Healthcare Decision Automation and Predictive Analytics

Transcription

1 Healthcare Decision Automation and Predictive Analytics Industry Expertise The healthcare industry faces tremendous challenges due to regulatory reforms and marketplace demands. Performance-based reimbursement models tied to patient outcomes and satisfaction scores have increased competition within the industry, making practice oversight vital to building and maintaining a successful practice. Providers are turning to an abundant and underutilized asset their data to develop new strategies in answer to the historic changes within their industry. As a respected leader in business intelligence and predictive analytics, Pandera combines innovative technologies with proven methodologies to design powerful applications that meet the individual needs of our clients. Our solutions are tailored to align with each client s specific strategic goals and operational procedures, providing decision makers with the information they need to drive profitability and operational improvements across their organizations. Pandera s combination of advanced technologies, broad competencies, and proven methodology enable healthcare companies achieve business objectives and ensure sustainable success in an ever-changing marketplace. We help healthcare organizations gain valuable business insight into their clinical, financial and operational processes by extending intelligence across multiple channels and improving business profitability and compliance by increasing data transparency, detecting market trends and integrating predictive analytics. Decisions Matter Your success lies beyond analytics and business intelligence. We deliver more than just insight. We help organizations make better decisions.

2 Pandera is focused on cultivating corporate DNA and engineering decision-making environments that mobilize business intelligence and immerse employees in knowledge. fast, focused & agile Enterprise Decision Automation solutions from Pandera provide datadriven insights that help our healthcare clients create continuity across all business functions, drive operational efficiency and promote alignment between organization practices and strategic objectives EDA allows an organization to develop custom reporting and analytics modules that are: Informational Provides current state and historical views for an area of interest Directional Data analysis that identifies trends and contributing factors. Pandera engineers solutions for success, instead of building to specs; strategically re-shaping your decision making environment to immerse every employee in knowledge using the widest array of mobile devices and interactive computing interfaces. This allows constant access to centralized intelligence, creating enterprise-wide alignment and an evolving ecosystem for decision continuity. This ecosystem optimizes processes and resources to cultivate corporate DNA, enabling every employee to attain peak performance, and unleashing business potential for ongoing success. Pandera EDA 360 Life-cycle Management EDA Acceleration Platforms Ideation, Strategy, and Advisory Universal Analytical Models Services Product Identity, Branding, and Marketing Business Agility & Process Application Builder (UAM) Decision Process Models Pandera Motion Human Process Optimization Optimization Advanced Visual & Cognitive Ergonomics Big Data & Event Streaming Managed & Alliance Services Actionable Guided tools reveal key data to support decision-making process. Forensic Modules to mine complex mathematics, to detect intricate patterns and to identify underlying trends. Pandera Systems Atlanta Orlando Tampa Nashville panderasystems.com

3 Data on Demand Lack of interoperability among best-of-breed systems undermines leadership s ability to develop operational strategy. Approximately 70% of clinical data is textual/ document-based and therefore unavailable via traditional reporting. Incomplete reporting in healthcare can lead to lower reimbursement rates, poor utilization of staffing resources and inability to effectively control costs. Potential Benefits Improve capacity and service line planning I mprove pricing and contract development I mprove quality and compliance performance A ccess to free-text data through analytical tools G enerate predictive and prescriptive forecasts using advanced statistical modeling and natural language processing Knocking Down Silos Realize best of breed s full potential Healthcare organizations rely on a patchwork of network systems to support their various departments. Clinical, financial and HR data reside in silos, and staff members often have no way to cross-reference information. Any reporting from these systems provides an incomplete picture of an organization s performance and prevents the ability to forecast trends. Lack of system interoperability undercuts leadership s ability to build effective operational strategy. Pandera Systems works with the healthcare provider s assorted systems to create an integrated, single conical model database that is dimensionally optimize for business analytics. Natural language processing tools enable machine learning and create a system that becomes more intelligent as it is used. Advanced statistical modeling creates functionality that generate predictive and prescriptive forecasting. Custom engineered data solutions from Pandera Systems let healthcare organizations draw upon a best of breed system s inherent strengths and lessen the effects of its inherent limitations. The result is the potential for powerful reporting and statistical forecasting that helps leadersip deliver exceptional business value and sustainable results. Atlanta Dallas Nashville Orlando Tampa Washington DC panderasystems.com

