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financial outcomes

Leveraging Analytics for Optimized Financial Outcomes

March 24, 2023

In today’s data-driven world, businesses are increasingly turning to analytics to derive set outcomes and help make better-informed decisions. Analytics can be particularly valuable in the healthcare domain, due to rising healthcare awareness and increasing demand for healthcare services. By using analytics to analyze patient-doctor data, organizations can identify patterns and trends, then convert them into valuable insights that can drive better financial outcomes. By harnessing the power of analytics, healthcare providers are able to identify high-risk patients, optimize resource allocation, enhance revenue cycle management, monitor and maintain quality and performance metrics, and map future trends. Implementing the right data-driven patient management solution can lead to better patient outcomes, reduced costs, and improved financial performance.

Translating Data to Actionable Insights

Conventionally collected data via manual data entry and paper-based records can be error-prone and time-consuming. This is where leveraging analytics and other advancing technologies come to the aid. However, deploying analytics to amalgamate an influx of patient data is not enough. Unless the captured data is available at the point of care, it cannot power clinical applications. With data liquidity, healthcare providers can significantly reduce their administrative tasks, while patients can eliminate the process of filling in the same details and repeating the information about their ailments every time they visit a provider. Additionally, ensuring data liquidity increases physician-patient collaboration, in addition to making each stakeholder more accountable and aware of the patient’s health.

Optimizing Resource Allocation

When an organization maps out its care delivery blueprint, the next step is to determine the tentative budget allocated for each process. This step has to be carried out initially so as to gauge the estimates and zero in on the exact figure for each task. This helps reduce wastage or excessive utilization. 

Cost analysis can be carried out systematically if certain steps are followed, such as:

1. Performing a detailed analysis to establish true costs associated with various processes.

2. Based on those insights, calculate the cost per patient, cost per service, and different procedure variances prevalent across different healthcare institutions.

3. Once such metrics are calculated, organizations can perform a complete cost analysis to better understand resource utilization.

4. Lastly, combine the medical and cost-analysis previously conducted to identify the best way to impart patient care.

Efficient Revenue Cycle Management

Revenue Cycle Management (RCM), simply put, is the financial process of merging the business and clinical sides of healthcare. A comprehensive data-driven approach is necessary to streamline RCM. Additionally, the solution needs to implement a framework for continuous cycle improvements, thereby enabling strong financial management. This can be achieved by monitoring trends and generating relevant data that can be used to derive actionable information through intelligent iteration processes.

Ideally, an RCM solution should possess particular features such as:

1. Ability to produce in-depth insights into the organization’s clinical and financial operations.

2. Display illustrative charts and graphs to effortlessly understand and monitor financial trends.

3. Permit revenue cycle and financial teams to observe and examine key as well as different metrics on demand, thereby saving time.

4. Empower top management to drive changes across all relevant processes and redefine the process of managing their finances.

Seamlessly Maintain Quality and Performance Metrics

When monitoring and maintaining the quality and performance metrics using analytics, organizations need to adopt a systematic approach. This includes defining the key quality and performance metrics, collecting and analyzing the collected data, monitoring the metrics over time, efficiently addressing any performance or quality issues encountered and implementing the right solution, and continuously improving the process. This approach offers significant opportunities to improve patient financial outcomes and reduce costs as well. 


A system can work smoothly if there are no redundant processes and information gaps. If the healthcare provider possesses the knowledge of the best medicinal practices for a patient based on relevant and important information, there will be remarkably lesser disparities in the care delivery process. Putting such a system in place is beneficial to both the organization and its patients. How healthcare organizations use data will shape the healthcare system in the years to come. Stay ahead of the curve by continually innovating, integrating necessary advancing technologies with existing processes, and embracing growth. You may also like to read our blog post on the opportunities for healthcare in the metaverse.

Interoperability in healthcare

Interoperability in healthcare – challenges, solutions, and the future

December 23, 2021

Healthcare in today’s day and age has grown multifold, offering the best medical facilities to patients. As an organization providing healthcare solutions – be it a clinic, a hospital or a pharmacy, keeping all your services linked can get hard. Interoperability in healthcare is an ideal way out from the tangled mess of organising your patients’ data for them. This system can help the multiple departments of your healthcare organization or entirely different collaborating organizations function as one unit and be beneficial for your business in many ways. That said, given the current pandemic situation, interoperability can also help reduce physical contact between the patient and the various service providers. However, it does come with its own set of unique challenges which can definitely be tackled without much fuss. 

