Business Intelligence

Using Insight to Improve the Value and Performance of Your Practice

Abstract:
Using information to improve the value of your practice can be a great way to create leverage and improve the performance of your practice.  Business Intelligence (BI) is the result of a complete system that produces meaningful insights by providing the information necessary to make business decisions.  Changes made from these insights both improve the performance and value of your practice.  It is important to identify the key elements required of a good Business Intelligence System, and the areas within a practice that can directly benefit from an effective Business Intelligence System.

Insight Creates Leverage

Insight leads to revenue growth, cost reduction, change and Administrator value. These insights are the valuable resources necessary to assist the practices to discover what is driving their economics. Business Intelligence, as opposed to raw data or volumes of information, provides a new insight into the situation, problem or opportunity. There is tremendous value in moving from the use of information toward a culture that is fact based in decision making. If there is not an insight associated with your information that can lead to better interpretations of a particular situation then we can not call it Business Intelligence.

Can Insights Produce Leverage that Improve Business Results?

For more and more practices, as their costs continue to rise and reimbursement continues to be reduced in a variety of ways from the payers, there is a realization that Business Intelligence is extremely important.  Being able to achieve the outcomes expected and make decisions for the future of your practice, requires thorough and complete Business Intelligence.  It becomes one of the key elements of a successful practice. Understanding the underlying data and the processes that are involved in driving collections can increase revenue by as much as threefold. Committing to this idea leads to better decision making in how best to spend a physician’s time to maximize revenue.  Having clear and concise information available allows for the ability to make sound decisions regarding resources, time management and process improvement.

Insights provide valuable combinations of information in not only the over-all practice administration and physician time management but at a claim level which calculates into increased revenue.  For example, when a claim requires an appeal for additional reimbursement, contract information often collides with clinical information.  Having both the clinical documentation to support your side of the appeal and knowing the contract restrictions and requirements provide an effective argument to effectively fight that denial and underpayment.  When the data is available and provides meaningful information, the options are endless in opportunities to evaluate and make changes in any area of your practice.

Business Intelligence is a 5 Part System:

1.  BI Framework

The place to start planning your Business Intelligence framework is with your practice management system, office productivity systems, and clinical systems. These are the tools that will give you the insights you need to improve financially. There are a variety of technology pieces that can be added to generate information needed. Getting the data out and having the right analytic tools can be a tremendous advantage when setting this framework. 

Just because something can be reported on does not necessarily mean you should or should not be paying attention to it.  Different things drive the economics in different practices; the unique structure of every practice requires equally as unique reporting structure and capability. Thinking through the things that can really create leverage and opportunity is the Business Intelligence framework. When implementing your Business Intelligence Framework it might be initially difficult to determine where to be looking for answers. Some already know where the biggest opportunities and areas of focus will be in their practice while others might not know where to start. It is best to do some preliminary evaluation of your practice position, processes, challenges, goals and objectives in order to find the best areas of focus. The same areas can be approached very differently depending on how the question is framed. Asking the right question can lead to the data you are seeking out, whereas, asking the wrong questions can very easily lead to the wrong answer and ineffective results. There is a great deal of structured and objective data that flows through a typical physician office. It is also very easy to get lost in this mass of information.  It becomes imperative that the information you are both seeking and evaluating is meaningful and represents relevant data to the questions posed.

2.  Base Information Systems

Historically there has not been a strong commitment to reporting within the practice management realm.  Off-the-shelf practice management systems provide reports that are generic and created with the entire medical industry in mind.  Consideration of specialties, practice size, unique compensation calculations or custom reporting is often a missing element.  Investing in an information system that will truly give the practice the tools necessary to generate an adequate representation of accurate data is one of the keys to being able to manage your practice effectively.  The result becomes increased financial performance and enhanced visibility to the overall performance of the practice.

