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

No Easy Outs in Healthcare BI, but a New Approach

When you played baseball as a youngster, and stepped into the batter’s box, the last thing you wanted to be was an “easy out”. Ironically, today many healthcare organizations are looking for the “easy out” to rapidly develop the business intelligence reporting needed to address regulatory reporting demands, population health No easy outs with healthcare BI, but a new approachmanagement and chronic condition management, to name just a few.

The pressure to quickly stand-up an enterprise data warehouse, put data governance in place, start loading and cleaning data is intense just to get to the point of creating dashboards and offering mobile BI. Overloaded Healthcare IT teams are dealing with demands to compress traditional time-frames of 18-24 months to get the BI foundation in place down to as little as 4-5 months, start to finish.

This situation begs the old saying of “do you want it fast or do you want it right?” You can bet the answer today is both. Generally, healthcare organizations develop a BI strategy that examines the current state BI architecture, envision a future state BI architecture, document the gaps and create a time phased roadmap to build out the infrastructure, software and development required to meet the business needs. Just describing the process tells us that it will be complex and time consuming, right? Read the rest of this post »

Hospital Price Transparency – Step 1: Understand True Cost

Is there a correlation between price transparency and cost? I read an article in the HFMA Strategic Financial Planning Newsletter recently about this and I can relate my personal experiences to it wholeheartedly. My observations are that hospitals segregate these two activities but I believe they are explicitly linked. I know there are many factors that influence Hospital Price Transparancyprice setting, not the least of which is the federal government (Medicare/Medicaid), but I suspect the reason that hospitals don’t more closely link pricing to margins is that they lack visibility into their own data.

When I first started working in healthcare in the late 90’s, my only prior exposure to revenue cycle automation came from the airline industry where pricing is tightly linked to both demand and yield.   I was part of the team that helped Continental Airlines transition into the era of de-regulation. It didn’t take industry leaders very long to identify the metrics that truly informed pricing once the government was taken out of the equation. This taught me very valuable lessons about analytics and instilled in me a drive to use data to improve operations.

To understand and achieve sufficient transparency and maintain a proactive approach to maintaining margins, hospitals must be capable of correlating costs for supplies and drugs, etc. with the cost of providers and overhead costs. Then they must compare this with the payments from payers, individuals and other purchasers. While we certainly can’t take the federal government out of the equation for hospitals, recent expectations have been set for quality performance that may help the affected organizations begin to take a more margin focused view of pricing. Bringing together the necessary data is not simple and definitely should be approached iteratively using a configurable set of analytic tools that can provide the right data to the right individuals in the organization who manage operations and continue or create new services. Read the rest of this post »

The Key to Driving Down Healthcare Costs

Healthcare costs are rising at a faster pace than the economy is growing. Hospitals are often the focus of this concern, because they constitute the largest single component of healthcare spending. When looking at hospital costs, it is important to keep in mind that there are both direct and indirect expenses that contribute HighPerformanceCostingExpressway_largeto the total cost of care.

How do we understand total cost of care? Our team of experts leverages a proprietary technology for our clients called the Perficient High-Performance Costing Expressway, which enables transparency of fully burdened margin by service, patient and procedure. For decades, spreadsheets and costing software have been the best alternatives in determining cost of care. It is now more important than ever to transform these methods and leverage administrative, clinical and financial data in order to gain control of healthcare costs. Creating transparent costing models to indicate profitability across multiple dimensions of data is the key to driving healthcare costs down.

Embracing data-driven decision making in a provider setting requires agile thinking to pinpoint and respond to the short- and long-term needs of the organization. This shift requires finance departments to transcend from the typical focus on aggregating data to a value-added analytical view of hospital data. This new approach will provide greater visibility into changes in variables and assumptions and will require organizations to fully understand and ensure transparency exists for key performance indicators.

In evaluating supplies, labor, productivity or clinical effectiveness, the quality/cost/value equation requires an organization to truly understand its data. This includes not only considering the right product at the right place but also applying a broader perspective on clinical evidence for resources used and approaches employed. Data by itself doesn’t make a company successful; organizations must act on information and filter what is useful, appropriate, and above all else actionable. Those few organizations that are able to transform data into decisions and harness the power of insightful and timely analytics are ahead of their competition.

Perficient will be on hand to demonstrate the High-Performance Costing Expressway on display at OpenWorld 2014. Stop by and visit with our Healthcare experts at the Healthcare Solutions in Industry Central (Marriott Hotel 2nd floor).
Not attending #OOW14? Learn more about our costing solution here.

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Knowledge Drives Precision

In recent years, dramatic advances in molecular biology, genomics, and related technologies have resulted in greater understanding of cancer at the molecular level. It is now possible not only to identify the genetic and molecular variations in each patient’s cancer cells, but to apply the results from the tumor profile, inKnowledge Drives Precision some circumstances, to begin to inform treatment strategies that target the molecular underpinnings of the specific disease in each patient.

