Clinical Data Analysis

 

The delivery of healthcare is increasingly complex with ongoing changes to regulatory requirements, reimbursement methodologies, technology expansion and the exponential growth of data generated from a myriad of sources including devices, both provider and consumer driven. To understand and interpret the data, one must understand medicine – the delivery of healthcare throughout the continuum of health – and, reimbursement for these services provided by physicians, professionals, and organizations.

   

The expertise and value I bring to clinical data analysis is with a focus on these core principles:

• Understand and convey the importance that data analysis provides using clinical and claims data. For example: using claims data from several providers can provide a clinical understanding of the individual patient’s medical condition that would otherwise require a manual review of multiple records or systems.

• Analyze data noting that outcomes can affect populations beyond the local level to the national and international level of healthcare. For example: the impact of individuals traveling internationally demonstrating similar symptoms validates further research of the individuals and the environment.

• Respect that each person working in healthcare is a valuable resource and should be accurately and timely reimbursed.

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Unique skills I bring to Clinical Data Analysis:

• Understand and communicate the language of medicine distinct to healthcare.

• Registered nurse with experience in inpatient acute care and the business of healthcare: Information Technology, Governance of Information, relationship of Informatics to data, and scope of Managed Care.

• Understand life cycle of billing for services from submitted claims to reimbursement of services.

• Appreciate current and emerging themes and the impact to Clinical Data Analysis: use of Artificial Intelligence, Cloud Technology, Clinical Terminologies (SNOMED CT), ICD-11, IoT (Internet of Things)

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Claims Analysis and Processing | Reimbursement

 

TE-AR Healthcare has extensive experience in the claims life-cycle, claims adjudication and processes, and claims data analysis. A flawless claims process affords the opportunity to accurately and timely adjudicate claims, as well as, capture data for advanced analytics. Analyzing claims data, along with discerning knowledge of patient care, we provide a unique picture of both the patient and the healthcare provider.

 

Connect with us for your claims’ adjudication and data analysis. Specialties include: accurate and timely process claims, enhance adjudication process, perform annual code updates [ICD-10, CPT, HCPCS] and collaborate with stakeholders to reduce cost and rework. 

 

 

Health Informatics

 

Informatics is the “science of information.” Through the use of computers and other technologies – mobile devices, we are building on the data and technology to facilitate knowledge for the healthcare worker. Healthcare needs are unique in that the information is needed at myriad locations across the healthcare continuum at any one time. The discipline of informatics and the role of the Informaticist are in the position to satisfy this need.

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Recognizing the overarching importance of the Electronic Health Record to the healthcare delivery system, as well as, an individual’s healthy lifestyle, my focus is on these services.

 

Services unique to TE-AR Healthcare

• Liaison leading collaboration among clinicians, database developers, data scientists, financial and business teams to interpret and provide meaning to medical and health information.

• Assess data within EHR for accuracy across healthcare continuum.

• Visualize outcomes throughout implementations and provide input to influence integration.

• Support and implement industry standards for clinical data, terminology, & medical coding

• Integrate reimbursement initiatives with the delivery of healthcare and the practitioner.

 

 

Digital Ethics 

 

Digital ethics is the intersection of several domains and professions – medicine, law, technology – each with their own professional ethical principles, rules of conduct, and standards. Building on these traditional establishments will pose new challenges and obligations for ethics in our digital information age. Data generated by the practitioner and consumer – tracking mobile devices, as well as, the actions of IT developers, vendors, and system technicians pose much debate and require solutions in the near future.

 

In addition to questions on an individual level, society’s increasing globalization trends lead to other ethical challenges. The culture, values, history and religious beliefs from a diverse populace must be weighted with the development and practice of medicine on a local level. Ethical obligations extend not only to the delivery of health care, but throughout the health care continuum including, data collection, analysis, reporting and research.

 

Digital ethics is an emerging discipline; TE-AR Healthcare is positioned to devote resources to these challenges and resolve ethical data issues on the digital frontier.

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Peer review

 

TE-AR Healthcare provides advice and guidance for articles and documents in an ongoing review process with stakeholders. We maintain confidentiality of the documents and integrity throughout the process while highlighting strengths and weaknesses, as well as, impact to the organization both internally and in the market place.

 

We select documents in our areas of expertise: ICD-10, health informatics and data ethics, information management, diseases and care management, standards of care, and business requirements and processes. Contact us to:

 

• Speed up time to publication and distribution

• Reduce bias from internal players with impartial review

• Provide recommendations in line with the owner's objectives