New analytics solution identifies readmission risk


Health Care DataWorks (HCD), a provider of business intelligence solutions and health care analytics, has launched two new dashboards.

The first provides hospitals and health care organizations with a better understanding of planned and unplanned readmission rates. The second helps manage length of stay for inpatients as well as ‘observation’ patients, providing visibility into patients who have exceeded their expected length of stay.

The new dashboards are the next evolution in HCD’s Enterprise Data Warehouse (EDW), used to capture and analyze data across an organization and contribute to improved patient care and financial stability.

HCD’s new Readmissions Management Dashboard helps organizations comply with the new guidelines that require hospitals and health care systems to implement strategies to reduce costly and unnecessary hospital readmissions.

It integrates a predictive algorithm to provide daily reports showing the risk of readmission of all in-house patients. Action worklists present opportunities for timely intervention and care coordination that can reduce readmissions and help avoid CMS penalties. Additional reports and graphs provide a holistic approach to tracking and monitoring readmission trends and related statistics.

The Length of Stay (LOS) Management Dashboard provides an at-a-glance view into patients that are staying longer than their expected LOS, and the financial impact to the facility. It allows drill-down into critical data that gives hospital management insights that can help eliminate, or at least minimize, revenue loss. The dashboard also provides visibility into LOS for patients under observation care, as well as short-stay patients staying for three days or less. A critical portion of these short-stays includes cases falling under the proposed Two-Midnight Rule.

The Two-Midnight Rule, first introduced in August 2013, determines which patients can be considered outpatients under observation, a status that is less expensive for Medicare to reimburse than inpatient care. Barring clearly set exceptions, stays lasting less than two midnights must be treated and billed as outpatient stays, which directly affects the amount of Medicare reimbursement hospitals can collect.

Although Congress has delayed enforcement of the Two-Midnight Rule until March 31, 2015, hospitals and health care systems must begin revamping their software systems, policies and procedures so that they will be in compliance and not be financially penalized when the rule takes effect.

“New guidelines and regulations mandate how organizations are evaluated and paid, directly affecting their bottom lines,” said Jason Buskirk, CEO of HCD. “As a result, more and more health care managers are turning to analytics for answers, realizing that analytics is no longer an option, but a financial necessity. Our new readmissions and LOS dashboards will have a significant impact on the quality of care these facilities provide, as they manage costs, enhance patient satisfaction, achieve savings and grow revenue.”