These days as you launch your browser, turn on the TV, or pick up a newspaper you are drawn to the national discussion of healthcare in America. In fact, this week the Supreme Court of the United States will hear arguments on whether the Healthcare Reform Act passed by Congress in 2010 is legally binding. Two cases will be argued next week. One case is regarding individual healthcare coverage.

The other case has to do with how allocated healthcare federal funds will be distributed in the state. Both the above explanations are simplifications of a very complex set of arguments. For a very good (and more detailed) explanation, please refer to “A Guide to the Supreme Court’s Review of the 2010 Health Care Reform Law,” Focus on Healthcare, January 2012, Kaiser Family Foundation.

We have all heard about the alarming rate of Healthcare costs in the United States. For example, from 2000 to 2008, the U.S. economy grew by $4.4 trillion; of that growth, roughly one out of every four dollars was spent on health care (that’s $1.1 trillion dollars). These debates are a central focus of efforts around Accountable Care, for example. Household expenditures on health care already exceed those on housing. And healthcare’s share is growing. We know this is taking dollars that could be used for other national benefits (schools, roads, law enforcement, etc.) but this is “healthcare” and we all want better health, right?

Both sides of the healthcare reform debate have very compelling arguments. We are going to watch history being made, just as those who watched L.B. Johnson sign the laws about Medicare/Medicaid that were then argued in the Supreme Court. We all will watch with keen interest as these stories unfold.

Looking back at the last two days of meetings, panels, vendor meetings and sharing I met up with a very close colleague of mine who is one of the brightest CNO’s I have ever met. Mary Jo and I decided to grab a bite to eat and digest what we saw and learned these past two days at HIMSS.

Mary Jo had a ton of stuff to get off her chest, so I ordered a bottle of German Riesling wine (our favorite) and asked her, “So what is on your mind?” Mary Jo took a look at me and said, “Are you sure you want me to share? I’ve got a lot on my mind and after these last two days I am now truly concerned about what we do when we both get back to work…” I poured the wine and got comfortable – and boy was she right, she had a lot on her mind. She started with:

“As we approach revolutionary changes for healthcare policy in the U.S., the industry itself is undergoing complex and confusing changes, many of which involve information systems. The use of IT in medicine has grown in the same way it is growing within the larger cultural landscape: technology is everywhere and though we are not sure what tools may come next, we do know that it is a mainstay. My problem, Steve, is that my nurses and doctors are not prepared to navigate all this change AND take care of their patients!

Information systems in health care practices have not just penetrated the exotic sciences of biotechnology and nanotechnology. The use of database management systems, network-based infrastructures and the significant growth of web-based systems- all paired with recent government legislation- is part of an industry-wide boom that will forever change the landscape of health care practices and administration. We are headed for the Perfect Storm.”

I began to sense that this was no longer a casual conversation. Mary Jo had just shared some of the most persuasive comments regarding the state of technology in healthcare I had heard in quite a while. I looked at Mary Jo and said, “In which booth did you hear this?” Then I smiled and tried to bring some needed humor to the moment. She was not having of this, and said, “This is serious; we are about to expose our clinicians to all of this technology and we do not have the staffing we need to manage through this maze. We do not have the training dollars or the right methodology for adoption of this innovation onslaught.” As I poured a full glass of wine for Mary Jo, I smiled and said, “I think I have a solution to our conundrum.”

Realizing that I needed to bring some kind of solution to the table, I commented that have seen some very exciting solutions to our situation and asked Mary Jo if she had over the course of the last two days seen what was being done in the area of Web Portal Technology and Customization for healthcare, specifically the hospital-based Provider. Mary Jo took a drink (complementing me on my choice of wine) and said, “Do tell.”

