Enhanced Care
Customer Solution Case Study
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Medical Group Uses Reporting Framework to Enhance Care and Control CostsOverview
Country or Region:United States
Industry:Healthcare
Customer Profile
HealthCare Partners (HCP) provides healthcare to 500,000 patients annually. HCP employs or contracts with more than 1,100 physicians and 3,000 specialists, and it partners with many major hospitals.
Business Situation
HCP wanted an automated reporting framework to help manage its revenue cycle and hospital inpatient bed days at the regional, medical office, and physician levels.
Solution
HCP worked with Microsoft Gold Certified Partner CitiusTech to develop a financial and operational reporting solution using Microsoft technologies.
Benefits
- Enhanced care
- Better connectivity
- Reduced costs
- Improved productivity
Rick Liu, Director of Decision Support, HealthCare Partners
Providing healthcare to more than 500,000 patients each year, HealthCare Partners Medical Group (HCP) employs or contracts with thousands ofphysicians and specialists. To provide support services, such as inpatientcare management, referrals, and billing, HCP relies on a detailed and dynamic reporting system. Unfortunately, HCP’s existing reporting framework did not provide the analytical tools or performance that the organization required, resulting in high administrative effort, increased costs, and inefficiency. HCP needed a system to manage its revenue cycle and analyze inpatient bed days at every level of the organization. Working with Microsoft Gold Certified Partner CitiusTech, HCP developed HCPReportCenter, a reporting solution based on Microsoft technologies. Now, HCP takes advantage of advanced analysis capabilities to control costs and enhance patient care.
Situation
HealthCare Partners Medical Group (HCP) provides primary and specialty healthcare to more than 500,000 patients annually in the Los Angeles Metro area of Southern California. Headquartered in Torrance, California, HCP employs around 500 primary care and specialty physicians in 40 medical offices. HCP also contracts with more than 1,100independent primary care physicians and more than 3,000 specialists. In addition, HCP partners with more than 20 major hospitals to help provide and manage inpatient care.
To provide services to both health management organization (HMO) enrollees and fee-for-service patients, HCP has contracts with most major HMOs and health insurance providers in Southern California. And because HCP provides a full range of support services for its network of independent physician associations, such as referrals, accounting, billing, and claims services, the medical group has developed a significant IT infrastructure to manage systems and practices throughout the enterprise.
“We manage both the professional and the institutional aspects of healthcare,” says Rick Liu, Director of Decision Support at HealthCare Partners. “And because we have to manage doctors, outpatient clinics, and inpatient admissions, we need systems that can provide very detailed and dynamic reporting.”
HCP developed a reporting system based on Oracle software to help it manage and coordinate its monthly revenue cycle, inpatient bed days, and other patient utilization metrics across the group’s five regional business units. However, the system lacked advanced analytics capabilities, and the Decision Support department at HCP had trouble getting the system to meet the needs of regional stakeholders, such as operations managers, medical directors, medical office administrators, and clinicians. The Decision Support staff often had to manually produce ad-hoc reports, using Microsoft Office Access database software or Office Excel spreadsheet software, and distribute them by e-mail or sometimes even in paper copies.
The situation not only created significant extra work for support teams, but it often resulted in valuable information being distributed inefficiently, making it hard to monitor the overall performance of the organization, identify trends, and coordinate action. “We were getting the information out there, but we wanted a better way to aggregate it for stakeholders who really needed it the most,” says Liu. “We wanted to consolidate all the financial and bed-day reporting into one central application that would provide a Web-based user interface and easy-to-use advanced analytics capabilities for key decisionmakers in our organization.”
Liu also wanted his team to spend less time on the mechanics of simply producing reports and more time providing analyses to manage costs and improve patient care. “If we could provide more information that was actionable, rather than just reports to sift through and read, it would make it easier to get beyond just closing the revenue cycle each month,” he says.
HCP wanted to build an automated, interactive, and user-friendly analytics and reporting solution that would provide easy access to reports and timely information for key decisionmakers. The medical group needed a system to help manage its revenue cycle and analyze inpatient and outpatient utilization at the regional, medical office, and physician levels. HCP wanted more dynamic reports that couldidentify trends and their causes, while minimizing the need for ad-hoc reporting.
Finally, HCP wanted to extend the solution framework to other operational and performance metrics so that the organization could continue to focus on controlling costs while enhancing the quality of care that it provides to patients.
Solution
In 2009, HCP began working with CitiusTech—a Microsoft Gold Certified Partner that provides technology solutions and services to the healthcare industry—to design and build a framework for delivering financial and operational reports using Microsoft data management and business intelligence technologies. The system, called HCPReportCenter, centralizes financial and inpatient utilization reporting across all dimensions of the organization. With HCP Report Center, stakeholders at HCP can access data marts for subject areas, such as inpatient or outpatient utilization, claims, or referrals, and optimize these complex datasets for enhanced reporting and analysis.
