The right Business Intelligence (BI) tool can address the twin challenges of today's healthcare industry and regulations: efficient, secure information retrieval and effective monitoring of day-to-day operations.
In February 2009, President Barack Obama signed the American Recovery and Reinvestment Act (ARRA). Title XIII of ARRA, called the Health Information Technology for Economic and Clinical Health Act (HITECH), allocated $19.2 billion toward the development of healthcare Information Technology (IT). This act seeks to bolster health IT to improve the delivery of healthcare in the U.S. by incentivizing the implementation of Electronic Health Records (EHR) and “Meaningful Use” of them. With various provisions and regulations, the Act provides assistance, tools, and resources to providers to allow for implementation and utilization of electronic health records.1
Patient Care vs. Asset Usage
A good Business Intelligence (BI) tool can accomplish a variety of tasks in a relatively simple way without overtaxing the Information Technology (IT) staff.
There are many tasks that hospital executives need to deal with on a regular basis. On the surface, two of these tasks—effective patient care and efficient use of assets—seem at odds with each another. In today’s healthcare environment, this is a critical area where an effective leader with the strongest tools can enjoy a distinct competitive advantage.
To achieve an advantage, healthcare executives need information that is both relevant and timely. Accurate, timely data is true “value data;” old or inaccurate data is not data at all.
The EHR incentive programs, which began in 2011, give payments to eligible professionals, eligible hospitals, and critical access hospitals as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology. “Meaningful use” means providers need to show they’re using certified EHR technology in ways that improve care.
Health IT systems, including EHRs, help providers communicate better with each other about patient care, which reduces medical errors, helps cut down on paperwork, and cuts out needless duplicate screenings and tests. These all lead to better coordinated patient care and lower health care costs.2
Empower Users With Simplicity
Executives are not alone in the quest for meaningful data. Other users can benefit from the ease of using a desktop icon to get a current snapshot of their area of concern. A dashboard of data related to the decision-making process can be a very valuable tool. In fact, a customized, optimally designed dashboard can put relevant, useful data right at the user’s fingertips.
The ultimate focus of a dashboard is to give a user an easy way to access related pieces of data to help them in their decision-making process. However, if the data isn’t current, they won’t use the dashboard. A good BI tool lets dashboard designers create the metrics needed by the users who rely on it, without a full blown, drawn-out, IT-intensive project.
Empower Users With Timely, Relevant Data
A good BI tool needs the ability to “look” at data that is as current as the user needs it to be.
Selecting which metrics to place on a dashboard is just as important as the ease of access. A desktop shortcut is a simple way to empower users with data. But, it can become a white elephant if the data in the dashboard isn’t relevant to the user’s needs. As the accompanying table shows, Key Performance Indicators, or KPIs, are extremely useful in dashboards. They give users powerful options for choosing the data that appears in the dashboard.
When a user accesses a dashboard or shortcut, the relevance of the data is as important as the content. A metric that may appear useful, becomes less so (to the point of uselessness) if the data is not timely or relative to the subject. In the financial world, for example, accountants often look at data in terms of a time period: a week, a month, or a year. The data they are looking for does not have to be up to the minute.
However, in the healthcare industry, many financial executives need to see the daily activity in certain areas to make informed decisions or adjustments. Whether a hospital or a department is headed in the desired direction depends on certain measurements. Seeing trends as they occur allows executives to take action to correct or improve the trend. Clinical personnel need information that is even more timely and up-to-the-minute. And, operational users may rely on data that is entered after an event, such as patient surveys.
Table: Common Key Performance Indicators
Empower Users With Seamless Data Retrieval
A good BI tool must allow dashboard designers to access data across platforms.
Many users who rely on data don’t know, or care, where it comes from—they just know that they need it. In reality, they often need to see data that is combined from different sources to get an accurate picture of the activity they are monitoring.
In today’s increasingly complex IT world, the data recording and the data collection may occur on different platforms. For example, a medical staff might enter the following types of patient data, in real time, using a PC program:
- When the patient first arrived at the hospital
- When the patient was admitted
- When certain medicine was administered to the patient
- When a specific test was performed
- When a physician examined the patient
And, this data might be stored in a PC database, such as Microsoft SQL Server. But, the hospital administrator’s dashboard must compare the codes used by the medical staff with the diagnostic codes used to bill the patient’s insurance company to catch discrepencies before the bills are submitted. This process can shorten the time required for the hospital to get reimbursed and improve their financial position.
