Hayes' Healthcare Blog

Driving Audit Productivity and Efficiency: 5 Key Steps

Posted by Susanna Partrick on November 30, 2016 at 9:00 AM

By Susanna Partrick, Senior Privacy and Compliance Administrator, Weill Cornell Medicine

Nearly eight out of ten healthcare internal auditors in a recent survey by PwC believe risks are increasing. As a result, almost nine out of ten say they have gone through or will soon be involved in significant business transformation. The conclusion is that these increased risks and transformative changes in the healthcare industry will require internal auditing to change as well.[1]

Unfortunately, few healthcare organizations are able to add resources during a time of shrinking revenue and tightening margins. To meet this increased demand, therefore, those of us responsible for the internal compliance program functions must find ways to be more efficient with the resources we do have.  Doing more with less has become an inevitable mantra for compliance auditing groups in healthcare organizations striving to minimize overall risk.

The concepts of productivity and efficiency are often viewed negatively – as simply buzzwords to wring more output from overworked staff. That doesn’t have to be the case. A huge part of our responsibility as leaders is to work cooperatively with our teams to improve the amount of work being performed by optimizing their skills, our processes, and the technology under our control.

Here are five key steps you can take to improve the productivity and efficiency of your compliance audit team.

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Topics: healthcare compliance, Audits, Hayes Thought Leadership Blog Series

Defining Your Terms: Do You Have the “Analytics” Solution You Really Need?

Posted by Robert Freedman on November 16, 2016 at 9:00 AM

Big Data. Bandwidth. Paradigm. Analytics?

It’s almost universally accepted that the first three have crossed over into buzzword territory and are in danger of losing any real meaning (if they haven’t already done so.) But is the term “analytics” heading down the same road?

We’re not saying analytics aren’t important. In fact, they are critical for healthcare organizations facing the onslaught of changes resulting from MACRA, increased oversight and the rush to value-based care.

But it’s important for us to define our terms. “Analytics” does not mean the same thing in all situations. In order to get maximum value, you need to make sure the analytics solution you’re using is appropriate for the task you are trying to accomplish. If it isn’t, you’re not likely to achieve your desired goals.

We spoke with one prospect recently who said, “Analytics is off the table. We already have so many analytics products. We don’t need any more.”

His situation may not be very different from your organization where you have no doubt deployed a number “analytics solutions.” You may have a large, expensive enterprise system in place. But if you’re like many organizations, those analytics programs are often focused on “bigger picture” issues like population health. While that is an extremely important initiative, as a compliance organization, you still need to leverage data for other operational goals like improving revenue flow and minimizing risk.

You may also have a number of system-specific analytics programs and visualization solutions that can provide valuable insight. Unfortunately, although these applications fall under the broad heading of “analytics,” they don’t provide answers that relate directly to your set of issues.

The end result is that even though your organization may possess powerful “analytics” solutions, you can often be left hungering for “analytics” that help you focus on your key risk areas. You may have trouble getting directly to the raw data you need but instead have to rely on filtered data provided by someone in an IT group. Such data sets compiled outside the compliance group can reflect a different purpose from the one you need. 

Actionable analytics requires iterative refinement of available data with subject matter experts who can pull out the “learnings” that are real and worthwhile. To accomplish that you certainly need “analytics,” but analytics that use raw billing and coding data to uncover risk areas before they can cause reputational and financial damage. These types of “analytics” solutions are much more specific. They are built on an analytics platform, but they are actually applications.

When looking for an analytics application best suited for risk and compliance management, here are five things you need.

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Topics: Healthcare Analytics, Risk-based audits

On the Road with John Halamka, Healthcare IT Observations

Posted by John Halamka on November 9, 2016 at 9:00 AM

By John Halamka, MD, CIO, Beth Israel Deaconess Medical Center and co-chair of the national Healthcare IT Standards Committee.

Over the past few months, I’ve been in England, China, Denmark, New Zealand, and Canada.

Each of them is rethinking their healthcare IT strategy and is not entirely satisfied with past progress.  

I’m often asked by senior government officials to help harmonize IT strategy at the country level. That I can do. I’m also asked to discuss the US Presidential campaign, but that defies rational explanation.

I frequently say that healthcare IT issues are the same all over the world.  Here’s a few common observations:

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Topics: healthcare IT, Hayes Thought Leadership Blog Series

The 3 C’s of Clinical Care – Clarity, Collaboration and Communication

Posted by Susam Vang on November 2, 2016 at 9:00 AM

While patients today have more complications and multiple health problems, clinical care has become even more complex and specialized.  These days, an entire team of healthcare workers including physicians, mid-level providers, nurses, and health professionals work together to coordinate a patient’s well-being while reducing the number of medical errors, increasing patient safety, and improving patient satisfaction. This collective effort also inevitably leads to improved patient outcomes.

Health information technology has also become even more important than ever as healthcare professionals manage patients suffering from multiple health problems and need to quickly learn new methods. Multidisciplinary health teams need to be assembled and work well together in order to solve complex health issues and attempt to understand the patient’s health problem(s). By asking probing questions, making an initial assessment and, after discussing among the team members, the healthcare team needs to provide a recommendation to the patient.

For this reason, healthcare is a multifaceted environment in which health professionals from different specialized knowledge, training, and responsibility for different tasks must work together, communicate often, and share resources. Teamwork is essential for delivering quality care to patients and in order to keep up with the ever growing healthcare challenges, you need to assemble the best team you can.

Teamwork in healthcare means collaboration and enhanced communication among team members in order to expand the roles of clinicians and health professionals. Additionally, teams function better when they are able to make decisions together, and when they have shared goals and a clear purpose in order to implement protocols and procedures.

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Topics: clinical optimization

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