What Metrics Do I Need For Better Patient Relationship Reporting?

With the push for better EHRs, patient portals and patient-reported outcomes (PROs), medical analytics consume well over 30% of the world’s data storage.

Since value-based care contributes to stronger revenue streams, health care organizations need to find the balance between interpreting data (such as PROs) and gathering the right metrics.

The challenge isn’t how to get these metrics. The challenge is determining what are the most meaningful metrics to prove the effectiveness of health care programs.

Here are the most valuable:

1. Metrics Based on Patient-Reported Outcomes

There are several key data points that care teams can only get from patients. In many cases, these health care metrics are the best ways to prove to payers such as Medicaid that the program works and is worth additional compensation.

This is where patient relationship management can help monitor and improve these required patient-reported outcomes.

Platforms like Welkin can provide easily downloadable, synthesized data that’s gathered from all patients in the program.

Here are some of the most important metrics that PRMs should consolidate for quick validation:

Outcomes That Patients Can See

As patients reach their goals with the help of their care team, they experience changes that indicate their program’s effectiveness.

For example, people with pre-diabetes or the early onset of heart disease may lose weight or increase their physical activity as they implement their care plans. These outcomes demonstrate how, within a short period of implementation time, programs can yield results.

Using these outcomes, PRMs can consolidate data—including daily steps or eating habits— to allow care managers to easily view and access the information. Plus, with real time data and easily downloadable CRV files, program directors can quickly submit current measurables to payers.

Clinical Improvements

Clinical improvements can demonstrate how the program addresses the risks and dangers of worsening disease. Data that shows risk reductions can increase the services payers are willing to cover.

Take A1c tests, for instance. As patients with diabetes take these annual tests, care teams can demonstrate how the program is helping patients reach their management goals and improve their conditions. The result is a lower likelihood of costly complications such as kidney damage or dialysis.

Quality of Life

When it comes to evaluating data, the ‘quality of life’ category tends to be overlooked. But a PRM can make the gathering of quality of life assessments and surveys seamless.

For example, patients with ongoing pain from conditions such as arthritis or fibromyalgia can indicate improvements with pain scales. Others who are losing weight or increasing physical activity may also report increased energy levels or improved alertness.

Metrics like these are invaluable for proving program effectiveness and can result in the lowering of future medical costs. Those who are experiencing a better quality of life are less likely to need a high volume of doctor’s visits, and patients who are improving metrics like cholesterol levels will probably require fewer medications.

As patients experience the benefits of patient relationship management, they’re also less likely to be readmitted to the hospital. This results in fewer expenses for medical facilities and better compensation for scalable health care systems.

2. Data That Shows Cost-Effectiveness

It’s one thing to be able to prove that your program is working, but it’s another to do it in a cost effective way. As conditions such as chronic diseases continue to grow, health systems desperately need workable solutions that are also affordable.

That’s why patient relationship management systems need to give program directors a 360-degree view of patient care reports and revenue streams.

Optimizing the Program’s ROI

Understanding expenses is a key part of care systems management. Metrics such as per member per month costs allow program directors to compare the value offered with monthly and yearly expenses. In this way, losing revenue simply because of inefficiency or losses within the program can be avoided.

In addition, some types of software that manage patient relationships can require a high level of customization before teams can maximize their workflow. Customization costs extra money and extra time which can cut into financial returns. Directors need a PRM that allows for easy configuration of workflow without requiring coding knowledge.

Comparing Output Versus Outcome

Limitless funds and infinite staff time might eventually turn into better patient outcomes, but then again maybe not. The U.S. spends twice as much on health care as many developed countries. Yet we still have one of the poorest life expectancies among these nations.

Program directors need metrics that show the level of active engagement that is needed from care teams in order to get the desired patient outcome. For example, it’s entirely possible to achieve positive patient outcomes at the expense of efficient workflow and cost. In the end, these limitations may keep care teams from reaching as many patients as they can.

Analyzing Patient Expectations

Medical systems need to be able to manage and meet patient expectations. When it comes to care plans, health care teams need a way to anticipate these expectations and adjust accordingly.

For example, if patients assume that a six month program means they’ll see results in six months, they may be disappointed. Sometimes goals are fully reached a month or more after they finish their care program. Therefore, if care teams don’t anticipate expectations and objections patient-reported outcomes may not reflect the cost-effectiveness and long-term impact of the program.

3. Indicators of Staff Efficiency

Programs can have all the right staff and still not reach as many patients as anticipated. The reason for this is often due to breakdowns in staff communication or workflow. This is why program directors need metrics to help them establish care team efficiency.

Maximizing Without Exhausting

Without data that shows how staff is being used, program directors have very little insight into care team workflow. Here are several questions to consider:

  • Is the patient load too light for our staff?
  • Is the patient load too heavy for our care teams?
  • Are we overstaffed?
  • Are we understaffed?

These analytics allow program directors to take notice of breakdowns in workflow and drains on valuable resources. Equipped with these metrics, they can adjust accordingly to save time and costs.

Unrealistic Timeline Expectations

Staff metrics can also be used to reveal unrealistic workflow expectations. For instance, if visits and calls are routinely taking longer than expected, directors can adjust processes and procedures.

In addition, these metrics can help directors identify workflow that can be improved with automation. For instance, one improvement for the lengthy call scenario above is to automate post-call emails and surveys. Another solution is to automate a list of questions that care managers can use to streamline communication.

Matching Expertise With The Right Staff Members

Sometimes care team workflow breaks down because jobs aren’t always matched to staff skill levels. Metrics can reveal where efficiency is being lost so teams can adjust expectations based on staff expertise.

Patient relationship management platforms should easily and inexpensively allow program directors and care teams to gather the right metrics to prove the effectiveness of the program.

How are you using data to prove your program works?