I shared my story with her on what I saw and learned at the show regarding the Oracle and Microsoft customization of Web based Portal technology that allowed access to and use optimization of:

• Electronic Medical and Health Records (EMR/EHR): With single sign-on and access from anywhere, any time. Currently, approximately 9% of US hospitals and doctors have deployed basic EMR systems, with that number predicted to double in coming years. With Web Portals, hospitals will have greater ability to use these exciting tools any time, from anywhere, by anyone with proper security access – doing more with less.
• Regulatory and Legislative Trends: Two related and complex regulatory and legal requirements are ICD-10 and HIPAA 5010. These both require a sea of change in how healthcare organizations use technology to manage data. With the advent of Portal customization we can leverage our resources to accommodate these required changes in the delivery of healthcare.
• The Information Technology-savvy healthcare professional: General healthcare infrastructure Operations Management, that is, how the healthcare system works. This includes managing and implementing successful projects in healthcare environments. The application of healthcare-specific IT management theory and practice needs a venue where anyone, anytime, from anywhere may access this technology and Web Portals accomplish this!

I took a breath, also taking a good healthy drink of wine, and said to Mary Jo, “We have seen and heard some outstanding presentations, spoken to industry experts, and taken away some just in time solutions, one of which is Web based Portal Technology.”

As I took my last sip of wine, I pointed out to Mary Jo that the current environment can be likened to the Titanic and the iceberg: much of what is inevitable is not in plain view, but is known to exist. Failure to plan a comprehensive execution strategy to address the above would come at a very high cost both in resources and revenue.

Therefore, those of us in healthcare management must be positioned to exploit the ensuing chaos and resultant opportunities for smooth sailing through the Perfect Storm and based on what I learned here at HIMSS, the use of Web Portal technology is one of the most powerful tool sets we could implement!

Later that evening, as I finished my last email for the night, I reflected on my sharing session with Mary Jo and realized that I had reached the tipping point in my quest for viable solutions for our clinical staff. When I get back to work, I must take a serious look at this new use of the web.

What a Day! I have come to view HIMSS as the source for what’s happening in healthcare. Today was not different – the floor of the conference was abuzz with folks asking (in almost a whisper):

“Will ICD-10 really be enforced by CMS come October 1^st, 2013?”

“Will we really need to have all of our systems switched over to accommodate ICD-10?”

And my favorite: “CMS will grant extensions to Providers – right?”

As I wandered through the maze we call HIMSS 2012, booths that featured anything to do with ICD-10 Assessment, or Remediation, were packed (ok, it is HIMSS) with people needing the answers to these questions. As I listened to the questions and responses I began to realize that the folks asking the questions were looking for answers that relieved their fears and anxiety – too bad, they will not get the ‘right’ answers they were looking for.

I say this not because I have a crystal ball and looked into it, or that I am in the know I know the answers because I heard these same questions last week in a Town Hall conference call with Congresswoman Jackie Speier. In this Town Hall meeting, there were a number of healthcare executives asking the above questions expecting Ms. Speier to save the day and share what CMS was really going to do and when.

One could hear a pin drop (and on the phone that is quite difficult) waiting with bated breath for the answers. What we heard was not what was expected…

To the question: Will ICD-10 really be enforced by CMS come October 1^st, 2013? – the answer was a soft-spoken, but clearly pensive response: Yes, the CMS mandate will be carried out as stated by CMS at this point in time. This could be taken in any number of ways, which was, from my perspective, what she wanted (or needed) to say. After all, she does not have a crystal ball either.

To the question: Will we really need to have all of our systems switched over to accommodate ICD-10? This was a question Jackie could not answer, but she did her best by handing it off to her go-to guy at her district office.

He addressed the question by backing into it – he began by clarifying that if CMS is going to need all claims submitted in ICD-10, it would appear “common sense” that a hospital would need to make sure they were prepared to file any claim in ICD-10 format.

At the completion of his response, it was as if the phone line was cut – the person asking the question thanked “Mr. Go-To Guy” and I guess was either out of questions or stunned by the response…

To the question: CMS will grant extensions to Providers’ – right? This was an easy question for the Congresswoman to answer., Her response was the same I have given when asked a question dealing with the future: “It depends” was Ms. Speier’s retort. Then she gave some pithy examples, however as the caller continued to want a definitive answer, the Congresswoman continued to hold the line: “it really does depend on many factors that we to take into account.”

Oh well, so much for getting answers from the horse’s mouth. Perhaps tomorrow as I roam the HIMSS Conference floor, some in the know vendor will have the right answers – I guess “it depends” on who I ask…

On the floor of HIMSS, day one – late afternoon and not even half way through the booths. Thus far I have felt much like Alice in Wonderland, LOST and wondering which way to go!