What are the benefits of interoperability?

For healthcare service providers

As said before, interoperability helps you unify your business. Once you have the system running, it can help save a lot of time on the back and forth that can happen between two departments; say, the pharmacy of your clinic and the billing system. Moreover, if you’re an organization aiming to provide your patients with multiple services such as operation or treatment aftercare, routine checkups, financial management and so on, running everything can get cumbersome. Interoperability can help you serve your patients better. Added to this is the benefit of efficiency. A unified system can give you more space to grow and connect with more organizations that complement your goals. Your patients can now get timely treatment enhanced by the data you collect via a patient’s mobile phone, wearable device, telehealth checkups, online prescriptions and medical bills that can be sent directly to a pharmacy from the clinic/ hospital and so much more. Lastly, interoperability can take your clinic to a global level by enhancing the quality of care you provide and in the process also save you millions.

For Patients 

As a patient, interoperability saves you the trouble of having to repeat your medical history to multiple practitioners. You can be assured that all your data – be it medications, allergies, conditions, tests or doctor’s who’ve treated you – will be stored in one encrypted corner for you to access when need be. A healthcare organization that provides you with this service can help save you a lot of time. Furthermore, you can also effortlessly connect with your pharmacy, insurance provider and the hospital billing to keep track of your expenses and bill payments. By remembering all your medical data for you, it’ll save you some bucks that would have otherwise been spent on discussing it with new doctors. 

For others

Interoperability can be a big help to pharmacies. They can now receive prescriptions from the healthcare providers and ensure that they’re always stocked for the same. Pharmacies that deliver medications to domiciles of patients can also use this option to upgrade their services. Apart from that, it can also be helpful to specialty pharmacies that undertake routine checkups, follow-up visits and offer other such medical services. Apart from that, interoperability can also help a clinic’s administrative staff segregate and store the information of the patient better which in turn helps avoid any errors on their part.

What about the challenges in interoperability?

Interoperability in simple terms is the ability to integrate multiple services into one entity to expedite data transfer. Despite its many advantages, not many clinics have been able to successfully inculcate it into their systems. In the US, less than 40 % of clinics have attempted to utilise it and have partially managed to share the data with other organizations. There are a handful of factors that hamper with the success of interoperability, the primary being the standards of use. Each organization has a different standard at which they operate. Bringing together such organizations  under a common system can get difficult and sharing data with them more so. The mode of operation can vary in the means of storing data, the format of retaining information and even the use of language in doing so. 

Secondly, when multiple organizations collaborate in one single system, the data gets too much to handle depending on the size of these organizations. If a pharmacy is exchanging data with more than one hospital for instance, there could be an overload of data in its system. This could decelerate the workflow of the pharmacy instead of expediting it. 

Lastly, corruption and lack of knowledge or resources also affect the success of interoperability. Some providers can input incorrect or faulty data for their personal gains which can affect the quality of services that the patient receives. Apart from that, there is also a possibility that providers can restrict information – in a process known as ‘information blocking’ – until the receiver pays a certain amount to be able to access it. Insurers can also sometimes be hesitant to provide a patient’s treatment and claim history to medical professionals. Apart from that a lot of providers are either rigid on sticking to the traditional systems or are unaware of the possibilities within interoperability. Moreover, the lack of financial resources for many organizations prevents them from investing in the same as well. Even if an organization does become a part of the system, its operators could lack the skills to exploit it in the best way possible. 

Is there a way to overcome these challenges?

  • To start off, government funding towards standardizing interoperability in healthcare service providers could be helpful. 
  • Secondly, usage of data integration tools and healthcare analytics solutions could help overcome the obstacle of data overload. These help with not just efficient allocation of resources but also cost-reduction for the healthcare service. 
  • There also needs to be a standardization of the language used by the various integrated healthcare service providers. This can help avoid any misunderstanding and make interoperability more efficient by making it readable to both the sender and receiver as well as the computer. 
  • Educating the operators on the availability of API (Application Programming Interface), AI (Artificial Intelligence) and healthcare analytics tools and on its utilization is crucial. They should also be made aware of the benefits of interoperability with regards to convenience and cost-cutting.
  • Organizations standardizing interoperability need to also establish a privacy policy that has been agreed upon by all collaborators involved. Along with that, the interface for the interoperability software needs to be made user-friendly.

