The Importance of Business Intelligence in Rural Hospitals
Business Intelligence (BI) is an area that has advanced rapidly over the past decade. The Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs greatly assisted healthcare providers, especially rural hospitals, in advancing the adoption of electronic systems.
Electronic systems on all levels of healthcare have provided large quantities of data that, once refined, can provide tremendous value for decision making. Subsequently, large healthcare organizations have invested significantly in complex systems that streamline the process of compiling EHR data into actionable information.
However, rural hospitals are lagging in both the development and implementation of BI tools, especially tools that target key revenue cycle functions.
Roadblocks on the journey to advanced Business Intelligence
When it comes to the Revenue Cycle specifically, two key factors prohibit rural hospitals from advancing their efforts in the area of business intelligence:
Commitment from hospital administration
In order to advance in this area, administration must be willing to allocate the resources necessary to build a program. The first step involves budgeting for the applications that will be needed in order to build a BI program. Predictive analytics and automation technologies are widely available. The rural C-Suite must understand the value of the data that they have at their disposal and the value in harnessing that data into something actionable. Without buy-in from the top of the organization, the program will never get off the ground.
Expertise to merge revenue cycle and IT
To quote the great Michael Scott, “I knew exactly what to do, but in a much more real sense, I had no idea what to do.”
Hospitals know that they have to do something in order to take advantage of the data that they are generating, but they often do not know exactly what they need to do. They simply do not have individuals within their current structure who understand the entire Revenue Cycle along with possessing the technological skills necessary to develop a BI program.
Expertise is one of the primary limiting factors prohibiting the implementation of advanced systems within rural hospitals. Developing a business intelligence program requires expertise in the targeted area (i.e., Revenue Cycle, clinical areas, etc.) and the ability to translate that expertise into the aforementioned applications.
As is the case with many specialized positions, rural hospitals are at a disadvantage when it comes to finding qualified personnel within their geographical area. This highlights the need for utilizing third parties in order to build a program. Once the foundation is in place, the vendor of choice can assist in training appropriate hospital staff in maintaining the program.
But why do we need Business Intelligence?
So, why is it important for hospitals to develop applications that allow them to use this data to their advantage? The answer to this question, as it pertains to the Revenue Cycle, is because insurers have utilized BI tools to their advantage for years.
Whether they are utilizing analytics for more accurate policy pricing, leveraging machine learning to process large volumes of claims and drive profitability, or applying artificial intelligence (AI) to assist in lowering cost rations, insurance companies have invested in leveraging their data to enhance their bottom lines. Any hospital who isn’t leveraging their own data in the same way will find themselves at an extreme disadvantage.
In a time when it is common to see hospital closures, reductions in service offerings, and negative margins, hospitals need every edge that they can generate.
Bradley, Paul and Jeff Kaplan. “Turning Hospital Data into Dollars”, Healthcare Financial Management, February 2010, pp. 64-68.
Katz, Marilyn. “9 Ways Insurance Companies Benefit from Business Intelligence”, 03 August 2020, wyn.grapecity.com/blogs/9-ways-insurance-companies-benefit-from-business-intelligence. Accessed 27 February 2023.
