When doing “the right thing” for the patient also contributes to the provider’s bottom line, we make a significant contribution toward the ultimate goals of improved quality, reduced costs, and desired outcomes. Through our data analytics expertise, BSGA will be a clinical and efficiency intelligence partner that helps you use your data streams to reveal insights to develop the analytics and informatics solutions you need to improve and manage the health care of your population.
The following represents a number of specific and identifiable milestones for success in our data analytics approach. Key components of a successful methodology:
• Determine the report analytics portfolio
• Identify appropriate variations and the opportunities for improvement
• Identify the appropriate data elements that must be collected and measured from both clinical and financial/
• Integrate multiple data sources using best-practice data management and validation
• Create an interactive data platform that can be accessed by clients
• Deploy accurate analysis tools that produce actionable knowledge
• Produce both retrospective and prospective analytics
• Develop business intelligence data mining and reporting methods that allow multi-user functionality
• Provide a single-source solution for clinicians, operations, financial, and business development teams
The key to our approach is identifying performance improvement opportunities that are:
1. Valuable: Would acting on the data demonstrably improve outcomes and value?
2. Credible: Does the opportunity have a significant enough return to warrant the investment to act?
3. Manageable: Do we have the tools and processes in place to have the impact we desire?
BSGA is a licensed user of the Optum Symmetry Suite of solutions that allows us to better understand and manage clinical resources, assess risk, measure quality, and conduct predictive modeling through an integrated platform and consistent methodology. These analytics are core to BSGA’s ability to help health systems improve their clinical and financial performance. We include the following tools in our analysis:
1. Symmetry Episode Treatment Groups
Optum™ Symmetry® Episode Treatment Group® (ETG) is an episode grouper for medical and pharmacy claims.
It provides a condition classification methodology that combines related services into medically relevant and distinct units describing complete and severity-adjusted episodes of care and associated costs. ETGs can be used in diverse applications integral to the success of clinicians, managed care organizations, health care plans, and administrators.
2. Symmetry EBM Connect - Connect evidence-based medicine to claims data
Optum™ Symmetry® EBM Connect® is decision-support software that compares medical and pharmacy claim, lab result, and enrollment data with evidence-based best practices for clinical conditions and preventive
measures. EBM Connect helps assess patient compliance with proven evidence-based treatment standards.
3. Symmetry Episode Risk Groups - Predict future health care utilization
Optum™ Symmetry® Episode Risk Group® (ERG) is a risk-assessment solution that predicts current and future health care usage for individuals and groups. Episode Risk Groups creates individual risk measures that incorporate episodes-of-care methodology, medical pharmacy claims information, and demographic variables. There are four different risk analytics produced – retrospective, prospective, demographic and underwriting risk.
4. Symmetry Pharmacy Risk Groups - Understand and measure patient health
Optum™ Symmetry® Risk Groups® (PRG) is pharmacy-based health risk-assessment software that uses prescription data and proprietary classification systems to help providers and organizations better understand and measure population health risk.
5. Symmetry Procedure Episode Groups - Evaluate clinical specialty performance
An effective way to measure the performance of surgical procedures, workup, and post-procedural services.
QlikView (“QV”) Business Discovery Platform
Once a customer’s data is analyzed with Symmetry, BSGA publishes the data in QlikView (QV). QV allows easy access to the customer’s data both for BSGA analysts and/or customer’s analysts. QV takes complex health care data and allows users to easily navigate and conduct analysis of the data. BSGA builds QV applications for each of its customers so BSGA can work directly with customers to create the analytics they need quickly.
BSGA analyzes multiple databases and uses a variety of analytical tools in order to provide customers with a more complete look at their situation in order to identify actions that can improve their clinical and financial position.