
While every healthcare organization has its own unique challenges when it comes to item master data management, many of the problems are the same – inaccuracies, duplicates, missing information – in essence “dirty data” that causes errors and rework throughout a number of operational and clinical processes (e.g. procurement, inventory management, patient billing).
Both Catholic Health and Oregon Health & Science University have implemented master data management strategies that leverage the NuVia® content management solution. While these organizations have derived significant value from their work, they can tell you that best-in-class data management doesn’t happen by accident. In this Q&A, Ashleigh E. Gross, supervisor for Supply Chain Analytics at Catholic Health, and Dina Walden, Content Manager for Oregon Health & Science University, share tips on how they developed sustainable processes to achieve and maintain quality data.
The second in a three-part series on the 2017 AHRMM Cost-Quality-Outcomes (CQO) Summit
As a nurse by training, Anne Snowdon, BScN, MSc, PhD., is appalled by the fact that preventable medical errors are a leading cause of death in both the U.S. and Canada.[i],[ii] As a researcher, she believes the supply chain holds the key to help reduce the numbers of patients who are harmed, not healed, in the hospitals of the two neighboring nations.
A group of providers joined GHX at the recent AHRMM conference for discussion about the challenges facing supply chain to deliver quality data to clinical teams and how to interface this data for charge reconciliation and billing. A growing item master, subsequent data management and maintenance, and clinician frustration were among the primary concerns discussed.
There are foundational challenges that supply chain is currently facing, specifically in the connection of item master data to the EHR. What has been considered best practice for item master/data management is now being questioned with the increased use of EHR technology. Current thinking is that in attempt to both increase accuracy in patient records and reduce missed charges, more is better. As a result, the item master is growing and imposing a significant impact on workflow, maintenance, etc.
How can you significantly influence your supply chain performance without the help of additional resources?
Healthcare provider organizations are tasked with this dilemma daily and the goal to go beyond just managing costs, but to actually reduce costs while improving patient outcomes. Supply chain specifically goes after this challenge with an eye toward expanding automation, using data proactively and improving contract price alignment.
The healthcare industry is undergoing a transformation aimed at providing higher quality, more cost-effective care. Key to striking the balance between cost and quality is data.
At GHX, we know data can help organizations set strategic direction and direct critical business and care decisions. However, this only holds true when “bad data” does not serve as the foundation for efficient and effective value analysis efforts.
For instance, healthcare providers take advantage of their supply chain data to help reduce cost and improve standardized patient care. That data, coupled with predictive analytics, helps to better anticipate future product demand — which enables providers to avoid losing speed to patient care due to discontinued or backordered products.
Healthcare organizations have traditionally worked to limit the product data held in item masters to the products used most commonly. Today, with expanded use of electronic health records, the item master is becoming more of a strategic asset and the single source of truth for item information in multiple systems. This evolution suggests that the item master may become more valuable by extending item data beyond routine stock and products.
Content is enabling provider and supplier organizations to make more strategic and effective business decisions in a rapidly changing market. Among the many forces driving change in healthcare are financial pressures, regulatory reform, systems change and standardization, and a surge in mergers and acquisitions.
Inaccurate data is limiting organizations from realizing the game-changing power big data can bring to healthcare. Clinical and financial benefits are within reach, but bad or “dirty” data continues to be the Achilles heel of actionable information in healthcare.