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ENTERPRISE HEALTHCARE BI 2016

GETTING VALUE FROM BI TOOLS: A U.S. AND GLOBAL PERSPECTIVE

| O C T O B E R 2 0 1 6 | P E R F O R M A N C E R E P O R T

1 I Global BI 2016 This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price.

ENTERPRISE HEALTHCARE BI 2016

Getting Value from BI Tools: A US and Global Perspective

TABLE OF CONTENTS DISCOVER FINDINGS ............................................................................................................. 2 DRILL DEEPER ............................................................................................................................ 6 COMPARE VENDORS ............................................................................................................. 29

Fully Rated Vendors

Dimensional Insight Health Catalyst IBM Information Builders McKesson Microsoft Oracle Qlik SAP SAS Tableau

Component Vendor

Epic

EXAMINE DETAILS ................................................................................................................... 52 KLAS PERFORMANCE DATA .............................................................................................. 65 SUPPLEMENTAL EVALUATION COMMENTARY ...................................................... 69

ENTERPRISE HEALTHCARE BI 2016GETTING VALUE FROM BI TOOLS: A US AND GLOBAL PERSPECTIVE

BI and analytics solutions are ever important as providers across the globe rise to meet the challenges of an evolving healthcare environment. While non-US healthcare providers are comparatively early in their adoption of these solutions, KLAS has identified several key factors that impact provider success: proactive guidance and communication, high value, and good usability. To help both US and non-US healthcare organizations in the BI selection process, this report highlights which vendors US providers say stand out or lag behind in these key areas and which solutions international providers are adopting to meet their clinical and financial goals.

REPORTS 2016®

2

1

CROSS-INDUSTRY VENDORS: DIMENSIONAL INSIGHT DELIVERING VALUE; SAP AND ORACLE FAIL TO MEET EXPECTATIONS

HEALTH CATALYST EMERGES AS A BI LEADER THANKS TO STRONG PARTNERSHIPS

Dimensional Insight delivers value thanks to good

development and cost transparency. Information Builders and SAS are also above average when

it comes to value. Most other cross-industry

vendors struggle to deliver value. SAP’s solution is seen as highly complex and requires extensive

training to understand, meaning customers are

unable to fully leverage it to drive outcomes.

Oracle clients struggle with value due to perceived

gaps in the solution, which they feel is outdated and receives little development. Providers say Microsoft’s poor implementation and training are initial barriers to success and that usability is a challenge in the long term. IBM customers

experience difficulty driving outcomes because IBM does not provide the support needed to

overcome the system’s complexity.

Health Catalyst develops deep partnerships that

combine guidance and consulting with strong training, responsive service, and proactive communication to ensure provider success. A few providers report that Health Catalyst

has built additional trust by sharing risk with customers. Dimensional Insight customers say

the solution’s strong tools help drive outcomes and deliver value, and early adopters of v.7

say the upgrade is a significant improvement. Customers say Epic’s usability is still a challenge but that the solution is maturing and that Epic is invested in provider success.

OVERALL SCORE vs PROACTIVE SERVICE

ARE PROVIDERS GETTING THEIR MONEY'S WORTH?

Component [C]

Proactive Service (1-9 Scale) (n=245)

Ove

rall

Scor

e (1

00-P

oint

Sca

le) (

n=28

3)

60

50

70

80

90

100

5.0 5.5 6.0 6.5 7.0 7.5 8.0 8.5 9.0

Market Average

Market Average

Component [C]

Fully Rated

Microsoft

Epic [C]

Oracle

Dimensional Insight

IBM

McKesson

Information BuildersQlik

SAP

SAS

Tableau

Health Catalyst

5.0 5.5 6.0 6.5 7.0 7.5 8.0 8.5 9.0

Epic [C] (n=30) 7.6

Dimensional Insight (n=28) 8.4

McKesson (n=15) 8.4

Information Builders (n=14) 7.9

Qlik (n=29) 7.9

Tableau (n=28) 7.8

IBM (n=18) 7.2

SAP (n=32) 6.4

Oracle (n=13) 5.9

Microsoft (n=10) 7.0*

Market Average * Limited Data

Health Catalyst (n=22) 7.6

SAS (n=10) 7.6*

(1-9 Scale)

U.S

. ON

LY D

ATA

SAS (n=14) 6.4

Health Catalyst (n=24) 7.7

Tableau (n=39) 7.8

Qlik (n=32) 8.0

3 QLIK AND TABLEAU MOST USABLE VISUALIZATION TOOLS; MCKESSON CLOSING THE GAP

Clients rate Qlik the highest for product usability. Qlik offers a flexible, customizable solution new customers easily understand. Tableau’s usability is complemented by excellent training and strong functionality; providers point to the relationship as an area for improvement. The usability of McKesson’s visualization tool is improving, closing the gap with Qlik and Tableau. McKesson has performed consistently year over year, fostering trust with providers, who are optimistic about McKesson’s future analytics road map.

REPORTS 2016®

HOW DO PROVIDERS RATE EASE OF USE?

Component [C]

5.0 5.5 6.0 6.5 7.0 7.5 8.0 8.5 9.0

Dimensional Insight (n=35) 7.7

McKesson (n=19) 7.8

Information Builders (n=22) 7.6

IBM (n=23) 6.8

SAP (n=40) 6.5Oracle (n=17) 6.7

Market Average

4 QLIK EMERGING AS MARKET SHARE AND MINDSHARE LEADER FOR GLOBAL HEALTHCARE BI

In a random sampling of providers across the globe, clients reference using Qlik more than any other BI vendor. Customers say Qlik is more complete than other visualization systems, with flexible, agile dashboards for both clinical and nonclinical data. Qlik is top of mind for global providers due to their international footprint and history. Founded in the United States, Tableau is comparatively newer to the global BI market. They are well respected and receive some consideration—providers in multiple regions consider Tableau due to the solution’s flexibility. Current users are highly satisfied, reporting that Tableau has helped them improve their clinician performance and supply chain. McKesson’s data visualization solution is not actively sold outside the United States.

VALIDATED USAGE AND CONSIDERATION GLOBALLYDATA VISUALIZATION VENDORS

0 5 10 15 20 25 30

Number of Regions with Validated Solution

Qlik 18 125

5 8 5TableauLive

Considered

(1-9 Scale)

Epic [C] (n=32) 7.3

Microsoft (n=17) 7.3

NON-US ONLY DATA

KLAS randomly sampled 86 providers across Asia and Oceania, Europe, the Middle East, Latin America, and Northern America to better understand which solutions international providers are leveraging, how they are using these solutions, and which solutions they plan to adopt in the future.

