If you’re a leader in a small or mid-sized provider organization, the amount of money larger health systems are investing in data should make you nervous.

Not all these investments will create a competitive advantage, but for some it will. And competing against these organizations will be very difficult if your own isn’t taking steps now to make strategic use of your data.

The real question is how should smaller providers go about using their data more strategically? Is it even viable given their limited resources?

The real question is how should smaller providers go about using their data more strategically? Is it even viable given their limited resources?

Recently I had the chance to speak with Rebecca Woods former VP of Provider Services at Lakes Region General Healthcare in New Hampshire about these important questions. Her answer was a resounding YES!! Smaller providers can use their data to compete, but leaders should get educated and be smart about how they do it.

Rebecca has unique experiences that cover both operations and technology in a small provider setting. She’s not only managed a provider network, but has also been the Chief Information Officer at Porter Medical Center in Middleburry Vermont. In both her roles she has been successful at helping these organizations generate more value from their data. We spent our time talking about those experiences.

Thanks again Rebecca for making the time to talk. How aware do you think leaders in smaller provider networks are about the data capabilities being developed in larger health systems?

In general, I’d say they aren’t as aware as they could be. With all the cost pressure in the industry, smaller providers are running so lean their leaders don’t have the time or expertise to focus on this issue. For some, their leadership is from a different generation that’s not as comfortable with technology. For others, using data strategically seems out of reach. Something they can’t afford to do when they consider the staff and budgets of the larger health systems.

I see it differently of course. It is possible for smaller providers to be data driven and to use their data in strategic ways. In fact, it's critical for small providers to improve their ability to leverage data. The industry is moving towards value based care and a more consumer based models. These trends require providers to be much more data savvy regardless of their size. 

Agreed. It’s already becoming more difficult for some to compete without these capabilities. How well positioned are smaller providers to use their data strategically?

For most part, not too well. Small provider networks are still struggling with their EMR implementations. In my experience, EMR ambulatory work flows aren’t as mature as inpatient work flows. And these work flows aren’t well integrated with one another either. This makes it challenging to bring data together to create a single view of the healthcare experience.

These challenges also create data quality issues that can have tangible impacts. Reporting metrics to ACO’s can be incomplete or inaccurate. For example, immunizations delivered when a patient is inpatient might not show up for that same patient in the ambulatory reporting. This could result in double dosing and/or impact contract incentives because the metrics are inaccurate. Revenue management can be a problem as well if procedure coding in the EMR is wrong.

Many healthcare leaders think that implementing an EMR will solve all these problems. That they’ll be able to easily access whatever data they need and it will be accurate. It’s easy to underestimate how much training is needed and how much data integration can be required outside the EMR system to make this a reality.

Data quality challenges are an issue for my clients as well. How have you overcome them? What’s worked best for you?

At Porter Medical Center it took many years to get the EMR data right. They had implemented Meditech and it took quite a bit of effort to get the work flows simplified and the staff trained up properly. We also put processes in place to measure and monitor data quality so the staff could be alerted to data related issues and fix them.

Initially we used Excel to help us with a lot of this reporting. We manually brought data together and reviewed it. But that quickly became unmanageable, plus there were time lags with the data. We ended up implementing a product called Medisolv to help make our data available in a timelier way. We also utilized Summit Healthcare to help us provide data to our ACOs. In the end all this work helped improve our ACO and quality related CMS metrics.

I’ve personally not found a silver bullet to solve data quality problems. It takes clinical, operations, finance, and IT working together over a sustained time-period to get the data right.

Absolutely, improving data quality is hard work. And it’s not the most glamorous work either. But good data is critical for good decision making. How about on the operations side? What kind of success have you had leveraging data there?

When I was at Porter, the CEO at that time asked what could be done to improve leakage and wait times for ambulatory patient scheduling.

After working through our data, we decided to implement a centralized access center. We started with prior-authorizations and referrals and then expanded to include all the specialties once we got the algorithms right. We were data driven the entire way and managed to significantly improve wait times for patient scheduling, in some cases automating them entirely. We also reduced leakage which improved the top line by $3 million over a 6-month time-period. The access center also contributed to an almost 40% improvement in cash on hand for the organization.

Like any change, implementing the access center did have its challenges. Some of the physicians weren’t initially on board with the concept. During this same time, a new CEO joined us who wasn’t completely sold on the concept. At one point the entire executive team discussed shutting it down. But because we took a data driven approach, the numbers made the case for us. The executive team agreed to continue the access center. And the CEO used our data to convince the physicians who weren’t yet on board that the service center made sense for the organization.

Beyond the obvious financial impacts, I find the business change aspect especially interesting. Many leaders underestimate the connection between business change and getting results from their data. How important was having the support of leadership to your success?

Leadership support is absolutely crucial. Any business change will encounter some resistance. At Lakes we wouldn’t have impacted our ACO incentives without the active support of the CFO. He helped the organization understand why we needed to change our operations.

The same is true for the CEO at Porter. She played a crucial role in getting all the physicians on board with the access center. Without leveraging data, executives will struggle to make a compelling case for any major change.

What great success stories. You’ve been able to leverage data without massive technology investments. What advice do you have for leaders in smaller networks about how they can do the same?

My first suggestion is for leaders to get educated. CEO’s in particular should have the same understanding of technology as they have of finance. They should understand what it’s about and what the opportunities are.

As far as leveraging data is concerned, I’d recommend starting small and proving out an opportunity first. You don’t necessarily have to make big investments to get great returns from your data. It should be about mindset more than tools.

I’d also recommend keeping physicians and nurses in the forefront of the process. Whatever is being proposed should help them move forward too.

My last piece of advice is related to people. One of my favorite quotes is from Tina Fey: “Being a good boss means hiring talented people and then getting out of their way”.

It’s crucial to hire great people, train them up, and then get out of their way. This is especially true in the context of leveraging data. Your staff need to learn how to be data driven so they can use data to help them lead and drive improvements across the organization.

Great points!! Thanks again Rebecca for taking time to tell us your success stories. The really do demonstrate that smaller provider environments can be successful at leveraging data strategically.

My pleasure. It’s been fun and I hope it encourages other small provider networks to make better use of their data! It’s not just a luxury reserved for big health systems.

If you’re a leader in a small or mid-sized provider organization and have experienced an explosion of data that's out-paced your ability to use it, my 10X Analytics Review can help.  

It's a quick and cost effective process that's designed specifically for smaller providers.  It will help you leverage the talent, data, and tools you already have to make more strategic use of your data.

If you'd like to learn more, just reach out to me at (630) 219-0047 or email me at Phil.Kelly@ipowerconsult.com.

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Phil Kelly

Phil Kelly

Managing Partner at iPower Consulting
Phil Kelly is the founder and principal consultant of iPower Consulting. He helps healthcare organizations improve their ability to access and use data. With over 25 years’ experience, he has helped clients be more data-driven, deliver technology solutions faster, and improve collaboration. If you are a healthcare leader and have ideas about how you want to use data in your organization, but aren’t quite sure how to go about it, Phil may be able to help. You can learn more about Phil at www.ipowerconsult.com or contact him directly at 630.219.0047 or phil.kelly@ipowerconsult.com.

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