Metrics Supporting Mission

Particular metrics will vary based on the individual circumstances of an organization, but it is important to track data and employ meaningful analysis of that data.

This article first appeared in the July/August 2017 issue of HealthLeaders magazine.

In any business, there are universal ways of measuring success: Top line revenue and bottom line results are essential metrics. In today's healthcare industry, there are a variety of factors that impact fiscal health.

The July/August HealthLeaders magazine is devoted to exploring the new metrics that matter to healthcare leaders. Our staff has interviewed individuals throughout the C-suite to learn where they are focusing.

You'll read about executives who track patient volume, admissions, and a "reputation radar." Others watch access metrics, such as patient wait times and abandonment rates, or call center engagement and problem resolution. Patient satisfaction, employee morale, IT security, and many more are mentioned.

Marc Harrison, MD, president and CEO of Intermountain Healthcare, focuses on metrics associated with customer service. "I'm more interested in access than just about anything because we can't make people better if they can't get in to see us," he says.

Alan Murray, president and CEO of CareConnect, the insurance arm of Northwell Health, tracks customer-focused communication metrics. "You shouldn't have to figure out who to call—we should figure out how to solve the problem. So we're continuously monitoring call logs, call handle time, abandonment rate, and Web chat email communications. However you want to communicate with us, we will adapt."

At the HIMSS conference earlier this year, I spoke with some vendor executives to get their take on what metrics providers should be watching.

Daniel E. Johnson, executive vice president of healthcare strategy at Experian Health, suggests two patient-related factors: out-of-pocket costs and patient engagement innovation.

"I think that providers should pay attention to patient out-of-pocket amounts carefully because those may change as the Trump administration looks to pull back some of the subsidies. This means that the government will pay for less of the overall bill and for certain patients, it will likely mean an increase in out-of-pocket expenses.

"Given this potential change in policy, providers must be sure that they're able to deal with collecting money effectively from people. Especially considering that 15 years ago, collecting money from patients wasn't a big priority for office staff. So, there's going to have to be a shift in focus."

Johnson also notes the connection between digital access and access to care.

"Why is it that we don't check in for appointments on a mobile app for visits? We're moving toward that now because consumers are demanding it. Everything we do seems to be on a mobile device. This should be a priority for providers, as consumers will be looking for these types of conveniences as they shop for healthcare services. Most patients want to easily interact with their provider via their mobile device or over the web."

Jason Williams, vice president of analytics & growth strategy at Change Healthcare pointed to the need to drill down into the data that is collected as a way to discover the outliers.

"Organizations usually know which metrics are critical. I would emphasize the data cuts underneath. So what I mean by that is the sorting of the data that says how those metrics stack up by payer or by user, or your registration person or your biller, or by physician in some cases if it's relevant," he says. "The outliers have a disproportionate impact on your performance."

"If you don't shine the light in the darkest place, then you don't really react to the biggest part of the opportunity to improve. So I think it's not necessarily just the metric, but the cuts underneath that trigger specific actions based on expected thresholds."

He also stresses that the analysis of data should be done by someone with specialized knowledge of the area being measured. "It should never be the case that someone outside of your team has primary responsibility for analyzing, assessing, and reacting to your performance."

"When you have a silo of IT or of data analytics people and they've got to learn 'why?' as they're generating data, that creates frustration. If there is a cross-functional island of data people out there, then they're not acutely helpful if you've got to always have iterations to teach them what you are trying to accomplish."

Of course, as important as data is, it is not everything. "Everything boils down to metrics, but I'm always cautious that they tell you a story but not the whole story," says Nancy Howell Agee, president and CEO of Carilion Clinic. "You also have to tune into what's really happening to your patients and staff. Data is not the intelligence. What else do you need to know?"

The particular metrics will vary based on the individual circumstances of the organization, but it is important to track data—and employ meaningful analysis of that data—to develop a system where the metrics support the mission.