Healthcare Industry Trends Blog http://blogs.perficient.com/healthcare A Perficient Blog Wed, 29 Oct 2014 19:00:28 +0000 en-US hourly 1 http://wordpress.org/?v=4.0 Copyright © Healthcare IT Solutions 2011 gserafini@gmail.com (Healthcare Industry Trends Blog) gserafini@gmail.com (Healthcare Industry Trends Blog) 1440 http://www.perficient.com/About/~/media/Images/About/perficient_logo_small.jpg Healthcare Industry Trends Blog http://blogs.perficient.com/healthcare 144 144 A Perficient Blog Healthcare Industry Trends Blog Healthcare Industry Trends Blog gserafini@gmail.com no no Time for Chicken Sandwiches Not Steak Dinners In Healthcare http://blogs.perficient.com/healthcare/blog/2014/10/29/time-for-chicken-sandwiches-not-steak-dinners-in-healthcare/ http://blogs.perficient.com/healthcare/blog/2014/10/29/time-for-chicken-sandwiches-not-steak-dinners-in-healthcare/#comments Wed, 29 Oct 2014 19:00:28 +0000 http://blogs.perficient.com/healthcare/?p=7106 The cost of healthcare is at an all-time high and many people feel the fee-for-service model is the main culprit for the skyrocketing costs. From a logical standpoint it makes sense, healthcare providers get paid more by providing more services. As humans we tend to consumeIt's time for chicken sandwiches not steak dinners in healthcare too much and spend too much, therefore, ditching the fee-for-service model would result in fewer services and less spending, right?

Not so fast, as logical as that sounds I am not completely sold on that theory. When we look at our lives  almost everything we do is based on a fee-for-service model. When we go out to eat,  go to the movies, get new tires on our car, get a haircut, hire a baby sitter or hire someone to do our taxes, we do it on a fee-for-service basis. Those providing the previously mentioned services would like to sell us more, but we generally resist because we don’t want to waste OUR money on unnecessary services. Generally speaking when we pay with OUR money we try to get maximum value and good providers try to be as efficient as possible.

Fee-for-service is not unique to healthcare, however, in the healthcare sector we shop with other people’s money. We have very little out-of-pocket cost for additional services and someone else “picks up the tab” for OUR spending. The third-party payer is one of the big reasons for rising costs and inefficiencies in the healthcare industry. It is human nature not to concern ourselves with the total cost of care, but rather, how much WE have to pay. How many times have you received an explanation of benefits and glanced over it only to notice the part that tells you what you are responsible for?

If we implemented a third-party payment model in other service industries we would be faced with the same inflating costs that we are dealing with in healthcare. If you were only responsible for a $30 copay every time you visit your hair stylist you would be inclined to get unnecessary services in addition to a haircut. Why, because YOU aren’t paying for them, someone else is picking up the tab.

Better yet, you are traveling for work and need something to eat. If it were personal travel you would grab a chicken sandwich and call it a night. But work is paying for it, so you have a steak dinner. As far as you are concerned a steak dinner costs the same as a chicken sandwich because YOU aren’t paying for it, you aren’t accountable for payment.

Healthcare costs and inefficiencies are going to continue to increase until we address the third-party payment model. Healthcare consumers need to be accountable and more aware of the total cost of their healthcare. A more aware and accountable healthcare consumer may be the motivation needed to live a healthier life. Or at the very least eat more chicken sandwiches.

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How Biofeedback is Set to Transform the Quantified Self http://blogs.perficient.com/healthcare/blog/2014/10/28/how-biofeedback-is-set-to-transform-the-quantified-self/ http://blogs.perficient.com/healthcare/blog/2014/10/28/how-biofeedback-is-set-to-transform-the-quantified-self/#comments Tue, 28 Oct 2014 12:07:04 +0000 http://blogs.perficient.com/healthcare/?p=7116 During the Connected Health Symposium last week, I noticed a significant trend that I have since been calling the “next big thing for the quantified self movement”.   What is the next big thing in a world dominated by fitness trackers and mobile apps?  That next big thing is biofeedback.  I gained access to quite a few innovators while at the conference.  They note that while clinicians have been using biofeedback for eons in order to understand any number of things about a human body, most of those tools do not come in a patient-friendly package.  Thanks to these innovators, now they do.  Here are four examples quantified self devices that use biofeedback to help patients understand and manage their health.

