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How an Emergency Services Provider Improved Data Visibility

Learn how Northwest Acute Care Specialists (NACS) used a data warehouse and Power BI to greatly improve data visibility and generate more actionable insights.

The Healthcare Industry Struggles to Gain Actionable Insights

Imagine going to a bank and waiting hours in line to see a teller to cash a check or withdraw money—today’s consumers won’t tolerate that. 

Yet, that’s still the reality in much of the healthcare sector, especially in emergency rooms. Those in need of emergency services often spend hours waiting to see a doctor. This is the opposite of a patient-centric experience. 

The healthcare industry struggles with adopting new technologies that can help them keep tabs on consumer expectations and avoid consistently falling short. 

Northwest Acute Care Specialists (NACS) provides emergency services at seven hospitals in the greater Portland area. Its Chief Operating Officer, David Silverman, experienced this struggle up close and personal. 

David has a strong background in technology, so he was painfully aware that he needed to modernize their organization’s operations. He clearly understood the root of the problem. “Our biggest challenge is that we didn’t have any access to data.”

A Lack of Data Visibility Limits Operational Progress

Although NACS generates a wealth of data, existing processes were severely limiting their team’s data visibility. This lack of visibility was hindering their analytics capabilities and operational progress. 

Information lived on the legacy platform of the hospital system. After treatments were complete, this legacy platform sent the records to a billing and coding company for the claims submission—a process that NACS had almost no visibility into.

NACS was often flying blind. Any information it received from the billing company would be two or three months old, and no longer actionable. The NACS team couldn’t track encounter metrics, while the static PDF from the billing company failed to provide nuanced data insights. 

David needed to create an environment where his team could own and access actionable clinical and claims data. But the information resided in disparate locations, such as the EMR, billing and coding company, shift administration software, and HR system. 

These sources didn’t talk to each other. David needed to pull data from all these platforms and build a centralized data warehouse to relay the information to NACS’ providers and complete the feedback loop.

Additionally, the trend toward value-based care and risk-sharing with payers meant that NACS needed to use data-driven insights to negotiate with payers and navigate new insurance models instead of taking the payers’ word for it. Meanwhile, providers wanted data about their performance to help improve patient outcomes.

“We had very limited access to data. We were flying blind or getting information that was two or three months old. Data wasn’t actionable, and we really couldn’t make heads or tails of it.”

Meeting Patient and Provider Expectations With a New BI Solution

NACS partnered with Skypoint to implement a smart data warehouse and build an “Encounters” datamart using Epic and LogixHealth data. The solution achieves the level of nuance and granularity it needs to meet patient and provider expectations. 

The solution integrates scheduling data with billing data from LogixHealth and other internal data sources into a new cloud data warehouse (Azure SQL database). It also leverages Power BI for healthcare data analytics, tracking metrics, and evaluating performance. 

The managed business intelligence solution included four work streams:

  1. Identify functional requirements, recommend tools and architecture, and update the project plan.
  2. Extract and land raw data from Epic, LogixHealth, and ShiftAdmin into staging tables to build and populate the dimensional models. 
  3. Build and populate a star schema to organize the information in the data warehouse.
  4. Build Power BI data models and reports and implement row-level security (RLS).

Skypoint enabled NACS to connect different data sources to generate real-time reports. The team leveraged these insights to effectively and easily evaluate both organizational and employee performance.

The solution also helped NACS uncover additional hurdles during the process. It shares information with a clinical emergency data registry (CEDR), which tracks 25 million emergency room visits a year. Skypoint helped NACS combine the data from CEDR and Epic to see how their performance stacks up nationally.

“Skypoint’s solution allowed us to connect different data sources to generate real-time reports. Now we can evaluate organizational and employee performance more effectively.”

Power BI: The Game Changer in Medical Billing and Coding

“For us at Northwest Acute Care Specialists, Power BI has been a game changer,” David said as he reflected on the change made possible by this implementation, pointing to one particularly impactful moment. 

On January 1, 2023, the reimbursement process changed for all emergency care providers. NACS implemented the data warehouse two weeks before the transition. David prevented any revenue loss thanks to the ability to track the billing and coding process. This is typically not the case for most other providers, who usually experience a falloff in these situations. 

By completing the feedback loop with robust visualization and reporting, David and his team now capture 60 to 70 unbilled encounters each month. These encounters would have fallen through the cracks in the past. Today, these new data insights help NACS recover significant revenue.

Most importantly, the schema helped NACS put the information in the right place within the data warehouse. This structure allowed David and his team to create meaningful visualizations to inform decisions. 

“By being able to track this change in billing and coding with Power BI, we saw no deterioration of our revenue during a big transition. In fact, we've seen a slight increase.”

Better Data, Actionable Insights, and Hours Saved

The data warehouse, Power BI visualization, and automation saved David and his team hours of manual effort compiling and making sense of data from various sources. 

The NACS team can easily use the registry number in NACS’ HR system, match it with the one in the EMR, and identify encounters within Epic that involve its physicians. These operational transformations are saving hundreds of hours of tedious and error-prone work each month.

“The data warehouse helps us eliminate myths and anecdotal information,” David said. “We can delve into the data, look at how other providers perform, and take any urban legend out of the discussion. The data warehouse gives us a system of truth to guide accurate and coherent decisions.”

Moving forward, David plans to collaborate with Skypoint on projects with a clinical focus, such as understanding patient demographics, procedures, and prescribing habits. Future collaborations will help connect operational metrics with clinical ones to paint a holistic picture.

“Skypoint sees our challenges with a fresh eye and shows us (and the industry) what’s possible,” David said. 

“Our relationship is a true partnership. The team invested in understanding the extremely complicated medical billing process. They even went to the emergency departments to watch our providers work to design a data warehouse that meets our needs, which is critical to the project’s success.”

“Our relationship is a true partnership. The team invested in understanding the extremely complicated medical billing process. They even went to the emergency departments to watch our providers work to design a data warehouse that meets our needs, which is critical to the project’s success.”

We love helping organizations design BI and data warehouse solutions that provide greater data visibility so you can use actionable insights to take smarter actions.

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