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Care Episode Analytics for Better Health Outcomes
The healthcare industry is increasingly adopting technology to digitalize its offerings. To maximize the advantages of technology, healthcare data needs to be consolidated. One of the possibilities with streamlined data is Analytics on the data. Analytics enables mining insights from the huge volumes of healthcare data available. Currently, there is a growing need for ‘episode care analytics’ where analytics is used to capture various points in a care journey, right from detection to treatment. This is being used to improve the care offered to patients, and to reduce costs.
The entire treatment a patient receives for an illness or other medical emergency is termed as an episode of care. Let’s say a patient has a heart attack, all the activities performed to diagnose it, find the underlying causes, and treat the patient is an episode of care. Once data is collected from hundreds of patients, analytics can be used to find patterns, areas of improvement, and to evaluate the expected cost of care.
Episode care analytics is helping healthcare providers with data that can be leveraged to understand areas that need more attention and improve care over time. Episode analytics is also seen as a stepping stone in value-based care models.
Use Cases of Episode Analytics
One of the main areas where episode-care analytics directly impacts is in payments. This model is gaining popularity as patients do not have to opt for the traditional fee-for-service payment model where healthcare providers charge for every service. Instead, episode-care payment includes all treatment received for an illness or medical event. For instance, a pregnant woman does not have to pay for every visit in an episode-of-care approach. Instead, the care is offered as a package for the entire nine-month prenatal period, delivery, and after delivery. This kind of care is also offered for various other types of treatment plans like for ex: knee or hip replacement surgeries.
Insurers or Clinically Integrated Networks (CINs) can leverage episode analytics to examine total costs of procedures and prepare network design. Since the ultimate purpose of CINs is to optimize cost, inference from episode care analysis will be beneficial. The analysis helps identify which providers can be included in the network to improve the total costs of the procedures.
Episode care analytics is highly beneficial in evaluating the current practice pattern. Providers and payers can set the performance benchmark for end-to-end care based on available quality and cost data. This practice will help direct patients to different facilities as necessary.
As value-based care is at the center of healthcare service, data from episode care analytics can be used for referral management to identify other healthcare providers who are competent in their field. This helps increase communication and promote team-based care. Ultimately, care analytics can result in optimizing cost and quality of care.
Episode data is instrumental in designing medical policies and plans. The analysis can be used to optimize cost, revise existing practices, improve resource utilization. If there is any inconsistency or overuse, new policies can be implemented, or existing policies can be updated.
Benefits of Episode Analytics
As the two primary benefits of an episodes-of-care program are financial and quality-of-care, episode-based analytics has become an integral part of healthcare organizations. It offers three important advantages to medical professionals — increased savings, improved quality of service, and better patient experience. The technology allows users to assess the patient risk level and create a more defined and personalized care delivery system accordingly. Evidently, episode-based analytics supports the value-based care approach both patients and healthcare organizations are beginning to focus on.
Certain areas of medical science involve patients undergoing multiple episodes of care. Healthcare providers can analyze trends and patterns to benchmarks by leveraging episode care analytics. This practice can allow organizations to compare data, identify areas of anomalies, and improve service.
Care episode analytics is also gaining popularity for its ability to measure the cost and quality of episodes of care. With the data available from these analytics, organizations can better picture the true total cost of care, design care models based on variations, implement measures to avoid potential complications, and use risk-adjusted scoring to identify risk groups.
Another important benefit is insight. As analytics offer deeper insight into the kind of patient care needed, healthcare providers can improve their service with a patient-centric approach to offer care coordination. As large volumes of data are collected for a single disease or healthcare service, hospitals and other healthcare facilities can get a system-wide analysis of care and improve care delivery. The data can be used for aggregate and case-by-case service offerings.
Recently, episode analytics has been used for case management. As the analytics give the users accurate comparisons at both the patient and provider levels, providers can use it to address specific health conditions more efficiently to have a deeper understanding of the journey.
GAVS helps healthcare providers, payers, life sciences and MedTech organizations through our end-to-end healthcare offerings some which include EHR Modernization with data management and interoperability, descriptive analytics, and AI led advanced analytics such as predictive and prescriptive analytics. Our services help manage data and derive meaningful insights to drive patient-centered and clinical outcomes-based care. GAVS solutions allow users to reduce diagnosis costs, avoid expensive duplicate testing efforts, handle newer collaboration models such as ACO, and support next-generation payment methods. To learn more, please visit https://www.gavstech.com/healthcare/.