Choose Muse

It is hard to make brain data real to a patient.  As a result, up until now there has been virtually nothing a person can do to improve Screen Shot 2014-10-28 at 12.01.25 AMtheir brain health. Psychoanalysis is highly stigmatized, which causes an even bigger drift to form between patients and cognitive health.  In order to fix this, clinicians have created a consumer friendly, clinical grade EEG to provide patients with their first real contact with their brain. The device is called Muse, and it is being dubbed “the brain sensing headband”.

By using the device, patient can improve their cognitive functions and see their outcomes in real time.  This device has also shown promising in the treatment of depression and other mental illness.  Since this treatment is wrapped in the quantitative self trend, it does not receive the same reluctance that stigmatized psychoanalysis does.  This provides promising new treatment options.

HeartMath

During the Connected Health Symposium, it was noted that 75% of physician visits are stress related.  Patients are often made to feel that they arScreen Shot 2014-10-28 at 12.02.55 AMe “stuck with it” and there is nothing that can be done.  However, a really neat connection between the heart and the brain can be used, through the power of feedback, to manage stress related illnesses such as heart disease.

I’m not sure if you knew this, but there is a “brain” in the heart that senses and responds to emotions and communicates through nerves to the brain. This heart-brain communication provides us with a way to manage our stress and  get heart healthy through the use of biofeedback.  Using biofeedback through tools like HeartMath, patients can gain windows into their hearts and brains to self manage their stress response. While this is certainly empowering for prevention of heart disease, heart disease patients have been studied, and have improved outcomes through using the HeartMath biofeedback system.

Stay tuned for an upcoming experiment that is set to merge the Muse and HeartMath technologies.

Sensoree

Screen Shot 2014-10-27 at 11.32.19 PMIf you work in healthcare technology, and you go to a Connected Health Symposium, then you will get your fair share of interesting conference performances.  In one such performance, we were introduced to Sensoree, which is a company that creates wearable technology that show visually, through light displays, what the individual wearing the technology is feeling.  This proves incredibly helpful for patients with Autism and Alzheimer’s that do not have the ability to communicate their emotional states readily.  Sensoree introduced these technologies by having circus performers wear them during an acrobatic dance routine.  As they danced, you could see their emotional states changing as a red glow of nervousness as the performers began turned into a blue glow of of focus to a purple glow of bliss.

 

BioBeats

This last bit, called BioBeats, is a platform for merging entertainment with healthcare.  In one very compelling move, BioBeats partnered with music crew Far East Movement in an attempt to connect millions of listeners to their health by way of mobile phone enabled heart beat sensors.  As Far East Movement performed, they encouraged their fans to record their hard beats.  By the time the song was over, they had collected over 1.5 million heartbeats that were, in real time, transformed into the beat that lived in the background of their performance.  Check out this “Turn Up The Love” performance below.

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Perficient Provides PIH New Tools In The Fight For Global Health http://blogs.perficient.com/healthcare/blog/2014/10/27/perficient-provides-pih-new-tools-in-the-fight-for-global-health/ http://blogs.perficient.com/healthcare/blog/2014/10/27/perficient-provides-pih-new-tools-in-the-fight-for-global-health/#comments Mon, 27 Oct 2014 18:16:37 +0000 http://blogs.perficient.com/healthcare/?p=7129 Kent Larson, Director at Perficient recently posted a blog about Partners In Health (PIH) and the new Microsoft tools they are using to help enable their mission to provide a preferential option for the poor in healthcare.

PIH is one of many organizations leading a coalition to combat the Ebola outbreak, working alongside two other organizations – Last Mile Health in Liberia and Wellbody Alliance in Sierra Leone. To help enhance communication and collaboration both domestically and internationally, PIH is migrating to Microsoft Office 365.