HCP dedicated a cross-functional team to collaborate with CitiusTech on an iterative development process for HCPReportCenter, while stakeholders continued to use the existing, Oracle-based reporting system. A beta version of the system was deployed to key users who provided feedback to the HCP team and CitiusTech. After further testing and training, the system was deployed to end users in fewer than 16 weeks, launching in the last quarter of 2009.
“CitiusTech was a tremendous development partner,” says Liu. “Because CitiusTech is so focused on the healthcare industry, they came in with a very strong understanding of the important metrics in healthcare, how to deliver them, and how to calculate them. They met our expectations every step of the way.”
Using HCP Report Center, HCP can consolidate reporting by subject areas and present it to stakeholders in dashboards that display financial view reports, operational view reports, and key performance indicators, such as member visits, inpatient days per thousand, or average length of stay (ALOS).Users can expand or contract reports as needed, for instance by selecting ALOS by region or by region and care type (Figure 1).
The Data Warehouse team manages the data marts with Microsoft SQL Server 2005 data management software, and Decision Support develops the reports using SQL Server Reporting Services and Excel Services in Microsoft Office SharePoint Server 2007. Stakeholders access the reports on the HCPReportCenter through a Web portal developed on Office SharePoint Server 2007, and HCP manages access to the portal with Active Directory Domain Services.
With more advanced functionality in its new reporting framework, HCP can now identify and analyze utilization trends. For instance, the Decision Support department has implemented an early warning system that provides a month-to-date estimate of bed days by the end of the month. If an alarming trend is identified in the middle of the month, care managers can act early to investigate. HCP has also developed a daily inpatient census that is available to regional medical directors, medical office administrators, or other stakeholders.
”A primary care physician can look at the census and see which of her patients was in an inpatient facility the night before and identify which are likely to be discharged soon,” says Liu. “She can check to see whether they had been readmitted from a previous admission, and how many prior acute or subacute admissions they may have had. She can then use this information to ensure that her patients get the follow-up care they need and help prevent them from being readmitted to the hospital.”
After deploying HCPReportCenter for inpatient utilization, HCP and CitiusTech added more subject areas to the system. “We moved on from the inpatient side to areas like specialty referrals, emergency room and urgent care visits, and claims,” says Dennis Swarup, Head of Provider Solutions at CitiusTech. “As time goes on, we’ll continue to look at other subject areas and other reporting that HCP wants to deliver to the organization.”
Benefits
By working with CitiusTech to develop the HCP Report Center with Microsoft technologies, HCP has significantly enhanced its ability to easily access, aggregate, and analyze information across multiple areas of the enterprise, including finance, utilization management, and business management. “Now we can use our reporting and analytics framework to move the organization forward, controlling costs while enhancing care for patients and support for doctors,” says Liu.
Enhanced Care
Better reporting helps HCP care for its 500,000 annual patients. By efficiently monitoring patients from outpatient visits to inpatient stays, HCP can help doctors provide better care and enhance outcomes. HCP is using the data to improve key data sharing among clinicians. In particular, this has helped HCP manage the care of patients with multiple co-morbidities. By reducing the chance of unnecessary hospital readmissions, HCP can avoid incurring additional inpatient costs and the risk of further complications for the patient.
Better Connectivity
With HCPReportCenter, HCP can extract source information that resides in disparate systems at its many medical offices and partner facilities, load it into a central data warehouse, and deliver the information in reports and analyses to key stakeholders and decision makers throughout the organization. “Now we have a central repository of all of the reporting for the organization,” says Liu. “It covers all of the relevant subject areas from a clinical management, financial management, and operational management perspective.”
Reduced Costs
According to Liu, staff members can now generate reports that used to take weeks in just days, sometimes hours, resulting in a reduction in time and effort of more than 70 percent. More importantly, stakeholders can receive completed reports more easily and quickly with the HCP Report Center Web interface. The organization also expects to reduce operating costs by providing more accurate and timely financial and operational analysis. “I definitely think there are material cost savings that we have achieved and will achieve in the future,” says Liu. “As we reduce our inpatient-utilization trends, we will see a tremendous cost savings and a huge return on investment down the line.”
Improved Productivity
By adding a powerful layer of analytics to its reporting capabilities and phasing out manually developed reports, HCP can make the entire organization more efficient and productive. Physicians can monitor patients more easily. Regional managers can evaluate facility performance and take corrective actions. And finance teams can analyze utilization measures and performance across regions, medical offices, and physicians, making it easier to manage the revenue cycle.“Rather than spending our time requesting and producing reports, we’re now spending our time analyzing the data,” says Liu. “That helps us achieve our overall goal of trying to manage and control costs without compromising care.”
While HCP provides better reporting, it has also reduced the complexity of the system for users. “Our stakeholders are medical professionals, not database experts,” says Liu. “Having the Office SharePoint Server interface that interoperates with Microsoft Office products that users are already familiar with makes HCP Report Center easy to work with. Our users were easily able to grasp the concepts.”
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