White Paper Searchable Data:

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1 White Paper Searchable Data: Analyzing What It Means To Your Practice

2 2 Searchable Data: Analyzing What It Means To Your Practice What is Searchable Data and Why is it Important? Searchable data means that information can be extracted by using keywords to sort through a collection of data. According to a report published in 2011 by HIMSS and sponsored by Anvita Health, two key factors that drive physicians to incorporate searchable data and analytics are: 1) achieving a high quality of care and patient safety and 2) increasing awareness about the costs associated with the provision of care. For healthcare technology, incorporating this type of searchability into patient charts is a natural next step to the mandated transition to EHRs. Similar to a google search, physicians who incorporate searchable data into the backend of their practices will be able to easily locate specific information about patients history and health by just using simple keywords. The findings of the HIMSS report also suggest that another key benefit of searchable data is that it can be analyzed on a single-patient basis or across a larger patient population to identify emerging trends. This allows organizations to identify both areas where they might be able to modify workflows and procedures to enhance patient care, as well as identify opportunities to reduce costs. Industry Overview Healthcare is an industry that has been completely transformed by technology. From electronic health records and personal health apps to the emerging revolution of digitized genomic data, the industry has had to adapt quickly to meet the new needs of patients and providers. Advancements in technology have taken health and wellness beyond the doctor s office and into the daily lives of consumers, via the internet, smart phones and new platforms that host health data and make care easier. What links all of these things together is digital data. Thanks to online search engines nearly everyone is familiar with searchable data in one fashion or another. For example, when you google allergy specialist, the results that come up are dictated by searchable terms that practices have incorporated into their websites and other online marketing channels to maximize their searchability. Physician s practices can leverage the benefits of searchability as well. Being able to locate patient data easily and report on outcomes accurately helps ensure that they are making informed decisions with a proactive approach to patient care. Being able to search on specific medical terms within patient records is also critical to conducting the reporting necessary for today s practices to maintain profitability.

3 3 Practices need to be able to mine databases on factors including: financial, demographic, physiological, phenotypic, genotypic, environmental exposure and lifestyle information for their patients. Each of these categories has multiple data types and when captured in a systematic and easily mineable way, this data can be used to guide clinical decisions, potentially preventing adverse events or improving therapeutic approaches. For example, a practice may want to report on the effectiveness of flu vaccinations or side effects reported from the vaccine based on patient age groups or clinic locations. With the right EHR system in place, reports like these are not only possible; they can be easy to compile. The importance of ensuring data is searchable, especially as healthcare technology continues to progress, is paramount. More efficient tracking of treatment plans for chronic conditions, extensive records of shots given, collaboration on lab tests ordered and other efficiencies are just the beginning. Having searchable data is a critical tool for measuring the practice s clinical outcomes and financial performance in real-time with customizable reports. The bottom line is that searchable data saves time, and ultimately, money. How Searchable Data Can Benefit Your Bottom Line Cost control is a key driver for most organizations, as they are under pressure to meet increased demands for services, while at the same time containing costs. Healthcare organizations can use clinical analytics to identify areas in which there are high variances in cost so that they can make modifications in service delivery, leading to reduced overall costs. Billing and Reporting Effective billing and reporting are the key elements to practices getting paid. Electronic coding and searchable data make these processes more efficient and thus increase fluidity with insurance companies. When physicians code visits using pen and paper, they may tend to under-code rather than risk over-coding which means that they may not get compensated for the level of service they re actually providing. Electronic coding of patient visits in an EHR system not only makes it easier for physicians to select the appropriate level of coding, but it also makes it easier for insurance companies to process claims more accurately and resolve claims faster. Cash Flow, Practice Efficiency and Communication According to an article titled Ten Ways to Improve Your Bottom Line by Analyzing the Data from Your Practice Management System, paying close attention to data can improve decision-making for services and dramatically improve revenue without even having to add any new patients. It is crucial that data be trended over a period of time so that trends can be spotted,

4 4 benchmarks compared and improvement plans developed. Seamless sharing of data across the Practice Management (PM) system and EHR makes financial and clinical reporting a much less time-intensive process. Ensuring that all data is contained in a single database is key to the prevention of duplicate data entry, allowing for streamlined communication with insurance companies and patients. Searchable Data as it Relates to EMR EMR systems are based on searchable, mineable data for a number of reasons including operational and financial benefits. Ultimately this type of data saves time for both the patient and physician. EMR When data is searchable, the practice s billing department will be able to obtain an accurate snapshot of accounts receivable at any moment. Having immediate access to this type of information makes it easier to spot issues of concern and address them in a timely fashion. Measuring the practice s clinical outcomes and financial performance in real time with customizable reports means that a practice can look at overall performance as well as individual provider performance to examine patient flow, billing, treatment patterns and more. Electronic coding also facilitates better communication among physicians, especially those who may be treating the same patient for various ailments. When a patient is referred to a specialist, it is far easier to share electronic medical records than paper charts. It is also much easier to fulfill patient requests for records in a timely manner. Clinical data repository Clinical decision support Computerized practitioner order entry (CPOE) Order entry Nursing documentation and physician documentation FIGURE 1: According to the HIMSS Analytics Database, these are the key elements in an EMR suite. In terms of improving workflow efficiency, mineable data regarding chronic conditions and their treatments is helpful for practices to track the outcomes of their patients and report internally on their practice effectiveness and performance. It also reduces errors that can be made when tracking histories through written documentation. Mineable, reportable data, particularly with chronic conditions, is crucial for the clinical reporting required to receive funding through government incentive programs such as the Physician Quality and Reporting System (PQRS), Meaningful Use and e-prescribing. Measures in the PQRS for example include preventative