“Precision medicine,” also known as “personalized medicine,” is the term used for this transformative new model of health care that involves the selection of diagnostic tests that have the potential to identify changes in each individual patient’s cancer cells. The use of that knowledge may help to prevent and treat cancer through the development of treatment strategies to target these specific molecular alterations. Ultimately, the goal of precision oncology is to improve patient outcomes. 1

I attended a conference session recently on this topic where an esteemed speaker panel took the audience though their vision of a time in our future when we could have a simple blood test on the way to our doctor’s office and arrive at the appointment to find our doctor fully prepared with a diagnosis and the ideal medication would already be identified based on our genetic makeup and perfectly formulated to avoid side effects for which you we are susceptible. Imagine this on a larger scale to speed up drug development, to create more precise therapies, faster and less expensively and apply this approach to improve the lives of people worldwide, at lower cost.

Perficient is helping clients such as the University of Colorado to establish a fully integrated informatics “highway” for precision medicine using the Oracle Health Sciences Translational Research Center platform to address formidable challenges such as:

  • Data Integration – the most foundational challenge is the need for an integrated data infrastructure spanning fully the genotype and phenotype (i.e., molecular and clinical attributes) of research subjects and patients
  • Individual Data Records – relevant data from the basic science, translational, clinical research, and health care domains need to be fully integrated at the individual data record, in order to produce “personalized medicine” models.2

Join us at #OOW14 to hear Michael Ames, MBI, Associate Director, Health Data Compass, Center for Biomedical Informatics and Personalized Medicine, University of Colorado and my colleague Lesli Adams, MPA @LesliAdams during the session “Creating a Digital Healthcare Safety Net with EHA and OBI for Care Transitions” located at the Marriott Marquis – Salon 10/11; Wednesday, October 1, 11:30am – 12:15pm.

We are an Oracle Platinum partner and we’ve gained valuable expertise from nearly 2,000 Oracle projects with our clients the past 15 years and we have amassed vast amounts of best practices and ideas to share. Stop by and visit with our Healthcare experts at the Healthcare Solutions in Industry Central (Marriott Hotel Atrium Lobby) at the Perficient kiosk (HMH-003) for a demo of the Translational Research Center.

Not attending #OOW14? Join our webinar Combining Patient Records, Genomic Data and Environmental Data to Enable Translational Medicine Wednesday, October 15, 2014 1:00 PM – 2:00 PM CT.

Sources:

1 http://www.n-of-one.com/about/what-is-precision-medicine.php

2 Michael Ames, MBI, Associate Director, Health Data Compass, Center for Biomedical Informatics and Personalized Medicine, University of Colorado

 

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Beyond the BI Strategy: 4 Steps to ROI

In a recent issue of PC Today (www.pctoday.com), there was a quote by Cindi Howson of BI Scorecard that really stuck in my mind: “There are far too many cases of companies having good data, good tools, but a culture that’s a barrier to using that data for action.” Frequently, outside Beyond the BI Strategy: 4 Steps to ROIconsultants are brought into an organization, especially in healthcare, to pull data out of silo’ed applications, cleanse it and land it in an enterprise data warehouse (EDW). Then the real fun begins as the organization tries to determine what their expectations are from this treasure trove of data. More importantly, this struggle to determine the value of the integration of clinical, operational and financial data can stall the return on investment for this important and difficult effort.

In conducting a business intelligence (BI) strategy, it is very important to investigate those silo’ed data sources to determine which elements can benefit which part of the organization and to notify internal groups of the new resources. In other words, the Enterprise Data Warehouse needs exploration and promotion to the key stakeholders or by the key stakeholders to gain new insights and derive the new value. Matching data to the right people is fundamental to success and deserves its own tracking mechanism in data governance. Moving beyond the original stakeholders and their requirements in a BI strategy and getting down to who really will use the data and how it is used helps drive stronger outcomes for the use of the integrated data. It truly isn’t just start with the end in mind, but exploring how the new integrated views of information can drive improved operational processes and solve daily problems in a real-time manner.

It is often frustrating to data warehouse builders because they understand the value stored inside but don’t know who needs the information to take action. It is worth educating and promoting this big investment! If a key data source is overlooked for real improvements in an important corporate process, then find it and add it. If data has moved past its useful life, then it should be moved to an archive to keep the enterprise data warehouse relevant and in step with the organization. Many organizations set up BI Competency Centers to help govern and develop the enterprise data warehouse, but my suggestion would be to make those centers a place for brainstorming, exploring and deriving value on an ongoing basis.

In healthcare, as we strive to lower costs and adopt a lean process improvement methodology, our process of using high-quality data should help identify new revenue opportunities, serve our communities more effectively and encourage us to explore possibilities. That exploration should start with the data that we work hard to acquire, extract, transform and load in our enterprise view. As data comes in faster, we need to respond quickly by connecting the data with the right users.

To summarize, in moving beyond the build stage of an enterprise data warehouse and gaining the return on investment, there are four key steps:

  1. Identify the “new” stakeholders that will use the EDW in their daily jobs
  2. Help the new stakeholders explore and learn what data is available to streamline clinical, operational or financial processes, possibly in a BI Competency Center to master tools
  3. Promote the success stories to create action from all parts of the organization
  4. Realize the return on investment from your EDW – celebrate!

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 »