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Kyruus Blog

The Patient Access Paradox

Why is that we as patients are told to wait weeks, if not months, to see a physician, when in fact many provider organizations are only operating at 50-60% capacity?

Our nation's healthcare system suffers from a mismatch between patient demand and provider supply, something that we refer to as the "Patient Access Paradox". Almost everyone has had a personal experience with the problem of long appointment wait times, which range between 3 and 30 weeks across the country for both primary and specialist care. Yet at the same time, our hospital clients experience as low as 50-60% physician productivity, struggling to "unlock" the capacity that is buried somewhere in their provider networks.

Topics: Information Access Physician Referrals capacity management nurse practitioners physician shortage patient access paradox doctors appointments Big Data Physician Network Strategy Hospitals Patient Access

Constant Medical Practice For Better Patient Access

Thanks to their star player, Johns Hopkins’ pancreatic surgical team has a batting average of .980. This is no small feat.

Topics: Information Access Physician Referrals Physicians Referral Management Big Data kyruus outpatient volumes Patient Access

Docs in Translation: How Clinical Fluency and Volumes Affect Outcomes

This post was written by Dr. Lara Terry, Kyruus' Medical Director

Rapidly advancing technology is enabling the production and consumption of healthcare data in a way not previously possible. With so much at stake in medicine, can Big Data help us decide on the “right” doctor to meet our medical needs?

Topics: Physicians Analytics Data Big Data patient experience kyruus Hospitals

Can’t Get No (Referral) Satisfaction

In the event of a medical illness, we all want to feel that we will get to the “right” doctor – someone expert in diagnosing and treating our specific condition using the best and latest in medical knowledge. Not surprisingly, there is a large and growing body of evidence suggesting that the “right” doctor for a given patient is the one with the appropriate training and clinical experience in that patient’s condition. This is particularly true in specialist care where procedures are more common and conditions more narrowly defined.

Topics: Information Access Physician Referrals Referral Analytics Physicians referral misdirection Referral Management Big Data kyruus Hospitals Patient Access

A Patient A Day Keeps the Doctor In Play

[Originally posted on O'Reilly Strata Blog]

Topics: Physician Referrals Physicians Big Data Concept Posts Hospitals

Kyruus to speak at Hospital & Physician Relations Conference with Dr. Michael Nochomovitz of University Hospitals

Oct 13-15: Hospital & Physicians Relations Summit (Scottsdale, AZ)
Kyruus Chief Product Officer, Julie Yoo, to speak with Dr. Michael Nochomovitz, President of University Hospitals Physician Services, on "Bridging Patients & Physicians With Big Data"

Topics: Hospital Executives Analytics Event News Referral Management Conferences Big Data Network Development Patient Access

Kyruus CTO to Speak at Brigham & Women's iHub Inaugural Hackathon

September 20-22, Boston, MA
Brigham & Women's Hospital iHub Hackathon
In partnership with MIT H@cking Medicine
http://disruptingmedicine.org/events/hackathon/

Topics: Event News Big Data

Kyruus CTO, Vinay Seth Mohta, to speak at StrataRx

"Are you Visiting the Right Doctor?

Topics: ProviderMatch Event News Referral Management Conferences Big Data Patient Access

Healthcare Innovators on Innovation

Kyruus CEO Graham Gardner amongst the healthcare innovators interviewed for this video.

Topics: Event Big Data Videos

PPSA's Final Ruling is Here: Now What?

This interpretation was written by Leon Goldman, Kyruus' Chief Privacy Officer and former Chief Compliance Officer at Beth Israel Deaconess Medical Center

The final rule of the Physician Payment Sunshine Act, commonly called “PPSA”, has been published in the Federal Register as of today, February 8, 2013. Anxiously awaited by the healthcare industry and the public alike, the final ruling means applicable manufacturers and group purchasing organizations will be frantically reviewing it, trying to ensure their organization’s processes and systems are ready and able to report the data to CMS by the deadline of March 31, 2014.

While there is anxious activity among the manufactures and GPOs, it is certainly less clear to hospitals and physicians what the PPSA will mean to them, and what exactly they need to be doing to prepare. Aside from providing the opportunity to review the data posted about them, PPSA does not place any statutory obligations on hospitals or physicians - it will, however, reveal a great deal of information about them to the public.

The process by which hospitals have monitored financial relationships with industry has long relied on individual disclosure, either on an annual or transactional basis triggered by specific events, such as seeking permission to perform research studies. Proactive review of publicly available information has not been part of standard review for most institutions - often because the perceived benefit of implementing such a process has not outweighed the cost of review, in both dollars and time. PPSA mandates not only the collection of a vast amount of information about “covered recipients” but also the creation of a vast database that must be downloadable, easily searchable, and aggregated. How and to what extent this will actually change the playing field is yet to be known.

This database will provide (relatively) easy access to vast amounts of information to the public, regulators, or the media for the first time. While some information is already available today via select states reporting and approximately 50 companies currently disclosing, PPSA will significantly increase the amount of information available to the public. We project the following:

  • Over 3 million public industry payment disclosures amounting to over $4 billion
  • Over 700,000 healthcare professionals indicated with public industry payment disclosures
  • Over 1,500 companies disclosing payments

At Kyruus, we have little doubt that agencies, such as the National Institutes of Health, will use the information as a way to “verify” what they are told by their applicants. The media, too, will see the data as an interesting source of information for investigative reporting. Lastly, individual patients and families will likely use the data to become more informed about their physicians and the relationships those physicians have with industry. Given all who will likely use the data, it behooves hospitals and covered recipients to be aware of the data.

Nevertheless, the presence of such a database will not relieve institutions of the need to gather information on their own as they have been doing up to this point. Factors for consideration:

  1. The annual posting of the data may not provide adequate information for organizations to fulfill their transactional obligations for events such as accepting payment from PHS for funded research.
  2. The PPSA database will contain nothing about non-physicians receiving payments or transfers of value about which the organizational policies require disclosure.
  3. There may be payments to physicians that need to be disclosed under an organization's policies, but which are exempt from reporting under the PPSA and can only be discovered through an active disclosure process.
  4. Consolidation of reporting by manufactures may make the information that is reported less useful to the institution for their assessment need. Again - the institution will need to continue to monitor data internally to understand what PPSA will mean for them, and what they need to do.

Kyruus believes that best practices will move organizations to develop policies and procedures that actively collect disclosure information from affected individuals and actively monitor publicly available information. This allows organizations to be in control of the information, to reconcile discrepancies, identify and eliminate problem areas, and to respond quickly to both public and regulatory inquiries.

Topics: Life Sciences Physicians Big Data Hospitals