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I feel like I complain a lot. I need to have some reconciliation about who I am as a personality. I am probably known to be hypercritical, not necessarily of individuals but of processes, of data, of kind of everything, and I’m extraordinarily demanding. Maybe, you should take everything I say with a grain of salt because I expect everything to perform at the optimal level to have great results for everything to work out. 

If that’s not what you’re shooting for, or if you’re a little bit more of, “Hey, if things work out, they work out,” or a little bit more of an 80% kind of person, I’m more of like a five-nines sort of person. So maybe, I’m not the proper perspective on some of these things.

Making sense of the rambling

It feels like I complain a lot. Or at least, I’m pointing out many things that are not particularly great. I think part of this is because I hate being sold to; I hate being marketed to. In addition, I refuse to listen to advertisements. Also, I refuse to listen to BS speak, where people ramble on stuff that isn’t very helpful or doesn’t really inform or maybe isn’t educational and is just like sales talk. I hate that stuff.

I think there’s a great need that we have in healthcare for things like benchmarking. They exist in many areas. If you want to look at a car and how it performs relative to other cars, in accidents, that information exists. It’s pretty well documented. And cars aren’t exactly the most sophisticated things on the planet. I’ve got to believe that some of the analytics that we’re doing are more sophisticated than most cars, especially given that they’re using incredibly dated chips. Side note, my computer engineering – “chip design.” 

A bit of background

In undergrad, I specialized in VLSI and ULSI. Unless you’re a real tech nut, it doesn’t matter, but they’re using old-school chips in those cars like microchips. It’s nuts. So they’re not precisely really technologically sophisticated products. I wonder how long it took them to get off of things like carburetors.

Healthcare analytics, benchmarking. We should have organizations to go to where they act as a repository and an aggregator of data. One of the challenges that we frequently found is that healthcare providers are reluctant to give up their data, billing companies are reluctant. Some people think their data is super valuable, so they don’t want to give it up. Others are just concerned about competitive issues (“Oh, you’re going to sell the data”) and so on. 

Such places like MGMA, CAP, the American Academy of Orthopedic Surgeons (AAOS), or whatever should be the places that we can go to aggregate data and help everybody because this should be one of the core functions that they provide. Yet, more often than not, it doesn’t turn out to be very valuable for most organizations, even if you give the data and get something back.

A few illustrations

For example, the MGMA has one for benchmarking where they’ve got something like 2,500 practices, and they have something that they’ve put out about this. It’s a pretty long webinar, an hour-long view, or something like that. As you start going through this process, you notice that pretty quickly, it becomes a sales pitch for many of the organizations who are involved.

Aside from the fact that I’m not too fond of that stuff (it drives me crazy), my perspective on this is as follows. Suppose you can teach somebody something valuable in your webinar, in your presentation, in your course, in your materials, whatever it is. In that case, you don’t have to sell because somebody can teach me something. Thus, I’ll immediately go like, “Oh, wow! These people know what they’re doing. I want to engage with them more. I want more of that. That helps me.” So you don’t need to put on the sale schlock and the sales shtick.

This is where I’m going to go off on the negative part because I don’t know what it should be instead of what it is now. In theory, it should be like, “Hey, we’ve got all this data, and we’re going to analyze it for you and benchmark.” For example, everybody will be able to get the actionable information (a keyword “actionable”). As a result, you can do something different in your practice, in your provider organization, in your billing department, or in your billing company,” whatever that might be.

Data analytics

Yet, the first person to speak is hardcore in the analytics part in terms of the infrastructure. They talk about some things that I think are right, and they say some things that are correct and valuable. He even talks about old school raising the top line in terms of “revenue,” providing actionable insights to control and improve clean claim rates. Great! Those are all good. Then, they’re kind of off into, “That’s the old-school stuff. The new stuff…” By the way, we haven’t even accomplished the old-school stuff, so I don’t know why we’re into the new-school stuff. By the way, we love sophisticated algorithms. But if nobody’s using it, what’s the point?

They talk about presenting data in a way that everybody can align. Well, they skipped the last thing that they talked about, which is that most of the conversations in revenue cycle management are about data quality, not about the actual results of the data, or the output, or what you should do. They’re talking about, “Is it good data?” or “What does the data mean?” and all these kinds of things. They skipped that part. Forget that for a moment.

Presenting the data

Now, we move on to the next part. They say all you need to do is present the data in a way that everybody can align. Well, I’ll tell you that that is not the top problem we encounter most of the time when we’re out in billing organizations, billing departments, and more. We can drop in data warehousing and roll it out, and everybody has access now to the data. We can even create KPIs for them, so it’s all visible, kicking all those things out. 

In theory, everybody should be able to agree and “align” around the data. We’ve done all the cleanup and normalized data and all these kinds of things before that preprocessing before you drop it into data warehousing, and it still doesn’t solve the problem. There were so many other problems, from people not having time to deal with it to them not having time to help you implement, to them not even having time to express what their objectives are and what they want to accomplish with this. Or you don’t have people internally who have the capability of using it.

How are you using your data?

The fundamental problem isn’t just that we don’t have data that people can align around. There are many, many other problems. It’s a very complex and profound problem. Or they suggest that just knowing the top 10 issues to chase and fix gets you over the biggest hurdle. Well, that’s not true. I can’t tell you how many times we’ve tried leading people to water, and then they can’t drink because they got too much on their back already. They’re lying there by the side of the lake, and they can’t drink.

Or they suggest that now everybody will be aligned around benchmarks and metrics. Again, that’s assuming people use it. That’s thinking people will take that information and do something with it. They will create some action plans. They will follow through on the action plan. And there are so many issues with that in terms of people not having capacity. Also, they may not have the capability, other things, or even just a culture in the organization or incentives. God, I wish just dropping in data would solve everything.

And finally

We are data fanatics. So it’s not that we’re knocking data. I think you need to have a data-centric and data-oriented organization to be successful. But you’ve got to have a lot of other things. Why? Well,  to make that happen and execute off of that.

That’s my sort of beginning rant. There will be more about this as the days continue.