The Role of Operations Platforms in Enabling Growth and Driving Revenue
Introduction
Today’s healthcare leaders are faced with challenges at a macro level that range from finding ways to drive revenue maintaining service levels, managing demand for value-based care, and attracting new patients while navigating new innovations and evolving care models.
At the same time, health systems need to manage the complex care access, delivery, and transition challenges that have emerged due to several factors—including growing demand on services, mergers and acquisitions, and changing reimbursement models. This means coordinating care across the entire care continuum which is one of the most important challenges facing health systems today.
Operations Platforms have emerged as the cornerstone of a health system’s organizational and digital strategy, providing centralization, operational alignment, and shared situational awareness to workflow, patient flow, and capacity management.
When Operations Platforms are used in partnership with an EMR, significant value and outcomes emerge – including, improved efficiency, increased revenue, and enhanced patient safety and satisfaction. These benefits make the concept of a Boundaryless Healthcare model a reality, where disconnected networks are connected through selective shared visibility, operationalizing a true market ecosystem of care. In fact, Operations Platforms play an important role in addressing the more than $275 billion of operational waste in healthcare through the logistical organization and optimization of resources, patient flow, and workflows.
The First Step Starts with Data Insights
There is tremendous power in data—and when it’s accessible and visible it provides the foundation for process improvements that lead to best-in-class patient care. Every health system needs to know where their patient referrals come from and how many they are receiving. They also need to know how they can accelerate the transfer and discharge process to accept more new patients, in addition to being able to monitor how patients are moving through the system—and if they are satisfied. With the right solutions and leadership, it’s possible to reduce patient wait times to under 90 minutes, achieve 85% on-time starts, and optimize room turnover to 25 minutes or less.
Data also creates enhanced visibility, so health systems have insight into their true market network, owned, affiliated, and non-affiliated facilities—breaking down barriers and evolving into a Boundaryless Healthcare system.
Finally, data makes it possible to effectively automate operational workflows and tasks—reclaiming precious clinical time so staff can focus on delivering care to patients.
With the right solutions, it’s possible to reduce patient wait times to under 90 minutes, achieve 85% on-time starts, and optimize room turnover to 25 minutes or less.
Centralize Operations, Streamline Workflows and Generate Growth
Enterprise data makes it possible to start streamlining the patient inflow process—creating visibility into the entire referral network to increase referrals and reduce leakage. By having visibility to your system’s beds, it’s possible to manage capacity and workflows to enable your organization to accept more patients and ensure patients are placed in the right bed, with the right resources, the first time.
By centralizing operations, the patient journey becomes seamless, connecting care across a network, regardless of affiliation and EMR.
This centralization also means solving for common challenges, including hospital-centric placement, capacity management, department referral and direct admit management, behavioral health management, limited visibility into capacity, ED-to-ED relationship referrals, and collaboration with the health system as a whole.
Furthermore, centralizing operations makes it possible to optimize growth opportunities by launching Clinical Command Center Operations, Transfer Center Operations, innovation on-demand, and data supported decision making. These tools make it possible to automate and enhance workflows to drive productivity by efficiently managing the integrated phases of care and improving the patient experience. It also lends visibility to owned, affiliated and non affiliated facilities.
Understanding the Role of an Operations Platform in Healthcare
Digital transformation requires strong executive leadership and engagement. This level of leadership support creates a foundation for success. Leaders play an essential role in driving adoption and communicating the benefits of Operations Platfoms, and the role they play alongside other health IT systems.
- Operations Platforms break down silos, enable situational awareness, and provide the operational foresight to drive long-term improvements. The central tenet is getting the right patient to the right facility, at the right time, by the right mode of transport at the start of their care journey.
- Operations Platforms help manage patient throughput including inbound, within the hospital, and outbound patients moving to the next phase of care.
- Operations Platforms leverage the expertise of health care professionals who have an essential combination of critical thinking and clinical skills—and consequently can make rapid, effective decisions around patient care.