Perficient is assisting PIH with their migration to Microsoft’s Office 365 (O365) solution. O365 will allow users to access their email from anywhere in the world on any computer or mobile device with access to the Internet. OneDrive for O365 will enhance collaboration between all PIH users, both domestically and internationally. The platform will provide PIH with a reliable and secure communication toolbox, including storage and collaboration tools. Deployment of O365 across PIH sites in Africa, Haiti, Russia, and the U.S. will enable PIH’s mission to provide a preferential option for the poor in healthcare  and will be an important tool to enhance communication as they respond to the Ebola outbreak in West Africa.

To read Kent’s entire post and to learn more about the mission of PIH click here.

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How to Create Habit-Forming Technology Solutions http://blogs.perficient.com/healthcare/blog/2014/10/27/how-to-build-habit-forming-patient-solutions/ http://blogs.perficient.com/healthcare/blog/2014/10/27/how-to-build-habit-forming-patient-solutions/#comments Mon, 27 Oct 2014 11:43:27 +0000 http://blogs.perficient.com/healthcare/?p=7114 Last week, I was at the Connected Health Symposium in Boston.  It is with great pleasure that I relay what I was taught during my favorite session by Nir Eyal author of “Hooked: How to Build Habit-Forming Products”.

shutterstock_78240940 copyWe know that mobile devices change our day-to-day behavior, but why are mobile devices so good at changing our habits?  To understand how, we must understand what habits are and how they are changed. Habits are impulses to do a behavior with little to no conscious thought.  When you think about it, social media sites like Facebook, Twitter, Instagram, Pinterest, and SnapChat get us to do some pretty bizarre behaviors as habits.  Now, over the span of just a few short years, billions are using these social platform as day-to-day habits that require little to no conscious thought.

It goes to say, then, that creating a habit-forming technology solution of any type would require us to speak directly to the unconscious mind.  To do this, Eyal advocates what is calls the “Hook Model”.  This is defined as using experience design to connect a user’s problem to your solution with enough frequency to create a habit.  To do so, it is critical that your solution include the following four components of a hook:

  1. Trigger: A trigger is a cue to action that prompts the user to perform a habitual action.  These triggers come in two forms.  You have external triggers in the environment that tell us what to do next. Common external triggers include what we call “calls to action” in marketing, which is the “Buy Now” request.  A friend telling you to try a certain solution is also a powerful external trigger.  However, it is the internal trigger that is the most important.  Internal triggers are associations in someone’s mind that inform what to do next.  These associations come from emotions, routines, situations, people, and places. Ultimately, this requires you to have an intimate understanding of your user’s painpoints and how they respond to those painpoints.  For example, people with depression check email more. The theory behind this association states that  people suffering from bad emotions turn to their technologies to feel better. Generally speaking: Lonely = Facebook, Bored = YouTube, Confused = Google. We use these technologies to escape negative valence states. So, how do you make better products and services that help people live healthier lives?  You need to understand what internal trigger you are creating an association with.
  2. Action: An action is defined as the simplest behavior done in anticipation of reward. The reward need not be in the form of Screen Shot 2014-10-26 at 8.08.31 PMpoints and leader boards.  Want examples of the most compelling rewards used by leaders today?  Scrolling on Pinterest. Searching on Google. Play button on YouTube.  These are all “rewards” in that studies have shown they relieve enough tension in the human mind to create an addiction to our mobile phones.  There is a formula you can use to predict the power of reward found in these singular behaviors. That formula is B=M+A+T.  According to BJ Fogg, in order for any behavior to occur, we need motivation, ability, and a trigger.  Motivation is the “energy for action” (how much we want to do a behavior). Six factors to increase motivation include: seeking pleasure, avoiding pain, seeking hope, avoiding fear, seeking acceptance, and avoiding rejection. Ability is the capacity to do an action (how easy or difficult it is to do).   Six factors can increase or decrease ability: time, money, physical effort, brain cycles, social deviance, and non-routine. This is why we are more likely to do something when we see someone we know doing it. We are also more likely to do something we’ve done before . X-Y access that’s Ability (how easy) vs. Motivation
  3. Reward: To get at the heart of reward, we have to start in the brain.  More specifically we have to start in a portion of the brain called nucleus accumbens, which has some unusual properties. When they allow lab animals to trigger this portion of the brain by pushing a button, those animals will continue to do so obsessively.  In fact, the machines have to be forcibly removed.  At first it was assumed that this portion of the brain activated a pleasure center.  That was not correct.  It actually activated the “stress of desire”. The thing is, there is a way to stimulate this itch that we crave to scratch. Within the premise of “the unknown is fascinating”, variability causes us to increase focus and not let go. If a reward is given on a variable basis, then it spikes activity in the nucleus accumbens. One import variable reward system are “rewards of the tribe”, which are things that feel good that come from other people like empathetic joy, partnership, and competition. Social media is a erasure trove for rewards of the tribe.  Rewards of the hunt, like gambling, also provide the variability that we desire. The information rewards we receive from search engines like Google are good examples of a reward of the hunt. The social media activity feed works in the same way  (that’s not interesting, that’s not interesting, wait, that’s interesting!).  Then there are rewards of the self.  A search for self-achievment has an important element of variability, which is why people are happiest when they are trying to reach a goal (as opposed to having already achieved that goal).   Mastery, competency, and control are rewards of the self.  Ultimately, variable rewards are about scratching the user’s itch but leaving them with the mystery of what will happen next.  One of the ultimate examples is the email inbox.  The quest to clear your inbox can be seen as a game because the little icon signifying that you have mail told you to do something.  Making that little icon go away is an important variable reward that keeps us coming back for more.
  4. Investment: This is a variable of the hook that most companies neglect, and, therefore, presents the greatest opportunity for growth. They receive a variable reward.  What’s next?  “Investments”are defined as the load for the next trigger.  Unlike physical products that deteriorate over time, habit forming technologies appreciate and get more valuable the more they are used because of the investments in stored value. The more content that is collected in iTunes, the more value it has and the better it becomes. The more accounts I connect in Mint, the more valuable it becomes to me.   The more followers I have the more interesting Twitter becomes. Users need to be able to store their value in your technology solution.  This value is stored as a reputation that a user can “take to the bank”. How likely are you to leave a platform after you have stored value in terms of reputation?