“We analyze clinical information about the number of outpatient and inpatient visits and which procedures have been done. We also get financial information about revenue and costs. There are many things that we use Tableau Server for, such as focusing on improving outcomes in the weakest departments and seeing what we can do as doctors and nurses to bring in more data. Tableau is a great vendor and has excellent analytics software.” - CIO

“We chose QlikView for our analytics. We looked at Microsoft, Tableau, and BusinessObjects. Microsoft said they wouldn’t be able to meet our needs, and Tableau was newer to the market. Qlik looked like the only vendor who was going to be able to meet our needs. Since we have been using QlikView, we have realized that we have been able to get a better view into our costs. If we wanted to get that view ourselves, it would have taken us years and would have been really cost prohibitive.” – BI Director

21MEDITECH 1

1 3Allscripts

4 6Tableau

1 6Microsoft

5 16Qlik

7

6

5

TABLEAU, QLIK, AND IBM SHOW PROMISE WITH CLINICAL GOALS

EMR VENDORS: CUSTOMER PERCEPTIONS OF CERNER’S AND EPIC’S BI SOLUTIONS DIFFER

CROSS-INDUSTRY DATA WAREHOUSE VENDORS IN HIGH DEMAND

Many providers hope to leverage their EMR vendor’s BI tools to accomplish clinical goals, and several BI/analytics vendors are being adopted for clinical uses as well. Visualization vendors Qlik and Tableau are often used this way due to their solutions’ strong dashboards and data aggregation capabilities. IBM is the only cross-industry vendor regularly used clinically, for things like tracking performance and quality. Both in the United States and around the globe, IBM Watson is viewed as a potentially disruptive solution, though the product is still in the testing phase and there are few proof points worldwide.

Providers look to their EMR vendors primarily to provide basic clinical reporting and in some cases to supplement other BI tools. The perception among international providers is that Epic provides both an enterprise BI solution and a population health platform. Cerner customers tend to see their vendor’s BI solution as a subcomponent of the Cerner population health offering, though Cerner does offer separate BI products. InterSystems’ module within DeepSee is used by a limited number of customers. Providers use Allscripts and MEDITECH for basic reporting. Data aggregation is mentioned as a challenge for Allscripts customers.

As data visualization tools become increasingly common, providers still rely on data warehouse vendors to aggregate underlying data. Oracle, SAP, IBM, Microsoft, and SAS have broad market share and mindshare across the globe due to their cross-industry presence and extensive partner networks. These vendors offer strong financial tools that allow providers to reduce costs but generally do not offer healthcare-specific guidance. A number of local solutions are still in use around the globe, though they are used less frequently than BI solutions that have large, worldwide footprints.

NUMBER OF VALIDATED CLINICAL AND NONCLINICAL USE CASES

0 2 4 6 8 10 12 14 16 18

1 2MEDITECH

2 11Oracle

2 5SAP

2 3SAS

2 4Epic

4 8IBM

Number of Clinical Use Cases Validated

Number of Nonclinical Use Cases Validated

Overall n=88

0 5 10 15 20 25 30

0 5 10 15 20 25 30

Oracle 6 13 4

3 4

43

SAP 12

6IBM 9 7

6Microsoft 8 5

4SAS

5 6Epic 7

2InterSystems 2

3 4Cerner 1

3 4Allscripts 1

Live

Considered

Live

Considered


Other vendors used and considered in this research include: Alteryx, Beijing Medical Technology, Biologics, Costing and Business Solutions, DataGenic, Dimensional Insight, Health Catalyst, Hitachi, Manteq, Medisolv, MKM Health, MicroStrategy, MV, Pentaho, Philips, Projjetta, Siemens, Speedminer, TIBCO, Transmit Health, and Truven Health


VALIDATED USAGE AND CONSIDERATION GLOBALLYDATA WAREHOUSE VENDORS

VALIDATED USAGE AND CONSIDERATION GLOBALLYEMR VENDORS

This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price.

Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2016 KLAS Enterprises, LLC. All Rights Reserved.

REPORTS 2016®

CO-ANALYST ALAN [email protected]

WRITER EMILY [email protected]

DESIGNER RYAN [email protected]

PROJECT MANAGER JAKE [email protected]

630 E. Technology Ave. Orem, UT 84097Ph: (800)920-4109 | Fax: (801)377-6345 | www.KLASresearch.com

AUTHORJEREMY [email protected]

CO-AUTHOR/ANALYSTJON [email protected]

REPORT INFORMATIONREADER RESPONSIBILITY:KLAS’ website and reports are a compilation of research gathered from websites, healthcare industry reports, interviews with healthcare provider executives and managers, and interviews with vendor and consultant organizations. Data gathered from these sources includes strong opinions (which should not be interpreted as actual facts) reflecting the emotion of exceptional success and, at times, failure. The information is intended solely as a catalyst for a more meaningful and effective investigation on your organization’s part and is not intended, nor should it be used, to replace your organization’s due diligence.

KLAS data and reports represent the combined opinions of actual people from provider organizations comparing how their vendors, products, and/or services performed when measured against participants’ objectives and expectations. KLAS findings are a unique compilation of candid opinions and are real measurements representing those individuals interviewed. The findings presented are not meant to be conclusive data for an entire client base. Significant variables including organization/hospital type (rural, teaching, specialty, etc.), organization size, depth/breadth of software use, software version, role in the organization, provider objectives, and system infrastructure/network impact participants’ opinions and preclude an exact apples-to-apples vendor/product comparison or a finely tuned statistical analysis.

We encourage our clients, friends, and partners using KLAS research data to take into account these variables as they include KLAS data with their own due diligence. For frequently asked questions about KLAS methodology, please refer to the KLAS FAQs.

COPYRIGHT INFRINGEMENT WARNING:This report and its contents are copyright-protected works and are intended solely for your organization. Any other organization, consultant, investment company, or vendor enabling or obtaining unauthorized access to this report will be liable for all damages associated with copyright infringement, which may include the full price of the report and/or attorney’s fees. For information regarding your specific obligations, please refer to the KLAS Data Use Policy.

ABOUT KLAS:For more information about KLAS, please visit our website.

OUR MISSION:KLAS’ mission is to improve the delivery of healthcare technology by independently measuring and reporting on vendor performance.

NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.

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DRILL DEEPER


ABOUT THIS REPORT Each year, KLAS interviews thousands of healthcare professionals about the products and services their organizations use. These interviews are conducted using a standard quantitative evaluation, and the scores and commentary collected are shared online in real time so that other providers and IT professionals can benefit from their peers' experiences. To supplement the data gathered with this standard evaluation, KLAS also creates various supplemental evaluations that target a subset of KLAS’ overall sampling and delve deeper into the most pressing questions facing healthcare technology today. The data in this report comes from both evaluation types and was collected over the last 12 months; the number of unique responding organizations for each is given in the charts below. The standard evaluations collected for this report come from healthcare providers in the United States, while the supplemental data comes from 87 randomly sampled healthcare organizations outside the United States.