As I made my way through the crowd, I stumbled into a booth where the banner “Follow the Money” was displayed; it intrigued me (which, I guess, is why they had the banner) like a moth to a flame. So I walked around a bit and then I realized what this was all about – this was a vendor focused on Business Intelligence (BI) Analytics.

Standing before me was a tall, well dressed executive banker looking gentlemen explaining to a couple of Hospital CFO’s why BI Analytics was so important to them. I became a fly on the wall and caught one of the most compelling explanations one could want to share with the likes of a Hospital CFO.

The story focused on what the current healthcare financial leaders should be collecting information on for the foreseeable future – initiatives that will help them increase their organization’s margins in 2012 and beyond, such as:

• Payment policing and standardization of contract requirements
• Contract performance modeling
• Shift in volume and cost risk to hospitals
• Consumer-directed health plans, price transparency and pay for performance
• Health plan consolidation
• Value-driven health care

As the discussion continued it was brought out by the vendor that the healthcare industry is at a crossroads. Healthcare spending is growing three times faster than wages and is expected to double from current levels to exceed $4 trillion by 2016, according to a Health Affairs article. As he went on, he pointed out that there is tremendous pressure on key industry stakeholders (here is where the two CFO’s started to become fidgety) to mitigate this cost growth.

This cost pressure means that hospitals need to extract additional efficiencies out of their operations and spend more time on revenue strategies. Hospitals will need to work with their respective leadership teams toward achieving more controlled growth in medical spending. Stakeholders, including government, employers, payers and providers are forging ahead with several models to contain the growth of healthcare costs and ensure quality of care. Price transparency, consumer-directed health plans (CDHPs), pay-for-performance (P4P) programs, health savings accounts and the payment incentives of the Centers for Medicare and Medicaid Services (CMS) are all moving healthcare in that direction. Regardless of which model reigns, in the future a greater emphasis will be placed on the value of healthcare services with the demand for transparency of service price.

These cost-saving and cost-shifting initiatives require hospital financial and clinical leaders to spend more time analyzing the data, but how is this to be done with the tools currently being used by the overwhelming majority of hospital financial systems? I was holding my breath waiting for the answer, when the vendor emphasized – YOU CAN’T! Now he had everyone’s attention…

Then, like a bolt of lightning, the vendor uttered the word, no different than that memorable scene in ‘The Graduate’ when, (I am sure it was this vendors dad who said this in the film) at a party, the vendor told Dustin “in a word Plastics.” So when the current vendor uttered the word ANALYTICS – we got it. To make all this happen he said, “you have to follow the money.” And how do you do that? You do it with Healthcare BI Analytics.

The moral of this story for me was get back out on the floor and search out those consultant firms that specialize in Healthcare Analytics because one thing is for sure: we need to better enable our healthcare financial leaders to FOLLOW THE MONEY better! And the way to do that is with BI Analytics.

Signing off from the floor of HIMSS 2012. Now go find that firm who will help you Follow the Money!

In a word: YES!

A hospital’s enterprise performance management program should offer proof that comparisons of actual performance against strategic objectives enable the healthcare organization to achieve rapid and effective organizational change. There are four initiatives that may go a long way to operationalize such a program initiative:

• Align performance metrics with strategic initiatives
• Structure dashboards for the CEO
• Link performance to annual reviews
• Customize dashboard views to the specific end user

Many healthcare organizations possess a wealth of untapped strategic information in their transaction systems (EMR, HIM, etc.). If this information could be summarized in a meaningful and intuitive manner and updated on a routine basis (daily if possible), senior leadership for these organizations (CFO, CNO, CMIO, CIO, CEO, CMO) would have real-time views of actual performance against strategic objectives, and could use the data to facilitate the allocation of scarce resources and accelerate change in a structured manner.

In the past ten years, there has been a “movement” afoot to begin tracking key performance indicators (KPIs) that impact financial performance of the provider enterprise. Those CFO’s who are able to muster the organizational resources to develop these KPIs can better monitor and manage performance across the organization’s multiple facilities. Provider organizations that have accomplished this process of data analytic dashboards have seen a dramatic reduction in operational costs in nursing, LIS, and personnel.

