A Q&A with SIS' Director of Analytics, Amit Jiwani, highlighting the ways analytics can help ASCs strengthen data accuracy and value, and improve overall case costing efforts.
Amit Jiwani, director of analytics for Surgical Information Systems (SIS), recently hosted a webinar where he discussed the ways analytics can help ambulatory surgery centers (ASC) improve their case costing efforts by strengthening the accuracy of data and enhancing the value of data to support improvement efforts. The audience was highly engaged and asked great questions during and following the program.
Below are the highlights of those questions and responses provided by Amit, edited for readability. To view the webinar on-demand, please visit the SIS Resource Library.
Q: How can we ensure the data collected by our ASC is accurate?
Amit Jiwani: A key component for improving the accuracy and completeness of your ASC direct materials cost is that the data should be captured in a technology system at the point of care. When that happens, accuracy goes up tremendously compared to postoperative documentation and data entry. If you document on paper and transcribe to an EHR or practice management solution after a case, there is a higher likelihood that you are going to miss some of that data. You can see how important it is that this data be captured correctly and why it's best that it be collected at the point of care.
Another concern around data accuracy is a user entering incorrect data. For example, instead of documenting that a case used two of a particular item, a person enters in 20 of that item, which balloons the associated cost of that case. Such data entry errors are inevitable when there's human interaction with a computer. The solution to resolving these data entry errors is gaining visibility into these errors easily and timely.
The benefit of using a good analytical solution is that it can help identify those data anomalies quickly, since they stick out like a sore thumb. They may not stick out when you're reviewing data in a table, but when you graph the data and see it represented as a picture, the anomaly will usually identify itself.
This goes back to why you should collect data at the interoperative point of care. You end up creating a feedback loop around when the data is captured and by analyzing that data at a regular cadence. As you start to identify anomalies, you can now bring that feedback to your clinical or administrative staff so they can correct that documentation error. Over time, this gets your data clean and allows you to continue to measure case costing accurately.
Q: How can you determine why physicians have different costs for the same procedures?
AJ: This is one of most important and primary use cases for collecting case costing-related data. To gain a better understanding of why your physicians have different costs, there are a few places you'll want to look. The first step you want to take is to determine whether the difference in costs concerns direct costs, indirect costs, or both. If it's direct cost related, then the first place you usually want to look is supplies and implants. If there are supplies or implants associated with the procedure or type of procedure and the physicians are using different supplies or implants, is there a difference in the cost of these pieces of equipment? If there is, then you'll want to start drilling down further, such as looking at whether there is a difference in the manufacturer of the items that were used and how that may be affecting cost.
On the indirect cost side, you're generally looking at the duration of the case in the operative phase. If there's one surgeon spending much more time in the operating room, and if you track OR minutes attributed by physician, you can see how such a variance would contribute to differences in indirect costs.
Q: When a physician questions case costing numbers, how should we respond?
AJ: Communication is crucial here. First, you need to ensure your physicians trust those numbers. Then it's a matter of developing a regular cadence where you're able to show physicians their average, their peers' average, how the figures were calculated, and the relative case volume that makes the information more statistically significant.
To develop stronger trust in the data, it can be worthwhile to allow your physicians to see the details behind it, such as how you take a case with line-item details and roll it up. This way, they can see and better understand the calculation process. Then you also want to help them understand where the variance is coming from. For example, if the variance concerns direct supply costs, you can show the physician how the manufacturer they use compared to the manufacturer their peers use lead to that difference. From there, you can work to engage them in renegotiating what you're being charged by a manufacturer or try to bring about a behavior change concerning which preference items the surgeon wants to use.