Figure 1

Standard Evaluations (US)

Estimated Size of US Healthcare Provider Client Base

Dimensional Insight 35 Small Health Catalyst 26 Small IBM 23 Midsize Information Builders 22 Small McKesson 20 Midsize Microsoft 19 Midsize Oracle 17 Small Qlik 32 Midsize SAP 40 Extensive SAS 15 Small Tableau 40 Midsize

Epic [C] 38 Midsize

Note: Some organizations may have rated more than one product. [C] = Component product (see definition below)


The specialty data for this report comes from the countries listed in the figure below: Figure 2

Country Number of Respondents

Australia 9 Austria 3 Belgium 2 Brazil 13 Canada 12 Chile 3 China 1 Germany 1 Iceland 1 India 2 Ireland 2 Netherlands 6 New Zealand 2 Portugal 1 Saudi Arabia 2 Singapore 4 Spain 2 Sweden 1 Switzerland 1 Thailand 1 United Arab Emirates 5 United Kingdom 12

KLAS Konfidence Level KLAS Konfidence1 is a measure of the sample size for any given product. In order for a product to be fully rated in this report, KLAS must have interviewed at least 15 unique provider organizations using that product (meaning we must have at least 15 standard evaluations and at least 15 supplemental evaluations). While KLAS strives to interview enough organizations for all products to be fully rated, this is not always possible. Some products are live in only a small number of facilities, and some vendors are resistant to providing client lists. Those products for which KLAS conducted fewer than 15 interviews are considered “Below Konfidence,” are labeled as such in all charts, and are not rated. Note that when a product has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.

1 The phrase KLAS Konfidence does not denote statistical confidence (which is a function of sample size, variance, random sampling, sampling structure, and occasionally population size), nor does it denote KLAS’ confidence in a particular product or vendor. It is measured by the number of unique organizations interviewed about a product, not by the number of individuals interviewed.


What Does the Asterisk Mean? Some respondents choose not to answer particular questions. Thus a product’s sample size for any one question may be lower than the total number of interviews conducted. When a vendor’s sample size for a particular question is less than 12, the score for that question is marked with an asterisk (*) and is noted as limited data. If the sample size is less than 6, no score is shown. Note that vendors’ overall scores are on a 100-point scale and represent the weighted average of several yes/no questions as well as other questions scored on a 9-point scale.

Other Product Designations Products that meet the criteria below are included in report discussions but are not rated. • Component [C]: Product that typically includes most but not all components that

comprise a complete system or that serves only a subset of the market. In this report Epic is considered a component solution because Epic’s solution is only sold to those using Epic’s EMR.


INTRODUCTION Business intelligence and analytics solutions continue to grow in importance as healthcare providers rise to meet the challenges of a rapidly evolving healthcare environment. These solutions are critical to the success of providers’ efforts to meet clinical and financial goals. Many providers see the possibility for improved clinical outcomes and a quick ROI using these solutions, but this dream remains elusive for some. Still, as the US market matures, some have formed strategic partnerships with BI/analytics vendors who are helping organizations overcome training and resource challenges to make a substantive impact on clinical, financial, and population health goals. Vendors who consistently help providers achieve success have several traits in common: strong training, a highly usable solution, and a relationship built on trust coupled with ongoing communication and support. As US-based healthcare providers are working to maximize the value they receive from their BI/analytics solutions, providers worldwide are just starting to move beyond EMR implementations to adopt solutions to meet their financial, and one day clinical, goals. This report includes two sections, which are based on interviews with two groups of healthcare providers:

Part One: This section highlights which vendors US providers say deliver value through good training, high usability, and strong partnerships, as well as who is making waves on the visualization front and how cross-industry products compare to healthcare-specific offerings.

Part Two: For this section, KLAS interviewed 86 providers across Asia and Oceania, Europe, the Middle East, Latin America, and Northern America to better understand which solutions they have adopted, how they are using these solutions, and which solutions they plan to adopt in the future.

PART ONE: BI/ANALYTICS EVOLVING IN THE UNITED STATES

Healthcare-Specific Vendors Generally Meet Providers Needs Well As healthcare organizations discuss the successes and challenges they have had with BI/analytics vendors, one trend is clear: while cross-industry vendors often have robust functionality, healthcare-specific solutions are still generally providing the best experience and outcomes for healthcare organizations. Providers say that what sets these more focused vendors apart is proactive partnering with customers to share best practices and ensure success; the delivery of cutting-edge functionality built for a healthcare environment; and a high level of usability that allows less experienced end users to derive value from the system. Customers of cross-industry vendors often report that the training they receive is insufficient to allow them to fully leverage the solution and that their vendors lack hands-on guidance. When it comes to healthcare-specific solutions, Health Catalyst, McKesson, and Epic stand out as strong options.


Figure 3 Health Catalyst Continues to Set the Bar for Performance and Partnership Providers say that Health Catalyst continues to be a trusted analytics partner, delivering a high-quality solution and an unmatched level of partnership. Those using the system say it has helped drive outcomes by helping them better understand the needs of complex patient populations, evaluate the efficacy of treatments, and easily aggregate data from disparate sources. Customers have typically relied on Health Catalyst for expertise and analytics consulting and feel the product is maturing quickly. This strong combination is how providers say Health Catalyst delivers value, especially when it comes to clinical outcomes—which are the system’s primary use case. An executive director looking forward to taking advantage of Health Catalyst for clinical goals shared, “It is very likely that we will use things from Health Catalyst for some of our upcoming initiatives. We have been running an RFP using analytics tools to help us with our population health strategy and accountable care initiatives, and Health Catalyst has been a big part of that process.”


Figure 4

*Limited Data

While Health Catalyst stands out as having a strong product, providers are quick to note that what truly sets the vendor apart is the trust they foster with customers and their proactive communication and guidance. Almost all providers say Health Catalyst keeps promises, and end users have a high degree of confidence in the vendor’s ability to continue to lead the market going forward. Customers report that the vendor communicates regularly, striving to understand the needs of each organization and working to ensure they are set up for success and that individual needs are met. Health Catalyst’s mentality was aptly described by a systems analyst who said, “Health Catalyst is very much focused not just on selling technology but also on providing true process improvements. They are more than just a technology company. They are not just a software company. They do sell software and technology, but their focus is just as much or more on providing services and tools to support process-improvement efforts. They are really less about the point-and-click things and more about having conversations with clinicians or staff members about what their workflows are and how those can be improved.” Health Catalyst has also begun to share risk with a limited group of customers, a fact that some say strengthens their confidence in Health Catalyst as an analytics partner.


McKesson Highly Trusted by Providers McKesson customers using the Analytics Explorer solution report that their relationship with McKesson is strong, that the solution is robust and functional, and that it drives tangible outcomes. Analytics Explorer is relatively new to the market but has consistently earned customers’ praise year over year. Reported benefits include faster reporting and analysis, the ability to aggregate data from multiple sources, and cost savings. While the solution is used for clinical use cases, end users say that the system’s financial and administrative capabilities are what bring the most value. This satisfaction is in large part due to the product itself, which offers strong, easy-to-use visualization tools that lead to good adoption and quick ROIs. A BI manager praised McKesson, saying,

Analytics Explorer is a highly flexible tool. It is not only a statistical tool but also a great presentation tool for our end users. The data quality is excellent. I can see the data quality before I am even done with a presentation. The product creates highly visual things. Analytics Explorer relates data very well. When we have multiple data sources, we are able to relate data from each of the sources very quickly and efficiently. Without the product, we would just be aggregating numbers. Analytics Explorer takes manipulating data out of the picture, and the users go from seeing data in a raw format to seeing data that is ready to be presented. Analytics Explorer has definitely broken down a lot of the assumptions we make with the data. We are able to explain points that are good and the points that have issues.

