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Month: May 2018

Using EDW for Hospital Readmission Reduction Programs

Posted on May 6, 2018 in Readmission Reduction Programs

You’ve probably heard of the term hospital readmission before. The name is quite self-explanatory but the medical definition is a bot more complex than that. According to the more technical and medical definition:

A hospital readmission is an episode when a patient who had been discharged from a hospital is admitted again within a specified time interval

Hospital Readmission rates have increasingly been used as an outcome measure in health services research and as a quality benchmark for health systems. This is why all healthcare organizations and hospitals have Readmission Reduction Programs to help them reduce readmission rates and also track the progress they make.

Reasons for Readmission Reduction Programs

There are many reasons why hospitals have ongoing readmission reduction programs besides the obvious goal of reducing readmission, there are government incentives that can be gotten if readmission falls below a certain percentage and there are also penalties if they rise beyond a certain percentage. Let’s discuss some of the incentives below

Medicare and Medicaid: Hospital readmission rates were formally included in reimbursement decisions for the Centers for Medicare and Medicaid Services (CMS) as part of the Patient Protection and Affordable Care Act (ACA) of 2010, which penalizes health systems with higher than expected readmission rates through the Hospital Readmission Reduction Program.

Since the inception of this penalty, there have been other programs that have been introduced, with the aim to decrease hospital readmission. The Community Based Care Transition Program, Independence At Home Demonstration Program, and Bundled Payments for Care Improvement Initiative are all examples of these programs. While many time frames have been used historically, the most common time frame is within 30 days of discharge, and this is what CMS uses.

Reducing Readmissions Using Technology

Readmission Reduction Programs

Reducing readmissions contributes significantly to lowering the overall costs of healthcare in U.S. hospitals, but tracking the metrics and reporting the results can be quite tasking and time-consuming. The process is greatly facilitated by analytics applications supported by an enterprise data warehouse to guide improvement projects. These are the keys to developing best practices that will ultimately help hospitals reduce readmissions, and avoid the penalties that result from noncompliance.

The advantages of technology cannot be overemphasized. The evolution of technology is beneficial to humans all around for several reasons even beyond the medical level. At the medical level technology helps in almost all aspects of care delivery from diagnosis to aftercare has been provided. With technology, patients can become more engaged with their care and their health and can be able to track their progress in aiding of their care.

Technology also helps healthcare organizations and hospitals manage their data (Big Data). You’ve probably also heard the term Enterprise Data Warehouse (EDW). The benefits of an enterprise data warehouse EDW don’t end with reporting, though. An EDW delivers the business intelligence tools a hospital needs to drive real cost and quality improvement initiatives and also reduce readmission rates.  Some of the benefits of an enterprise data warehouse are that it enables health systems to:

Readmission Reduction Programs

  • Establish a baseline for all quality measures
  • Perform analytics to pinpoint opportunities for improving quality
  • Track the success of improvement interventions
  • Measure and sustain results over the long-term

One effective way a hospital can keep its readmission reduction program effective and up-to-date is by adopting a healthcare enterprise data warehouse (EDW) to meet the many reporting demands. Here are a few examples of how an EDW helps solve the reporting burden:

Users can access integrated views of financial, clinical, and operational data from throughout the enterprise. Data collection and the analysis process become automated. Manual data collection and tracking simply won’t work in the future. These manual processes consume time and resources and often result in inaccurate or missing information. Users can collect data from across the enterprise to integrate clinical, financial, and operational data from inpatient and outpatient settings.

Reports are generated automatically, ensuring that the right data gets to the right audience at the right time. The benefits of an EDW don’t end with reporting, though. An EDW delivers the business intelligence tools a hospital needs to drive real cost and quality improvement initiatives. In specific, an EDW enables health systems to:

  • Establish a baseline for all quality measures
  • Perform analytics to pinpoint opportunities for improving quality
  • Track the success of improvement interventions
  • Measure and sustain results over the long-term