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Healthcare BI and Analytics including Master Data Management, Targeted Analytics, Governance, Enterprise Data Strategy, and Data Assessment

Healthcare Benchmarking Part 2 of 2

In my last blog post, I introduced the fundamentals and importance of healthcare benchmarking. I highlighted the benefits of benchmarking as well as the advantages and disadvantages of various types of benchmarking. The main point I hope you took away wasHealthcare Benchmarking - Part 2 of 2 that regardless of the type of benchmarking, the purpose is the same – to help healthcare organizations identify ways to improve their overall performance.

Now that you are aware of what healthcare benchmarking is and why it is important, in this blog post, we will focus on the key steps to implementing an effective benchmarking project to begin reaping those benefits.

Benchmarking Process and Key Steps

It is not secret that a well thought out process is essential to the success of any major project. Implementing a benchmarking project is no different. Below are the key areas of focus to consider before undertaking any benchmarking initiative. I have derived many of the specifics using a variety of resources, such as Six Sigma, the Juran Model, etc., to provide further context around each step. You might say, I have taken the “best of the best” from each resource…coincidence, I think not.

Plan and Prepare
Identify Opportunities and Prioritize1 – Top management must decide which processes are critical to the success of the organization and select projects from these. Once a shortlist of processes to be bench-marked is ready, the processes need to be prioritized as per a predetermined set of criteria to fulfill the requirements of all customers (stakeholders), especially the end customer1.

Deciding the Benchmarking Organization1 - The next step in the process is to decide the organization whose processes will serve as the benchmark. The benchmark can be a single entity or a collective group of companies, which operate at optimal efficiency2. Information on their processes should be gathered from various sources and the most suitable organization selected1. It is always important to ensure that more detailed information about the selected organization will be accessible and that comparison with the organization’s process will be relevant and useful1.

Organize a Benchmarking Team – The most successful benchmarking projects involve a team approach3. The organization should leverage existing teams that may be involved in similar topics to those that are being bench-marked, if possible. In the event a new team needs to be created for a benchmarking project, The Joint Commission, suggests that the organization seek the following when building the team3:

  • Individuals closest to and most knowledgeable about the process or issues under investigation
  • Individuals critical to implementation of any potential changes
  • Individuals likely to be directly affected by any changes that result from a project
  • A respected and credible leader who has a broad knowledge base
  • An individual who has the authority to make decisions
  • Individuals with diverse knowledge base and strong analytical skills
  • Individuals familiar with benchmarking and how it can be used in performance improvement
  • Individuals who are skeptical, resistant or even opposed to certain ideas and who can service as sounding boards or provide alternative viewpoints.

Collect Data
This step is perhaps the most important, most difficult and most time consuming activity in the process1. It involves creating a plan for collecting data from selected targets, conducting site visits and creating a site visit report4. Many times the information on processes and procedures followed at another company are confidential, and it is not always easy to gather authentic information, even after making a planned and approved visit at another organization1. The preparation for collecting necessary information and documenting this information in a systematic way has to be carefully planned and executed.

Analyze Data
Validation and Normalization5 – The key activities here are the validation and normalization of data. Before any meaningful analysis can be performed, it’s essential that all data be validated to establish its accuracy and completeness. Some form of data normalization is usually required for direct comparisons to be made.

Identify Gaps5 – To be of value, the analysis must indicate the benchmarker’s strengths and weaknesses, determine (and, where possible, quantify) gaps between the benchmarker’s performance and the leaders’, and provide recommendations for the focus of performance improvement efforts. Based on this thorough analysis, an improved process(s) should be developed. Properly identifying the gaps will result in a clear picture of the organization’s processes in comparison with others within the business or industry.

Communicating Results – Communicating the benchmarking results and their implications to significant audiences in the organization and motivating them to carry out changes is vital4. It will result in a complete understanding by the target audiences of the necessity for changes in the processes involved and a desire to carry them out4. The communication must be delivered in a very clear, concise, and easily understood format via an appropriate medium5.