This is how customer attitudes change and habits are formed. If you are building a technology that requires habits, then you need to ask these five questions to know if you have been successful:

  • What internal trigger is the solution addressing?
  • What external trigger gets the user to your solution?
  • What is the simplest behavior in anticipation of reward?
  • Is the reward fulfilling yet leaves the user wanting more?
  • What “bit of work” is done to increase the likelihood of returning?

Eyal ended his talk with a discussion on the morality of manipulation.  Designing habit-forming products is a form of manipulation. As a result, engineers of these solutions need to be careful. We need to be responsible for the impact we have on changing user behavior by using this power for the force of good by fixing one of the world’s problems.

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Webinar: Healthcare Enterprise Data Model: Buy vs. Build Debate http://blogs.perficient.com/healthcare/blog/2014/10/23/webinar-healthcare-enterprise-data-model-buy-vs-build-debate/ http://blogs.perficient.com/healthcare/blog/2014/10/23/webinar-healthcare-enterprise-data-model-buy-vs-build-debate/#comments Thu, 23 Oct 2014 18:00:27 +0000 http://blogs.perficient.com/healthcare/?p=7099 Transformation is sweeping across healthcare in the United States at a rapid rate. Healthcare organizations, regardless of size, need to embrace new technologies in order to keep up with the quickly changing landscape and comply with evolving regulatory requirements.Healthcare Enterprise Data Model: Buy vs Build Debate

The solutions to these challenges have one thing in common, the need for accurate information. In some cases, the information required can be sourced from a single system, but in many situations, the need requires information from a wide range of systems that could include Electronic Medical Records (EMR), Claims, Financial and Human Resources.

The solution for many organizations starts with the creation of an enterprise wide data warehouse (EDW) that serves as their “single version of truth”. At the foundation of the data warehouse is the need for a data model that accurately organizes the data in meaningful ways. Many organizations will build their own data model while others will look to leverage an industry proven data model from an experienced vendor. This choice to buy vs. build, can be one that causes great debate within organizations both large and small.