How Remote Patient Monitoring Reduces Patient Readmission

September 13, 2021

Hospital readmissions have placed a substantial financial strain on the United States’ healthcare system. The average cost of readmissions in 2016 was $14,400, according to the Agency for Healthcare Research and Quality (AHRQ). According to the Center for Health Information and Analysis, hospital readmissions cost Medicare roughly $26 billion each year. More importantly, readmissions have a detrimental impact on patients, frequently resulting in a deterioration in health.

When the Affordable Care Act became law, over 20% of Medicare patients were returning to hospitals within 30 days of release. The Centers for Medicare and Medicaid Services (CMS) began reducing compensation to hospitals with high readmission rates as part of the legislation’s mandate. Two proactive hospitals used post-discharge follow-up procedures to ensure that patients understood and followed doctors’ recommendations. These efforts were fruitful. According to CMS, 49 of the 50 states reduced hospital readmissions between 2010 and 2015 

What is Remote Patient Monitoring?

Remote patient monitoring (RPM) is a way of healthcare delivery that leverages the newest advancements in information technology to capture patient data outside of typical healthcare facilities. It is sometimes abbreviated as RPM (and is also known as remote patient management). Remote patient management is about bringing more healthcare out of the traditional environment, into the home and where people live, work, and play every day. It’s also about leveraging technology to bridge the gap between the conventional physical setting of healthcare and where people want to live every day.

Naturally, this comfort raises their levels of involvement; and by raising engagement, remote patient monitoring can assist enhance the quality of treatment. Patients are incentivized to better engage with their own health because of the convenience of quality RPM models, but clinicians are also better equipped to understand and manage their patients’ health situations, with a more constant stream of data that provides a much clearer picture of the patients’ health.

This allows physicians to see what’s going on with patients early. As a result, caregivers can more properly monitor what’s going on and ask more pertinent questions. In brief, RPM empowers doctors to know what is happening with their patients daily as it happens. Read about how to avoid these 4 remote patient monitoring pitfalls for more information.

How Can Remote Patient Monitoring Reduce Hospital Readmissions?

  • Enhanced Follow-up Procedures

Patient participation is frequently included in a successful follow-up strategy. Self-care practises, such as sticking to medication regimens and dietary restrictions, are critical to recovery in many situations. Symptom monitoring may also be important in avoiding problems. 

Physicians make every effort to emphasise the significance of patient compliance. Unfortunately, people without medical expertise may find it difficult to comprehend this information. Further, contacting healthcare professionals may be difficult but fortunately, improvements in RPM have made it easier than ever for patients to follow up. Apps for video conferencing are extremely handy. They help patients avoid complications and subsequent hospitalizations by offering rapid and easy access to healthcare experts.

  • Improved Clarification 

Patients need to effectively follow the advice that might help them avoid further hospitalisation and readmission. Unfortunately, busy healthcare practitioners do not always have the time to devote to this clarification. 

All too frequently, patients come home only to discover that they have forgotten their self-care instructions. It might be challenging to absorb spoken information from a healthcare practitioner during a period that is typically defined by stress and uncertainty. Many patients also have difficulty understanding printed discharge instructions. Because certain activities might be more complicated outside of a medical setting, comprehension is essential. RPM can help patients connect with a healthcare professional for real-time video support.

  • Additional appointments

In most situations, following up entails more than simply checking in. Nurses, personal support workers (PSWs), and care coordinators may help with particular chores while also monitoring patient well-being. However, post-discharge visits with family doctors and specialists are typically required.

However, in-demand practitioners may not be able to see individual patients as frequently as they would want. On the patient’s end, COVID-19 and other factors such as transportation make in-person visits challenging. Further, rescheduling is not always easy. Missed visits, as well as extended wait times, might cause health issues to go undetected. As a result, poor health outcomes and ultimately hospital readmission may occur.

RPMs such as Acuma Health allows doctors to attend to more patients in less time. It can reduce missed appointments, allowing more patients to obtain the specialised follow-up treatment they require and reduce patient readmissions drastically. For more information and insightful updates, follow us on Facebook and Twitter.