Implement
Create Goals - The project team’s next step is to set/revise goals for the improvement of the organization’s existing process, close the performance gap(s) identified in step 3 and create realistic and unambiguous new standards for the processes involved1&4. These goals can, and probably should, be stretch goals that will result in a process even better than the other organization’s best-in-class process1. Make sure management has approved and that all in the organization/business area understand.

Develop and Execute Action Plan1 - After the improved process and goals are accepted by all concerned or likely to be affected by it, a formal, detailed action plan is drawn with all key activities taken as inputs as well as the organization’s culture. The detailed action plan should carry the important things like a time line, individuals responsible for carrying out the tasks, any short-fall in the completion of tasks and what stretch targets are taken to compensate the short-falls. Those responsible should be committed enough to ensure that the tasks and assignments are completed on time.

Measure
Monitor Process – As with most projects, in order to reap the maximum benefits of the benchmarking process, a systematic evaluation should be carried out on a regular basis2. Senior management must be committed enough to ensure proper coordination of various activities, monitor the progress of implementation of the plan and work as a barrier-remover in the implementation process1. When the revised process is in place, a complete report has to be prepared, showing the benefits of the revised process compared with the expectations at the time of approval of the proposed revision of the process1.

Recalibrate as Necessary4- The organization needs to ensure it remains on the cutting edge by continuously evaluating the bench-marked practices and re-instituting the benchmarking process when necessary. This will prevent complacency by creating the habit of evaluating procedures to identify opportunities to improve.

Benchmarking is a very powerful performance improvement tool. However, it is vital to understand the basis behind it, follow a proven implementation methodology and gain organization-wide commitment to the cause. Benchmarking is critical for healthcare organizations to achieve and sustain the clinical effectiveness and operational performance they so desperately need.

Does your healthcare organization benchmark? Does the organization have a process that is followed similar to the aforementioned process? Has it proven successful?

Resources for this blog post:

  1. http://www.isixsigma.com/methodology/benchmarking/benchmarking-ten-practical-steps-review-points/
  2. http://www.tutorialspoint.com/management_concepts/benchmarking_process.htm
  3. http://books.google.com/books?id=2mQpVORlulEC&printsec=frontcover#v=onepage&q&f=false
  4. http://www.qualitydigest.com/feb/bench.html
  5. http://businessfinancemag.com/business-performance-management/7-steps-better-benchmarking-0

Reduce Hospital Re-admissions with Business Intelligence Tools

Steven Gregor, Microsoft Business Intelligence Consultant at Perficient,  has been working with a client to help reduce readmission rates, a key component of the Affordable Care Act. Often times healthcare organizations have a difficult time analyzing readmission data because it is located in multiple systems. The use of business intelligence tools allows data to be filtered and analyzed to help reduce re-admissions and improve quality of care.

One way to drive such a reduction strategy is to enable analysts and providers with business intelligence tools that put various re-admissions metrics at their fingertips.  Additional value is garnered when those metrics can be filtered, sliced, diced and compared against a number of useful dimensional attributes.  Developing and automating such tools helps business users avoid having to write monotonous queries, piece together disparate data from various sources, and manually compile things like month end readmission rates.

In his post, Steven explains the process he followed and the solutions implemented to help the client analyze their re-admissions data.  You can read his full post here.

Managing a Patient Experience Program with PressGaney

Greg Seeman, Lead Technical Consultant at Perficient, has been working closely with ProHealth Care in Waukesha, WI to bring their data warehouse online and integrate reporting within a Microsoft SharePoint  2013 BI system.

This would be the 2nd phase of this year-long project. On deck was the task of improving workflow through the Patient Experience program. The Patient Experience program is an internal program common to any healthcare system that focuses on patient satisfaction and quality. Surveys are a key component of the data gathering processes many healthcare institutions use to manage patient experience.

In his post, Greg explains the solution used to manage their data overload where they were spending countless hours downloading reports, creating spreadsheets and number crunching. You can read his full post here.