3.  Data Collection Processes

Being able to capture the information necessary to provide appropriate data to fuel discussion and ask the difficult questions of your practice starts at the front desk in collection of data and continues through every aspect of the practice management process.  There are trade-offs in the amount of money the practice chooses to invest to collect data versus the value received from that data.  The structure and format of the data collection process is important to consider when evaluating any system.  It is often helpful to review the end result of the reporting capabilities to determine the quality of the data collection process.  The format and availability of data is in direct correlation to the report data outcome. There is often no direct correlation between the number of pages in a report and the number of insights gained. This is something that should be carefully considered when assessing different practice management systems and their reporting capabilities.  The number of reports available in any given practice management system is not necessarily a reflection of the quality provided therein.  Taking the time necessary to evaluate the quality of the data represented in comparison to your practice’s unique requirements is an important step in the evaluation process.

4.  Reporting and Analytics

The process of reporting and analytics is so critical to what will be gained from these reports. Many practices produce a large volume of confusing reports. The practice routinely produces the reports and there is often very little review that is performed because the information is confusing, redundant, unclear or simply worthless.  This stack of paper is essentially useless if insights are not gained from the information being reported.  An ideal report is one that can provide insight to specific areas of particular interest clearly and concisely.

It can be very easy to be misled by statistics.  There are a number of reports that can be used to prove any given point. Why not put all of this data together in a way that shows the interrelationships between these points by telling the whole story. Not every number presented on a report can be relied on to present accurate data. Just because something has a number on it does not mean that it is therefore true. The same data can be given a new look to produce new insights that we might not have seen previously. Understanding the underlying data that drives the report results is crucial to being able to use the data effectively.  Being able to change the parameters of the underlying data to provide alternate views can be helpful in the process as well. It is important to be able to identify trends associated with your practice. When the information is available to both identify and track the trends, it takes the guess work out of the planning process.  Identifying the trend and taking the steps to successfully manage the outcome directly correlates to the reporting capabilities and quality of data.  The ability to extract the data necessary to identify the trends is crucial to this process.

Consistency of data utilization is also important.  Often the data is not used consistently throughout the organization and creates confusion as to conflicting change recommendations.  The data structure needs to be clearly defined to avoid negative decision making and inconsistent goals as well as expectations.

The basic goal is to be able to understand and rely on the data presented to drive the changes necessary for effective change and practice management.  Let the data tell the whole story and use that story to drive change in the appropriate direction for your practice.

5.  Learn and Act

Being able to take the reports and analytics provided and create the opportunities for change may very well be the most important piece of the Business Intelligence Model.  When you have taken the steps to successfully identify the data points necessary for evaluation, reduced them to a meaningful format and qualified the data as accurate, the change process then becomes the key to success. If the physician does not have the desire to develop this idea of Business Intelligence, it might be best to consider having the relevant staff members looking into these matters on a regular basis.  Having the right kind of decision making processes and appropriate accountabilities in order the implement the necessary changes is the only way to move forward. 

Good Business Intelligence is one of the keys to running your practice as effectively as possible. It provides the appropriate tools to make the decisions necessary for positive growth of your practice based on the individuality of each physician.
Look for reports that provide any combination of data in multiple formats.  They provide evaluation from a claim level review to practice performance level evaluations.

Custom reporting is the key to being able to accurately produce the information needed for effective practice administration.  The excel format provides not only functional usage of the data but allows for better communication with practice administrators, contract administrators and financial advisers.  Good reports provide drill-down capabilities to enable qualification of any data represented.  The ability to customize the report formats and data quickly becomes one of the most important tools to any practice in managing the data available.

Look for reporting that provides periodic review at both a claim level for compliance and trend identification at the executive level.  By providing the executive level review of your data you will be able to identify trends or issues important to the management of your practice.
Remember, the right information at the right time with a solid plan for change implementation becomes one of the keys to success.

For more information on Business Intelligence, listen to the podcast interview with Tim Coan of ALN at http://www.soundpractice.net/article.cfm?id=288