For example, when Cleveland Clinic’s CEO mandated that KPI dashboards be developed and that hospital management use these dashboards to track operational costs, the following benefits in the quality of patient care, and cost containment were realized:

• Reduced nursing agency expenses by more than $5 million per year since 2006
• Reduction in blood product expense by more than $400,000 annually through careful analysis of blood product usage. More effective recruiting of clinical professionals to prepare for seasonal shifts in employment

Focusing on Key Performance Data: In order to build out the necessary KPI dashboards that will deliver on the notion of reducing cost, one must assess the current state of operational drivers that have an impact on financial performance within the hospital. The status quo methodology is to evaluate the organization’s performance metrics based primarily on financial outcomes. Applying metrics to operational drivers allows the organization to better appreciate the relationship between operations and finance, enabling the organization to align operational tasks with strategic goals. Historically, healthcare organizations have focused on improving their revenue cycle and financial performance. However, today’s additional regulatory compliance and improved quality of care mandates there is much more to focus on than revenue cycle and financial performance.

One access metric that a provider should consider tracking would be hospital registration throughput for those patients registering for a procedure. Patients registering and being scheduled for a procedure in a particular department could be tracked and surveyed regarding service levels and quality of interaction. The provider would establish a goal to have the in-patient registration process completed within a specific time frame for the process.

With the focus of both managers and staff, timely goals could be established. Using the information within the analytical dashboards, the progress and success of these goals could easily be tracked.

One might ask, “Is improvement as simple as identifying the issue and monitoring for change?” Providing managers and staff with accurate, intuitive and easily interpretable data is one-third of the recipe for improvement. The other key ingredients are alignment with strategic objectives and a system for accountability.

To help encourage improvement in areas that involve physician participation, the CNO and CMO could use monthly medical executive committee meetings to reinforce the importance of key metrics, review performance in a transparent forum and give physician and nursing leaders an opportunity to share best practices.

Anyone who has had to track KPIs manually will be quick to share that it is a labor-intensive task that requires extracting data from system audit reports on a weekly or monthly basis. The data, which is generally a month old, may have been extracted into Excel 13-month run charts and compared with targets. Those who have done this work will speak to the fact that such labor intensive work effort produced modest improvements in practice and performance, especially around the revenue cycle. When introducing automated functionality (KPI dashboards) to the process of tracking KPIs, the initial success of this effort has been noted to prompt hospital leadership to identify additional operational drivers that have an impact on financial performance.

It has been reported that by introducing healthcare analytic dashboards into the hospital organization users were able to take a minimum of 20 operational indicators via a monthly “performance wheel” report and distribute them to executives in over 150 departments on a routine basis with minimal impact to staff. By graphically representing all indicators on a single page the performance wheel facilitated tracking of current performance against target goals and the previous month’s performance. Indicators included:

• Relative value unit (RVU) per staff full-time equivalent (FTE)
• Average direct cost per case
• Average patient length of stay (ALOS)
• Speed of answering appointment calls
• Coding denials

It was further noted that these performance improvement efforts created a new culture of accountability and led to a heightened interest in expanding the use of indicators to improve performance, further enabling executives to focus on the indicators that reflected the organization’s priorities. New indicators could be implemented to track revenue cycle effectiveness. When dashboards were implemented, denials decreased, accountability for obtaining prior payer authorizations was established, patient access improved and operating income increased significantly.

Once the organization had determined that daily extraction of data and delivery of information would be possible, significant improvements to performance were noted. This new business intelligence infrastructure has the ability to also consolidate data into a distributed enterprise data warehouse model linked to highly intuitive dashboard views customized to the end user.

The more efficient infrastructure, combined with web-based tools, will enable the hospital to create executive dashboards that provide daily information via the intranet. These dashboards have the capacity to display a balance of KPIs from finance and operations to provide a high-level view of performance across the entire enterprise. Meanwhile, unit-manager dashboards may be created to facilitate a more concentrated focus on performance within a specific area.

Accelerating Performance Improvement: The timeliness of the data presented in the dashboards enables executives to closely monitor operational performance and even evaluate the effectiveness of interventions in as close to real time as possible. From a workforce-management perspective, the specificity of dashboard data allows managers to monitor labor productivity on a daily basis to drive performance improvement.

