Inaccessibility of clinical and financial data may hamper quality of care

The closer hospital employees are to a patient, the less likely they are to have easy access to clinical and financial data that may help their organizations improve quality of care, says a study by the Healthcare Information and Management Systems Society.

The survey, sponsored by the health IT company McKesson, looked at how health care organizations access and use clinical and financial data to improve clinical quality. The survey found that although data are widely accessible and used for quality reporting, the information is less accessible to nonexecutive employees, such as physicians. Organizations also face challenges accessing and using clinical and financial data together, which can help them gain insights into quality measures and predictive modeling.

The survey of 175 health care workers, all of whom were involved with clinical informatics in their organizations, was conducted online between March 10 and April 15. Eighty-six percent of respondents said their organizations have a clinical transformation team in place or are forming one.

Only 25% said they are able to integrate clinical and financial information together. Less than 50% of organizations made clinical information available to all employees, including employed physicians. Just 29% made financial information available to all workers.

But 75% of high-level executives had access to clinical information, and 82% had access to financial information.

Deb Bulger, executive director of product management for the Health Systems Performance Management division of McKesson, who consulted on the survey, said many organizations have been hesitant to share financial information with their staffs, because it may not look great and they are not ready to be completely transparent. Organizations also were concerned that staff members won't be able to interpret what the data show.

Spread of dashboard technology

Use of dashboard technology, which analyzes data and presents the information in easy-to-read formats, is spreading and will be important to organizations seeking to earn bonuses for meeting federal meaningful use criteria of their technology. Bulger said earning those bonuses will depend on work flow processes at all levels, and it's important for staff to document certain measures to monitor their results.

Unless the financial and clinical data are together, employees can't see the cause and effect of their decisions, she said. "At the staff level, if I don't understand the overall measurement and how my behavior could potentially impact the dollars my organizations could earn from a stimulus perspective, then I may not take that as seriously," Bulger said.

To make sense of the data, analysis needs to be easy. One under-utilized tool is the data warehouse, which only 35% of respondents use. In fact, many said they still use manual processes to report and analyze data. More than half of the surveyed organizations are focused on ensuring that their electronic medical record systems are fully functional.

Bulger said the warehouses can collect and integrate a variety of data from multiple sources, including EMRs of hospitals, physician practices, payers and others.

"Now we want to be able to, as an organization, look longitudinally at the patient care process," she said. Additionally, the warehouses have the ability to apply layers of logic so that queries and groupings of data can be done easily.

Bulger expects the use of warehouses to grow, especially among accountable care organizations that will need to look at costs versus quality of care.

The report concludes that organizations are beginning to put in all of the technical tools needed to foster clinical transformations. "Despite this, there are numerous improvements that organizations can make to enhance their ability to use clinical and financial data to improve patient outcomes," the study authors wrote.

The HIMSS study is online (link).