Leveraging Data in Healthcare: Best Practices for Controlling, Analyzing, and Using Data, 1st Edition (Paperback) book cover

Leveraging Data in Healthcare

Best Practices for Controlling, Analyzing, and Using Data, 1st Edition

By Rebecca Mendoza Saltiel Busch

CRC Press

215 pages | 23 B/W Illus.

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Description

The healthcare industry is in a state of accelerated transition. The proliferation of data and its assimilation, access, use, and security are ever-increasing challenges. Finding ways to operationalize business and clinical data management in the face of government and market mandates is enough to keep most chief officers up at night!

Leveraging Data in Healthcare: Best Practices for Controlling, Analyzing, and Using Data argues that the key to survival for any healthcare organization in today’s data-saturated market is to fundamentally redefine the roles of chief information executives—CIOs, CFOs, CMIOs, CTOs, CNIOs, CTOs and CDOs—from suppliers of data to drivers of data intelligence.

This book presents best practices for controlling, analyzing, and using data. The elements of preparing an actionable data strategy are exemplified on subjects such as revenue integrity, revenue management, and patient engagement. Further, the book illustrates how to operationalize the electronic integration of health and financial data within patient financial services, information management services, and patient engagement activities. An integrated environment will activate a data-driven intelligent decision support infrastructure. The increasing impact of consumer engagement will continue to affect the organization’s bottom line. Success in this new world will need collaboration among the chiefs, users, and data creators.

Reviews

"Ms. Saltiel Busch powerfully and succinctly reflects the current role and challenges of the modern CIO. In her cogent analysis, she alludes to the demands of the evolving healthcare business and technology, projecting that the more innovative and forward thinking CIOs are better equipped to manage change and ultimately thrive in their professional roles."

— Lac Van Tran, Senior Vice President, CIO, and Associate Dean, Rush University Medical Center, Chicago, Illinois

"Organizations aspiring to meet the challenges of the future would be prudent to consider the frameworks and processes outlined by Ms. Saltiel Busch in evaluating the state of their healthcare data. Her book outlines the people, processes, assumptions/constraints, and technology competencies that should be considered in conducting effective gap analysis management. Kudos for developing a roadmap for this complex body of work!"

— Michelle Currie, CDO, CETA Performance Services LLC, San Francisco, California

"Technological advances in healthcare, including EHR implementation and related technologically incentivized revenue streams, present a double-edged sword to the healthcare industry. Ms. Saltiel Busch identifies many of these risks and challenges—most notably the evolution of new but necessary hybrid management roles that join clinical and financial technology in a new and different way."

— Kevin Flynn, Vice President Finance/CFO, Associates in Nephrology, SC, Chicago, Illinois

"As Ms. Saltiel Busch aptly points out, the executive leadership roles are becoming increasingly integrated. As the healthcare industry embraces the challenges of the Triple Aim, the collaboration of the information executive team is critical."

— James Brenza, CDO, InXite Health, Delaware, Ohio

"Ms. Saltiel Busch provides great insights as to the changing dynamic in leadership teams at hospitals and health systems."

— Scott Becker, CEO and Publisher, Beckers Hospital Review, Chicago, Illinois

Table of Contents

Current Operational State of Managing Health Information

A Bit of History

Public Policy’s Shift to the State

Systems and Subsystems

The Easiest Route to Population Management

Somebody Has to Pay the Bill

An Evolving System and the CIO’s Role

Final Thought

CEO Perspective

References

The Role of the CIO and Hybrid Chiefs in Charge

Chief Information Officer

A Bit of History

Hybrid Roles of Information Officers

The CIO Today

Key Market Barriers for CIOs to Overcome

Key Internal Barriers for CIOs to Overcome

Final Thought

CIO Perspective

References

The Role of Patient Financial Services

A Bit of History

Hybrid Roles of Patient Financial Services

Patient Financial Services Today

HFMA’s MAP Keys in Revenue Cycle Management

Key Market Barriers to Overcome

Role of Data and Revenue Integrity Management

Final Thought

CRO Perspective

References

The Paradigm Shift in the C-Suite

A Bit of History

Shifting Roles at the C-Suite

C-Suite Today

The Balancing Act

Key Market Barriers to Overcome

Role of Data and Revenue Integrity Management

Final Thought

CEO Perspective

References

Data and Information Strategy Assessment Tool

A Bit of History

Current State from the CIO Perspective

Key Principles: Healthcare Data and Information Strategies

CDO Cubic Approach

IIRB Model, Framework, and Analytic Roadmap

Data Intelligence Strategy Using the Healthcare Continuum

Final Thought

CCO Perspective

References

Gap Analysis Management

A Bit of History

Hybrid Roles of Gap Analysis Management

Gap Analysis Management Today

Gap Analysis Strategy Using the Healthcare Continuum

Key Market Barriers to Overcome

Final Thought

CDO Perspective

References

Denial Management Analysis

A Bit of History

Hybrid Roles of Denial Management Analysis

Denial Management Today

IIRB Model, Framework, and Analytic Roadmap

Denial Management Strategy Using the Healthcare Continuum

Key Market Barriers to Overcome

Final Thought

CIO Perspective

References

Revenue Integrity Management

A Bit of History

Hybrid Roles of Revenue Integrity Management

Electronic Medical Health Record

Revenue Integrity Management Today

Key Market Barriers to Overcome

Final Thought

CFO Perspective

References

Integration of Information Roles

A Bit of Human Anatomy and History

Integration of Leadership Roles

Key Market Barriers to Overcome

Role of Revenue Integrity Management

Final Thought

CDO Perspective

References

Redefining Workflows

A Bit of History

Redefining Workflows

Case Study

Case Study Highlight: Metrics

Key Market Barriers to Overcome

Final Thought

Director of Nursing Informatics Commentary

References

Evolving to a Data-Driven Organization

A Bit of History

Data: The Core Asset

Another Approach on the Scavenger Hunt for Data

Data Intelligence

New Data Assets

Key Market Barriers to Overcome

Preparing for the Future

Final Thought

CDO Perspective

References

Defining the Role of the Chief Data Officer

Data Governance

A Bit of History

First CDO

To Whom Does the CDO Report?

Role and Responsibilities of the CDO

CDO Role in Healthcare

Key Barriers to Overcome

Final Thought

CDO Perspective

References

Appendices

C-Suite Acronyms

Datum Asset Strategy: Incorporating Key Points within Book

Human Capital Workflow

About the Author

Rebecca Mendoza Saltiel Busch is the founder and chief executive officer of Medical Business Associates, Inc. (MBA), established in 1991 as a minority, woman-owned medical data auditing and healthcare consulting firm. She attributes her company’s success to the development and implementation of a unique analytical workflow process—interactive and iterative behavioral model, system, and method for detecting fraud, waste, and abuse—that identifies all critical tasks, conditions, and standards to promote a stable, dynamic, and scalable healthcare business. In addition to holding eight U.S. patents, authoring three books and 52 articles, delivering more than 100 presentations, and serving as an adjunct professor, Ms. Busch has provided expert testimony on health-related issues in both state and federal court.

About the Series

HIMSS Book Series

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Subject Categories

BISAC Subject Codes/Headings:
BUS041000
BUSINESS & ECONOMICS / Management
BUS053000
BUSINESS & ECONOMICS / Quality Control
BUS070080
BUSINESS & ECONOMICS / Industries / Service Industries
MED002000
MEDICAL / Administration
MED043000
MEDICAL / Hospital Administration & Care