Applications

The biggest cost center of any health care organization is a physician with a pen. Unless you understand the true nature of the physician's patients and the processes of care for each of those patients with their associated resource consumption and fiscal implications, accurate executive support intelligence remains elusive.

HCI applications are derived from analysis of co-morbid patients, their clinical pathways and cost weights associated with the elements of those clinical pathways.

HealthCare Intelligence LLC recognizes that physicians must treat patients and incur diagnostic and treatment costs irrespective of the reimbursement methodologies defined by Medicare, Medicaid and other payers.

The traditional industry incentives have focused on the economic relationships between the institutions, the payers, length of stay and aggregated contract costs as the basis of negotiation.

The relationship between a patient's revenue and a patient's costs are a poor gage of performance.

HCI is a solution with a business intelligence that meet the demands of a changing and highly competitive environment.

With HCI's intelligence products:

I. Strategic Planning for Business Strategy and Competitive Intelligence across institutions

• Operational cost profiling across local, regional and national institutions
• Operational performance monitoring & demand forecasting
• Market & trend demand analysis between institutions
• Market shares & competitive assessment
• Developing provider and network profiling strategies

II. Macro Allocations for facility planning with HCI's Patient Resource Modeling:

• Facility faster panning
• Seasonal trends of clinical services usage with regard to bed allocation
• Functional programming by showing relationships of demand between clinical services
• Medical equipment issues
• Budgeting & performance monitoring
• Managed care & community-based modeling
• Plan for service expansion
• Develop marketing strategies
• Determine physician recruitment needs

III. Clinical line / Product line management for performance improvements:

• True comprehensive patient population report
• Show actual resources needed within patient mixes and their associated costs as a function of the actual resources used from diagnosis to therapeutic departments
• Analysis of tertiary markets and centers of excellence (feedback loop for management)
• Real vs expected costs for clinical services and physician profiling.
• Engineering work flow with micro-costing
• Statistical modeling for clinical services (trends, forecasting, queuing models)

IV. Quality Enhancement:

• Physician profiling through effective patient profiling and process of care.
• Resource consumption for any mix of complications
• Expected and actual costs vs revenue
• Percentile performance measure for every single patient that can be grouped by center of excellence, clinical services and/or physician or group of physicians
• Review patterns of clinical production and enhance their quality assessment programs