1st Edition

Leveraging Data in Healthcare
Best Practices for Controlling, Analyzing, and Using Data





ISBN 9781938904844
Published December 10, 2015 by CRC Press
239 Pages 23 B/W Illustrations

USD $68.95

Prices & shipping based on shipping country


Preview

Book 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.

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

...
View More

Author(s)

Biography

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.

Featured Author Profiles

Author - Rebecca Mendoza Saltiel Busch
Author

Rebecca Mendoza Saltiel Busch

President & CEO, Medical Business Associates, Inc.
Westmont, IL, USA

Learn more about Rebecca Mendoza Saltiel Busch »

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