New operational realities demand new ways of measuring the qualitative value of clinical procedures.
The primary goal of any healthcare provider is to improve the lives of patients through effective treatment. However, because they are also businesses, hospitals have concerns that entail much more than this. To be viable in the long term, hospitals must manage their margins to fund their mission.
There are three main pillars of business concern for any hospital:
- Clinical — health outcomes are measured with the goal of healthier patients leaving the facility.
- Financial — the dollars must add up to keep the enterprise solvent.
- Operational — staffing and facilities are measured against cost and need.
Ultimate success for a hospital demands focused attention on all three areas. It's incumbent upon clinicians and service line managers to work together to seek out efficiencies in each of them.
New Operational Realities
Payers' shift away from a fee-for-service model toward a value-based payment model demands that clinicians and administrators expand the above-mentioned pillars to include cost, patient outcomes, and patient satisfaction.
These changes aren’t easy. Providers have long been paid based on quantitative measures: the number of procedures performed. New operational realities demand new ways of measuring the qualitative value of those procedures. Reimbursement is linked to these metrics, and hospitals must find ways to leverage their investments in data technology in order to maximize their financial opportunities.
Granular Data Brings Actionable Insights
Data is critical to the shift to VBP. For example, for CABG procedures, if we know that extubation under 24 hours after surgery improves patient outcomes, it makes sense to monitor that metric internally on an ongoing basis. When outliers crop up, data points gathered from across the treatment spectrum can allow us to understand why. Perhaps a different treatment was needed at the outset, or some other patient health factor influenced that measure.
Over time, granular data can allow us to understand which type of treatment is best for patient outcomes in that circumstance.
It is discrete, granular data that can help providers fine-tune their processes in order to improve patient outcomes — and of course patient satisfaction. This same kind of close analysis can be applied to reducing costs. But for all three new, expanded pillars, efficient data collection, management, and analysis are needed.
LUMEDX offers cardiovascular data intelligence: technologies that collect more than 30,000 discrete data points—from point-of-care devices to physician reporting. This rich data set enables meaningful insights in the areas of treatment options, clinical evaluation and training, and service line optimization.
For more information, visit www.lumedx.com
July 29, 2024 
