Predictive Analytics and Enhanced EHRs in Healthcare: How it Impacts Your Practice

Choosing the right data can optimize growth and rehab therapy patient outcomes

Rehab therapy practices are uniquely positioned to gather patient data and utilize it to their—and their patients’—advantage through EHRs. But not all data is created equal: it’s about strategically selecting data from EHRs and using it to leverage predictive analytics to zero in on the specific KPIs that will drive efficiency and improvements. Many EHRs don’t have the predictive analytics necessary to take all of the data and turn it into actionable insights. With partners like Net Health, this EHR data becomes an invaluable resource.

But predictive analytics are only as valuable and as robust as the data on which they’re built. In other words, EHRs that collect very specific and detailed data—like one specifically for rehab care therapy—will yield better and more useful results than a more general EHR platform. In order to have a positive and notable impact on your business and patient outcomes, you’ll need a wealth of data to feed your predictive analytics. Consider partnering with a vendor that can supply both the detailed data and the large data sets you’ll need in order to zero in and get more accurate predictive analytics.

In a Forrester Opportunity Snapshot, commissioned by Net Health that surveyed 217 rehab therapy leaders from private practices, hospitals, and contract therapy organizations, 76% of rehab leaders expect to see the most benefit from an enhanced EHR platform’s ability to use predictive insights to identify trends.

Through AI and machine learning, these advanced analytics unearth insights that would otherwise be missed by humans alone. By identifying these trends and patterns across all aspects of the business, practices are positioned to make better data-driven decisions that improve patient outcomes, compliance, and revenue.

Widespread outbreaks or other public health issues and risks can be reduced due to the early identification of public health trends provided by the predictive analytics and platform data; these potential problems are detected and dealt with before they even arise.

With the powerful combination of AI, machine learning, and predictive analytics, therapy care can predict how a patient will respond to treatment based on historical data of patients with similar conditions and compare it to the patient’s performance. A platform with these capabilities could also aid in measuring patient satisfaction, assuring retention, and monitoring progress, alerting the care team if an intervention or course correction is necessary. Being armed with the right data and analytics could also reduce readmissions and rehospitalizations.

AI and automated processes can help reduce cognitive load and burnout for staff by taking care of mundane tasks. Billing issues can be identified and resolved automatically, which reduces denials and also contributes to improved patient satisfaction. Scheduling is optimized for the facility’s efficiency, which is better for both patients and staff. Clinical documentation becomes automated or more streamlined, which frees up clinicians to spend more time with patients and less time on paperwork.

However, simply investing in these advanced analytics is not enough. To be successful, rehab therapy practices will need to assure their staff is on board and understands not only how to use the technology, but how it helps them in their jobs, how it improves patient care, and how it can propel the business forward. Investing in an enhanced, customizable EHR platform that is capable of growing with you is another important factor to successful implementation. This will differentiate the elite providers from the crowd—their patient care and outcomes will be better, operations will be more efficient, and costs will be reduced.

KPIs for elite rehab therapy providers

In the Forrester research survey, rehab therapy respondents named their top priorities as accelerating growth (81%), improving patient outcomes (76%), and implementing solutions that leverage data and analytics (75%). It’s through this data and analytics that practices can achieve their top goals of growth and better patient outcomes. But it’s not just collecting and analyzing any data, it’s the right data. Let’s take a closer look at which KPIs will be most beneficial for rehab therapy practices to track, analyze, and implement in order to reach their goals.

Accelerating growth and streamlining operations through predictive analytics

Growing your business and streamlining operations go hand in hand, and your EHR data plays a key role. Optimizing EHR analytics can help to reduce costs, improve decision making at the business level and the point of care, and can even reduce billing errors.

Keeping a close eye on how your revenue funnel is functioning with the following KPIs will help to determine any gaps in the process so you can maximize both conversions and revenue, while increasing the quality of care. Plus, you’ll also see what works well and provides the best ROI, so that you can replicate it in the future as you continue to grow.

KPIs to grow your revenue streams

• Total number of referrals from all sources: Tracking the diversification and quality of your leads and referrals will help to better set you up for long-term success. For example, you’ll be able to see if your leads are coming mostly from one source, in which case you might want to consider spreading out your influence and diversifying. Because what happens if that one doctor moves away or closes their practice? You’d be down one of your major sources of incoming leads.
  
