Leveraging data in healthcare : best practices for controlling, analyzing, and using data / Rebecca Mendoza Saltiel Busch.

Format:

Book

Author/Creator:

Busch, Rebecca S., author.

Contributor:

EBSCOhost.

Louis B. Flexner Medical Book Fund.

Language:

English

Subjects (All):

Medical informatics.

Medical Informatics.

Medical Subjects:

Medical Informatics.

Physical Description:

1 online resource (xxiii, 215 pages.)

Place of Publication:

Boca Raton, FL : CRC Press, Taylor & Francis Group, [2016]

System Details:

text file

Summary:

The healthcare industry is in a state of accelerated transition. The proliferation of data and its assimilation, access, use, and security are ever-increasing challenges. Finding ways to operationalize business and clinical data management in the face of government and market mandates is enough to keep most chief officers up at night! Leveraging Data in Healthcare: Best Practices for Controlling, Analyzing, and Using Data argues that the key to survival for any healthcare organization in today's data-saturated market is to fundamentally redefine the roles of chief information executives-CIOs, CFOs, CMIOs, CTOs, CNIOs, CTOs and CDOs-from suppliers of data to drivers of data intelligence. This book presents best practices for controlling, analyzing, and using data. The elements of preparing an actionable data strategy are exemplified on subjects such as revenue integrity, revenue management, and patient engagement. Further, the book illustrates how to operationalize the electronic integration of health and financial data within patient financial services, information management services, and patient engagement activities. An integrated environment will activate a data-driven intelligent decision support infrastructure. The increasing impact of consumer engagement will continue to affect the organization's bottom line. Success in this new world will need collaboration among the chiefs, users, and data creators. Book jacket.

Contents:

1 Current Operational State of Managing Health Information 1

A Bit of History 2

Public Policy's Shift to the State 3

Systems and Subsystems 4

The Provider Perspective and Core Challenge 26

One Patient, One Condition: Different Benefit Plan Rules 26

The Easiest Route to Population Management 27

Going Forward 27

Somebody Has to Pay the Bill 28

Roadblocks in Technological Revolution 28

A Review of the Status Quo 29

An Evolving System and the CIO's Role 30

Moving from Data Storage to Utilization of Data 30

Benefits from a Data-Driven Environment 31

Business Intelligence: Integration and Deployment 32

Taking Necessary Steps 33

Other Noteworthy Operational State-of-Healthcare Delivery Marker Information 34

Final Thought 35

CEO Perspective 35

Endnotes 35

2 The Role of the CIO and Hybrid Chiefs in Charge 37

Chief Information Officer 37

A Bit of History 38

Hybrid Roles of Information Officers 39

The CIO Today 41

The Balancing Act 42

Ongoing Pressures 42

Key Market Barriers for CIOs to Overcome 43

Health Information Exchanges 44

Accountable Care Organizations 44

Key Internal Barriers for CIOs to Overcome 45

Final Thought 48

CIO Perspective 48

Endnotes 48

3 The Role of Patient Financial Services 51

A Bit of History 52

Hybrid Roles of Patient Financial Services 53

Patient Financial Services Today 54

HFMA's MAP Keys in Revenue Cycle Management 54

Physician Practice Management and the Use of HFMA's MAP Keys in Revenue Cycle Management 56

