Data Analytics in Healthcare: Physician Analytics Coming Soon

In my previous blog, I discussed five reasons why you should do physician data analytics including: 1) Improve communication, 2) Lower the overall costs, 3) Improve volume of patients seen, 4) Improve patient satisfaction and 5) Improve quality of patient care.

We recently obtained a tool for launching the pilot physician data analytics service. This project will involve developing a physician claims database (from the 5010 Professional EDI file) and applying analytical tools to the data. We can then compare financial and clinical parameters from the blinded data across different physician groups.

The new tool includes:
• The ability to aggregate data across demographic, financial and clinical areas;
• The identification and stratification of various populations based on configurable algorithms;
• The availability of standard reports including ACO, PQRS, HEDIS and cost versus quality metrics;
• Advance ad-hoc reports including comparative analysis across physician groups, i.e. group practice and system performance;
• Analytics and reporting
o Pilot project will focus on physician analytics and reporting from data contained in physician claims;
o With the addition of clinical information, the analytics can be more patient, clinical and case-management focused.

Once the analytics system is fully populated with administrative, financial and clinical data, functionality could be expanded to include:
• Predictive analysis based on over 20 risk factors;
• Population surveillance using population level guidelines at the patient level;
• Chronic illness tracking and management using evidence-based guidelines;
• Prevention, screening and wellness management;
• Integrated continuity of care record of the patient;
• Comprehensive case management functionality;
• Rx adherence and reconciliation management.

As you see from the functionality above, physician data analytics will be essential to effectively operate a physician practice group and provide the most efficient and effective patient care. The value equation or, Return on Investment (ROI), is very high!