• Total number of evaluations performed: This tracks your first in-person scheduled visit with the patient where you’ll determine your plan of care together. It’s also an important part of the revenue funnel process, because this metric will tell you how effective your practice is at converting leads and referrals into evaluations. If you see a drop off in conversions, this metric can pinpoint the exact part of the process where you can make improvements, like wait times, front staff experience, or schedule management.
  
• Total number of completed visits: This is the number of visits after the initial evaluation. When combined with external data from your peers through partners like Net Health or FOTO, this KPI becomes a lot more useful. If your total number of completed visits is well below the industry average, it’s a sign that you should take a closer look at diversifying your leads or considering if you’re being too niche in your targeting.
  
• Completed visits per episode of care: This is a ratio that delves into how many times an individual patient is seen in an episode of care. This drills into the details of specific patient types or types of care provided, whereas the total number of completed visits gives you the bigger picture data across all patient and care types. This can also tell you if certain patient types are more likely to cancel appointments or self-discharge.
  
• Patient churn rate: This KPI is tied to the one above, as it will track the percentage of patients who stop treatment and discontinue their therapy plan. If you have a high churn rate, this is a clue that some part of your rehab therapy funnel could use refinement. Using this in combination with the other KPIs will help you to zero in on which areas need improvement and where to invest your time and budget.
  
• Total billable units: These are generally 15-minute units of time but can vary. This KPI can help to provide an accurate picture of the type of care you’re giving (group therapy vs one-on-one, for example) and any trends that develop in your total billable units, whether up or down.
  
• Billable units per visit: While total billable units gives you the big picture, the billable units per visit allow you to see exactly how time is being spent and allocated per each patient. Breaking it down into patient types, referral source, and type of payment plan, for example, can provide you with the details you need to assure that the time you’re spending with the patient is time well spent.
  
• Cost per procedure: This gives you an idea of how efficient and optimized your operations are. Monitoring this KPI can give you insight into where to take advantage of cost-saving opportunities like renegotiating vendor contracts or improving processes to keep costs down.
  
• Employee turnover rate: Keeping track of how often your employees leave for a new job can be a key indicator of the health of your practice. If you have a high turnover rate, investing in recruitment or retention strategies could be beneficial for maintaining your workforce.

Assuring efficient reimbursements and claims

Rehab leaders surveyed by Forrester agreed that EHR analytics will drastically improve their organizations and deliver meaningful benefits to employees and patients. Notably, they expect to see the most benefit from an enhanced EHR platform’s ability to prevent claim denials and payment delays (81%).

EHRs act as a single source of truth for all staff, which reduces coding and billing errors, as well as assuring accurate documentation to receive reimbursements in a timely manner. The best EHR platforms will include guardrails to ensure the correct billing and documentation to satisfy MIPS reporting. Let’s take a look at some other useful KPIs you can gain from your EHR data.

• Denial rates: KPIs like initial denial rate, top denial reason, and payor-specific denial rate can assist with identifying any trends or patterns so that you can take steps to implement any necessary staff training and other prevention strategies.
  
• Claims processing time: Revenue cycle length is determined by how long it takes for your organization to receive payment. Tracking the processing time can help you to fine tune your financial planning and can be a helpful indicator in determining and predicting cash flow.
  
• Accounts receivable turnover: This KPI measures how efficiently your organization collects payments. It’s an important indicator to assure that you’re collecting timely payments.

Improving patient outcomes and value-based care

In the Forrester Opportunity Snapshot, 79% of rehab leaders named improving decisions at the point of care as critical or important to achieving optimal business growth and improving patient outcomes—in fact, 43% believe that failing to invest in EHR analytics will compromise patient outcomes.

For practices looking to improve their value-based care, consistent patient outcomes and enhancing the process are key. This includes tracking metrics across clinical, operational, and patient engagement/satisfaction outcomes. Predictive analytics can also assist with assessing and improving the overall health of communities at large—healthier communities mean healthier patients and better outcomes. Let’s dive a little deeper and see what KPIs are most important to track.

• Units per day per therapist: This gives you an idea of how efficient your employees are and how much time they spend with the patient. But it’s only one piece of the puzzle in determining better patient outcomes.
  