Avoiding These Four Remote Patient Monitoring Pitfalls

July 16, 2021

During the height of the COVID-19 pandemic, many patients were fearful of going to the doctor. However, it became even more crucial to monitor their health during this time. This is where remote patient monitoring (RPM) became vitally important to the virtual health strategy of every payer and provider. RPM uses digital technology to collect data on symptoms, medicines, therapy, and biometrics from patients who are not physically present in a healthcare facility, typically through the use of an app on the patient’s phone. The software then securely communicates that data to healthcare experts for evaluation and suggestions.

Patients can benefit from increased access to healthcare, greater quality of treatment, and more support and peace of mind, among other things. Healthcare providers, on the other hand, receive a more in-depth view of their patients’ health data, which may lead to fewer readmissions, improved patient outcomes, and recurring income.

RPM has the potential to benefit both patients and healthcare practitioners. Having said that, healthcare professionals who want to establish and manage an RPM program should do so with caution. There are several types of hazards and blunders that might arise. As a result, let’s take a deep dive into the top four RPM pitfalls you can avoid with the program:

  • Too Many Resources for Patients to Use

When patients have to manage multiple interfaces, gadgets, and tracking mechanisms, it becomes burdensome for them to have to manage monitoring their health, thereby not providing an accurate picture to their care nurse. Health leaders can make digital care more accessible and understandable by providing patients with a single interface that manages all of their requirements. Whether a patient is managing diabetes, heart disease, or another chronic illness, having a single location for all of their health information allows them to actively engage in their care. Read about how electronic patient portals are becoming redundant

  • Impersonal Clinician-Patient Interactions

Electronic health records (EHRs) placed a screen and computer between physicians and patients in the exam room, severing a sacred bond. Telemedicine may also wreak havoc on this connection, since this new screen may increase existing access disparities. Recent research discovered that individuals over the age of 65 had the lowest odds of using telehealth, while Black and Hispanic patients had lower probabilities than their White or Asian counterparts.

Facilitating equitable access might involve a variety of actions such as giving digital help and language interpretation, lending patients essential gear, and providing Wi-Fi connection. Adequate language interpretation continues to be a serious problem, owing in part to price and availability. As financial demands on providers increase, a need for innovative compensation techniques, such as cost-based reimbursement and inclusion of linguistic requirements in potential payment models, is necessary.

  • Complicated Technology 

Patients should be allowed to connect biometric devices with their health management platform by health plans and doctors. For example, if a patient has a glucometer gadget, it should be simple to link it to their digital health app or platform to sync vital data. This allows the patient to follow their blood sugar levels without having to manually enter data into the app. Integrating with a wide range of devices and manufacturers raises the possibility of a patient engaging with RPM and makes digital care more accessible.

As some gadgets are costly or difficult to use, providing patients with a variety of integration choices assures more accessibility and engagement with the solution. To keep members engaged in a digital health platform, health plans and doctors should incorporate RPM data into each patient’s daily routine, such as making a daily checklist for patients that includes medicine reminders, biometric check-ins, and a daily objective. Providing articles that are simple to read and encourage individuals to advocate for their own health and care can also be beneficial. 

  • Unnecessary Overload of Work

EHR digitized notes and labs made information more easily accessible and shared in a data revolution in healthcare. However, it has rapidly taken over the days and evenings of healthcare workers, with some doctors spending more than half of their workdays on the EHR. If not carefully managed, the proliferation of telehealth could similarly reshape clinicians’ workdays by adding virtual visits on top of a full slate of existing clinical responsibilities or allowing duplicate information and/or work requests to flow in from multiple channels if systems aren’t interoperable.

Many medical centers have made progress taming the expanding workload by scheduling dedicated virtual visit sessions for primary care providers rather than adding them on top of a full workday, improving telemedicine efficiency by admitting patients into virtual exam rooms, taking histories, and notifying providers when their patients are ready to be seen. They also make certain that interdisciplinary teams are included in the delivery of virtual care. Furthermore, FastCheck visits allow patients to come in before or after a telehealth visit for a 15-minute session for vitals, labs, or other treatment that cannot be given electronically. To gain the benefits of telemedicine while avoiding an unwarranted increase in physician responsibilities, continued operational innovation will be required. Read about how AI-driven healthcare data management impacts the future of healthcare.