These codes and billing information often reside on a much larger, more secure, platform than a PC, such as Power SystemsTM running IBM i (System i,® iSeries,® AS/400®) or, someday, Watson. And, different machines or platforms often store data differently, making cross-platform communication a challenge.
We are seeing data-driven personalization happening in delivery systems, care management programs, value-based insurance programs, mobile health and consumer engagement platforms, among others. The marriage of wearable sensors with electronic medical records and other enterprise data is feeding “big data” analytics systems that drive significant personalization of consumers’ healthcare experiences.4
Patient Care And IT
Obviously, there is a bit of bias when you ask an IT professional if improvements in the technological infrastructure could benefit the entire organization. But, there is some truth in the statement: “When you have a stable foundation, you have a better overall structure.”
Most IT leaders believe that IT can have a positive impact on patient care by improving clinical/quality outcomes, reducing medical errors, and helping to standardize care by supporting evidence-based medicine. Clinicians also are playing a bigger role in shaping IT use in their organizations by providing input about their needs.
In the 2012 Annual HIMSS Leadership Survey, participants were asked to select from a list of choices indicating areas where IT could have the most impact on patient care:
- Thirty-eight percent (38%) of respondents indicated improvements in clinical and quality outcomes. (This was also the most frequently selected item in the 2011 study.)
- Twenty-two percent (22%) of respondents indicated reducing medical errors/improving patient safety.
- Sixteen percent (16%) of respondents indicated standardization of clinical care using evidence-based medicine.
Interestingly, respondents were least likely to select remote monitoring of patients and ensuring that patient data is private and secure.
Obviously, improving patient care is a huge challenge in today’s healthcare world. Increasing patient volume with the aging baby boomer population has executives eyeing the future, while dealing with a myriad of issues today. The seemingly constant change in supply costs, staffing, and salaries keeps them on their toes. Increasingly stringent governmental regulations and requirements require a variety of information at a moment’s notice.
Progress In Spite Of Obstacles
A good BI tool lets organizations create visibility to the information without a large IT or development staff.
Many organizations trim their IT staff along with other departments during tough economic times. This causes the IT staff to carry more of the workload required to gather data to meet governmental, operational, and clinical needs. Nearly one-quarter of the respondents in the 2012 HIMSS survey indicated concern regarding the staffing resources needed to implement IT projects for EHR. This was a change from prior years where the overall lack of financial support for IT was counted as the main barrier.3
When the average user has a tool to see the data they need to see, both the tool and the user become more powerful. If that same tool expands the range to power users and IT staff, the entire organization flourishes. However, it is still critical to train new users in the appropriate use and understanding of the data they’re seeing, regardless of their level of expertise.
Security is an extremely important discussion at all healthcare organizations. With the need to comply with the Health Insurance Portability and Accountability Act (HIPAA) and other regulations, centralized management of both the data and the software used is required. The choice of platform is the first step for a sound security decision. The Power Systems platform, for example, has security features, such as auditing, built into its operating system. This system was the first general purpose system to attain the Department of Defense C2 security rating. And, its operating system (IBM i) has never been successfully attacked by a virus.
IT security breaches continue to plague organizations, but the reduction in actual violations reported this year suggests that efforts to secure patient information are working. Compliance with HIPAA security regulations and Centers for Medicare and Medicaid Services (CMS) security audits dominate the IT executive’s security concerns.3
The US Office of Inspector General has performed dozens of independent audits of departmental agencies, as well as audits of state and local governments, contractors, and hospitals. The audits have identified vulnerabilities in the following areas:
- Network access and management
- Security program infrastructure, including security program documentation, contingency plan documentation, system inventory accuracy, and acknowledgment of management responsibilities
- Security training
- Personnel security, such as background checks and user account management
- Oversight of contractors
- Integration of security into major applications, including certification and accreditation, contingency plan testing, privacy impact statements, and annual self-assessments
Considering the prominent role a powerful BI tool plays, the platform and the security that protect it are especially vital to a healthcare organization.
For any healthcare organization to manage their data efficiently, it must find a way to harness the power of the information it collects and use it to improve the organization’s effectiveness. A good BI tool must:
- Accomplish a variety of tasks in a relatively simple way without overtaxing the Information Technology staff.
- Have the ability to “look” at data that is as current as the user needs it to be.
- Allow dashboard designers to access data across platforms
- Let organizations create visibility to the information without a large IT or development staff.
And, most importantly:
- Place the power of information into the hands of those who need it the most.
“Not having the information you need when you need it leaves you wanting. Not knowing where to look for that information leaves you powerless. In a society where information is king, none of us can afford that.” – Lois Horowitz