• Average length of stay and visits per episode of care: This also measures your practice’s efficiency. It can be an indicator of if a particular patient could be at risk for readmission or other negative factors. In many cases, the longer the hospital stay, the more chance there is an increased risk of infection or other complications arising. Keying in on this metric can help you to reduce patient stays and increase better patient outcomes and value-based care, and it could place you in the optimal position to receive any associated Centers for Medicare and Medicaid Services (CMS) incentives.
  
• Patient attendance, participation, and treatment success rates: The more you can involve and engage the patient in their own treatment, the better their outcomes and success rates will be. Seventy-eight percent of rehab therapy leaders believe that through enhanced EHRs, they can better personalize care, improve patient outcomes, and pivot to a value-based care model (Forrester research).
  
• Readmission rates: This measures your quality of care. Improving your readmission rates, while providing better patient outcomes, is also a way to optimize your financial performance and assure you receive the full amount of CMS reimbursements.
  
• Bed availability: Balancing this metric is important for quality of care and efficiency of your business. If bed availability is too high, you might be overstaffed and paying for unnecessary employees and facility operations. If the opposite is true, you could be understaffed and patient care and outcomes could decline as a result.
  
• Staffing ratios: This assures that you have an appropriate mix of the right kind of staff properly trained in your different needs areas. It’s important for quality of patient care, as well as employee satisfaction and reducing burnout.
  
• Patient safety measures: This could encompass things like any post-treatment infections, reactions to medications, or errors in prescriptions that compromise patient outcomes.
  
• Medical equipment utilization: Keeping track of if and when any medical equipment is used for procedures is a good way to either justify upgrading or purchasing any new equipment, or it can alert staff to when a well-used machine might be in need of repairs.
  
• Staff productivity: This measurement impacts other key areas that affect the overall efficiency of your business, like compliance, billing, and patient treatments. It can help to determine where streamlining is needed and any other efficiencies you can implement.

Building trust and loyalty to attract and maintain patients

In the Forrester survey, 70% of rehab leaders said that building trust and loyalty is an important priority that will impact not only their bottom line, but the level of care they provide to their patients. It’s a no-brainer that patients who have better outcomes are more likely to trust you, return to your practice in the future, and send referrals your way. Here are some KPIs to keep in mind.

• Patient satisfaction scores: Surveying your patients and asking them how they are feeling and how they are moving through their treatment plan can indicate how successful and effective your methods are, and can help to assess where improvements or adjustments in the process might be needed.
• Number of touchpoints and patient interactions: This can be through patient portal engagement, reminder emails or calls, or other methods of keeping patients engaged. However, more touchpoints does not always mean better care or happier patients; it’s a fine balance. Monitoring this KPI can help determine any trends so you can adjust your engagement plan accordingly, by adding or removing touchpoints where needed.
• Social determinants of health: Research shows that social determinants of health account for up to 80% of outcomes. These are things like economic stability, education access and quality, health care access and quality, living environments, and social and family contexts. The care provided by rehab therapy professionals is only one piece of this complex puzzle.

Reducing risk of preventable events

Another important area that rehab leaders are focused on is reducing risks related to preventable events that lead to lower reimbursements or penalties (69% of respondents). Predictive analytics and keeping track of the following KPIs can help alleviate risk in this area.

• Fall risk, pressure injuries, hospitalizations, mortality, rehospitalizations: These metrics will alert you to high-risk patients who are susceptible to these events so that you can plan and adjust accordingly to assure a successful discharge and timely reimbursement.

Turning data into action: How to use KPIs to reach your goals

So, now you have a wealth of data and (hopefully) a robust EHR platform to assist with making sense of it all. As with all data collection, how you use the data is just as important as what data you collect. But none of these data point areas and KPIs stand alone—all are interconnected and work in tandem to grow your business, improve patient care, and alleviate the workload on your staff. Let’s take a look at some ways in which you can put your newly acquired data to good use.

Accelerating growth and streamlining operations

Predictive analytics and EHR data in combination can assist rehab therapy practices with simplifying workflows onto the same platform, thus also simplifying the flow of patient information. Simplified operations makes it easier for staff to access patient information and reduces the likelihood of any billing or coding errors. For example, analytics solutions can assist with identifying operational bottlenecks, like duplicate patient data entry, and eliminate the need for staff to spend time and resources on these redundant tasks.

