Competition in hospital care is heating up. As patients learn that they have choices, hospitals are evolving into organizations that help prevent medical problems, as well as focusing on increasing patient profitability and value by treating people with a propensity for certain conditions, such as risk of heart disease, before those conditions reach high-risk levels. Patient data is the key to hospitals' improvement and growth.
"Some patient admissions represent a loss as soon as they walk in the door, because the cost around certain services is high, while the reimbursement is low," said Brian Frisch, vice president of planning and marketing for Solucient, a healthcare database consulting firm that publishes an annual index of the top 100 hospitals and their benchmarks for success. "So they're seeing a benefit in finding ways to prevent complications for diseases that are controllable, such as heart failure and diabetes."
One hospital leading the way is Mission Hospital in Mission Viejo, Calif. The largest hospital in south Orange County, with 338 beds, Mission regularly mines its centralized database to build profiles of people who fit into certain target groups, such as those at risk of severe heart disease.
"We look at what a typical heart patient looks like in admissions, apply that model to households within a 10-mile radius and come up with a list of people who look like potential heart patients," explained Rick Miltenberger, marketing director. "Then we mail them a personalized letter directing them to take part in an online health assessment. On average, 2 % to 3 % of recipients take the assessment."
After the assessment, Mission continues to build on the relationship. Those whose results are considered extreme receive a follow-up letter, along with a call from a nurse suggesting they see their primary care physician.
"From there, we tracked whether they were admitted, what type of service they had while they were here, what their treatment was, the dollars charged, and whether they joined one of our support groups," Miltenberger said.
The hospital sends a follow-up letter offering a free EKG, which received a 25% response to one mailing. Those who take the EKG will get another communication focusing on something appropriate for that individual.
Mission has a similar program to attract women with high-risk pregnancies to its neonatal center. But with 3,000 babies delivered a year, Mission is not looking to drive up volume.
"We're looking to maximize the volume we have," Miltenberger said.
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For hospitals like Mission, keeping track of its progress is becoming standard procedure. Companies like Solucient, which delivers patient care metrics and benchmarks, provide those abilities. One of the most well-known benchmark studies is the Joint Commission on Accreditation of Healthcare Organizations, which offers accreditation and related services that support healthcare performance improvement. Another study is from the Centers for Medicare & Medicaid, which offers reimbursements to organizations that track, measure, and report patient care performance.
According to Jerod Loeb, the Joint Commission's executive vice president for research, "Since 2002, when hospitals began collecting core measurable data, we have seen statistically significant improvements in performance in most areas measured. Hospitals now have the advantage of standardized data-collection protocols and standardized measure specifications that permit apples-to-apples comparisons."
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