5 5 care, screenings and laboratory testing for chronic kidney disease and chronic obstructive pulmonary disease. The Importance of Searchable Data to Achieving Meaningful Use Meaningful Use requires organizations to report on multiple measures in order to achieve incentives. speeds up this process allowing for time to be spent on other practice matters. In addition, physicians who don t have data recorded in a searchable format, are not able to report on it; meaning they cannot participate in a number of incentive programs even beyond Meaningful Use. Making Sure Your Data is Searchable FIGURE 2: The three main components of Meaningful Use Research in a 2011 HIMSS/Anvita Health report indicated that practices are carefully analyzing data that is being generated during the care delivery process and mapping that data against the process measures, such as capturing flow sheet data and changes in vital signs that have been identified in the meaningful use criteria. A key criteria of Meaningful Use is the practice s ability to attest that they are meaningfully using the technology they use to manage their practice. For example, one for the requirements in meeting Stage 1 Meaningful Use is to perform at least one test of certified e-health record s capability to electronically exchange key clinical information, such as problem list or medication list, among providers of care or patient-authorized entities. Searchable data 3 Clinical analytics gives users the tools to turn data into information. According to the Merriam-Webster dictionary, data can be defined as factual information (as measurements or statistics) used as a basis for reasoning, discussion, or calculation. Information is defined as the communication or reception of knowledge or intelligence. Translating data into information is not without its challenges. Some methods for data entry - including scanning, digital handwriting, voice recognition, and point-and-click - do not produce searchable data. It is important not to simply convert a paper chart into an electronic one, but to actually create a structured, electronic database that can be used for data mining. Just because data is housed electronically does not necessarily mean that it is ready for analysis. In some instances, data is captured in a free-form method, such as a note and when this happens, the information needs to be converted to a discrete, or structured, field

6 6 for data analysis to take place, using natural language processing technologies. It is important to capture information at the source as data elements so that it can then be mapped into appropriate fields and analyzed. Creating indexes and organizing data is an important step in ensuring data will be easily searchable. Assessing What Your Practice Needs Practices must first evaluate their current needs, future goals and what data is most important to capture/analyze Required data by governmental or other external organizations. Data that will assist with cost savings. to the practice, so that general security measures can be adjusted to individual practice requirements. Patient Trends and Preferences Collecting and analyzing data on patient appointment tendencies, for example, flagging those who are most likely to be no-shows, can help manage staffing and reduce the amount of money that can be lost on missed appointments. Schedules can be optimized by anticipating fluctuations in patient volume and accordingly adjusting the number of staff. This way, patients are receiving timely care while the practice runs more efficiently. The Future of Data Analytics FIGURE 3: According to a 2011 HIMSS/Anvita Health report titled Clinical Analytics: Can Organizations Maximize Clinical Data? much of the information that healthcare organizations ultimately choose to report is driven in one of three ways: Some other things to consider when evaluating practice needs: Privacy/Security and Searchable Data An issue that often comes up in discussions surrounding searchable electronic records is patient privacy and security of sensitive medical information. While this is a legitimate concern, reporting within most EHRs produces de-identified patient data so that security is not compromised. System security levels and access should be customizable Patient care is an evolving field and the availability of continually increasing data sets should yield information that will allow for enhanced patient care. As the sources of data and information continue to increase and come from a wider variety of sources, analyzing and reporting will become a more complete, beneficial process. The quality and quantity of source data will increase as new and improved clinical IT applications allow more information to be captured from within the patient s own facility and the use of patient portals will allow patients themselves to input details. As healthcare organizations begin to share even more, the collaborative data will create a more complete picture of a patient s medical condition.

7 7 Another influence on the amount of clinical data that will be available for analysis in the future will come from the shift to ICD-10. Under the current ICD-9 system there are only 17,000 codes available for identifying diagnoses and procedures. According to the Department of Health and Human Services, the ICD-10 in October 2013 will result in a total of 155,000 codes, allowing for the accommodation of diagnoses and procedures in a way that is not possible today. This will enable new levels of analytics, including quality reporting, pay-forperformance and bio-surveillance. Closing the Loop on Searchable Data In closing, as technology throughout the healthcare industry continues to develop and shape the way practices and physicians work, the importance of ensuring data is searchable is a necessity. In addition to allowing for more efficient tracking of treatment plans and extensive records, searchable data is also an important tool for measuring a practice s clinical outcomes and financial performance in real-time, saving time and money. Metadata is another important component, especially as The Office of the National Coordinator for HIT s proposed rule for Stage 2 of the EHR Meaningful Use program begins the process of including use of metadata as criteria for compliance. This means that individual pieces of information are tagged data elements because each unit of data is accompanied by a mandatory metadata tag, describing the provenance, attributes and required security and privacy protections of the data. For additional information on searchable data in healthcare practices, visit Hegenberger Road, Suite 800 Oakland, CA (866) 99-GO-EMR Fax: (510) info@meditab.com About IMS Since 1998, IMS (Intelligent Medical Software) has been a proven clinical automation system that maximizes staff productivity, advances patient care, manages resource utilization, and reduces practice costs. This multi-award-winning, multi-certified Electronic Health Records (EHR) and practice management system combines clinical charting, e-prescribing, population management, decision support, practice analytics, document imaging and much more, on a single database platform. We take tremendous pride in providing comprehensive, user-friendly, and affordable solutions for each practice s unique needs. Time tested and proven, IMS generates tangible returns for medical practices of all sizes and specialties. Headquartered in Oakland, California, with offices and partners across the United States, IMS empowers hundreds-of-thousands of users nationwide. twitter.com/meditabian facebook.com/ehrsoftware