Healthcare Executives Sound Off on Data Challenges

Last week, we hosted one of our Executive Council meetings up in Park City, Utah. These meetings bring together executives from many of our client sites to discuss the challenges they’re facing and ways in which 3M Health Information Systems can help them achieve their goals. It wasn’t always easy keeping the group focused on the topics instead of the view of the snow-covered mountains through the window behind me, but when the subject of analytical needs came up, I had their attention. The discussion quickly turned to the challenges they face in getting the data needed to manage regulatory requirements, reduce costs, and improve quality of care. The client executives participating voiced a number of concerns, including:

– Difficulty in getting longitudinal data across the healthcare continuum
– Inability to get data from unstructured text within their EMR
– Limitations of claims data only
– Use of data to identify “avoidable care” so they can reduce costs and improve outcomes
– Data needed to manage compliance risk

Preventing Fraud with Predictive Analytics

HIPAA, ACA, ICD-10—the healthcare industry today is awash with regulatory events and government initiatives. Compliance has never been more essential across the healthcare spectrum, not least because fraud investigations—whether performed by RACs, investigations by the Department of Justice/OIG, or a payer—are becoming more and more frequent.  These investigations are often difficult to staff for and can be resource-intensive.

So, how do we remain compliant while also preparing for this onslaught of scrutiny? Using data and predictive analytics can help to identify and flag risk areas before they’re put under the microscope.  Even better, this information can prevent having to audit high-risk claims and assign scarce resources to audits post-discharge.