Key Market Barriers to Overcome 58

Role of Data and Revenue Integrity Management 60

Final Thought 63

CRO Perspective 63

References 64

4 The Paradigm Shift in the C-Suite 65

A Bit of History 65

Shifting Roles at the C-Suite 67

C-Suite Today 70

The Balancing Act 71

Key Market Barriers to Overcome 72

Role of Data and Revenue Integrity Management 73

Final Thought 73

CEO Perspective 74

References 74

5 Data and Information Strategy Assessment Tool 77

A Bit of History 78

Current State from the CIO Perspective 79

Key Principles: Healthcare Data and Information Strategies 84

CDO Cubic Approach 86

IIRB Model, Framework, and Analytic Roadmap 86

Data Intelligence Strategy Using the Healthcare Continuum 88

P-HCC Definition 88

S-HCC Definition 88

I-HCC Definition 89

C-HCC Definition 89

T-HCC Definition 90

R-HCC Definition 90

Final Thought 91

CCD Perspective 92

References 94

6 Gap Analysis Management 97

A Bit of History 97

Hybrid Roles of Gap Analysis Management 98

Gap Analysis Management Today 99

Balancing Act 100

IIRB Model, Framework, and Analytic Roadmap 101

Gap Analysis Strategy Using the Healthcare Continuum 103

Key Market Barriers to Overcome 105

Final Thought 110

CDO Perspective 110

References 110

7 Denial Management Analysis 111

A Bit of History 111

Hybrid Roles of Denial Management Analysis 112

Denial Management Today 114

Balancing Act 118

IIRB Model, Framework, and Analytic Roadmap 119

Denial Management Strategy Using the Healthcare Continuum 121

P-HCC: Define All Relevant Parties and Roles Involved 122

S-HCC: Define Relevant Practice Standards by Each Player Identified 123

I-HCC: Define People, Process, and Technology Workflows 123

C-HCC: Define Risks of Fines or Penalties 123

T-HCC: Define Any Roadblocks to Data 123

R-HCC: Define the Laws to Which Program Is Subject 124

Key Market Barriers to Overcome 124

Final Thought 124

CIO Perspective 124

References 125

8 Revenue Integrity Management 127

A Bit of History 127

Hybrid Roles of Revenue Integrity Management 128

Electronic Medical Health Record 128

Revenue Integrity Management Today 136

Balancing Act 137

Key Market Barriers to Overcome 137

Role of Revenue Integrity Management 138

Final Thought 138

CFO Perspective 138

References 139

9 Integration of Information Roles 141

A Bit of Human Anatomy and History 141

Integration of Leadership Roles 145

Traditional Roles 145

Management Role Integration 147

Balancing Act 148

Key Market Barriers to Overcome 148

Role of Revenue Integrity Management 149

Final Thought 149

CDO Perspective 149

Endnotes 150

10 Redefining Workflows 151

A Bit of History 152

Redefining Workflows 154

Case Study 155

RIT Demonstration 155

RIT Illustrative Focus 155

RIT within the Domain of the CIO? 155

Case Study Background 156

Case Study Highlight: Use of MDAs 160

Case Study Highlight: The Gap 160

Case Study Highlight: The Tasks 165

Case Study Highlight: The Fix 166

Case Study Highlight: Results 167

Case Study Highlight: Follow-Up 167

Case Study Highlight: Metrics 168

Key Market Barriers to Overcome 169

Final Thought 170

Director of Nursing Informatics Commentary 170

Endnotes 170

11 Evolving to a Data-Driven Organization 173

A Bit of History 174

Data: The Core Asset 175

Data Library: Inventory of Data Assets 176

Another Approach on the Scavenger Hunt for Data 178

Data Intelligence 179

New Data Assets 180

More New Data: Ultimate Data Aggregators 181

Processed Data: The Start of Mining for Intelligence 181

Data Warehouse: The Route to a Data-Driven Organization 182

Key Market Barriers to Overcome 182

Preparing for the Future 183

Final Thought 186

CDO Perspective 186

References 187

12 Defining the Role of the Chief Data Officer 189

Data Governance 189

A Bit of History 190

First CDO 191

To Whom Does the CDO Report? 191

Role and Responsibilities of the CDO 191

CDO Role in Healthcare 194

Recommended CDO Qualifications 195

Considerations 195

CDO Organization 196

Key Barriers to Overcome 196

Final Thought 197

CDO Perspective 197

References 198.

Notes:

Electronic reproduction. Ipswich, MA Available via World Wide Web.

Description based on print version record.

Local Notes:

Acquired for the Penn Libraries with assistance from the Louis B. Flexner Medical Book Fund.

ISBN:

9781498757737

1498757731

Publisher Number:

99966610797

Access Restriction:

Restricted for use by site license.