Providers also report high satisfaction with the executive involvement they experience. One CIO shared, “We feel like we have access to McKesson leadership when we need to and like we can bring up hard questions. McKesson responds with flexibility and promptness to our issues.”

McKesson has also made strides to improve usability over the years, closing the gap with visualization competitor Qlik. One customer shared, “We actually have a lot of hospital staff members who want the visualization functionality to be easy to understand and not be over engineered. The staff members sometimes need a series of visualizations to be standard in layout and design. Analytics Explorer makes things like that easy for staff members.”

With a Strong Multiyear BI Focus, Epic Becoming a More Viable Option Despite Challenges In an effort to consolidate and gain additional value from clinical data, many providers are looking to their EMR vendor to develop robust BI and analytics tools. Providers using Epic’s solution say they are generally satisfied, and many feel that the solution is maturing. What sets Epic’s solution apart from other vendors’ is Epic’s focus on embedding the solution in the clinical workflow. Additionally, Epic stands out for their commitment to implementations, support, and ongoing development. One optimistic provider shared, “We will have more content in the future. The capability and linkage we need already exist in the Cogito system. In the next iteration of the product, Epic is going to integrate the Cogito solution with Watson, which is a great, innovative, predictive-analysis product that incorporates cognitive learning.”


Providers say Epic could improve the product’s usability and quality. Compared to customers of other top performers, Epic customers have lower satisfaction in these areas. When discussing functionality, providers say that the tools are good but are often too complex for non-IT users, have gaps in risk management, and cannot access non-Epic data. A VP of medical records said, “We need to present the information in a way that best suits the users’ needs. The system is very confusing. . . . After a few years, [Epic] realized those tools weren't powerful enough to do long-term reports, so they added another set of tools. But they never went back to homogenize things. They left what was there with all of its pluses and minuses, but they never looked back or tried to develop a cohesive strategy for data presentation. That is extremely frustrating.” Epic’s Cogito BI solution is available across all Epic applications and their population health platform. Cerner customers tend to adopt their vendor’s BI solution as a subcomponent of the Cerner population health offering, though Cerner does offer separate BI products (PowerInsight Explorer and PowerInsight EDW). For this reason, Epic is the only EMR vendor whose BI solution is measured in this report.

Data Visualization Vendors Fostering Satisfaction In addition to healthcare-specific vendors, visualization-focused vendors are also reported by healthcare providers to provide good value and a positive overall experience. Some vendors are healthcare specific and visualization focused. Generally speaking, visualization-focused vendors demonstrate high ease of use, good implementations, and effective training.

Figure 5


Qlik: The Usability Leader’s Simple Tools Drive Outcomes Qlik leads the BI market for usability. Providers report that Qlik’s solution is flexible and customizable and that inexperienced users can easily begin to use the system and access valuable information. This ability helps drive tangible outcomes around clinical outcomes and quality, financial goals, and administrative efficiency. For example, a vice president of population health said, “In QlikView, the physicians have a connection that lets them jump right into another application. The likelihood of hospitalization is sitting right there on the screen, and they can open that information up while they are looking at patients. . . . QlikView is very intuitive and easy to use for an overall view of how we are doing and for a single provider checking quality and other things for the day. And it is easy for providers to see how they are doing compared to the whole site.”

Figure 6

*Limited Data Note: Some vendors do not have enough data to display

Providers would, however, like Qlik to develop more strategic relationships with customers, noting that executive involvement is weak and that Qlik’s service is not proactive. According to one BI director, “Qlik is the worst vendor to work with in terms of support. With other vendors, we call them, and they always return our calls and get issues resolved. With Qlik, we seem to have to follow a trail. We get sent from one person to the other, and we are not able to resolve things quickly. Most of the time, my staff has to Google or reach out to other contacts to get information. The support has always been like that with Qlik.” Providers also say that their relationship with Qlik could be improved through additional pricing model transparency; just over one-third of providers report that Qlik charges for every little thing.


Figure 7

*Limited Data

Tableau Offers Good Implementations and Training; Some Relationship Work Needed Tableau has a strong implementation process and stands out for providing outstanding, comparatively low-cost training. Providers say Tableau’s implementation process is timely and straightforward, in part due to the solution’s simplicity. Even when compared to other relatively simple systems, Tableau still stands out. An IT director described his reaction: “From a software perspective, I have never worked with a more simplistic vendor than Tableau in all my years of experience. Their system crosses multiple areas. From the sales cycle to installation, we had Tableau Server up and operational in 20 minutes. It was downloaded, installed, and working.” Providers also point to training resources, usability, and strong dashboards as strengths.


Figure 8

*Limited Data Note: Some vendors do not have enough data to display

While users overwhelmingly report a positive experience with the solution itself, many would like to see Tableau make strides to improve the strength of their relationships with their healthcare clients. Customers say that Tableau’s support team is friendly and helpful but that the vendor is not as proactive as they would like. Additionally, several providers note that they feel the distance between them and top executives is increasing as the vendor grows. One BI director shared, “Tableau is not the most proactive when it comes to communication or problem resolution. We put in a ticket, and they try to help us solve the problem, but they aren’t the best. I feel like they leave us hanging a little bit.”

Few Cross-Industry Solutions Providing Value: Dimensional Insight Stands Out With the exception of Dimensional Insight, Information Builders, and SAS customers, providers using cross-industry solutions struggle to get their money’s worth, reporting that their solutions often lack the basic level of training and usability providers need to be successful and that the vendors have a tendency to charge for every little thing and are not improving their healthcare offering. For many customers, these solutions are a necessity due to their data warehouse capabilities.


Figure 9

*Limited Data

Dimensional Insight’s Version 7.0 a Success, Providing Value Dimensional Insight is an industry leader when it comes to ensuring that customers get their money’s worth. This perceived value is the result of strong ongoing development, excellent functionality, and transparency around cost.

Providers say that Dimensional Insight’s functionality translates into strong outcomes for the organization. Use cases for this solution are a mix of both clinical and nonclinical, and reported benefits include easy tracking of key metrics, improvements to patient satisfaction, supply-chain savings, and reduced readmission rates. Additionally, early adopters of the recent v.7.0 release note that the upgrade is a significant improvement. A director of IT shared, “We recently upgraded our system from v.6.4 to v.7.0. That was a very substantial upgrade that had a huge, positive impact on our system and users. It increased the storage capabilities significantly and made the software faster. In addition, the support was very smooth. Dimensional Insight did an excellent job of assisting us in installing this upgrade.” Another user noted that the strong functionality in the new version outpaces that of the larger cross-industry vendors’ systems. Beyond functionality, providers say that Dimensional Insight keeps promises and that the vendor is transparent about costs, as noted by a data analyst: “I like that The Diver Solution is a suite of products. We can do everything we need to do and not worry about having to pay extra for it. Dimensional Insight doesn’t nickel-and-dime us.” The same analyst went on to


explain that “Dimensional Insight is really easy to work with. The people there are honest and always have integrity. Dimensional Insight's support team members are great because their turnaround time is usually less than 24 hours.”

