Healthcare leaders are swimming in a deluge of data. Patient outcomes, referral patterns, claims — the spreadsheets are nearly endless. Without the right healthcare business intelligence tools to make sense of it, it’s easy to drown in the sea of data points. Navigating the data is of the utmost importance for today’s savvy healthcare leaders. Those who harness data, using the right analytics and business intelligence software, can identify the right growth opportunities, streamline revenue cycle management and improve patient experience and loyalty — all “musts” to remain competitive in an industry with shifting reimbursement patterns and a stream of new, disruptive entrants. Now is the time for hospital leaders to stop drowning in data and instead make it actionable to create strategies that will carry their organization into a successful future. It’s possible with the healthcare business intelligence tools available today. When it comes to choosing when, where, and how to receive care, today’s patients have more choices than ever. For one, several organizations from outside of healthcare are increasingly entering the industry to solve the cost, quality and access problems that plague it. Companies like Google, JPMorgan Chase, Amazon, Wal-Mart and others have made different attempts to disrupt healthcare. Venture capitalist firms and “payviders” are also extending their reach into the industry. These new entrants also tend to prioritize consumer-focused tactics, meeting the growing expectations patients have for convenience and personalization. Research from Guidehouse (PDF) found that 60% of patients expect their digital experience with healthcare organizations to mirror the digital experience with retail organizations. They want a frictionless experience — and most traditional healthcare organizations are not providing that today. These changes, coupled with the continued shift to value-based care arrangements, mean hospital systems need to respond to stay relevant, solvent and competitive. Relying on old approaches won’t cut it. Leaders must look to data to continue to grow market share and improve patient loyalty amid a changing reimbursement landscape. Using business intelligence tools to parse data and make it actionable is the way leaders can make data-driven strategic decisions and remain successful in the face of these challenges. Given the vast array of data available to leaders and the breadth of challenges ahead, hospital systems need to prioritize how they put data analytics to use. Keeping a growth mindset during a challenging period for provider organizations may seem daunting, but using business intelligence tools to find the right opportunities makes it much more manageable. Start by analyzing available data about current patients and the surrounding community. One hospital’s patient population may have young couples preparing to have children, while another hospital may serve a quickly aging community, for instance. That information can lead to data-driven decisions about where is best to invest for future needs, or what can be safely scaled back. Data analysis can also help systems optimize sites of care and expand service lines to better serve their patients. Ines Vigil, MD, MPH, Clarify’s general manager and senior vice president of provider solutions, put it best: “By developing a data-driven strategy for your organization’s site of service delivery, you’ll reduce the risk of selecting inappropriate and administratively burdensome services, you’ll improve the experience of patients and their providers, and ensure you will grow profitably over time.” Physician engagement is another area ripe to spur growth. BI tools can uncover how to best work with them. Powerful software can analyze referral patterns to see where physicians are referring out of network, allowing leaders to then dig in to discover what’s causing those gaps and attempt to redirect referrals back into network. Transparently showing physicians the data leaders to better engagement and can help drive behavior change. Hospitals must receive proper payment to continue serving patients, whether in a fee-for-service contract or a value-based care arrangement. But claims denials are on the rise, with a recent report finding nearly 11% of all claims were denied in 2022. Business intelligence tools can make the front and back end of the revenue cycle more efficient, reduce the number of denied claims, and ensure timely and accurate reimbursement. Inaccurate enrollment files are a common reason insurers deny claims, according to a report from the American Hospital Association. Harnessing business intelligence on the front end of the revenue cycle will simplify the registration process for patients and ensure accuracy, leading to fewer denied claims. BI tools can also work on the back end of the revenue cycle process, improving reimbursement rates through data-driven denial prevention management and optimizing billing processes to minimize payer-related revenue loss. Health systems that prioritize gaining and keeping loyal patients will thrive as patients continue to act as informed consumers of care and expect personalized care and experiences. Attracting patients first and foremost requires a proven track record of providing high-quality care. Predictive analytics can help providers tailor care plans to individual patients and also report out about the quality improvements that follow. This will encourage new patients to seek out the high-quality, personalized care provided in the hospital system. Beyond personalized care plans, patients are increasingly looking for a personalized care experience. Digital patient engagement tools, when coupled with data analytics, can capture and analyze real-time patient feedback and satisfaction ratings, as opposed to relying solely on oft-delayed HCAHPS scores. This real-time feedback allows for continuous improvement and a more satisfied patient base overall. Though business intelligence tools can help usher hospital systems into the future of healthcare, there are still challenges associated with realizing its benefits. Data accuracy, security and integration should all be addressed prior to implementing a business intelligence strategy. Federal and state laws hold healthcare organizations responsible for protecting all types of data, from personal health information to general demographic data. Leaders who want to leverage BI should look for a company that is intimately familiar with the healthcare data regulations and also engage key leaders within the organization to ensure proper data governance. Healthcare is also an infamously siloed industry, and consolidating data from various sources is a challenging but necessary step to optimize the use of new BI tools. Working to integrate information within the system before implementing a business intelligence strategy will help optimize the use of those tools. And as with all investments and organization-wide change, leadership from all departments and the C-suite must be on board with the new business intelligence strategy. Demonstrate what BI tools can deliver — from uncovering growth opportunities to improving payment rates — to gain buy-in from leaders across the organization. Between digitally advanced companies rapidly entering the industry and a challenging and changing reimbursement landscape, it is more important than ever for hospital systems to make data-informed, strategic decisions. Healthcare leaders that prioritize use of business intelligence tools can turn their deluge of data into actionable reports and insights that will grow revenue and cement a loyal patient base while improving care.A changing industry demands a data-driven response
Three priority use cases for business intelligence tools in healthcare
Identify growth opportunities
Streamline revenue cycle management
Enhance patient care and experience
Overcoming challenges in implementing BI in healthcare
Stop drowning in data — put it to work instead
- Author Details