4 Physician Performance & Enablement Adoption rate for current physician performance tools is low due to lack of current data, lack of customization and lack of mobility tools. Potential Benefits R ole-based, relationshipbased tools track physician performance tied to patient outcomes C ustomizable by specialty, service line U ser-friendly tools, data access and reporting increase staff adoption Rank, index physician outcomes based upon peer performance and internal benchmarks Meaningful Measurement Data transparency and ease of access encourage adoption of best practices. The emergence of practice models that tie reimbursement to patient outcomes and patient satisfaction makes practice oversight vital to building and to maintaining a successful practice. Clinical staff typically perceive monitoring tools as irrelevant, ineffective and not helpful, so adoption rates are typically very low. Most monitoring tools rely upon claims data which is often days old. The lack of recent data makes it difficult to coach clinical staff on areas of opportunity due to fading memories and high volume of patient throughput. The lack of visibility to peer performance further lessens the usefulness of monitoring applications because staff performance is viewed strictly in a bubble and not relative to overall practice performance. Solutions are also not available on mobile platforms, so access to information is inconvenient. A lert monitoring via text messaging and Physician tools by Pandera Systems are role-based, relationship based and customizable by specialty and service line. Staff members are ranked and indexed relative to peers and organizational benchmarks. Pandera s product suite features a wide array of mobility features, including alert monitoring via text message and , as well as full support on ios and Android mobile platforms. V isibility to transactional clinical data enables rapid response to address performance opportunities Pandera Systems helps healthcare providers drive consistency across their practices with solutions that promote data transparency, staff collaboration and alignment to organization goals. A vailable for ios and Android mobile platforms

5 Pandera provides engineered solutions specifically crafted to satisfy your organization s DNA. We deliver constant access to centralized intelligence and unmatched analytics via user-friendly environments on the widest array of platforms, interfaces and mobile devices. Our approach enables actionable insights and enterprise-wide alignment that produce peak performance and sustainable success for our clients. Case Study Data for Crucial Conversations Client s existing physician performance tools relied on claims data that was often days old. In order to improve physician performance, decrease costs and improve patient outcomes, the client required performance tools that use historical claims data as well as near real-time clinical metrics in order to track staff workflow, patient throughput and physician productivity to quickly address areas of opportunity to drive behavioral change. The Solution Simplified Physician Performance Application which creates a single place for doctors to access their procedural volumes, patient volumes and patient satisfaction scoring in order to compare with organization benchmarks. The tool is built to be informative and create awareness on areas of improvement for the healthcare specialties in which physicians operate. The Results M otivates discussion among clinicians and physicians regarding practice opportunities. Facilitates physician input for remediation plans. P atient satisfaction reporting available on demand, improving ability of leadership and staff to address performance issues and areas of opportunity. Atlanta Dallas Nashville Orlando Tampa Washington DC panderasystems.com

6 Solutions for Quality Outcome Reporting Poor patient outcomes and low scores in patient satisfaction result in lower reimbursement rates and patient leakage. Areas of opportunity are usually addressed retrospectively, making sustainable process improvements difficult. Potential Benefits D ynamically defined metrics allow trending analysis along with past performance and current factors. Q uickly identify areas of opportunity at point of impact R ank and index clinical outcomes based upon userdefined protocols Physician & staff tracking T rack adherence to treatment protocols F ormat reporting on demand to match needed level of detail high-level down to deep-dive I mproved ability to manage patient populations, patient throughput, and staff workflow The Power of Now Drive process improvements to improve payfor-performance results The advent of performance-based reimbursement models have increased the pressure on healthcare providers to continually improve patient outcomes and patient satisfaction scores. This increased accountability for quality care feeds the current trend of consumerization in healthcare, leading to increased competition and higher patient leakage rates. Many providers struggle to maintain overall performance levels in the face of rapidly changing regulatory guidelines pertaining to quality outcomes. Pandera Systems develops custom applications that feature dynamically defined metrics, allowing organizations to identify and address areas of opportunity at the time of occurance rather than in retrospect. Providers can also rank and index clinical outcomes based upon user-defined protocols and benchmarks. Robust reporting and user-friendly interfaces provide data visualization that can be viewed at a summary level or examined in greater detail at the level of contributing domains. Pandera Systems provides tools that help the healthcare providers refine workflow processes at the point of impact to improve patient outcomes and to enrich patient satisfaction, leading to greater success for the entire organization.

7 Pandera provides engineered solutions specifically crafted to satisfy your organization s DNA. We deliver constant access to centralized intelligence and unmatched analytics via user-friendly environments on the widest array of platforms, interfaces and mobile devices. Our approach enables actionable insights and enterprise-wide alignment that produce peak performance and sustainable success for our clients. Case Study Raising Performance in Near Real-Time To increase executive visibility into high impact quality initiatives in their organization, the client sought a reporting solution that would aggregate and trend transactional clinical and operational data to easily identify areas of opportunity based on defined quality and performance metrics. They also required visualizations and alerts to help drive process improvements and better outcomes throughout the patient s encounter. The Solution Pandera developed an application for the Quality and Process teams to measure and to monitor compliance with regulatory demands and clinical strategies combined in a simple tool. Physicians, CMO s, and other support staff use this application in real-time to look back, but actively engage each other to drive behavioral modification across the patient touch points. The Results I mproved compliance near real-time. Reduced risk by managing Now not backwards looking. Positioned for ACO-based financial benefits. 5 0% improvement in quality across opportunity areas resulting in 4M in savings from outcome improvements. Atlanta Dallas Nashville Orlando Tampa Washington DC panderasystems.com