- Operations Platforms provide consistent clinical protocols, along with an enterprise-level view of all available beds—leading to consistent and precise patient placement.
- Operations Platforms generate real-time and historical data, providing the hindsight that helps drive accountability and collaboration across the organization; insight and the ability to track and measure performance goals consistently and in a central location; and the foresight to implement process standardization and departmental benchmarking.
- Operations Platforms help achieve a balance between capacity and utilization, and between strained tertiary facilities and under-utilized community facilities. As a result, health systems can optimize growth and revenue opportunities through improved communication, reduced wait times, and increased access to care.
Why Operations Platforms are Mission Critical in Healthcare
A Deloitte Insights article, Integrating Digital Health Tools to Help Improve the Whole Consumer Experience, outlines the priorities facing healthcare leaders today, including:
- Strategy and governance – the ability to clearly define a formal, comprehensive digitally enabled care delivery vision that engages and aligns leadership through enterprise governance structures with clear decision rights.
- Business model – existence of structures and processes that enable digital health’s financial viability, regulatory compliance, organizational advancement and, asset efficiency.
- Customer experience and engagement – foundation that offers a differentiated care and well-being experience, supported by education and marketing of a clear value proposition to promote members utilization of services, feedback, retention, and improved outcomes.
These are just a few of the reasons why an Operations Platform makes sense for healthcare leaders it provides a holistic operational overview that makes it possible to respond quickly to ever-changing conditions and make the data driven decisions that drive efficiency and increase revenue.
The ability to make these decisions confidently based on data is more important than ever—according to Becker’s Healthcare, 19 hospitals and emergency departments have already closed in 2024 due to high costs and shifts in care needs and 50 hospitals and health systems are cutting jobs.
At the CEO level, an Operations Platform enables immediate feedback by implementing systems, controls, and feedback loops. CEOs can see the services that are growing, which ones are right-sized, and what services can be transitioned to alternative points of care [outpatient imaging]. With enhanced visibility, the platform provides objective data indicating if the system is meeting, exceeding, or is off target with core metrics.
At the COO level, an Operations Platform provides transparency, visibility and access to real-time demand for care. It solves cross-functional problems—resulting in fewer calls related to operational issues, happier physicians, strong workforce retention and enhanced ROI due to the efficient use of space and effective processes.
Across the board, an Operations Platform provides improved strategic planning—enabling the identification of qualified patients; planning for near-term and long-term capacity and staffing; gaining visibility into performance versus plan; delivering favorable outcomes; facilitating transitions of care to a full range of post-acute options; and ensuring caregivers are appropriately involved in post-acute care planning and tracking.
How an Operations Platform Complements an EMR—Breaking Down Silos and Creating a Boundaryless Healthcare Model
Healthcare is a lifelong journey, with patient needs that continuously evolve and health systems that must adapt. As health systems become the ecosystem supporting this journey, it is more essential than ever to optimize every component—from admission to referral, discharge, and beyond to ancillary and supportive services.
While the EMR provides a critical means of capturing patient data, it lacks the robust capabilities needed to manage enterprise-wide operations, workflows, and capacity on a large scale.
Operations Platforms fill this essential gap by addressing operational needs and integrating care settings that are often fragmented. These settings span owned facilities (acute, ambulatory, post-acute, urgent care), affiliated sites (physician practices, ambulatory, post-acute, long-term care centers), and non-affiliated locations (physician practices, post-acute care, urgent care, hospital-at-home, and acute care). This level of connection fosters expanded partnerships and growth opportunities, creating a dynamic and profitable healthcare ecosystem.
I think operational efficiency and growth work in tandem with each other. So yes, growth is an important driver, but if we’re not maximizing operational efficiency, then we’re just layering on complexity into the organization where a future acquisition would fail or be more challenging than it needs to be.
Chief Executive Officer, Large Health System
Creating the “Green Ocean” with an Operational Complement to the EMR
The Green Ocean is a way of working alongside and complementing the EMR, providing a necessary foundation of actionable data and analytics that supports the EMRs core billing and patient data capabilities. An Operations Platform works alongside and complements the EMR, fully integrating workflows with the clinical documentation that helps improve capacity planning by reducing operational bottlenecks and using predictive analytics to help determine demand and therefore better plan for staffing needs.