At a high level, the pros to building your own enterprise data model will come down to flexibility and control. If you choose to build your own customized model, you will get to make each and every design decision based on how your organization operates, this can be very tempting.

The main advantage to buying a data model is the time to implementation. Many of the tough decisions are made for you, based on years of experience across a wide range of customers; purchased models are often much faster to implement.

As the debate continues you will need to weigh factors like experience, time to value, risk, integration accelerators and impact on your staff. Each of these topics needs to be considered as your organization decides whether to buy or build your enterprise data model.

Interested in more information on how to weigh the pros and cons of this critical enterprise decision? Join Perficient on November 18th for a complimentary webinar. We will examine critical factors that need to be evaluated when deciding whether to build or buy an enterprise data model. We will explore real-life client stories and discuss how they benefited from their decisions.

Upcoming Webinar: Healthcare Enterprise Data Model: The Buy vs Build Debate
Tuesday, November 18, 2014 @ 2:00 PM CT

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In Healthcare, Connectivity Is Not Collaborating http://blogs.perficient.com/healthcare/blog/2014/10/16/in-healthcare-connectivity-is-not-collaborating/ http://blogs.perficient.com/healthcare/blog/2014/10/16/in-healthcare-connectivity-is-not-collaborating/#comments Thu, 16 Oct 2014 19:00:22 +0000 http://blogs.perficient.com/healthcare/?p=7081 Interoperability between different electronic health record (EHR) systems is one of the most important requirements that hospitals and physicians must meet as they prepare their systems for attestation in Meaningful Use Stage 2.

However, let’s examine the real goals of interoperability within healthcare: In Healthcare Connectivity is not Collaborating

1) To make sure “information follows the patient regardless of geographic, organizational, or vendor boundaries”

2) To have at least one or more instances in which providers exchange an electronic summary of care with all the clinical data elements between different EHRs. Establishing this connectivity does not insure the real goal of collaborating across the continuum of care for the patient’s benefit.

The debate still rages on the role of the patient in this interoperability process as well. We have all, as patients, had our medical files spread across a family doctor, multiple hospitals, specialists, health plans and today, even multiple pharmacies. The prospect of creating a complete picture is staggering, let alone having all of those healthcare providers really collaborate on our behalf. Is it the patient’s responsibility in this ever-changing healthcare electronic revolution to compile this electronic mess into a coordinated whole or will the industry magically create it as a result of Meaningful Use Stage 2?

It is worth arguing that interoperability in Meaningful Use Stage 2 only creates a baseline of connectivity between two or more systems to exchange information and puts in place the ability of those systems to use the information that has been exchanged. It does not create collaboration on behalf of patients within the healthcare provider community, especially between competing players like local hospital systems or healthcare providers versus payers. Having the ability to connect only trades fax machines for electronic transactions, if tools aren’t employed for physicians for example to collaborate over a single patient.

In advocating for collaboration, let’s examine the reality of an exchange of a set of electronic transactions about a patient versus where the process would need to be for genuine care coordination. Today, a fax from the hospital to the family physician is the notification that the patient was hospitalized and needs follow-up in coming weeks. Based on the type of hospitalization, a call between the attending physician and family physician may be warranted, and a potential referral to a subsequent specialist may be in order. Simply communicating electronic documents doesn’t address the interaction between key people in the decision-making process and the assumption that the inclusion of unstructured physician notes will suffice may be optimistic.

This means that health information exchange is different than health information interoperability. Exchange is necessary for interoperability, but it is not sufficient by itself to achieve health information interoperability, especially to streamline real collaboration on behalf of patients. It is time to examine an expanded view of both interoperability and health information exchange to promote ease of collaboration between the parties involved, including secure physician to physician communications – electronic or instant message, for example, and secure physician to patient communications. As an individual patient having to deal with multiple patient portals today for communicating with my healthcare providers, there is a real concern to address this issue sooner rather than clean up confusion later.

Can we define collaboration in a way that traverses healthcare’s landscape of emerging connectivity?