Information Builders Offers Solid Solution; Stronger Healthcare Relationships Desired Customers say that they are pleased with Information Builders’ overall functionality and product development. Providers report generally good usability, and the system’s flexibility and the level of insight it provides are also noted as strengths. A decision support manager explained,

Scalability, agility, and usability are all strengths of the WebFOCUS product. For example, the usability is high from the perspectives of the end users and developers. WebFOCUS is very user friendly for a developer because we can build whatever we want, and from the consumer perspective, we can build anything from simple dashboards to very complex, multi-dimensional reports. The ability of the system to scale is great because we can have 10 users just as easily as 2,000 users. WebFOCUS is extremely agile because we can use BI solutions for projects that are around the life cycle of any project, whether the cycle lasts a month or even a year. We can build things out extremely quickly. We can pull data in from any data source we want. We don't have to do any detailed work for data modeling. We can pull the data from a text file or an Excel file.

On the relationship side, however, providers report some gaps. Specifically, providers say that while the support and executive interactions are good overall, the vendor lacks proactivity. A business office director noted, “The vendor’s service just doesn’t seem to be very proactive. We participate in user calls and things like that, but those things are really how we are finding out what problems other people are having so we can fix them; we don’t get proactive communication from the vendor about glitches they know of or problems with updates. I feel like we get more help from other users than from the actual vendor.”

SAS Provides Strong Support, Helps Drive Outcomes While providers using cross-industry vendors tend to report numerous challenges, one vendor who provides responsive, knowledgeable support to help providers overcome these issues is SAS. Providers report that the support personnel are transparent, have good follow-through, and are quick to resolve issues. A physician care director explained,

Compared to all of our software vendors, including the vendor for our wretched EMR system, SAS continues to be absolutely phenomenal when it comes to support. They have been like this throughout all of the years we have worked with them. The support is not ticky-tacky support, where we submit a request and SAS gives us a number. The SAS support people are like dogs with a bone. When we have a problem, they don't just give us an answer; they give us alternatives. Also, they leave our ticket open for 24 hours after they give us an answer, so if we try a solution that doesn't work, we are able to go back to


SAS without going to the end of the support queue again. Anything involving service to the customer is primo. They have always given 100% when it comes to support. It is unbelievable. That is what I love about SAS.

Figure 10

*Limited Data

In terms of the system’s usability and the vendor’s overall relationships, SAS performs like a typical cross-industry vendor. Providers say that the system can be complex and that the vendor does not proactively communicate around updates and future development. Additionally, many report that the price of SAS is comparatively high and that the tools they need to fully leverage the solution are cost-prohibitive. An IT director shared, “SAS told us we could do one thing with their license, but then things didn't work that way. We are wondering if there is a more affordable open-source option, mainly because of money. For the amount of money we spend on SAS Analytics, we are not seeing the value.” Microsoft, SAP, IBM, and Oracle Struggle to Deliver Value to Providers Of all the vendors in this report, including the healthcare-specific and cross-industry vendors, Microsoft, IBM, Oracle, and SAP have the biggest client-reported gaps when it comes to proactivity, service and support, usability, training, and good communication. As a result, providers using these systems say they are highly dissatisfied and are not optimistic about their vendors’ ability to help them in the future.


Microsoft Falls Down on Implementations and Functionality Providers say Microsoft is usable overall. For example, a vice president of administration noted, “What Microsoft does really well is make products that are very intuitive. Microsoft's systems are easy for people to learn. . . . [Other vendors’] products are much less intuitive, require more experience, and sometimes require additional training.” However, users say that implementations and functionality are pain points. One IT director described the challenge experienced by his organization: “The visualizations are clunky in Power BI, and the system requires more advanced programmers and staff than other tools.” Another challenge that Microsoft customers, as well as the customers of many other cross-industry vendors, face is a lack of personal attention. A vice president of health information explained, “We are a small fish in Microsoft’s enormous pond, so they are not jumping out of their skin to come and help us with things. Other vendors are much more proactive with us.” SAP Customers Held Back by Complexity and Poor Support In healthcare, SAP is one of the most commonly selected analytics vendors in the United States due to strong brand recognition and data warehouse capabilities. Customers report challenges across multiple areas, including functionality, usability, and training. Additionally, many feel that SAP has not kept promises and that the vendor needs to improve their support. An enterprise warehouse director shared, “We get a new account manager every three months, so there is no continuity. Every time we need to get something escalated, we have to talk to somebody brand new. But I certainly wouldn’t characterize our relationship as bad. It is fine, and it is what we expect from a company like SAP. We wouldn’t be exploring the idea of growing our use of the platform if we were concerned about our relationship with the vendor.” Users say that the solution is unintuitive and complex. They feel they lack sufficient training and that success requires significant provider investment. According to a COO at a large health system, “BusinessObjects Business Intelligence is seen as high-capacity, high-capability software, but I am not seeing that. I wonder whether it really helps us. We divert so many resources and so much attention to this system that we forget about the patient. That is easy to do because the requirements for some of these systems are so high.” IBM Customers Struggle with a Lack of Partnership IBM customers report ongoing challenges around implementations, training, usability, and service. As a result of these challenges, around one-third of IBM users say that given the chance, they would not buy the solution a second time.


Figure 11

*Limited Data

Providers note that IBM’s lack of healthcare-specific understanding is a challenge, and that the functionality, while strong, is not geared toward a hospital environment. Additionally, providers say that the solution is highly technical and requires a significant investment in training and IT resources. As a result, few small organizations report success with IBM. Even among successful larger organizations, providers note that success is largely provider driven. One CEO described her experience: “We struggled with IBM in the beginning, but we started having much more success as soon as we brought in our new chief technology officer. Our relationship with Cognos Enterprise for a while was just to fix little bugs and put patches on something; that was not very helpful. We were walking in mud and not really getting anywhere. It was a bandage approach. We have really tuned up Cognos Enterprise now; our reports are really sharp, and we have visibility into great data that actually changes behavior. It makes our conversations with physicians very data driven.” Looking forward, a few providers express optimism around IBM Watson and the vendor’s recently acquired solutions, such as those from Merge, that will feed data into that system.

Oracle Customers Highly Dissatisfied with Oracle’s Performance and Communication Despite their strong presence in the data warehouse market, Oracle has the lowest provider satisfaction of all the BI/analytics vendors measured by KLAS. Providers say they receive limited value from the solution due to gaps in healthcare-specific functionality, a


lack of communication, and poor development. Of these challenges, development and functionality are top-of-mind challenges for many customers.

