Operational vs. Actionable Analytics
Updated: Oct 13
by Rebecca W. Crytser, MS, RN, CHRI, CPC, Senior Clinical Advisor & Revenue Integrity Coordinator at Effy Healthcare, and founder of Revenue Integrity PRN
In the light of the unfortunate recent event of the COVID-19 pandemic, a growing number of hospital leaders, more than ever, are understanding the value of real-time data analytics versus the limitations of operational data analytics to address and promptly solve problems in every aspect of operations.
Effy Healthcare platform fine-tunes an existing Revenue Cycle Management (RCM) operational system, and eliminates the need to replace any existing system, even if that system is not ideal. Costs are reduced because EFFY’s solution powered by RAID Healthcare — an end-to-end software platform used worldwide by leading healthcare systems, telecom companies, utilities, retail and other complex industries — costs less than a replacement system, and is much more powerful.
No disruption costs or need to play “catch up/clean up” as it is often required when implementing new end-to-end software.
No large upfront investment required.
By simply overlaying a real-time data analytics system, EFFY’s solution captures, collects, reconciles and analyses data out of any current transactional system, so managers can quickly gain control of aggregating data, and detecting/resolving issues that impact revenue integrity, as well as clinical and operational performance, in a way that is the most cost-effective.
Real-Time Data is the Real Game-Changer
The most efficient analytics is based on accurate and timely data. Real-time data is where hospital organizations really gain the ability to define the rules and set validations. The most effective approach to data is the enterprise consolidation level stems from completely merging all data from multiple sources, so that comparable data has the same name and format.
By merging the data, users can create the ability to answer consolidation questions, such as “What was total revenue throughout the enterprise?”, and from there, drill down to see all the component parts that make up that revenue number.
Actively Improve Your Bottom Line
Here’s an example on how real-time data analytics work: if a drug treatment is changed to one that requires pre-authorization, an alarm is sounded, so the pre-authorization can be requested. The alarm is triggered by data originating from the pharmacy system (or module if incorporated across one large system) and matched to the third-party payer’s requirements for pre-authorization. Without this capability, payment is denied. With it, a series of 14 questions enables the organization to save millions of dollars.
An analyst, using a RCM solution built upon RAID Healthcare has the reconciliation and analytical tools to rapidly respond to any alert. Instead of channeling the issue up through all of the relevant departments, which is time-consuming and demands the attention of a number of people, the analyst can simply offer an integrated workflow to guide a “fix,” resolving the problem quickly, and improving the bottom line.
Effy’s actionable analytics for healthcare efficiency platform, powered by RAID technology, enables your organization to harness the power to solve analytic and business challenges, big and small.
Effy’s mission is to help hospitals, hospital systems and Integrated Delivery Networks transform data in actionable insights to retrieve, review and compare massive amounts of operational, clinical and financial data across their total enterprise. Using a fully customizable, exception-based triggers to identify deviations from norms, reducing errors and denials, EFFY improves your efficiency and productivity and helps you meet compliance requirements in a time that government regulations are volatile and quickly shifting.