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The Problem with Health IT is in the Definition http://blogs.perficient.com/healthcare/blog/2014/10/13/the-problem-with-health-it-is-in-the-definition/ http://blogs.perficient.com/healthcare/blog/2014/10/13/the-problem-with-health-it-is-in-the-definition/#comments Mon, 13 Oct 2014 18:21:45 +0000 http://blogs.perficient.com/healthcare/?p=7051 There has been a lot of debate around the challenges within the healthcare industry. Much of the discussion stems from the fee-for-service model and the focus on services and reimbursement rather than the patient. Health information technology has its own set of challenges when it comes to addressing healthcare issues. The Problem with Health IT is in the Definition

If we truly want to put the patient at the center of their own healthcare experience than we need to take a step back and look at the relationship of the patient and the entire healthcare ecosystem. Healthcare should focus less on the products and services and more on the patient and provider relationship. Furthermore, health IT should support these relationships, however, by its own definition it doesn’t.

By definition,  Health information technology (IT) encompasses a wide range of products and services—including software, hardware and infrastructure—designed to collect, store and exchange patient data throughout the clinical practice of medicine.

The definition does not mention the patient and provider relationship and the emphasis is on products and services, software and hardware and does not reflect on the benefits of patient data exchange.

A better health IT definition: An automated approach that facilitates the relationship between the patient and the healthcare system through the accurate and secure electronic exchange of data, ensuring the right data is available at the right time for everyone that is engaged in the patient’s care.

This definition includes 3 critical components:

  • The importance of the patient relationship with the healthcare system
  • The importance of accurate and secure electronic data exchange
  • The benefits of data exchange in regards to patient care

A new definition will not solve the challenges of the healthcare industry, but it is a good place to start. It may be enough of a push to ensure technology developers are developing meaningful applications that improve patient outcomes, which should be the ultimate goal of health IT.

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Upcoming Webinar: Combine Data to Enable Translational Medicine http://blogs.perficient.com/healthcare/blog/2014/10/09/upcoming-webinar-combine-data-to-enable-translational-medicine/ http://blogs.perficient.com/healthcare/blog/2014/10/09/upcoming-webinar-combine-data-to-enable-translational-medicine/#comments Thu, 09 Oct 2014 18:40:52 +0000 http://blogs.perficient.com/healthcare/?p=7074 The success of translational medicine is in the data and the ability to combine multiple sources of data to enable better patient care and outcomes. Unfortunately most academic research organizations (ARO) and hospitals have multiple systems that house data creating an inability to mine through the data to identify clinical insights, disease patterns or treatment options. Combining Patient Records, Genomic Data and Environmental Data to Enable Translational Medicine

Patient records, genomic data and environmental data need to be in sync to speed the process of bringing safer therapies to market and provide “bench to bedside” medicine. Combining multiple sources of data can enable complex and meaningful querying, reporting and analysis for the purposes of improving patient safety and care, boosting operational efficiency, and supporting personalized medicine initiatives. Integrated data will  enable implementation and delivery of translational medicine anytime and anywhere.

Please join Perficient’s Mike Grossman, a director of clinical data warehousing and analytics, and Martin Sizemore, a healthcare strategist, for a complimentary one-hour webinar in which they will discuss:
  • How AROs and hospitals can benefit from a systematic approach to combining data from diverse systems and utilizing a suite of data extraction, reporting, and analytical tools, in order to support a wide variety of needs and requests
  • Examples of proposed solutions to real-life challenges AROs and hospitals often encounter

To register for the webinar click here
Combining Patient Records, Genomic Data and Environmental Data to Enable Translational Medicine
Wednesday, October 15, 2014  | 1:00 PM CT

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No Easy Outs in Healthcare BI, but a New Approach http://blogs.perficient.com/healthcare/blog/2014/10/08/no-easy-outs-in-healthcare-bi-but-a-new-approach/ http://blogs.perficient.com/healthcare/blog/2014/10/08/no-easy-outs-in-healthcare-bi-but-a-new-approach/#comments Wed, 08 Oct 2014 16:52:24 +0000 http://blogs.perficient.com/healthcare/?p=7057 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?