Figure 12

*Limited Data

Customers report that Oracle’s functionality is slow, the tools are not cutting-edge, the dashboards are limited, and the tools are complex and unintuitive. Overall, customers describe Oracle as behind the industry and lacking innovation. A BI director said, “I would not buy Oracle Business Intelligence Enterprise Edition again. There isn't a good enough range of dashboards, and the system feels like it is a few years out of step. We haven't been able to extend the tool with our own custom visualizations.”

PART TWO: AN EARLY LOOK AT THE GLOBAL BI LANDSCAPE Providers in Asia, Europe, the Middle East, Northern America, and South America are adopting BI and analytics tools to address emerging population health and financial needs. KLAS interviewed a random sample of providers across the globe regarding what BI/analytics solutions they have already adopted, how these systems are being used, and what additional solutions they plan to adopt in the future.


Figure 13

Regardless of region, providers in KLAS’ global sample point to a few vendors as being key to their current BI and analytics strategies, including Qlik, Oracle, SAP, IBM, Microsoft, Tableau, and Epic. Many leaders in the US market, such as Health Catalyst, McKesson, and Dimensional Insight, are not mentioned by global providers as being widely recognized or considered.


Figure 14

Qlik Seen as the Global Leader for Both Market Share and Mindshare

Qlik is by far the most commonly used vendor by non-US healthcare providers in the study. It is adopted primarily because of the solution’s strong visualization tools and high usability. Providers using the system say that the functionality is fairly robust, and several note that Qlik’s system is more complete than other vendors’. An IT director in Asia explained, “The nice thing about Qlik is that we are not locked into using applications from specific vendors. We can get information from a lot of different sources. These days, flexibility, agility, and ease of use are key aspects of a system.” This provider continued, saying “We chose QlikView for our analytics. We looked at Microsoft, Tableau, and BusinessObjects. Microsoft said they wouldn’t be able to meet our needs, and Tableau was newer to the market. Qlik looked like the only vendor who was going to be able to meet our needs. Since we have been using QlikView, we have realized that we have been able to get a better view into our costs. If we wanted to get that view ourselves, it would have taken us years and would have been really cost prohibitive.”


Across the globe, Qlik is primarily used for nonclinical use cases, such as reducing expenditures, improving staffing efficiency, and viewing financial dashboards. However, Qlik is one of the few global players being broadly used for clinical use cases as well. For example, a CMIO in Europe said, “For the time being, QlikView is taking care of all of our needs. We have it integrated with our QuadraMed system. I have a clinician dashboard that tells me what I am doing. It launches my surgical logbook for me and tells me my waiting list. That logbook launches within the QuadraMed system.” Cross-Industry Vendors Oracle, SAP, IBM, and Microsoft See Broad Adoption, Consideration Oracle, SAP, IBM, and Microsoft are also top considerations globally, owing largely to their cross-industry, international presence and expansive partner networks. These vendors are perceived by providers as having strong financial tools that will allow them to reduce costs and meet financial goals. Providers also find the data warehouse capabilities of these solutions attractive, and many are looking forward to consolidating data sources. While providers primarily intend to use these solutions for nonclinical purposes, several IBM customers are making use of the offering to improve clinical care and outcomes. A CEO of a health system in Europe shared, “There are a lot of standard reports for billing and other things. We can look at our patients in the system and access good information about them, including the billing information. The system also provides the clinical data in an integrated view. We have all that information available to our managers of the medical and nursing departments. The managers can see how their departments are doing with quality and performance.”

Qlik and Tableau Go Head-to-Head to Meet Data Visualization Needs While Qlik holds the lead in terms of market share and mindshare, providers across the globe are also looking to Tableau to meet their data visualization needs. Providers note that these vendors’ usable, highly functional data visualization tools can be leveraged easily for clinical use cases. In fact, aside from EMR vendors, Qlik and Tableau (along with IBM) are the most commonly used tools to help improve clinical performance and outcomes. A CIO in the Middle East using Tableau said, “We analyze clinical information about the number of outpatient and inpatient visits and which procedures have been done. We also get financial information about revenue and costs. There are many things that we use Tableau Server for, such as focusing on improving outcomes in the weakest departments and seeing what we can do as doctors and nurses to bring in more data. Tableau is a great vendor and has excellent analytics software.”


Figure 15 The Role of the EMR Vendor Another emerging global trend is the increased reliance on EMR vendors to supplement existing BI tools. In this research, all major global EMR vendors have customers who currently use, or plan to use, their EMR vendor for BI/analytics tools. This includes Allscripts, Cerner, Epic, InterSystems, and MEDITECH. Providers note that this approach will allow them to leverage their EMRs to the fullest, and they view these vendors as being critical to improving clinical care. Almost all Epic customers interviewed stated that they hope to use Cogito to make better use of the data in their EMR. According to a CIO using Epic in Asia, “We don’t fully understand all of our gaps in our clinical care areas. Without the data to support those gaps, we have to work to get the senior management people to buy in to fixing those areas. I need to have the data to say that there is a problem and what the likely causes of the problem are, and I need that data to be easily understood by the senior management.” Cerner also receives heavy consideration from their global customer base, and many of these customers specifically point to population health as an area in which they plan to make use of HealtheIntent. An IT manager in Australia shared her organization’s plan to use Cerner in the future: “We are interested in leveraging our EMR to get reports on things like shoulder surgeries. We could look at the pain pump and recovery times, and we could leverage the reports to drive best practices.” MEDITECH, Allscripts, and InterSystems are also mentioned by providers as key vendors in their BI strategies; so too are South American players MV and Philips.


CONCLUSION: LESSONS FROM THE UNITED STATES FOR INTERNATIONAL HEALTHCARE PROVIDERS

The individual needs of healthcare organizations across the globe vary greatly, and some providers have made great strides to develop comprehensive BI/analytics strategies. Despite these differences, there are several findings in the US market that may help international providers be successful. As US providers did early in their BI adoption cycles, international providers are heavily relying on cross-industry vendors to meet their needs. While this may be a necessity today for many, trends in the United States indicate that many of these vendors—with the exception of Dimensional Insight, Information Builders, and SAS—cannot provide the long-term value and outcome delivery needed to make a large clinical impact. In response to the emergence of this challenge in the United States, healthcare providers turned to simple visualization tools and healthcare-specific solutions to fill knowledge and functionality gaps as well as quickly provide value to their organizations. The evolution of the US-based analytics market may be useful to keep in mind as international providers search for BI solutions. Additionally, US providers have discovered that robust technology is important but that proactive service, training, and usability are what matter most to organization success. For international providers who are considering BI/analytics solutions, selecting a vendor who stands out in these three areas may improve their ability to meet both clinical and financial goals.