For example, nursing dashboards used within the hospital consolidate critical performance information in one easily accessible location. Major KPIs in the nursing dashboard may include:

• Productivity
• Patient experience, such as the criteria contained within the CMS’s and the Agency for Healthcare Research and Quality’s Hospital Consumer Assessment of Healthcare Providers and Systems program
• Quality metrics
• Drill-down capabilities into key human resources metrics, such as overtime by job code and employee

Dashboards support focused initiatives for performance improvement. Through a combination of focused interventions on root causes and weekly monitoring of agency costs, hospitals have reported the reduction of nursing agency expenses from more than $500,000 per month to less than $50,000 per month, thereby reducing annual expenses by more than $5 million. Of course, most of the reductions in nursing overtime and agency expenses were simply the result of raising the awareness of the nurse manager of KPIs using the dashboards.

One significant advantage of the dashboards is that they present cost, productivity, quality and patient experience data in a single location, thereby helping executives analyze the interdependencies between performance metrics. For example, the dashboards allow users to investigate the relationship between hours per patient day, skill mix, quality of care, and patient experience.

Tapping the power of business intelligence is not simple and the investment in personnel and infrastructure can be significant. The key to success in this type of initiative is the organic development of business intelligence tools and the strong partnership and level of trust between a hospitals finance and operations teams. The ability to pinpoint and evaluate clinical, operational, and financial interdependencies provides a more holistic view of performance at a time when payers and consumers are demanding more accountability for clinical outcomes and patient experience in today’s complex in-patient hospitals. Such a synoptic view of performance across all levels of the organization also can crystallize expectations and priorities – and help to focus scarce resources on what is truly important – the highest quality care at the lowest possible cost to the patient; just ask your hospital CFO.

References for this blog post:

• http://www-935.ibm.com/services/us/imc/pdf/cs-cleveland-clinic-092605.pdf
• http://www.carefx.com/businessintelligence/
• http://www.clevelandclinic.org/innovations/pdf/InnovatorAwardsDinnerArticle_Oct.pdf

Provider Institutions (hospitals, medical centers and other health systems) are currently at a crossroads when considering how to best represent clinical and business information in a meaningful way that can be understood by all levels of the organization. We find increasing awareness and use of “digital dashboard technology” to provide relevant information to clinicians and hospital administrative staff in a visually rich, easy to understand format to improve the quality of patient care, as well as develop strategies to reduce cost in the delivery of improved patient care.

Designing and using clinical dashboards requires substantial clinical (physician and nursing) involvement and a well-defined process. The criteria for developing a model for a Data Store, a data warehouse and series of individual dashboards, may be of use to you and your organization as you move forward in the world of healthcare analytics dashboards. After all, Information Technology (IT) is not useful if it is not meaningful to the user. Here are the 8 steps that can ease your transition into healthcare analytical dashboards:

1. Meet with users to determine data needs
2. Design the appearance or presentation layer
3. Design the semantic layer
4. Design the physical layer
5. Develop and test all 3 layers
6. Perform QA
7. Conduct a Pilot
8. Begin general rollout

Here are basics for these steps:

