Data-Driven Healthcare: Boosting Efficiency and Patient Care with Predictive Analytics

In the highly competitive healthcare industry, optimizing operational efficiency and enhancing patient care are paramount. A leading healthcare provider in the APAC region, known for running one of the largest hospital chains, faced a significant challenge: a drop in inpatient volumes coupled with rising operating costs. The solution lay in innovative digital transformation, spearheaded by Cigniti’s Patient Revenue Intelligent Maximizer Engine, which ultimately led to a remarkable increase in outpatient (OP) to inpatient (IP) conversion rates.

The Need for Change

The hospital chain was experiencing a troubling trend: patients were increasingly getting prescribed tests done outside the hospital, which negatively impacted the hospital’s revenue cycle. This low percentage of OP to IP conversions posed a challenge to creating long-lasting improvements in their revenue cycle management.

Recognizing the dual opportunity to enhance patient care and increase conversion rates, the Chief Information Officer (CIO) identified a need for a system that could anticipate patient demand and predict, in real-time, the probability of patients opting for external tests.

The aim was to leverage information flow across crucial areas like patient access, interactions, and billing to make informed decisions and provide timely interventions.

The Partnership with Cigniti

To address these challenges, the hospital partnered with Cigniti. Cigniti’s task was to devise a Patient Revenue Intelligent Maximizer engine. This engine was designed to configure real-time patient data and share insights with hospital management, enabling them to predict and influence patient behavior effectively.

The Approach

Cigniti’s team collaborated closely with the healthcare provider to develop the engine, integrating various data points such as patients’ location, surrounding weather, health status, and distance from residence. This data was crucial in predicting the likelihood of patients getting tests done outside the hospital.

The engine’s “action layer” played a pivotal role by sending personalized messages to patients. These messages informed patients about the in-house testing facilities at optimal times, helping them make better-informed decisions about their care.

Achievements and Impact

The implementation of the Patient Revenue Intelligent Maximizer Engine yielded impressive results:

• Increase in Conversion Rates: By analyzing patient data and predicting those likely to opt for external services, Cigniti’s team could target these patients with personalized messages. This strategic intervention led to an increase in conversion rates from outpatient to inpatient services.
• Reduction in Cost to Collect: Automation efficiencies enabled by the engine allowed for better allocation of staff to higher-value activities. This reduction in manual intervention and enhanced efficiency led to a significant decrease in costs.
• Reduction in Denials: The engine provided an efficient dashboard for standard data on patient intake, prescription filling, and updates. This comprehensive data support reduced the number of denials by 50%.
• Reduction in Bad Debts: By closely scrutinizing each patient’s condition and urgency for tests, the hospital could engage patients early, enabling them to track, verify, and undertake necessary tests in a timely manner. This proactive approach reduced the bad debts by 25%.
• Customer Data Analytics: The engine’s ability to extract and consolidate information across all departments provided a 360° view of each patient. This holistic perspective enhanced critical health and financial decision-making, ensuring the best outcomes for patients.

Conclusion

The partnership between the healthcare provider and Cigniti is a testament to the transformative power of digital engineering and predictive analytics in the healthcare sector. The Patient Revenue Intelligent Maximizer Engine not only enhanced operational efficiency and patient care but also significantly improved the hospital’s revenue cycle. This case study highlights the potential of technology to address complex challenges in healthcare, driving better outcomes for both patients and providers.

Cigniti’s innovative approach and successful implementation have set a new standard for healthcare providers looking to optimize their operations and improve patient outcomes through intelligent data-driven solutions.