Hospitals Using Big Data to Reduce Visits, Boost Profits

Long Island Business News
August 22, 2014
Hospitals Using Big Data to Reduce Visits, Boost Profits
By Claude Solnik

It may seem counterintuitive, but local hospitals are using clinical data to reduce patient visits.
The move comes as Medicare, Medicaid and private insurers begin paying hospitals on a per-patient basis, rather than per individual service. That’s resulted in flat fees for patients that can become lucrative with fewer services rendered.

The shift is creating new jobs, opportunities and issues as hospitals use information and data to boost efficiency – and defeat disease. Using “big data,” a combination of clinical, financial and operational information, hospitals can analyze electronic medical records to determine which patients will need more follow-up, and the most cost-effective way to do so.

“Big data is high volume, high velocity and high variety,” said Marcy Dunn, senior vice president and chief information officer at Rockville Centre-based Catholic Health Services of Long Island. “With the advent of the electronic medical record, information is firing at us all the time about our patients.”

The data revolution is leading to upfront costs to store and analyze information, not to mention the salaries for the analysts necessary to comb through the data. Great Neck-based North Shore-Long Island Jewish Health System, for example, employs nearly 100 individuals whose sole purposes are to dissect clinical, financial and operational data.

“Not only are we collecting more than we ever collected, we have to store more,” said Jeffrey Kraut, North Shore-LIJ’s senior vice president for strategy and business informatics. “We have to organize the data to make it accessible.”

Dunn said CHS is using information to identify people who return to the hospital frequently and doing more follow-up, to make sure “when they’re not in the hospital, they follow prescribed methods and medications.” The health system is primarily tracking patients with congestive heart failure, diabetes and chronic lung disease.

Meanwhile, North Shore-LIJ created Care Solutions to provide staffers who coordinate care and follow up when needed.

“You’re taking care of them more effectively and efficiently,” Kraut said. “It costs money to do it, but there’s also an economic reason you want to do this.”

When care coordinators avert an unnecessary emergency room visit or re-admission they save $6,000 or more.

“If I avoid one of those events, I paid a significant portion of the cost of that infrastructure,” Kraut said. “We’re not spending money on care that could have been avoided.”

After North Shore-LIJ data showed many cardiac patients were re-admitted within 30 days, it began sending nurse practitioners to patients’ homes. Kraut said that’s reducing re-admissions.
Hospitals, which typically employ thousands, also are using data to manage risk and care for their employees as they increasingly self-insure.

North Shore-LIJ and CHS already self-insure, but Mineola-based Winthrop University Hospital, Oceanside-based South Nassau Communities Hospital, Port Jefferson-based John T. Mather Memorial Medical Center and Brookhaven Memorial Hospital in Patchogue won’t be self-insuring until 2015.

The need to store information is turning hospitals into massive, virtual vaults, full to the brim with confidential medical and financial information that’s increasingly making them targets for hackers. If the wrong person gets their hand on any bit of information, it could mean an easy path to identity or insurance theft.

“Security is a big concern,” Dunn said. “We do a lot to protect names, date of birth, social security and insurance information.”

Of course, no online vault is impenetrable in this day and age it seems. Manhattan-based New York Presbyterian Hospital/Columbia University Medical Center in May agreed to pay a $4.8-million settlement following a data beach.

Kraut said systems currently in place include firewalls and ways of identifying inappropriate efforts to access data.

“When you’re dealing with any patient information, you have to have a reason to have access to that data,” he said. “If you normally don’t go into certain types of data and try to access it, it raises a security flag.”

 

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