Improving Health Outcomes Through Episode of Care Analytics

The treatment given to a patient for a medical event – either a brief illness or emergency – is called an episode of care. It refers to all aspects of the care given, starting from diagnosis, finding the triggers, deciding on the treatment plan, and finally the treatment itself. As is evident there is so much data that relates to one episode of care for one patient. When there is consolidated data of care episodes from thousands of patients, analytics can be used to find patterns in the data, to highlight improvement areas, and to arrive at probable costs of care. 

The healthcare industry is increasingly adopting technology to digitalize its offerings. To maximize the advantages of technology, healthcare data needs to be consolidated. One of the possibilities with streamlined data is analytics on the data. Generally speaking, analytics – not just care episode analytics –  enables mining insights from the huge volumes of healthcare data available. Currently, there is a growing recognition for episode of care analytics as a means to improve the care offered to patients, and to reduce costs. It is also seen as a stepping stone in value-based care models. 

Areas of Impact

One of the main areas where episode-care analytics directly impacts is in payments. This model is gaining popularity as patients do not have to opt for the traditional fee-for-service payment model where healthcare providers charge for every service. Instead, episode-care payment includes all treatment received for an illness or medical event. For instance, a pregnant woman does not have to pay for every visit in an episode-of-care approach. Instead, the care is offered as a package for the entire nine-month prenatal period, delivery, and after delivery. This kind of care is also offered for various other types of treatment plans like for ex: knee or hip replacement surgeries. 

Insurers or Clinically Integrated Networks (CINs) can leverage episode analytics to examine total costs of procedures and prepare network design. Since the ultimate purpose of CINs is to optimize cost, inference from episode care analysis will be beneficial. The analysis helps identify which providers can be included in the network to improve the total costs of the procedures. 

Episode care analytics is highly beneficial in evaluating the current practice pattern. Providers and payers can set the performance benchmark for end-to-end care based on available quality and cost data. This practice will help direct patients to different facilities as necessary. 

As value-based care is at the center of healthcare service, data from episode care analytics can be used for referral management to identify other healthcare providers who are competent in their field. This helps increase communication and promote team-based care. Ultimately, care analytics can result in optimizing cost and quality of care. 

Episode data is instrumental in designing medical policies and plans. The analysis can be used to optimize cost, revise existing practices, improve resource utilization. If there is any inconsistency or overuse, new policies can be implemented, or existing policies can be updated.

Main Advantages

As the two primary benefits of an episodes-of-care program are financial and quality-of-care, episode-based analytics has become an integral part of healthcare organizations. It offers three important advantages to medical professionals — increased savings, improved quality of service, and better patient experience. The technology allows users to assess the patient risk level and create a more defined and personalized care delivery system accordingly. Evidently, episode-based analytics supports the value-based care approach both patients and healthcare organizations are beginning to focus on.

Certain areas of medical science involve patients undergoing multiple episodes of care. Healthcare providers can analyze trends and patterns to benchmarks by leveraging episode care analytics. This practice can allow organizations to compare data, identify areas of anomalies, and improve service. 

Care episode analytics is also gaining popularity for its ability to measure the cost and quality of episodes of care. With the data available from these analytics, organizations can better picture the true total cost of care, design care models based on variations, implement measures to avoid potential complications, and use risk-adjusted scoring to identify risk groups. 

Another important benefit is insight. As analytics offer deeper insight into the kind of patient care needed, healthcare providers can improve their service with a patient-centric approach to offer care coordination. As large volumes of data are collected for a single disease or healthcare service, hospitals and other healthcare facilities can get a system-wide analysis of care and improve care delivery. The data can be used for aggregate and case-by-case service offerings.  

Recently, episode analytics has been used for case management. As the analytics give the users accurate comparisons at both the patient and provider levels, providers can use it to address specific health conditions more efficiently to have a deeper understanding of the journey. 

Long 80 envisions transforming the face of technology-enabled healthcare through innovative solutions and services. With data integration, descriptive analytics, and AI powered advanced analytics such as predictive and prescriptive analytics as one of our key offerings, Long 80 enables better care and outcomes at a lower cost. For more on our healthcare offerings, please visit https://long-80.com/ 

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