COMPARE VENDORS


FULLY RATED VENDORS

DIMENSIONAL INSIGHT THE DIVER PLATFORM: 88.9

Figure 16


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HEALTH CATALYST ANALYTICS PLATFORM: 89.5

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IBM COGNOS ENTERPRISE: 76.6

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*Limited Data


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INFORMATION BUILDERS WEBFOCUS: 81.7

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*Limited Data


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MCKESSON ANALYTICS EXPLORER: 86.9

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*Limited Data


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MICROSOFT BI SOLUTIONS: 80.6

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*Limited Data


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ORACLE BI ENTERPRISE EDITION: 70.0

Figure 28

*Limited Data


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QLIK PLATFORM: 83.9

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SAP BUSINESSOBJECTS BI PLATFORM: 73.4

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SAS ANALYTICS: 83.7

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*Limited Data


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TABLEAU SERVER: 86.7

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COMPONENT VENDOR

EPIC COGITO: 87.8

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Figure 39


EXAMINE DETAILS


Figure 40

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Figure 42

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Figure 44

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Figure 46

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Figure 48

Figure 49

*Limited Data


Figure 50

Figure 51

*Limited Data


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*Limited Data


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KLAS PERFORMANCE

DATA


Fully Rated Vendors Dimensional

Insight Health

Catalyst IBM

Information Builders

McKesson

Sales & Contracting Product Works as Promoted 8.3 7.8 7.3* 7.3* 8.2 Money’s Worth 8.4 7.6 7.2 7.9 8.4 Avoids Nickel-and-Diming 91% 94% 62% 94% 91%

Implementation & Training Quality of Implementation 7.8 8.0 6.4* 7.3 7.7 Quality of Training 7.5 8.0 6.9* 7.1 7.7

Functionality & Upgrades Overall Product Quality 7.9 7.9 7.3 7.5 7.7 Delivery of New Technology 7.6 7.8 6.5 7.3 7.6 Ease of Use 7.7 7.7 6.8 7.6 7.8 Supports Integration Goals 8.0 7.7 7.2 7.3 7.5 Product Has Needed Functionality 7.8 7.1 7.0* 7.0* 7.8*

Service & Support Quality of Phone/Web Support 8.0 8.2 6.4 7.4 7.6 Proactive Service 7.8 8.3 6.0 6.8 7.5 Executive Involvement 7.7 8.4 6.6 7.7 7.8 Keeps All Promises 98% 98% 87% 80% 92%

General Likely to Recommend 8.2 8.1 7.1 7.4 7.7 Drives Tangible Outcomes 7.8 7.6 7.1* 7.5* -- Overall Satisfaction 8.0 8.0 7.2 7.4 7.6 Forecasted Overall Satisfaction 8.2 8.3 7.2 7.4 8.0 Part of Long-Term Plans 91% 95% 90% 72% 84% Would You Buy Again 90% 93% 68% 84% 93%

Note: The highest score for each indicator is highlighted in green, the lowest in red. *Limited data


Fully Rated Vendors, continued Microsoft Oracle Qlik SAP SAS Tableau

Sales & Contracting Product Works as Promoted 7.4* 6.4* 8.0 6.8 -- 7.9 Money’s Worth 7.0* 5.9 7.9 6.4 7.6* 7.8 Avoids Nickel-and-Diming 93% 65% 61% 76% 86% 92%

Implementation & Training Quality of Implementation 7.0* -- 7.3 6.3 -- 8.1 Quality of Training 6.7* 7.5* 7.5 6.4 -- 8.3

Functionality & Upgrades Overall Product Quality 7.7 6.3 7.9 6.7 7.8 8.0 Delivery of New Technology 7.4 6.2 7.4 6.3 7.3 7.6 Ease of Use 7.3 6.7 8.0 6.5 6.4 7.8 Supports Integration Goals 7.2 6.5 7.7 6.8 7.0 7.3 Product Has Needed Functionality 6.7* -- 7.4 6.3 -- 7.0

Service & Support Quality of Phone/Web Support 6.9 6.1 7.2 6.0 7.6* 7.5 Proactive Service 6.5 5.3 6.4 5.3 6.8* 7.3 Executive Involvement 6.0 5.7 5.8 5.9 6.3* 6.4 Keeps All Promises 88% 89% 87% 92% 94% 96%

General Likely to Recommend 7.2 6.4 7.9 6.6 7.9 8.2 Drives Tangible Outcomes 7.1* -- 8.1 6.4 -- 7.7 Overall Satisfaction 7.3 6.3 7.9 6.4 7.5 7.6 Forecasted Overall Satisfaction 7.4 6.4 7.9 6.5 7.7 7.8 Part of Long-Term Plans 85% 80% 95% 89% 89% 96% Would You Buy Again 80% 67% 93% 77% 95% 93%

Note: The highest score for each indicator is highlighted in green, the lowest in red. *Limited data


Component Vendor Epic

Sales & Contracting Product Works as Promoted 7.8 Money’s Worth 7.6 Avoids Nickel-and-Diming 95%

Implementation & Training Quality of Implementation 7.6 Quality of Training 7.5

Functionality & Upgrades Overall Product Quality 7.9 Delivery of New Technology 7.6 Ease of Use 7.3 Supports Integration Goals 8.0 Product Has Needed Functionality 6.8

Service & Support Quality of Phone/Web Support 8.0 Proactive Service 7.6 Executive Involvement 7.9 Keeps All Promises 95%

General Likely to Recommend 8.0 Drives Tangible Outcomes 7.3 Overall Satisfaction 7.7 Forecasted Overall Satisfaction 7.9 Part of Long-Term Plans 98% Would You Buy Again 98%


SUPPLEMENTAL EVALUATION

COMMENTARY


Comments for the following questions: What key vendors make up your current BI/analytics strategy? If you are planning to purchase any additional or replacement BI/analytics solutions in the near future, which BI/analytics vendors are you considering? Are there any other innovative BI technology or vendors that you’ve seen in your market? If you are not considering any BI/analytics vendors in the near future, why? Additional Comments


What key vendors make up your current BI/analytics strategy?

Allscripts We are mainly using the analytics side of Sunrise Clinical Manager to report data. We are mostly just using Sunrise Clinical Manger to access things and report basic metrics. We do analytics on our EPR data, and I think our ability to display the data particular to a clinical team is failing at present. I think one of the issues is that the Allscripts product doesn't look at the data warehouse, the PAS, or other sources of data. It just looks at the data in the Allscripts EPR. We use Sunrise Clinical Manager for standard reporting. We don’t use the analytics functionality in any deep or meaningful way. There may be some useful piecemeal things, but when it comes to informatics, service firms are immature in their ability to support IT-enabled healthcare work.

Beijing Medical Technology One of our hospitals just signed a contract with a local company for a data warehouse. I don't think it is a serious project; the product will not meet our needs. As an organization, we are still in the stage of market research.

Biologics We are using the Biologics tool to analyze our patients’ locations and make sure that we have services available accordingly. For example, we were able to make sure that we had certain types of imaging available where we didn't have much but where a lot of our imaging patients were traveling to.

