Tea Buzz



Announcing the Addition of Pediatric Claims Data to Physicianology

Posted June 18, 2018

If you’re a business development professional for a pediatric clinic or children’s hospital, your marketing approach likely isn’t the same as your counterparts’. Most pediatric encounters don’t come from people who’ve Googled your name and services or walked in off the street. The majority of visits to organizations such as yours are the result of a direct referral from another doctor. Rarely do patients go straight to a children’s hospital without being referred there from somewhere else.

You don’t necessarily need to market to consumers, but if you’re in a competitive market, you need to know your market – and that of your competitors’ – and reach out further. You need to market to the physicians, not the patients. In order to better know your market and your competitors, you need data.

Despite ongoing data security challenges, consumer data is now more prevalent and more important to the healthcare industry than ever before. The need for data-driven strategies to increase consumer engagement is also rising. While all healthcare data sets are sensitive and must be handled with care, there is one data set in particular that has been the most difficult to access and utilize – the pediatric data set.

Pediatric data needs to be handled more securely because it’s comprised of data on minors. Previously, pediatric data was not shared as equally as other data sets due to its highly-sensitive nature.

Until now.

Recently, more payers have been willing to share their pediatric claims data, and Tea Leaves Health has been able to access it for use in the Physicianology™ application. This makes Tea Leaves Health the first (and currently only) physician engagement vendor to have access to previously unattainable pediatric claims data. Not only are we the first to have the data, but we are the first to have it for not just inpatient, but also outpatient and all other care settings, as we do with our adult data sets.

Many organizations use a PRM solution to find out what workload is being sent to physicians outside of their system. Claims data is extremely valuable when trying to understand referral patterns. It’s hard to gauge the referral patterns of pediatricians or children’s hospital physicians without the claims data.

Currently, our platform contains data for the Pediatric Cardiology service line. We partnered with one of our clients to review this data, and in the near future we will also be receiving data for the Oncology, Neurology and Neonatal Intensive Care service lines. Our pediatric claims data is compiled using claims by age (<18) and procedure. This will allow you to search the data for a number of different use cases, similar to the one below.

Pediatric Data in Action

One of our client partners has a children’s hospital in the Southeast. It was suspected that physicians in neighboring cities were sending their pediatric patients to a large city instead of the client’s hospital, where similar services were available and closer to the patients’ homes. The client asked Tea Leaves Health to find all the pediatricians in specific areas of their market that were bypassing the client and going to another city.

Using the pediatric claims data, we were able to provide our client a list of all the physicians that are bypassing them and sending patients outside of the area. Equipped with this information, the client’s liaison team visited those doctors to educate them on procedures offered, quality outcomes, specialist information, etc. We continue to monitor the outcomes, but the goal is to increase awareness of services offered, so the patient can receive excellent care, closer to home.

The situation above is only one example of the many ways you can use pediatric claims data for strategic growth. To find out more, contact our Physicianology experts.