According to a study done by health care research firm KLAS, in 2011, as the focus of the health care industry shifts from quantity to quality of health care, clinical, and business intelligence will play a big role in implementing this transformation. The study revealed that 60% of health care organizations planning to become Accountable Care Organizations (ACOs) feel that clinical and business intelligence will provide them the necessary analytics to identify quality gaps, inefficiencies, and cost issues.

The study also highlighted that 14% of health care organizations were using predictive analysis offered by these clinical and business intelligence tools for better management of patient care, marketing information, and clinical data analysis. As data in the healthcare domain is distributed among a number of systems (finance, claims, billing, pharmacy, patient care, etc), it has become essential for health care organizations to use technologies that allow the collection, integration, and analysis of this data for better clinical decision making.

How Can Clinical and Business Intelligence Tools Prepare Accountable Care Organizations?

With strict norms needed to be followed by ACOs, solutions easy to implement, user friendly and provide the right analysis to improve the quality of health care experience are needed. Some of the major benefits of using clinical and business intelligence tools for ACOs are:

•    HEDIS quality measures: This has become the become industry standard and needs to be followed by every health care organization. In a sense, the performance of any health care organization is measured by their adherence to these norms. The accreditation process is a complex procedure that requires reconciliation and auditing of data from various sources. Clinical and business intelligence tools help in the extraction and analysis of information from various departments (patient, claims, labs, etc.) and present the information in the most concise and effective manner.•    Clinical registries: Intelligence tools help in better understanding and collaboration of data from various registries. There are various registries that store information about chronic diseases, quality measurement, patient data analysis, and much more.  Clinical and business intelligence tools help in better alignment of data from these registries, leading to performance improvement for the hospital.
•    Clinical data and claims analysis: Managing claims information helps organizations prevent fraudulent claims and optimize their pricing strategy. Because the software provides details down to individual records, it helps provide better patient support while keeping a tab on costs.
•    Operational and cost analysis: Because these tools provide web-based reports, it is easier to identify the efficiency of each employee and physician. The use of dashboards helps measure the success of pay for performance initiatives. The analytical capabilities also help in identifying any extra costs incurred by the organization while helping to develop measures to identify underutilized resources.
•    Marketing analysis: Clinical and business intelligence tools help in analyzing marketing efforts and track their success in effectively promoting products and services. By tracking campaign costs against the ROI, organizations can compare any campaign’s performance and devise cost-effective techniques that suit the requirements without compromising on results.

With 64% of health care organizations planning to become ACOs in the next three years, the clinical and business intelligence market is bound to expand phenomenally. According to a survey by Gartner, the business intelligence market is expected to touch $12.7 billion in 2012. With stringent quality parameters being defined for ACOs and with the demand for health care rising rapidly, it will soon become mandatory for organizations to use clinical and business intelligence tools. Using these tools will help the organizations implement numerous technology solutions, from gathering, organizing, and analyzing data to implementing these results for a healthier tomorrow.