Healthcare Benchmarking Platform Using Anonymized Data Mediation
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Solution Overview
Problem
Conventional hospital performance ranking systems are limited by relying on publicly available data, such as Medicare and Medicaid claims, and cannot access raw data from hospital systems, leading to incomplete patient data and inability to isolate actionable steps for underperforming hospitals to improve their financial and clinical performance.
Innovation Solution
A system that imports anonymized patient and financial data from hospital software applications to generate a Performance Index, allowing hospitals to benchmark themselves, identify peer groups, and receive actionable recommendations for improving key performance metrics through automated ordering of drugs and supplies.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of information
If hospitals use publicly available Medicare and Medicaid claims data for performance ranking, then hospital comparisons can be made at a high level, but detailed actionable information about specific cost and clinical function differences between hospitals is not accessible
Solution Approach 1:
The patent introduces an intermediary system (the healthcare data platform) that mediates between hospitals' internal data systems and external users. This platform anonymizes and aggregates detailed cost, operational, and clinical data from multiple hospitals, making it accessible for benchmarking while protecting individual hospital proprietary information. The intermediary transforms raw internal data into actionable comparative insights without requiring direct access to individual hospital systems.
Solution Approach 2:
The system creates anonymized copies of hospital data that preserve the structural and relational information needed for benchmarking while removing identifying details. These synthetic data copies allow underperforming hospitals to analyze and compare against best practices from top-performing hospitals without exposing sensitive operational secrets or proprietary information from the source hospitals.
2Measurement precision
If hospitals rely on claims-based performance indicators, then some approximation of quality of care and financial health can be measured, but the ability to perform detailed comparative analytics is limited
Solution Approach 1:
The patent merges multiple data sources and data types (cost data, operational data, clinical outcomes) into a unified benchmarking framework. By combining these previously siloed information streams, the system enables comprehensive comparative analytics that simultaneously measure financial performance, operational efficiency, and clinical quality with high precision and broad versatility.
Solution Approach 2:
The benchmarking platform is designed as a universal system that can measure and compare multiple dimensions of hospital performance (financial, operational, clinical) across different hospital types and specialties. The system adapts to various healthcare settings and can be configured to benchmark against appropriate peer groups, providing both precision in measurement and versatility in application.
3Ease of operation
If underperforming hospitals cannot access detailed information from better performing hospitals, then data privacy is maintained, but the ability to make specific changes to improve financial, operational, or clinical performance is hindered
Solution Approach 1:
The system applies local quality by providing customized, targeted benchmarking information to each underperforming hospital based on its specific deficiencies and peer group comparisons. Rather than providing generic data, the platform delivers localized insights about specific cost drivers, operational processes, and clinical functions where improvement opportunities exist, making the performance improvement process more actionable and efficient.
Data Source
AI summary
The example embodiments may relate to retrieving a plurality of cost of care records identifying costs to treat a plurality of patients diagnosed with a particular ailment, wherein each of the cost of care records indicates a cost to treat one of the patients using a selected one of a plurality of treatment modalities, wherein each of the treatment modalities identifies at least one of a drug and a supply item. The example embodiments may further relate to processing the cost of care records for determining at least one factor for each of the treatment modalities, determining a performance index for each of the treatment modalities that is a weighted function of the at least one factor, selecting one of the treatment modalities based on the performance indices, and automatically ordering at least one of a drug and a supply item identified in the selected treatment modality for delivery to a health care provider.