presented by: rich temple, national practice director - it strategy, beacon partners

Business Intelligence (BI) in Healthcare

Building the Roadmap to Realize the Fullest Potential of BI to Transform Your Organization

Presented by: Rich Temple, National Practice Director - IT Strategy, Beacon Partners

June 3, 2013

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Heading – Ariel 40

• Why the particular interest now?• Business case / ROI opportunities in BI• How to avoid historical pitfalls• How to achieve true transformation through BI• Building the BI roadmap• Dialogue / Q&A

Agenda

Heading – Ariel 40• Providers having to do more with

less% Affordable Care Act (ACA)

reimbursement carrots and sticks% Value-Based Purchasing (VBP)% Tighter enforcement of regulatory

mandates

• New healthcare business models eating into traditional sources of revenue% ACOs% Bundled payment% Penalties for sub-par quality or

excess re-admissions

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Why The Particular Interest Now ?


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Areas of Tangible ROI Utilizing BI

Heading – Ariel 40• Potential mergers/acquisitions, clinical integration,

minimizing risk arising from the Affordable Care Act, ACOs, PCMHs, etc.% Predictive modeling / “what-if” analyses% Regression analysis: gauging the impact of one

variable on another when analyzing outcomes

• Coordination of care (clinical resource utilization, physician profiling, LOS)

• Organization alignment: Hospital-Hospital & Hospital-Physician

• Service line management• Achieving economies of scale

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Strategy Development and Implementation


• Improved productivity and staffing• ED optimization

% “Door-to-doc” tracking% ED wait times% ED turnaround time (optimizes revenue and patient satisfaction!)

• IP discharge tracking• Improve patient flow• Track OR utilization and start times

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Improved Operational Efficiency

Emergency Department OperationsReal Time Bed, Patient and Doctor Status, ED Wait Trends

** Information Builders Confidential **


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ED Optimization – “Door-to-Doc” Tracking

• Each bubble represents a physician – larger bubbles mean larger numbers of patients seen by the physician

• X-axis is door-to-MSE time for each physician• Y-axis is MSE-to-disposition time for each physician• Graphs were posted to the doctors – each doctor knew

their own color

BEFORE 30-minute “door-to-

doc program”

AFTER 30-minute

“door-to-doc

program”

Heading – Ariel 40• Overall monitoring of census and visit volume• Revenue cycle optimization• Cost reduction strategies (including unit of

service costs)• Identifying winning and losing service offerings

% Are there particular outliers (e.g., doctors using a particular expensive implant) that are unnecessarily driving up costs?

• Monitoring and improving profitability• Reducing administrative overhead• Supply chain management (unit costs,

inventory management, group purchasing)9

Better Financial Performance

Information Builders Healthcare Solutions Hospital Clinical Operations Management Dashboard

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• Ongoing compliance with clinical best practices

• Coordination of care (clinical resource utilization, case mgt., physician profiling, LOS)

• ACO / PCMH / PQRS / CQM reporting – detailed dive and targeted interventions

• Population management • Patient return to the ED within x hours/days• Readmissions• Hospital-Acquired Infections

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Improved Quality and Clinical Outcomes


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Compliance with Clinical Policies

Following this type of model, large portions of “chart reviews” can be done automatically and nearly real-time!


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Going Deeper – Real-Time Compliance Monitoring


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Sample ACO / Population Management Dashboard

Heading – Ariel 40• Zeroing in on problem areas around MU

requirements, Clinical Quality Measures (CQMs) or Physician Quality Reporting System requirements% Broken by doctor, by unit, by time of day… anything

• ACOs% Physicians whose quality or productivity may be

putting the ACO at risk% Population management initiatives

• Targeting interventions before they require huge and expensive interventions

% Reimbursement modeling (ICD-10 a notable example)

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Some Profound Needs – Today!


• Much at stake in terms of the long-term viability of the provider organization% Need to tightly control their quality indicators as well as key

performance indicators on the financial side

• As healthcare organizations become more complex, these measurements become increasingly challenging and increasingly critical

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Quality and Reimbursement

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BI’s Checkered History – How to Avoid Pitfalls

Heading – Ariel 40• “Nice-to-have” vs. “Must have” - competing

priorities• Integrating disparate data across systems• Lack of an enterprise perspective • Seen as an IT project / lack of focus on end-user

needs• Lack of overall buy-in from leaders and line staff to

the organizational BI vision• Usability – effective optimization of workflows• Data governance and “sources of truth”• Underestimating impact on hardware, network and

connectivity infrastructures

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Where Has BI Encountered Challenges?


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Integrating Disparate Data Sources – Where was THIS?

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How to Deploy BI to Provide Organizational Transformation


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Enterprise-Wide Vision


• Leadership comes together to identify organization-wide vision

• Identify benefits to the organization% Need for detailed data to survive

and thrive% Unambiguous data sources of

truth • Commit the time and resources

necessary to ensure success• Identify non-IT project sponsors • Begin process of identifying subject-

area workgroups to help identify

needs and explore ideal BI solutions.22

Lay Groundwork For Success Immediately


• Early in the process to get everyone thinking in an aligned manner

• Some likely agenda items:% Why Analytics is So Critical Today% What’s Possible with Analytics – Some Sample

Use Cases% Current and Planned Strategic Initiatives% Current State of Analytics% Desired Future State and How Do We Get

There?• What are the likely challenges in getting there?

