Trend to Watch: Data Revolution

ASCs that embrace ‘big data analytics’ are boosting efficiency, improving patient outcomes — and gaining a competitive advantage.

Your ASC generates and collects an enormous amount of data every day, but are you putting it to work to improve your practice? That’s the basic question posed by proponents of “big data analytics.”

Putting data to work

As senior director of strategy, solutions and innovation, Justin Mooneyhan helps lead technology modernization, enablement and innovation across AMSURG, a national surgery center management organization, and its more than 250 U.S. ASCs. He says big data is important across every segment of the healthcare industry, but ASCs have traditionally been slower to adopt it. Now, however, more of the ASC ecosystem recognizes the value and imperative of putting data to work to guide clinical and operational improvements. Since 2019, AMSURG has invested significantly in building a data warehouse to aggregate various sources of data and build business intelligence around it. Mr. Mooneyhan and his colleagues make the business intelligence case to each AMSURG ASC, which vary in their embrace of tech — a truism across the industry.

“Some ASCs are more tech-savvy; they’ve invested in technology and have systems that can generate good analytics from their data,” says Mr. Mooneyhan. “Some are still on paper and have manual processes. Some are in between, with data points on certain things but not others. You need a holistic view of your data to bring more insight into various decisions you might want to deploy. We’re trying to solve for that by standardizing more of our systems.”

AMSURG’s current focus is making its ASCs’ billing more intelligent by enhancing its standardized central billing office as a service offering across its centers. The system pipes each ASC’s billing data into AMSURG’s data warehouse. “Your billing system impacts your accounting functions, your month-end close processes, your revenue cycle management functions and capabilities and your operations,” says Mr. Mooneyhan. “You need a solid billing system and good processes in place from a revenue cycle management perspective to get those analytics that drive meaningful insights.”

What kinds of insights can a standardized, intelligent billing system provide? “You can look at your claims and denials to improve your denial management function, which helps your accounts receivables and cash position,” he says. “If you have better analytics to know which claims are getting denied, you’re probably going to put some effort based on that insight to try to close that gap so you don’t have as many denials, which means less administrative work.”

Clinical insights

Big data analysis can also provide valuable clinical information to improve practices by plugging individual ASCs’ data into external data sources. “For example, we have a heavy GI ASC portfolio and presence, and we leverage the GI Quality Improvement Consortium (GIQuIC) clinical data registry,” says Mr. Mooneyhan. “In fact, we are its largest supplier of data, providing about 25% of it. Our GI physicians can look at how their clinical quality bumps up against their peers, industry benchmarks or competitors. For these competitive providers, it’s very important and very powerful, and it impacts quality of care in a really positive way.” How so? “If they have good data on adenoma detection rates, for example, they can see, ‘I’m 10% ahead of the national benchmark and 20% ahead of competing ASCs in our region,’” he says. “If they’re behind, they can say, ‘How do we get better?’ and it drives action to see how they can improve.” AMSURG is working to connect its providers with similar data registries for orthopedics and ophthalmology.

Standardizing and integrating data like electronic medical records can also better connect ASCs with their physicians’ offices. “If you have the full continuum of care digitized and interoperable, the physician practice can send the patient’s medical record and referral to the ASC, as well as schedule the patient, digitally,” says Mr. Mooneyhan. “There’s no slow, manual faxing or analog process. It just populates in the surgery center clinical record and pushes data back interoperably to the physician practice. The administrative efficiency there is huge, and it also solves some physician burnout issues — ‘Where’s this record? I didn’t get this piece of information because it was scribbled on a piece of paper.’”

Competitive edge

All this digitization can be overwhelming for many ASCs whose time-honored practices have served them well, but don’t neatly plug into the much more data-intensive competitive landscape that is emerging.

“Our physician partners and our operators tell us, ‘We want better data. We know the technology’s there, but how do we get there?’” says Mr. Mooneyhan. “The biggest thing we say is, ‘You need to standardize.’ The problem with that is it costs money. These systems aren’t cheap, and the workflow changes that come with them can be difficult. It sometimes takes months or years, depending on how big the surgery center is, and how complex its workflows are.”

Mr. Mooneyhan says artificial intelligence (AI) and machine learning can leverage big data as well. “Generative AI is the buzz of the industry,” he says. “Case volumes is one example of predictive AI we’ve started honing in on. If we can better predict the number of cases and cancellations based on our historical data and train these machine learning models, then we know how to flex up and down on staff on a given day. If you pipe in weather data, seasonality, those types of things, you can get some really interesting and impactful predictions.” He says the models his team has built have proven highly accurate so far.

He is also exploring use of generative AI to produce what he calls “chat with your data.” Based on a closed, internal-only, large language model, staff can interact with data like never before. “Instead of an employee searching for the holiday schedule HR emailed or searching for it on SharePoint, they can just type in ‘what is the holiday schedule for 2023?’ and it is sent to you like ChatGPT,” says Mr. Mooneyhan.

AMSURG is taking a methodical and careful approach to AI, however, particularly because of security and compliance implications. Cybersecurity, obviously, is a hot-button issue. “The more data that’s produced and the more people interacting with it, the more opportunities for bad actors,” says Mr. Mooneyhan. “We have a really strong security policy and regimen that we follow, a very robust, tight and stringent security and risk assessment process when we’re evaluating a new technology or analytics platform. We don’t deploy anything unless it meets the criteria in that security risk assessment.”

ASCs that aren’t part of larger organizations like AMSURG can look to vendors and IT firms for help in this endeavor. Those that aren’t at risk of falling behind, says Mr. Mooneyhan. “If you really want to drive meaningful growth and provide a strong value proposition for physicians to want to bring their procedures to your center, you need to be thinking of your data strategy and your data architecture,” he says. “Having data to track the patient experience so you can improve it is critical, too. That’s how you will grow over time. It’s past time to invest. Data has an extraordinary amount of power to help bring positive change to physician, clinician and nonclinical staff burnout, and to improve patient care and experience.” OSM