It also helps with things like determining optimal staffing levels based on the available staff and your business needs, which can improve operational efficiency and assure you’re not over or understaffed, or wasting efforts. For example, Duke Health is using predictive analytics to schedule surgeries, predict operating room times for each procedure, and manage a shared EHR calendar. This optimizes both the surgical suite use and the surgeon’s time, assuring both are operating efficiently.

Your EHR data gives you information on patient demographics and overall health history—this goes without saying. But while that data can help provide a clearer view of your operations, it can also highlight some opportunities for growing your business.

Consider things like:

• Are you under or over-performing in certain areas location-wise?
• Are there certain patient demographics or conditions in which you’re seeing growth? Can you alter your marketing and communications efforts to better serve and target these audiences?
• How effective is your therapy revenue funnel, and are there opportunities between referral and completion of treatment where you can improve?

You can then use AI and advanced analytics to segment your patients based on this data and target specific groups with tailored messaging that speaks to their unique needs. A personalized approach like this can reduce no-shows or canceled appointments, speed patient throughput, and increase patient engagement, satisfaction, and payments. Taking the extra step to automate these processes with AI will then remove that extra workload from practice staff, freeing them up to spend more time with patients or in other beneficial areas. This is an important tool for accelerating business growth, but it also improves the patient experience, satisfaction, and outcomes, as well as that of your practice staff.

Assuring efficient reimbursements and claims

Data collection and effectively analyzing it can make it possible for rehab therapy practices to improve revenue and reimbursements. Predictive analytics can take into account current occupancy levels and assessment of payer mix and compare it with historical data to predict future resident trends and provide practices with an overview of their finances. This can help rehab leaders to make better decisions around spending and staffing.

Automation and tools from EHR solutions can also provide accurate coding and billing which automatically applies optimal coding and modifiers for services and payers, claim adjustment reason codes, and more. Automating this part of the billing process takes the load off of staff and prevents issues that arise from human error.

As an example of putting automation into practice, One Medical developed an automated copay collection into their EHR, which drastically improved their copay collection rates while contributing to a better patient experience. With automated copay collection, patients had a speedy check-out process and could leave immediately after the completion of their visit.

Predictive analytics can also assist with the management of high-risk patients by alerting staff to which patients are more susceptible to events that could put them at risk for rehospitalization, so that those patients can receive additional treatment, care, or medication as necessary. This assures that patients are not readmitted and the practice does not have to pay a penalty.

Improving patient outcomes and value-based care

Predictive analytics and advanced EHR platforms are poised to launch the rehab practices that utilize them into the next generation of health care. As Nasir Khan, MBBS, Regional Director of Clinical and Quality Analytics at Loyola Medicine, Trinity Health, says, this powerful combination has sparked “a change in practice and behavior, resulting in a measurable improvement in some of the patient quality outcome metrics, financial performance, and overall operational efficiency for our organization. Data drives change if it’s crafted to tell an actionable story.”

In the Forrester study, 78% of rehab leaders said they expect to see the most benefit from an enhanced EHR platform’s ability to provide more personalized care that improves outcomes. For example, the reaction to an increase in the average length of stay is to discharge earlier. But a robust data set and mature analytics analysis can tell a different—and more detailed—story. It can flag patients that have increased risk factors that could result in readmission if they are discharged too early, thus allowing providers to pivot and make better real-time care decisions.

This in combination with a patient’s current health and past conditions—like medication reactions, history of illness, past surgeries, or other factors—can paint a clearer picture and help rehab therapy teams to develop a more personalized care plan that preserves the patient’s quality of life and improves outcomes. In addition to better individualized and personalized care, population level tools can help to track health needs of your community that may be unmet, disease outbreaks and progressions, and how other demographics affect patient care and outcomes.

When it comes to value-based care, the data sharing provided by advanced EHR platforms and predictive analytics can help to assure providers receive incentive payments and patients receive the best possible care and outcomes. Analytics can assist with keeping compliance current by comparing current care frameworks against industry best practices and calling out potential issues with reimbursement documentation before it’s submitted for approval. Automating coding processes to assure accuracy before a claim is sent is another way these advanced platforms can assure patients and providers receive their associated benefits and best possible care.