% Next Steps in Moving Forward 23

Leadership “Whiteboarding” Session

Heading – Ariel 40• Communicate, communicate,

communicate… to EVERYBODY

• Commitment to soliciting feedback from

EVERYBODY at all steps in the process

• Reinforce that BI is now an essential

component of long-term survival for the

organization

• BI is not “Big Brother” – but rather a way to

allow everyone to achieve clinical and

financial excellence

• Engage leadership in ongoing report-outs,

town halls and ongoing electronic

communications

% Use Marketing as a major tool to

accomplish this 24

Start Messaging Campaign on Day One

Heading Ariel 40

• Customized dashboards• Access rights• Drill-downs• Data governance• Filters• Data

validation/normalization

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• Alerts• Trending over time• Scorecards• Benchmarks• Predictive modeling• Textual searching and

analyses

High-Level Education on BI Concepts


• Data governance % Who owns what data and how is it to be rendered% Duplicative, potentially conflicting data across multiple systems

• Data validation / normalization • Data visualization• Begin the process of identifying and

prioritizing BI “use cases”

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Address Basic BI Concepts from Day One

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Building the BI Roadmap


• It is all-too-tempting to start the heavy lifting of data mapping and code building to populate a data warehouse right away

• Resist the urge to do this (except at a general level for predictable data needs)

% Analogous to getting directions from Mapquest without knowing where you’re going

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First Define the Destination

Heading – Ariel 40• BI cannot be effectively deployed on a

department-by-department basis% Too many disparate systems% Inability to validate specific sources of

truth

• To build a BI Roadmap, stakeholders need to be brought together to begin identifying:% The overarching vision for BI in the

organization% Current-state reporting capabilities and

gaps based on current internal needs and regulatory requirements

% Future needs based on downstream mandates (ACA, ICD-10, collaborative arrangements with other providers, etc.)

% What is possible with BI29

Developing an Enterprise BI Roadmap


• Provide the resources to design, build, validate, deploy, and maintain the BI infrastructure

• Establish a formal governance structure for the project

• Assurance that workflows across the enterprise are restructured to fully utilize the new BI tools

• Leadership meetings should have the BI tools as their agreed-upon basis for metrics% Be prepared to embark on true

organizational transformation to have meetings and accountability be based on agreed-upon data points from the BI tool

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Developing an Enterprise BI Roadmap

Heading – Ariel 40• Interview both leaders and line staff

• Ask about current-state pain points

and perceived needs to optimally

perform tasks

• Partner operational leadership, IT

staff, and analytics staff so that

communication challenges can be

bridged immediately

• Consciously seek to build

enthusiasm and involvement among

all stakeholders

% You want all stakeholders to feel as

though it is their system and they

have a stake in its success31

Engage Stakeholders Directly


• Attempt to inventory all “use cases” (specific types of reports that stakeholders indicate will help them perform their duties most effectively)

• Have operations, IT and analytics team members work collaboratively to complete worksheets that speak to details about each use case

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• Begin the process of establishing how a data warehouse will be designed and what the likely hardware/storage/connectivity requirements will be for this

• Don’t go TOO far down this road % Much of what will be designed will be directly impacted by your engagement of stakeholders, but …% Begin the process so you can have some sense of estimated costs, staging logistics and what will need to procured

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In Parallel to Outreach Efforts


• Prepare high-level implementation plans to lock down resources and prepare the organization for what will need to be done and when

• Again, don’t go TOO far down this road % Your discovery process will have a profound impact on what your implementation plan will look like

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In Parallel to Outreach Efforts


• Steering Committee to review information gleaned from the

discovery process

• Roadmap to be driven by specific end-user use cases

• Based on need and technical challenge, prioritize when use

cases will be deployed and offer modifications as needed

• Process in place where alternate suggestions can be offered

• Governance structure that can review and sign off on the BI

Roadmap

• PITCH THE BI ROADMAP to the entire organization

• Offer opportunities for last-minute revision based on end-user

feedback

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Putting the Pieces Together

Heading – Ariel 40• NOT an IT project!!!• IT does play a major role in deploying

and maintaining, but the project must be sponsored and overseen at the highest (non-IT) levels of the organization

• Make sure all necessary staff is dedicated to this effort

• Solicit input aggressively but take a hard line that people have to use the system when it is fully ready for deployment

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Final Thought

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And Let the Journey Begin!

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Dialogue / Q & A

1.800.4BEACON │ BeaconPartners.com

BOSTON · CLEVELAND · SAN FRANCISCO · TORONTO

Thank You

Rich TempleNational Practice Director – IT Strategy

Beacon [email protected]

presented by: rich temple, national practice director - it strategy, beacon partners

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