Patient Data Can Improve the Delivery of Care While Reducing Healthcare Costs

By Charu G. Raheja, PhD

With the new health laws in full swing, hospitals, healthcare plans, and accountable care organizations are all trying to find ways to improve patient care and decrease the unnecessary use of healthcare resources. Simultaneously, patients and caregivers are looking for ways to decrease hospital admissions, readmissions, and unnecessary visits to both hospitals and physicians’ offices.

To help allocate resources more effectively, an analysis of health data and patient demographics is crucial. We know that certain patients are more likely to use resources unnecessarily. Therefore, in order to successfully work within the new healthcare mandates, providers need to identify which patients would benefit most from preventative education and assistance. Then, providers can incorporate protocols to provide these patients with information and support that can help reduce the unnecessary use of healthcare resources. Unfortunately, while many providers are interested in engaging in such services, few know where to turn to obtain the patient data required to make meaningful decisions.

A Natural Data Collection Partner: One of the best available resources for quality patient data comes from nurse triage centers experienced in collecting and analyzing data.

  • As these centers support several practices, they have access to highly diverse patient populations. This allows them to provide quality data on a variety of population groups.
  • Triage center nurses assist several hundred patients daily, allowing for a large collection of data in a short time.
  • Triage nurses often interact with patients via a series of inquiries. They can easily incorporate additional, quick survey questions to obtain needed data.

For example, data can be used to evaluate a wide variety of items related to ER use, such as:

  • Which patients are more likely to be readmitted to a hospital;
  • Which patients are more likely to think that they need to go to the emergency room;
  • Which patients are more likely to truly need an emergency room visit.

This information can also be broken down by various demographics, such as whether men or women in their fifties are more likely to need emergency care, which group tends to ask for help right away, and which group tends to wait too long before seeking medical help, resulting in a more severe condition.

Using Data to Find Cost-Cutting Solutions: Another example of how the data can be used to identify the unnecessary use of healthcare resources is demonstrated in the table below. Utilizing collected data from actual patient calls, analysis shows that when compared to patients with private insurance, patients in government insurance programs were more likely to go to an emergency room if they did not have access to a nurse triage center.

As these patients are putting additional strain on ER resources, one solution may be to increase provider-initiated education to patients who are on government insurance. Through basic information, patients can learn when and where to receive basic care, thereby reducing the unnecessary use of the ER. This one basic change could equate to a tremendous savings to healthcare systems.

This is just one example of how quality data can make a positive difference in healthcare delivery and costs. Once having access to this data, healthcare providers are able to utilize a wealth of diverse information to improve the care they offer patients, as well as help determine how best to allocate financial and personnel resources.

Charu G. Raheja, PhD, is the chair and CEO of TriageLogic Management. For more information and additional resources, email charu.raheja@triagelogic.com.

[From the April/May 2013 issue of AnswerStat magazine]