At Acuma Health, we aim to provide our patients with real-time engagement of both their care and data. We also foster personalized, genuine and professional relationships between our team and our patients with easy to use technology. For more information and insightful updates, follow us on Facebook, LinkedIn and Twitter.

How Electronic Patient Portals are Becoming Redundant

June 29, 2021

Technology has evolved over the years and now, many aspects of our lives have been digitised. The healthcare industry especially is one that adopted this trend once the pandemic hit. As most people are unable to see their doctors, as usual, they have since relied on digital technology to obtain medical attention and advice. For many years, digital technology has been driving transformations in inpatient care, but there is no doubt that Covid-19 has catalysed a significant increase in this adoption. Read how AI-driven healthcare data management impacts the future of healthcare to know more.

To be sure, the rise in phone and video calls that have replaced in-person consultations during the pandemic has gotten a lot of attention. Virtual consultation platforms have proven to be extremely successful and popular, even among older generations. At the same time, electronic patient portals haven’t been keeping pace with the times, and they are soon becoming redundant as a need for real-time engagement with data rises. 

Electronic Patient Portal Use Today

The GAO (Government Accountability Office) reported in 2017 that nearly 90% of providers offered access to their respective patient portals. However, less than one-third of patients used theirs. Later, further reports showed that only 52% of patients were offered online access to their records, and only 28% used it. The top reasons for people using their portals were to get lab results (85%), refill a prescription or make an appointment (62%), and message their provider (48%). But they never returned to the portal again. 

According to some studies, about 8% of internet users, or approximately 93 million Americans, have conducted online searches for health-related topics. Why aren’t more consumers seeking their own health information or using portals to participate in their own healthcare? The following information could help answer this question. 

Cons of Using Electronic Patient Portals 

Patient portals, generally speaking, are health IT interfaces on which patients can view their own protected health information (PHI). Although this can be viewed as a good thing because patients do have the right to see their own health data, it also opens doors for security concerns. A patient portal could be yet another way for a potential hacker or healthcare data thief to gain access to a patient’s data, potentially leaving that patient vulnerable to identity theft. The possibility of data breaches increases, therefore you will need to work with a vendor who offers robust, secure EHR software. This is how these concerns can be kept to a minimum with appropriate safeguards. 

The Department of Health and Human Services (HHS) recently clarified HIPAA regulations regarding patient access to health information, making clearer the conditions under which patients may access their health information and the HIPAA protections that information has. The Office of the National Coordinator for Health IT (ONC) also states that patient portals often have several technical safeguards to protect from healthcare data security issues

Additionally, it was noted that when patients received their medical test results online, many of them found the process to be very convenient. However, a large number of people complained about the lack of interpretation of their results, which a healthcare provider would usually provide. This led them to be scared and anxious about their diagnosis for several days until they eventually had to get in touch with their doctors in person or over the phone, making these portals redundant. Among these, another disadvantage of using patient portals is the most basic problem-  some patients may lack computer experience, preventing them from getting the most out of their portal.

Improving Patient Experience 

If the days of a physician’s call or a face-to-face meeting to discuss test results are over, the portal that replaces them must not be less informative or sensitive to patients’ needs. Patients’ rights to understand cannot be replaced by quick access. Even if a test result is not clearly negative, presenting an uninterpreted report through a portal can be painful for patients and certainly ineffective. According to a recent study, nearly two-thirds of 95 patients who received test results via a portal received no explanation for the results. Nearly half of those polled conducted online searches or contacted their doctors.

Of course, improving the patient experience is at the heart of all care coordination efforts. When providers fail to communicate and data is not shared promptly, the patient suffers the most. They are not the consumer-minded individuals who are eager to “take charge of their own care,” as we frequently hear in the media. Many people rely on care coordinators to be their advocates, inform family members, and share new medications, diagnoses, and preferences with the facility to which they are transitioning. 

At Acuma Health, we ensure HIPAA compliance and our patient engagement app provides timely interventions and lower cost of care, better formulary management system, which leads to higher member satisfaction and retention. It is our goal to provide our patients with real-time engagement of both their care and data. Follow us on Facebook and Twitter for more insightful information and updates.

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