By centralizing access to the operational data, it’s possible to create the enterprise-wide situational awareness necessary to grow patient volume through increased acceptance of transfers and referrals—leading to effective load balancing across the entire health system. And by understanding where patients come from, and where they’re going with this operational layer, it’s possible to enhance proactive planning, including appropriate staffing, referral optimization, automation of patient flow and discharge processes and the operational resilience not possible with an EMR alone.
What sets an Operations Platform apart is its ability to span multiple EMRs across the enterprise, extending connectivity beyond the limits of a closed EMR system. Unlike EMRs, which often lack deployment across all owned entities, affiliates, and especially referring and transfer partners, an Operations Platform unifies these disparate areas. It automates processes beyond EMR capabilities, creating a ‘Green Ocean’ of actionable data and analytics that drive both efficiency and growth. Furthermore, while EMRs activate only after a patient enters the system, an Operations Platform enhances growth by increasing the quantity and quality of referrals well before patient entry.
Capabilities of an Effective Operations Platform
The benefit of this operational evolution is that it is possible to expand the platform to meet the needs of a health system as it grows and expands. These solutions are customizable and makes it possible to meet you where you are in your digital journey, with capabilities that include:
- Shared Situational Awareness (Data Insights) enables real-time, system-wide patient and healthcare analytics visualization across the enterprise, pulling data, maximizing algorithms, and delivering insights through engaging dashboards that support informed patient flow decisions.
- Census Trend Analysis creates workflow efficiency by identifying and recapturing hidden capacity. As part of an enterprise-wide system, it enables health systems to manage capacity, coordinate patient care, automate flow, and improve asset utilization, allowing providers to focus on what matters most—patients.
- Automated Capacity Verification take care directly to the patient by managing care for patients being treated outside a health system.
- Accelerated Access
- ED Demand & Flow
- Physical and Staffed Census Trend Analysis
- Predictive Admissions
- Prescriptive Placement
- Flexible Insights – Length of Stay, Task Management, etc.
- Planned Discharge Progression Visibility
- Load Balancing (Virtual Care Support) maximizes the utilization of available beds and services within a health system, such as placing a patient in a community hospital instead of a level one trauma center when appropriate.
- Predictive Discharges (And Automated Discharges)—eliminate the labor-intensive and manual task-related inefficiencies within the hospital, increase efficiency and open beds to new patients.
- Selective Interoperability – Developed Shared Visibility with Regional Partners
- Connected Workflows – Integrated Global, Staff & Resource Management (All things movement)
- Virtual Operations – Manage Patients Outside of Your Health System
The Role of a Measurable ROI in Decision Making
A Deloitte. study, Quantifying the Value of Digital Transformation in Health Care, supports the importance of integrating technology effectively into healthcare, stating, “Pursuing digital transformations, with a clear road map and strategy for the future, is essential for continued growth and future-proofing of health care businesses. However, identifying where to invest with limited capital across one or multiple transformation pillars—Products, Services, and Experiences; Digital Enterprise; and Digital Core—can be complicated if impact is hard to quantify. A framework that identifies how digital initiatives can lead to business value as well as a database of benchmarks that provides ways to quantify can support the buy-in organizations need for digital investment.”
Conclusion
Just as every health system has an electronic medical record for clinical documentation, they also need an Operations Platform as a complement to automate workflows and generate actionable data to address bottlenecks before they occur.
An Operations Platform provides interoperability between acute, non-acute, affiliated, and non-affiliated facilities, allowing health systems to optimize access to care, streamline care delivery, and connect transitions of care that improve the patient experience.
Finally, by bringing together leadership, operations, clinical, technology, finance and all system-wide departments and keeping them engaged and aligned, the result is a successful implementation and sustained progress, ultimately leading to improved outcomes and greater patient satisfaction.