Nearly half of these hospitals were repeat offenders, according to an analysis conducted by Modern Healthcare, and these hospitals saw their Medicare payments cut by 1% for the second straight year.
If 1% doesn’t seem like much, then consider Northwestern Memorial Hospital in Chicago and Stanford Health Care in California – both of which were penalized in Fiscal 2018. Northwestern’s penalty is estimated to exceed $50 million, or roughly one-quarter of the organization’s bottom line, while Stanford’s penalty is estimated to be roughly $10 million – this, for an organization that reported a $7 million loss on its most-recently available cost report.
Let's step back a moment and take a closer look at the HAC Reduction Program.
The HAC Reduction Program ranks performance of hospitals on measures for catheter-associated urinary tract infections; central-line-associated blood-stream infections; surgical-site infections; Clostridium difficile infections; and Methicillin-resistant Staphylococcus aureus infections. In addition, 10 other quality measures – including pressure ulcers and in-hospital falls – are also evaluated. The hospitals performing in the bottom 25% on these measures are hit with a penalty.
Harnessing Big Data
Given the potential negative financial impact of the HAC Reduction Program, why aren’t hospitals working harder to improve their performance measures? In reality, they are, but the barriers and obstacles to effective data collection and analysis are enough to bring even the biggest teaching and research hospital to its knees.
Not only that, but many organizations still rely on paper forms to collect patient safety information and incident reports. If there is any integration with an electronic medical records system, that integration likely requires some form of manual data entry, which introduces even more problems. First, the data could become lost before it is ever entered. Second, the lag time between an event and data entry allows for improvement opportunities to be lost. Third, data entry could be inaccurate and unreliable, resulting in the “garbage in, garbage out” phenomenon.
Harnessing Big Data requires specialized solutions built for the task at hand, which is why a fully electronic patient safety reporting system can often be the difference between penalties and penalty avoidance – or, in the case of Stanford, the difference between a negative bottom line and a positive bottom line.
What to Look For
When evaluating a patient safety and incident reporting system, first and foremost, it must collect information electronically from a variety of sources while also using technology to systematically review and analyze this information to create a better understanding and implementation of medicines, healthcare tools, procedures, and practices to ensure improved care.
That’s not all. A fully functional Big Data solution should take advantage of carefully created algorithms – aka artificial intelligence – to continually mine the data in real time and generate flags and alerts that can prevent negative events from occurring. Such artificial intelligence capabilities are the backbone of DatixWeb and Datix Cloud IQ and are the first step toward reducing hospital-acquired conditions – and the associated CMS penalties.
Improving Risks and Reducing Penalties
Although the human benefit of harnessing Big Data is that it improves patient care and reduces preventable patient harm, the financial benefits are reductions in the cost of patient care and improvements in efficiency. How? By using powerful software to analyzing incident report data, trends can be spotted, action plans can be devised and implemented, and future harm events can be averted. What's more, Big Data not only saves money, but also improves efficiency by freeing resources that otherwise would have been used to deal with the aftermath of harm events that were not successfully side-stepped.
By reducing variables such as human error and inaccurately inputted information, lowering the amount of time it takes to collect data, and organizing that data into well-structured applications, technology can reduce a healthcare provider's risk of patient safety penalties. For most hospitals, the financial return on investment of such technology can be 10x to 20x per year.
The human ROI is priceless.