1. Meet with clinical and business users to determine major data needs. Many users and potential users of dashboards aren’t familiar with the systems’ power and capabilities. They typically use non-interactive spreadsheets and graphs that present data in fixed rows and columns and lack the flexibility of Web-based tools. The first step in this phase is to inform clinicians of the many additional possibilities that a more powerful tool offers, with examples that are clinically based. First, build sample dashboards to demonstrate the tool’s capabilities and how having these dashboards added value to the work being done by the user. Then ask clinicians to identify several key measures, dimensions and filtering criteria for the dashboards they were interested in.
2. Design the appearance or presentation layer. For dashboards to deliver the most benefit, users must agree on appearance and presentation standards before the design phase begins. It’s crucial to achieve agreement on items such as color schemes, graphical objects and navigation standards so future dashboards will look, feel and behave consistently. This will improve user satisfaction and reduce training demands for each new dashboard. This also is very important in separating specialty and sub-specialty areas. Design of these dashboards requires that we think carefully about the hierarchy of the data they want depicted in the dashboards and what levels of the hierarchy will be visible to the user. In our example, the hierarchy is Specialty-Practice, Physician, and Patient. Depending on a user’s security status, he or she may or may not be able to see the patient data. Once the hierarchy and associated measures were grouped into a dashboard page, select the graphical elements. Histograms, line graphs, pie charts and simple tables present the data in an intuitive fashion that meet users needs and simplify navigation throughout the dashboard pages.
3. Design the semantic layer. The semantic layer maps the presentation layer to the physical layer. Developers prove their worth in the design of this layer. Defining patient populations by disease categories, grouping drugs hierarchically by therapeutic area and organizing physical locations are examples of the challenges that the semantic layer’s designer faces. Users play a key role in formulating those definitions. In-depth knowledge of both the presentation layer design and the physical data models is essential.
4. Design the physical layer. As mentioned, try not to change the design of the physical layer. Whenever possible, avoid creating an entire new physical data structure, because doing so generates the need for additional extract, transform and load (ETL) steps each time the clinical data warehouse is updated. Redundantly storing data produces additional storage, backup and maintenance costs and opens up the risk that duplicate copies of data won’t be updated with the same frequency as the original.
5. Develop and test all three layers. Users who are new to the dashboard development process will likely need to see how the systems operate with real data. It is useful to introduce clinicians to a working prototype to gain early feedback on the design. Regularly scheduled demo and review sessions (biweekly was noted to be best) help developers refine and test the design. When you’re engaged in this phase of the project, take care to manage scope creep, since the clinical user and business key stakeholders and/or participants might be tempted to request new capabilities or data that weren’t in the original design. Put off responding to such requests until a subsequent release of the dashboard has been completed.
6. Perform quality assurance. Here are several quality-assurance requirements developed during deployment activity:
   • Use data from the actual data warehouse, rather than simulated or test data.
   • Include weekly, monthly and quarterly data warehouse updates during the QA process, especially when the data being used in dashboards will cross calendar months, quarters and years. A year-end data update would be ideal, but most projects can’t wait that long.
   • Compare dashboard data to the original source systems, to ensure that no translation or presentation errors were introduced during development.
   • Test system performance and response times with large amounts of data to ensure that the dashboard responds effectively to users’ needs.
7. Conduct pilot tests. Before making a dashboard available to the general clinical and business population, ask a small group of users to pilot-test it for a few weeks as a short extension of the QA phase. This provides additional information on usability, performance and quality.If the pilot group (users from the clinical and business setting) recommends moving forward, proceed to roll out completed specialty department dashboards to “key users” within the general population of that specialty. If the pilot group identifies problems, the development team resolves them in as much of a “real time environment” as possible to decrease the development cycle time.
8. Begin general roll-out – This phase involves these major components:
   • User orientation: New clinical and business users may need a brief training session on how to set up “My Dashboard” views and reports. Those who have used dashboards in the past should be able to use the new dashboard with no assistance, as long as the presentation layer was designed well. These users can also act as trainers to those needing assistance. “Users training users” works better when dealing with the clinical end user.
   • Support documentation: Gather design and operational specifications and post them on support sites. Also, develop a “one page” data sheet on how to use the system and post this to the organizational training web site, as well as How To documents with screen shots of the tools in use.
   • Help-desk hand-off: Write scripts and give them to the help desk for guidance in responding to support calls. Having staff that are better suited to communicate with clinical staff may prove very helpful as well. This could be an RN who has the technical expertise to demonstrate how the tools work and show users how to best exploit the technology.

So, there you have it, follow these eight steps and your organization will save development time, insure that the dashboards will be used by those who requested them, and most importantly, you will give meaning to the data, which in turn makes the data useful!

Has your organization implemented healthcare analytic dashboards? How have these 8 steps helped?

As we approach 2012, it is critically important to consider the implementation of Healthcare Analytics. This point could not have been made more clear to me than it was during a final “orals presentation” prep to a recent prospective healthcare system client.

“Technology has finally been embraced (begrudged by some in Healthcare) by the Healthcare industry, just as Providers are facing the quandary of how to assemble useful information from the enormous amount of healthcare desperate data available through EMR’s, CPOE systems, HIM claims processing systems and other departmentDatabase systems we all know exist within a Provider”.

