A modern medical practice produces millions of data points with every patient interaction. But are you getting the most out of that data, and using appropriate key performance indicators (KPIs) to make sure that patients are getting the best care?
In a recent episode of the MGMA Ask an Advisor Podcast, hosts Daniel Williams and Christy Good addressed the importance of network utilization KPIs and how they can be leveraged to enhance patient satisfaction and operational efficiency.
Understanding and Identifying the Important Metrics
According to Good, the most important network utilization metrics to track include appointment wait times, referral patterns or overall resource allocation.
“Those metrics are the ones that directly impact patient experience,” she explains. “If a patient faces a long wait time or poor care coordination, the satisfaction scores can decrease. So it’s important to really look at those KPIs to ensure smoother operations and higher patient engagement.”
In practical terms, Good says that means taking a close look at metrics which can enhance care transitions, such as appointment availability, referral completion rates and post-discharge follow-ups. Tracking response times for patient or portal inquiries can also provide a clear picture of improvements critical to better patient engagement.
“Ensuring that referrals are completed reduces patient frustration, as well as many billing problems which you don’t want them to experience if you have not done what you need to do,” she adds.
Proactive Benefits of Monitoring Network Utilization
By tracking these specific metrics, Good says practices can identify bottlenecks in scheduling and redistribute their resources to meet demand. If a particular specialty has long wait times, a practice can adjust staffing or expand its availability, which can reduce delays and improve patient satisfaction.
“Provider availability and even equipment usage can help practices allocate resources more efficiently, so flexing your scheduling based on your patients’ needs can really help with timely care, and boost satisfaction,” she says.
That can also help prompt a proactive strategy to avoid fragmented care, versus losing patients through leakage – those who didn’t get seen in a timely fashion, didn’t get the care they needed or possibly turned to other out-of-network options instead to seek care.
“Referral patterns and care transitions within the network ensure that patients move seamlessly between providers, so by tracking how many referrals are completed versus lost, it can highlight gaps in care coordination and allow them to address these issues proactively, instead of reacting and losing patients.”
Using Data to Offer Personalized Care Plans
Network monitoring can also be used to flag patients who need timely follow-up or post-discharge support, which can significantly lower readmission rates, especially for high-risk patients. If hospitalization is necessary, network monitoring can help provide more coordinated communication between a practice and a hospital, to ensure better and more consistent follow-up care. It can also be used to track patients who do utilize out-of-network care and make sure that their medical records are consolidated.
Technical Integration Can Cause Hang-Ups
Often, there’s a lack of integration between information systems such as EHRs and practice management tools, which can cause issues in sharing information between the network of medical practices and hospitals. One of the quadruple aims continues to be promoting more interoperability, using solutions such as data aggregation tools to help unify those disparate information and get a complete view.
Practices also need to assure that their patient monitoring systems comply with regulations such as HIPAA and have robust encryption and access controls, to help ensure both data security and patient privacy.
Start Small and Lean on MGMA’s Help
To help defray some of the costs involved in network utilization monitoring, Good also suggests small practices leverage some of MGMA’s benchmarking tools and resources.
“Big data systems or software that gathers it can be costly, for sure, so smaller practices can start by just looking at specific solutions to their biggest challenges. MGMA’s tools can help a practice measure their performance without large upfront investments in technology.”
Resources
For more information and support on effective KPI tracking and optimization, visit MGMA.com and explore our wide range of resources, including these resources:
MGMA DataDive: A comprehensive benchmarking tool that provides detailed metrics on network utilization, enabling practices to compare their performance against industry standards.
Ask an Advisor: For personalized guidance, practices can reach out via email at advisor@mgma.com to connect with MGMA experts.