Healthcare Benchmarking – Part 1 of 2

I am an avid sports junkie. I literally wake up and fall asleep watching SportsCenter. Last month, while watching the NBA Finals (Go Spurs!), I concluded that sports and healthcare have a lot in common. Sport, is a “physical activity that is governed by a set of rules or customs and often engaged in competitively1.” If we simply swap out the words physical activity for medical practice(s) in the aforementioned definition, we would be describing today’s healthcare organization, no?

For me, the parallel of the two industries really lies in their competitive nature-seeking to be the best. The whole premise of sports is to encourage competition, to be the world’s best Healthcare Benchmarking - Part 1 of 2player, team, or country. Similarly, the healthcare industry encourages competition by seeking the best physician, practice, health system, equipment, outcomes, cost and efficiencies. However, you cannot be the best unless you know what “best” means. What is the threshold you are comparing yourself to in order to be called the best? What are the weaknesses that are holding you back from being the best?  What is the benchmark for best?

In sports it is a little easier to identify. For example, after six titles, five Most Valuable Player awards and 10 scoring titles, Michael Jordan is considered to be the best player of all time. He is the benchmark of greatness in the sport of basketball-he is what all other players aspire to be and what they evaluate themselves against. Unfortunately, in healthcare it is not as easy, as these types of statistics are not as readily available. However, in recent years, in an effort to help define and understand “best”, more and more healthcare organizations are finding value in benchmarking as a tool to assess their current thresholds and a way to improve their process and overall performance in an attempt to be the best.

In this blog post, you will be provided a general overview of benchmarking. In the next blog post we will take a closer look at the actual process of benchmarking. Read the rest of this post »

ACA’s Quality Rating System – An opportunity to gain market share

Starting in 2015 all issuers of Qualified Health Plans (QHPs) on the Healthcare Marketplace will need to provide Quality Rating System (QRS) measurements that will be aggregated and scored to provide consumers with a star rating for each product offered.

How many stars will you have?

How many stars will you have?

Although there are still details to be worked out by CMS, the required measures for the 2015 beta test are in place. All issuers that wish to continue providing QHPs on the Marketplace will need to provide the required measures. There are two different sets of measures included in the beta specifications.

The first is a set of clinical quality measurements that are mostly taken from the current NCQA HEDIS accreditation process. Many issuers already collect the data for these measures; especially, if they are meeting the requirement to be accredited for the Marketplace today and are using NCQA for that process.

The second is set of measures derived from an enrollee satisfaction survey (ESS) that needs to be performed by an accredited third party survey vendor. Most of the questions in the ESS are drawn from CAHPS. The survey processes requires that a sample of data is drawn, audited by a third party and provided to the survey vendor. The vendor then performs the survey and reports the results to CMS. Questions focus on rating an enrollee’s satisfaction with a plan over a six month period.

While the QRS initiative driven by the ACA attempts to provide transparency, it also creates a competitive market that will force issuers to look at ways to increase the quality of care and enrollee satisfaction to deliver better scores. The prize? For consumers, better products. For issuers, a larger share of the market.

Want to participate and win? Then you need a solution that not only provides the required measures, but also provides insight and the ability to drive quality improvements. This can be accomplished with a well thought out solution architecture that provides processes for delivering the measures and the means for analyzing data to drive improvements.

Healthcare Embraces the Cloud

Liza Sisler, Director at Perficient, recently wrote a blog post about the incredible growth of cloud based services by healthcare organizations:

 “Nearly all cloud adopters plan to expand their cloud services; areas for growth include archived data, disaster recovery and hosting operational applications and data”.   

“The top three reasons for adopting cloud services include lower maintenance costs, speed of deployment and lack of internal staffing resources. The survey shows a positive growth outlook for cloud services as almost all healthcare organizations currently using cloud services plan to expand their use of these tools.”

With healthcare organizations traditionally being slower to adopt cloud based options due to security concerns, this study shows the changing landscape for payers and providers. You can read the full blog post and view an infographic on cloud adoption in healthcare here.