8 Revenue Cycle Management Optimization & Financial Tools Healthcare providers face declining revenues due to structural changes in the industry. Complex administrative processes and incompatible systems are roadblocks to putting operational efficiencies in place. Potential Benefits R eceivables, payment compliance and cash views are combined into single reporting platform where focused metrics and forensic analysis identify contributing factors to financial performance T rack regulatory protocol compliance and coding accuracy to identify potential areas of lost reimbursements P redictive modeling of costs and revenues based on patient factors (e.g., demographics, diagnoses, comorbidity, etc.) M onitor key factors affecting ACO compliance (ex: clinical outcomes, HAC s, utilization patterns, patient leakage, etc.) Financial Insights Simplified Analytics and decision management tools to help maximize revenue and cash flow. Changes in the healthcare industry have further complicated the already complex task of managing the revenue cycle. Providers depend upon patient receivables more than ever due to increased copayments, increased deductibles and the growth in fee-for-service channels. Thin profit margins are further reduced due to lower reimbursement rates, increase in denied claims, new regulatory requirements and the demand-side pressures caused by the consumerization of health care. In the face of these mounting challenges, all phases of the revenue cycle are under intense scrutiny as providers seek to eliminate administrative inefficiencies in order to maximize revenues. Pandera Systems provides custom-engineered analytics and decision automation tools that help healthcare organizations mine existing data assets and discover opportunities to grow revenue and control costs. Powerful, easy-to-understand visualizations provide instant insight into performance factors, inefficiencies and opportunities for improvement. This comprehensive solution set is delivered through a flexible, scalable technology platform that delivers the agility to respond to the healthcare industry s dynamic challenges. Pandera Systems helps healthcare organizations align management controls with strategic objectives, creating continuity across all business functions.

9 Pandera provides engineered solutions specifically crafted to satisfy your organization s DNA. We deliver constant access to centralized intelligence and unmatched analytics via user-friendly environments on the widest array of platforms, interfaces and mobile devices. Our approach enables actionable insights and enterprise-wide alignment that produce peak performance and sustainable success for our clients. Case Study Establishing a Single Source of Truth Faced with multiple silos of information and reporting systems, our client struggled with data aggregation and providing visibility and accessibility to key financial performance indicators at varying levels of their organization. With no single source of truth, the client faced numerous metric definitions and reporting requirements that resulted in workflow inefficiencies, reporting redundancies and lost revenue. The Solution Combine AR, Payment Compliance, and Cash views into single system to track effectiveness across the systems and allow forward planning for finance teams. Allow any of the measurements to be focused on and understand contributing metrics and causal factors driving the trends. The Results S ignificant decrease in AR days by ~11 days. 15% in Improved Cash position. 21% Improved upfront payment collections. Atlanta Dallas Nashville Orlando Tampa Washington DC panderasystems.com

10 Supply Chain and Expense Management Supply chain is the fastest growing cost driver for healthcare providers. Inconsistent purchasing practices and lack of oversight tools create inefficiencies that undermine organizational performance. Potential Benefits Monitor pharmaceuticals and supplies usage by unit, by supplier and by payor to improve contract negotiation leverage for reimbursements and purchasing Standardize supply purchases to maximize purchasing power, reduce carrying costs Manage supplier and reimbursement contracts across multiple clinical units Achieve right-size inventory levels for greater patient safety and increased quality of care. Reduce waste and diversion of supplies and pharmaceuticals. Smart Procurement Mine your data for insights to lower costs, higher reimbursements, improved quality of care Supply chain is the second largest cost driver in healthcare, behind labor, and the fastest growing expense category. These costs are not just the price of supplies. Procurement costs, storage, waste, spoilage and diversion add up and create significant drag on profitability. Effective supply chain management addresses all of these factors and can save 5-15%, according to Gartner research. Those savings equate to increased profit of 2-7%. In addition to the obvious financial benefits, supply chain management contributes to increased patient safety and quality of care. Effective inventory management reinforces product standards and ensures that the right supplies and pharmaceuticals are available in the right quantities to meet patient demand. Pandera Systems develops solutions that provide quick access to current and historical data aggregated from multiple sources. Purchase history and inventory management reporting allows providers to better manage supplier contracts and monitor vendor performance, leading to increased contract negotiating power. On-demand report customization provides managers and executives with the ability to view usage for an entire organization, by business unit, by payor or at the patient level. Pandera s monitoring tools allow healthcare providers to treat supply chain as a strategic asset.

11 Pandera provides engineered solutions specifically crafted to satisfy your organization s DNA. We deliver constant access to centralized intelligence and unmatched analytics via user-friendly environments on the widest array of platforms, interfaces and mobile devices. Our approach enables actionable insights and enterprise-wide alignment that produce peak performance and sustainable success for our clients. Atlanta Dallas Nashville Orlando Tampa Washington DC panderasystems.com