While we were making ready for the team preparation, I started asking myself “what are the reason(s) we [in healthcare] are racing to deploy Healthcare Analytics, and continue to miss the target?” Then it came to me, we are healthcare people – focused on delivery of healthcare, not PhD statisticians with a research team focused on the problem. However, the leadership teams charged with improving the healthcare “bottom line” still need to be more focused on how to turn data into strategic and meaningful information – I have noted five strategies that may just do the trick, read on! That said, first, know the “end game”, namely your goals and challenges.

Goals and challenges: We all need to bare in mind that that “Healthcare analytics is the Holy Grail with respect to the enhanced delivery of healthcare,” The conversion of lab data, CPOE stats, consults, and the myriad of other related data into meaningful trends holds the promise of increased coordination of patient care, patient safety, increased quality of care and cost-efficiency for not only individual patients, but also for provider system, is one of the strategic goals of accountable care. However, turning patient data into usable information is challenging; furthermore, once healthcare providers can access the information, determining how to act upon it poses even more problems.

Finally, one must differentiate between healthcare data – the facts entered into the EMR – and information – the interpretation of the facts in a meaningful context. Just because you have a lot of data doesn’t mean you can do anything with them. It becomes mission critical, especially today with all changes occurring in healthcare, to get as much data converted into information that is usable. What is needed are strategies to get the ball rolling!

Five Strategies to Consider:

1. Establish a Governance body (not just an org chart). Hospitals should set up a governance structure to manage implementation of data analytics capabilities. The CEO, CMO, CNO and CIO should all be involved. The CMO and CNO need to communicate the kind of information they want to the CIO, who has the IT knowledge to conduct the actual implementation. “You need to have a governance structure [in which] the CIO takes the lead but has the [CMO and CNO] to always ensure that whatever he or she is doing is going to meet their needs,” he says.

Hospitals should also consider partnering with a professional organization experienced in Healthcare data analytics. Reason being, the learning curve would be much steeper and the time to implementation longer if the providers try to create an analytical tool on their own. “It’s a major undertaking that takes time and a good deal of effort. [If providers do it on their own] it usually ends up on the back burner and never gets done.”

2. Determine the desired information Wanted. Due to the large amount of data available to providers, from the plethora of data sources, hospital leaders need to define what information they want. “You have to be able to filter what’s really important to you based on the hospital and specialty service you’re interested in. Hospital Leadership should also determine when they want the data, how they want it presented and who they will share it with.

3. Format the GUI, and package the information appropriately. One of the keys to analyzing data is presenting it in an appropriate format. For example, if the hospital wants to understand the lab data for someone whose blood is drawn twice a week for five weeks, simply looking at the 10 data points would not yield any useful information. “It’s meaningless if there’s no reference point,” Instead, the hospital would need to trend the data and benchmark it against regional demographic norms and national averages.

4. Maintain the Level of Data Security. Once the provider has meaningful information, they need to decide who to grant access to and establish security protocols to ensure access is available only to those individuals who need it and have a need to know. Access to information does not have to be all or nothing, however. This is where HIPAA, healthcare ethics, and Governance come into play – decisions of this nature may be addressed with an established review by using the HIPAA standards developed, and the Governance/ethics teams convened by the hospital.

5. Insure Timely and Proper Sharing of the Information Effectively and Efficiently. Even if healthcare data has been converted to information and the information has been secured, analytics cannot produce benefits of improved quality and reduced costs if the information is not shared effectively. Therefore, it is a strategic choice to use a “push” rather than a “pull” technique for sharing information with those within the healthcare system that may need it.

Present it to them in their daily work. Don’t [make] them try to find it. The difference between “push” and “pull” is similar to opt-out and opt-in systems. In a “push” environment, the individual would be automatically presented with data that they would have to consciously ignore or dismiss – or opt out of receiving it. In contrast, a “pull” environment would require individuals to find the information themselves, or opt in. The former method increases the probability the individual will be aware of the information they can use to improve patient care.

Following these five strategies may not be all that you need to do, but it WILL get you started down the path of getting what you want – meaningful and actionable information that will be strategic in reducing cost and most importantly, improving the delivery of patient care…