BUSINESS INTELLIGENCE (BI) IN
HEALTHCARE
Wisconsin HIMSS – December 11th, 2013
Presented By:
Rich Temple, National Practice Director, Beacon Partners
Kevin Underwood, Manager of Enterprise Reporting,
Aurora Health Care
Agenda for Tonight’s Presentation
• What is BI?
• What makes healthcare unique as it relates to BI?
• How can healthcare organizations derive real ROI from BI
investments?
• Aurora Health Care’s experience with BI and where it is
looking to go in the future
• People, process, and governance – key building blocks
to success with BI
• Questions / discussion
BI: Definition
from
www.businessdictionary.com
from
en.wikipedia.com
BI in Healthcare – What Makes It Different?
• Healthcare is slow to embrace new technology, in
general
• Many disparate systems across different niches of
the healthcare system that need to be “normalized”
(departmental, financial, supply chain, clinical,
quality, revenue cycle, hospital, physician, HIE, etc.)
• Many different nomenclatures and coding structures
• No easy common identifier for individuals (patients)
• Different variables can impact one another in unique
ways
̵
Example: medications and allergies, this sort of
contraindication is not nearly as pervasive, if present at all,
in other industries
Why The Particular Interest Now?
• 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
Areas of Tangible ROI Utilizing BI
•
•
•
•
• Cash collection tracking and trending
productivity
and
staffing
• Denials
management
• Optimize
Coordination
of care,
case
Correlate
quality,
complications,
and
• DNFB
management
management.,
physician
profiling)
multiple
operational
• toArray
revenue
tools
• of
Tracking
qualitytracking
indicators
and
• readmissions
ACO/PCMH/CQM
reporting
– cycle
variables
• Implementing
costbottom
reduction
financial
line strategies
for possible
detailed dive
and targeted
Identify
patient (including
flow chokepoints
that cost
unit ofPCMHs,
service
costs and or
ACOs,
acquisitions,
interventions
money and
decrease
patient
particular
cost
outliers and units and
collaborations
• you
Population
management
(e.g.,reducing
wait
intocare
physicians
these
outliers)
• Coordination
- clinical
• satsifaction
Readmissions
within
30contributing
daystimes
and of
EDreturns
and ancillary
areas)
administrative
overhead
resource
utilization,
physician
to• theReducing
ED
within
two days
in on late
OR starts
or underutilized
• Overall
supply
chain
management
(unit
profiling,
LOS
tracking
• Zero
Infections
surgical time blocks
costs,• inventory
group
Service management,
line management
purchasing)
6
AURORA HEALTH CARE’S
BI JOURNEY
Who is Aurora Health Care
• Aurora Health Care is an integrated not-for-profit health
care provider serving communities throughout eastern
Wisconsin and northern Illinois.
• 15 Hospitals
• 159 Clinics
• 70 Retail Pharmacies
• Lab
• Home care
• 30,000 employees (1500 employed physicians)
• 1.2 million unique patients a year
• 93,000 IP Adult Discharges
• 6 million patient visits
• $4B+ annual revenue
Aurora IT
• Recently completed a 3 year rollout of Epic EHR system
wide
• Previously used Cerner EHR for 10+ years
• 14 Hospitals at HIMSS EMRAM Stage 6
• Aurora Pyschiatric Hospital is not eligible
• Most Wired Hospitals Award winner for 10 straight years
• Recently redesigned Patient Portal
• Multiple years into Meaningful Use Attestation
• 700+ IT Employees
Aurora BI – Where We Are
• Multiple IT Teams Managing Data
• Multiple Tools / Access Points to Data
• Struggle with Data Governance – Managed by Multiple
Parties
• Lack of Self Service Options / High Demand for Data
• High Number of Distributed Reports / Often Duplicating
Data
Aurora BI – The Good
• Recent Successes:
• AIM (Aurora Information Management) system
• Aurora Daily Flash – Standardization
• Aurora Report Steering Committee
• Core Reporting
Aurora BI – Struggles (Industry)
• Industry Struggles
• Healthcare Spending on IT
• Slow Adoption
• Lower by Percentage of Revenue than Most Private Industries
• Focused on EHR Spending (Meaningful Use)
• Reduced Reimbursement Rates / Cost Cutting
• ROI - Difficult to Calculate Early / Guarantee
• Complexity of Data
• Patient Data (Labs/Vitals/Problems/Previous Diagnosis)
• Standards / Definitions
• ICD-9 (10), LOINC, SNOMED, etc… exist
• Meaningful Use
Aurora BI – Struggles (Internal)
• Aurora Standards
• Large System – Fast Growth
• Diverse System (Hospital Size, Locations)
• Changes in IT Leadership
• Focus on Infrastructure / Technology
• Changes in EHR systems
• Business Focus
• Executive Leadership / Sponsorship
• Difficulty in Prioritization / Changing Focus
• Business Commitment Needed (High)
Aurora – Where We are Going
• Technologies / Platforms Change – Fundamentals Do Not
• Single Reporting Steering Committee
• Provide Executive Sponsorship
• Define Vision
• Data Governance
• Collaboration and Cooperation Across IT
• Standardization
• Core Reports to Drive Business
• Self Service Data – In a Controlled Format
Where Healthcare BI is Going
• Population Management / ACO
• Cost Reduction / Responsible Use of Resources
• Disease Management / Treatment and Outcome
• Meaningful Use
• Research
PEOPLE, PROCESS AND
GOVERANCE
Key Building Blocks to BI Success
Enterprise – Wide Vision
Lay Groundwork for Success Immediately
• 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.
Start Messaging Campaign on Day One
• 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
Engage Stakeholders Directly
• 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 success
Address Basic BI Concepts from Day One
• 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” (“roadmapping”)
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
High-Level Education on BI Concepts
• Customized dashboards
• Access rights
• Drill-downs
• Data governance
• Filters
• Data
validation/normalization
• Alerts
• Trending over time
• Scorecards
• Benchmarks
• Predictive modeling
• Textual searching and
analyses
Engage Stakeholders Directly
Putting the Pieces Together
• 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 enduser feedback
Final Thought
• 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
DIALOGUE / Q & A
Thank You
Rich Temple,
National Practice Director,
Beacon Partners
rtemple@beaconpartners.com
Kevin Underwood,
Manager of Enterprise
Reporting,
Aurora Health Care
Kevin.underwood@aurora.org