An NIH report suggests implementing a framework in which patients are segmented based on related health and circumstances that outline a consistent set of needs, like individuals with back pain or elderly people with multiple chronic conditions for example. Providers can then deploy a specialized team of caregivers to meet those specific needs, thus improving operational efficiency, reducing costs of care, assuring adequate staff allocation, and providing more personalized treatment for better patient outcomes.

Value-based care is also important for ongoing success of hospitals, rehab therapy clinics, and skilled nursing facilities. With tools like CMS’ Care Compare, anyone can look up the overall rating of a facility. While it’s true that ratings cannot tell the full story, it is still an important deciding factor in a patient choosing your practice (or not). A poor rating on sites like these could result in a loss of referral business, being dropped from preferred provider networks, and other penalties. Detailed data and predictive analytics can help facilities zero in on any quality of care issues and solve the problem at the root, rather than putting bandaids on the effects further down the rehab therapy funnel.

Building trust and loyalty to attract and maintain patients

Patient-centered care can be achieved with a combination of EHR data, predictive analytics, and social determinants of health, which in turn leads to patient loyalty and improved outcomes. This robust data allows for internal benchmarking between practices with multiple locations, as well as taking into account external industry data, like average number of visits, treatment success rates, and patient satisfaction, to name a few, and comparing performance.

Patient engagement is key to not only keying in on the patient journey through your rehab therapy funnel and pointing out potential gaps, but also in improved patient outcomes, growing your business, and operating an overall efficient practice. One study discovered that higher-quality interpersonal exchanges with physicians in addition to more out-of-office contact results in higher patient engagement. Spending time talking with patients and allowing them to ask questions and fully understand their concerns, checking in between appointments, or messaging them on telehealth platforms like MyChart are ways to involve patients in their own recovery and provide them with better experiences. Engaged patients are more likely to complete their plans of care, plus they can serve as an excellent source of word-of-mouth or online referrals for your practice.

For example, OptumWA scaled the use of their EHR in combination with their patient portal MyChart to stay connected with patients and improve their access to care. “As a result,” says Brett Daniel, MD. Chief Medical Informatics Officer, “we have already surpassed our aggressive annual target for new digital touches and have seen rapid patient adoption to help us deliver more connected care with fewer hands.”

Beyond enabling optimal patient engagement, predictive analytics can also assist with personalizing treatment plans and giving patients an idea of how many visits it will require and the exact type of treatment they’ll need to achieve specific outcomes. Providing patients with this clear path forward can more actively engage them in the entire care process, increasing buy-in and compliance during their journey. Your historic data and the data from your EHR partner can also let patients know the average level of improvement they can expect to see with a particular treatment plan, plus the benefits of sticking with a treatment plan and how it improves their chances of improving more quickly.

Reducing risk of preventable events

Understanding and analyzing risk of preventable events can help to improve patient care planning and outcomes, which results in better patient satisfaction and optimal reimbursement, specifically in areas scrutinized by CMS.

Preventing cancelations or patients falling out of your rehab therapy funnel is another way to put your data to work. Predictive analytics can help with not only determining appropriate staff levels based on current and predicted needs and avoiding staff shortages, but also in intervening with patients who are more likely to cancel and assuring that they maintain engagement in their treatment plan.

Predictive analytics can be used to estimate a disease’s likely progression in a given patient based on historic data of similar patients and comparing it to large data sets. Collecting patient data from EHRs and applying predictive analytics can help clinicians to better understand and plan for how a patient’s individual health factors could contribute to and affect the disease progression, thus improving patient outcomes.

This kind of close monitoring allows for early detection of changes in a patient’s health and can help with identifying and predicting a patient’s potential decline before it happens, allowing clinicians to intervene early and course-correct. Assessing a patient’s fall risk and detecting, predicting, and tracking early warning signs, for example, is another way this data can be instrumental in reducing risk of preventable events.

Conclusion

Predictive analytics paired with the right KPIs can allow rehab therapy practices to better predict events all across the patient care lifecycle and plan their care and allocate resources accordingly to meet these needs—which means improved care and experiences for the patients and reduced costs for the practice. Partnering with the right vendor can lighten the lift and take some of the guesswork out of the implementation process, so you can put the valuable insights to use right away. Put simply, it uses past patient data paired with robust formulas and calculations to help providers better visualize the future so patient care and business outcomes are at the top of their game.