It is time to examine the traditional waterfall development approach to building enterprise data warehouses necessary for addressing the current demands for business intelligence in healthcare. While we could dialog on the use of Agile versus waterfall for development, I want to propose a more radical approach: a business intelligence assembly line process. We need to reorganize our thinking towards automating the steps to deliver raw materials quickly, i.e. identifying a data source, gauging its quality and delivering it for assembly, before adding it to the BI visualization process. The data normalization and data quality can be addressed with another manufacturing idea: continuous improvement over time. Instead of traditional thinking of having to move all data into a common data model, this approach allows for data sources (raw materials) to be substituted, if needed, in the assembly line process for business intelligence reporting over time.

The people, process and technologies need to be aligned to the assembly line process for delivering high-quality products (dashboards and reports) faster and faster from re-usable components in the process. Engineering a new product would start with a design goal and identify how it would be built as opposed to only delivering what the underlying data warehouse can deliver. This assembly line approach provides the flexibility to introduce new concepts like big data or streaming real-time data as manufacturing techniques to speed up assembly line delivery without the big bottleneck of forcing everything through a common data model or wait for assimilation into the enterprise data warehouse.

Trusted data sources, like trusted raw material vendors, will be the secret to rapid BI manufacturing success. Do you like the idea of a business intelligence assembly line versus standing up a whole factory? Let’s poke holes in the idea to see if it is a better alternative!

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Budgets: Daily, Weekly, Monthly or Annually? http://blogs.perficient.com/healthcare/blog/2014/09/30/budgets-daily-weekly-monthly-or-annually/ http://blogs.perficient.com/healthcare/blog/2014/09/30/budgets-daily-weekly-monthly-or-annually/#comments Tue, 30 Sep 2014 15:00:45 +0000 http://blogs.perficient.com/healthcare/?p=7040 I think most healthcare entities are now moving to a more frequent budget cycle and if academic, they probably have to do a semi-annual legislative budget. They probably also at a minimum re-forecast based on updated actuals once a quarter.

Is their value though to gathering actuals daily or weekly and adjusting tactical plans based on current month trends? In today’s rapidly Budgets: Daily, Weekly, Monthly, Annuallyevolving healthcare environment, provider organizations must be able to identify financial performance gaps continuously and quickly change course when needed.   As we discussed in my blog: The Role of Finance Within the Hospital has been Elevated, this requires a partnership with operations to ensure that the correct metrics are correlated within the budget process. Agility is also influenced by the mechanism the hospital uses for budgeting and whether they use a rolling forecast to replace or supplement the annual budget process.

What is a rolling forecast? The rolling forecast is usually a quarterly budget with a two to three year horizon that keeps a close eye on the organization trajectory. Typically the forecast budget is not prepared at the department level but may instead focus on divisions or even at a hospital level. Global budget drivers and assumptions will typically be the same as the annual budget but those unique to a department or division may not be line items. The forecast is built using historical trends, current conditions and future assumptions for budget drivers. Some forecasts may be primarily driven by revenue drivers with expenses flowing from ratios defined to the model.

The forecast feedback process fosters the partnership between finance and operations to allow the organization to course correct sooner and reinforce the cause and effect relationships that impact reality.   Some organizations use the rolling forecast process in conjunction with the annual budget and others have moved to using the forecast only.

Benefits of replacing the annual process with a rolling forecast may include:

  • Spending fewer resources on budget preparation and variance analysis.
  • Reinforces a culture of continuous performance management.
  • Allows a longer ramp-up time for course correction.
  • Supports the organization’s economic model (3-5 year macro level plan) used for capital allocation decisions, margin targets, M&A modeling and other purposes.

The rolling forecast should be tailored to meet your organization’s needs and based on my experience; the forecast should be a continuous learning process and more flexible to make necessary changes when needed from both a process and a technology perspective.

Perficient is a large healthcare systems integrator with deep healthcare domain expertise and we are a platinum Oracle partner having implemented over 450 projects leveraging the Oracle Enterprise Performance Management platform.   Stop by our booth at #OOW14 from September 29th – October 1st at the Healthcare Solutions Pavilion in Industry Central (Marriott Hotel Atrium Lobby booth HMH-003) and at the Perficient Main Booth #2221: Moscone South Exhibition Hall Level 1.

Watch our blog for more details about what we are learning at OOW14!

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