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Patients Shopping for Quality and Value

Data from a recent study by the Employee Benefit Research Institute shows that individuals enrolled in high-deductible health plans are more likely to behave like consumers and seek data on price and quality before receiving care.1 This, combined with the effects of the Affordable Care Act, where trends are reflecting that more than 80% of individuals enrolled in exchange plans chose high cost sharing plans, are turning patients into consumers.2

Patients shopping for quality and valueThe high-deductible health plans are reinforcing the need to provide accurate pricing and quality data to patient shoppers as well as the need for provider organizations to understand service line margin to be able to adjust their service offerings accordingly.

My colleague Melody Smith Jones, @MelSmithJones, recently wrote about this in her blog post, What the Market Says You Need in Your Patient Portal.

“The forward-thinking strategists in healthcare organizations nationwide should have their sites on the marketplace horizon.”

I invite you to read Melody’s entire blog for more about what features the market is demanding, but I would like to focus on the last item in her list: “Integration of clinical and financial data”… Read the rest of this post »

Understanding the Value of Care – It’s Not a Guessing Game

Robert S. Kaplan, PhD, writes about improving the “value of care” in this month’s HFMA magazine.

“Existing cost measurement systems in healthcare are inadequate. They typically use inaccurate and arbitrary cost allocations and provide little transparency to guide clinician and staff driven efforts to reduce costs and improve processes to enhance outcomes.

They also fail to focus on the correct unit of analysis: patients being treated for specific medical conditions over complete episodes of care.Untitled design

Unless the sector can implement better cost measurement and management systems, the promise of value-based care will remain unfulfilled.”

He goes on to write about the virtues of using Time Driven Activity Based Costing (TDABC) in healthcare by directly attributing all resources to the organizations outputs of services (therbligs). The full article can be viewed at HFMA.org.

Recently Cleveland Clinic partnered with Kaplan to take on this daunting task. During the pilot, accurate cost data was used to help leaders understand profitability by service line, and better support clinical teams in driving efficiency. The pilot project was setup to determine whether TDABC costing and relative value unit (RVU) based costing would produce materially different results. The results uncovered significant enhancements in clinical and administrative processes for the procedures studied and reduction in expense related to direct administrative and support processes for two types of heart valve procedures. Read the rest of this post »

The “Secret Sauce” for Financial Transparency

Assembling the data needed to achieve financial transparency is both a technical and political challenge. My recent BLOG In Managing Finance at Hospitals, the Proof is in the Data discusses this in detail. I thought I’d take a moment now to discuss some of the software that combines clinical and financial data for cost management to elaborate on the “secret sauce”.

The Perficient High Performance Costing Expressway combines the power of Oracle’s OLAP engine, Essbase, via the Hyperion Profitability & Cost Management (HPCM) application, along with Oracle’s leading healthcare data model to allocate and store data.

Our goal with the Perficient High Performance Costing Expressway is to accelerate the implementation of these solutions by defining the commonly used data element inputs into a standard interface formats that can be easily consumed into the HPCM application. This data will seamlessly flow from Oracle PeopleSoft General Ledger, via the adapters available for the Hyperion platform, or the Oracle Health Care Data Model within the data warehouse, if employed, since both the source and target data mappings can be predefined. For data sources that are not sourced from either location, Perficient will work with the client to connect the source data needed into the standard interface format. The diagram below provides a high level view of the overall process for consuming data into the model.

Oracle Data Mart

Read the rest of this post »

Squeezed Reimbursement. Eroding Margins. Smarter Consumers.

We have all witnessed the great impact healthcare reform has had on the healthcare industry. The landscape is changing so quickly it can be overwhelming for everyone involved. The new environment is more competitive and complex than ever and consumers are now in the driver’s seat. I say consumers because lets face it healthcare patients aren’t patients anymore, they are consumers and we must treat them that way.Squeezed Reimbursement. Eroding Margins. Smarter Consumers.

With information at their fingertips, healthcare consumers are utilizing their retail experience, tapping all of their resources and doing their research before making decisions about their care. Healthcare organizations are in a tough spot, reimbursement is being squeezed, margins are eroding and consumers are smarter. Organizations have two options – raise their costs and put a band-aid over the gushing wound or take steps to truly understand their costs and fix them.

Lets look at the first option – raising their costs. Keep in mind healthcare consumers are smarter, they are “shopping” around to find the best deals and they understand a procedure that costs more doesn’t necessarily mean the outcome will be better. In the competitive healthcare industry raising costs will result in lost market share, probably not the best option for healthcare organizations that want to be around long-term.

The second option – understanding costs. More times than not healthcare organizations do not understand their costs. Much like healthcare consumers, organizations have access to mountains of data but often times their information is located in disconnected silos making it very challenging to connect the dots. Understanding costs requires healthcare organizations to leverage clinical and financial data to make data-driven business decisions. Read the rest of this post »

Following the Money Trail: Understanding the True Cost of Care

Healthcare leaders are challenged to understand the true costs associated with providing care. If you ask caregivers to determine their current workflow, they don’t really know where the patient and family go before or after each step of their care so the total care pathway is not in their purview. This is a well-known challenge for implementing clinical effectiveness improvements whether it comes to improving care or lowering cost. I’ve worked on multiple committees in the hospital environment designed to lower costs for current patients and/or provide transparency on expected charges to consumers (future patients). One tactic that we used to achieve transparency was to shadow the caregivers to gather information about the care process to define each step and duration of the care pathway. We were able to compare this data to retrospective analysis of patient populations to “test” our Following the Money Trail: Understanding the True Cost of Caredata.

It would have been even more powerful to feed this data into a Time-Driven Activity Based Costing (TDABC) Model to determine not only the forecasted charges but also the “true cost” of care by modeling how much is being spent on consumables, personnel and space/equipment during the care pathway. Coupling TDABC with a time based study to pinpoint the best places to reduce cost and measure to make sure that the change is actually an improvement, creates a collaborative environment for handling cost reductions and avoids the traditional approach of having to implement top-down, across the board budget cuts.

Join  our team of industry experts for a webinar. “Leveraging Clinical and Financial Data to Identify Cost Savings, Improve Profitability and Improve Decision-Making” on June 17, 2014 from 2:00 to 3:00 CST. Using a case study discussing multiple scenarios for activity based costing for Pediatric Care Transitions, this webinar will explore how the Perficient High Performance Costing Expressway extracts clinical cost data, consolidates and allocates across the system to discover true patient costs.

The Perficient High Performance Costing Expressway delivers solutions that work for the people who need them at the right time and for the right cost. Perficient experts will be on hand in booth #1159 at HFMA National Institute 2014, #ANI2014. Join us there to view a demo of the Perficient High Performance Costing Expressway and hear our BIG IDEAS!

Follow me on twitter @teriemc

View my recent blogs:

Elevating the Role of Finance within the Hospital

Enterprise Warehouses: The Gift that Keeps on Giving

Balancing clinical effectiveness with profitability

 

Information Is Your Competitive Advantage

Information has always been available to us, but never before has there been so much at our finger tips, coming at us so quickly from many different sources. We can no longer continue managing our enterprise information the same way we have for the last 30 years, it is not sufficient. With that I would like to welcome you to the new generation of information management.Information is Your Competitive Advantage

Information is only useful to us if we can access it, understand it and can compare it to what we already know. Healthcare organizations rely on information to make smarter, faster and more impactful business decisions. Business leaders want access to many different kinds of information, but the problem is that information is often stored in separate, disconnected silos making it challenging to use the data strategically to generate business intelligence. Instead, often times, business leaders make decisions on intuition rather than hard data.

Enterprise data management solutions instantaneously capture data from enterprise systems, cloud devices and applications and help organizations standardize and deduplicate data. This helps organizations manage their information more effectively and minimizes conflicts and organizational data issues. Organizations need enterprise data management solutions to automatically track the performance and behavior of the data stored in their systems so they can make better business decisions.

Data alone is not useful, but data that can be turned into information is your competitive advantage. Enterprise information management (EIM) enables businesses to obtain more value from their data and content, unifying what has traditionally been a dichotomy. EIM turns unstructured and structured data into information, information that drives profitable business actions, and ultimately improves quality of care and business outcomes.

Industry expert and healthcare analytics strategist, Juliet Silver explains the importance of an EIM in a recent interview.