Cerner We use a couple of small business intelligence tools provided by Cerner from a clinical perspective. But we don’t have one tool that can provide intelligence on all areas of our healthcare organization.

Costing and Business Solutions We use CostPro Plus for pricing.


DataGenic We have a data warehouse from a supplier called DataGenic. The system focuses a lot on the financial and predictive sides, but it really lacks certain things for quality and patients.

Epic Basic reporting Data warehouse, reporting. Not yet live. I am trying to get Epic’s Slicer Dicer system up and running. It isn’t running yet because of our own internal hardware limitations. We are still working on getting the interfaces, data transmissions, and ETL tools set up. We are implementing Cogito right now. It will provide additional clinical and financial data capabilities for our other Epic products. We use Cogito. For a number of reasons, we don't use it as our main data warehouse; we have our own. We plan to migrate someday in the future, but not at this time. Currently, we use Cogito because we need the functionality. We have some organizations that we are obligated to send data to, and we send data to registries. We will be using the Cogito system to report on our data.

Hitachi We use the Hitachi system as our enterprise-wide data warehouse.

Homegrown We use our homegrown system to aggregate data from a variety of systems.

IBM There are a lot of standard reports for billing and other things. We can look at our patients in the system and access good information about them, including the billing information. The system also provides the clinical data in an integrated view. We have all that information available to our managers of the medical and nursing departments. The managers can see how their departments are doing with quality and performance. We are using Cognos Enterprise as one of our front-end tools. The BI we are doing is nonclinical and noncritical. It is supplementary. Toward the end of this year, we are going to make a decision about our go-forward strategy. We have been moving toward a new strategy for two or three years now. With the steps we have taken with our data warehouse, the expanded use of Cognos Enterprise, and what we are doing


with our PeopleSoft product, our organization has been happy with our progress. However, they would like to see more. What we will decide depends on what the business wants to spend the money on to get results. We have a product of IBM called Cognos Enterprise. We selected this because our system map is based on Cerner’s Millennium system. On the other side we have our main IT systems, including Oracle’s business suite and a PeopleSoft system. Cerner and Oracle have BI tools, but we decided to have an independent BI system like Cognos Enterprise because of the way we are trying to mix clinical information and financial information for our managing process. It is quite easy for our technicians to learn how to use Cognos Enterprise. That is quite important to us because we are not using external resources for the implementation of the indicators. We are using internal resources, and they are quite good. We are really happy with Cognos Enterprise. It is not a solution of the IT department; it is a solution of the management-control department, and that department is where all the reports are created. Our role in Cognos Enterprise is to create areas. We have to move all of the information from Cerner’s business suite to Cognos Enterprise. We have Cognos Enterprise. We have worked with IBM to develop our strategy and maturity plan around analytics. We don't bring in information on the patients at this point. We have sort of started down the business intelligence and analytics road. We have the Cognos platform, but it is not fully developed yet by any stretch of the imagination. We are using Cognos Enterprise as a data warehouse and for some real-time reporting capabilities. Cognos Enterprise has been working okay, but a lot obviously depends on the data we get. We are doing some financial, ERP, and clinical analytics, but we are in the early phases, and a lot has not been done yet. We use Cognos Enterprise for tracking hospital performance, not mining data. My vision is to implement analytic tools to help us prevent labor accidents. We have a lot of interesting data, but we are just getting started. Our users like the system, and it works perfectly for what they use it for. We use Cognos Enterprise mostly for financial data and some clinical data. We use an ETL tool to harvest the data and use it for analytics. We use Cognos Enterprise to collect the data in the format we get from all the healthcare organizations into a data warehouse, and then we transform the data, convert it to graphs, and run the reports. Cognos Enterprise is okay, but it is not solving our major issues, which include gathering data and making sure the data is of the right quality. We also use the Cognos tool for some data visualization, but we supplement the data visualization things with some other products.

InterSystems Our higher-ups can configure DeepSee, and the people below them can compare former days to the current day or last week to this week. The users are very comfortable with the system. We really like the reports about falls. We can run the reports based on location, so


we can let our staff members know where we experience the most falls and when. That really helps us minimize the number of falls per patient. We bought DeepSee with a dashboard and KPIs. We use DeepSee more for our healthcare indicators. It is very good. It doesn't take long to generate a dashboard or an entire graph. DeepSee is an excellent solution. Sometimes we make some modifications, but the system satisfies more than 90% of our needs, and we can modify it to make it meet the rest of our needs. We like DeepSee. It is built on an object-oriented schema and a monthly-dimension schema, so it can analyze the data and compare it to the data in our other BI system. We don’t need to create an active template library (ATL) for DeepSee because the database back end is built on monthly dimensions. Our other system, however, is a relational database, so we have to create an ATL tool in order to move the data to another schema.

Medisolv For BI, we are using what MEDITECH originally offered. It is a Medisolv product. We are currently using that system, but it is not managed very well. Pulling out any reports is difficult. But there is a future upgrade coming that has a couple of analytics dashboards that look good.

MEDITECH Our EMR from MEDITECH feeds into what we need to have done on the BI side. MEDITECH has been very reliable. We consolidate about 700 reports to drill down. There is some visualization, but it is not great. The system looks at both clinical and financial data.

Microsoft Data warehouse Our current data warehouse is SQL based, and we made it ourselves. We have our own tooling and ETL. We made a program and every rule for our data warehouse. We are still using this warehouse because Epic is an American organization, and in our region, we have another billing system that we use for invoicing. That system was not in the Cogito data warehouse for a long time. I think that system is there now, so our main financial component is going to start working with Cogito. I think we will move to the Epic solution, but we haven't planned that transition out yet. We are developing our own in-house data warehouse using the Microsoft platform as a base. We are not using anything Microsoft has developed specifically. We are using the product as a basic data warehouse and to get basic reports.


We use our BI system from an operations perspective. Our data warehouse produces reporting elements that refresh every 10 minutes, and our operations people use those elements to look at the bed status, the discharge status, the waiting times, the number of patients on trolleys in the ED, the number of patients seeking beds, and the bed status across the hospital. We also use the BI system a lot for finances. We do some work on activity-based funding, so a lot of the data is married to the financial data in order to drive that initiative. Our business managers use the system a lot to see their operational status. This BI tool is very strong, and we are happy enough. The system seems to do what we want it to do. We use the self-service BI tools mostly for reporting. With Power BI, we can use administration-type reports. It gives us good visualization. We can point it to a database, and in a few hours, we can start pulling reports. However, the data is sometimes hard to get out. The user interface is great and easy to use. Our systems and applications people point the Power BI application in the direction of the data, and the product works out schemas itself. The things on the back end are really good as well. Power BI fits our cloud and data strategies.

MicroStrategy The solution is used by smaller hospitals for their BI. We use the MicroStrategy system for clinical purposes.

MV MV offers some dashboards that are integrated with the EMR and the PAS, but the vendor only offers basic tools.

Oracle I think we get on really well with the PeopleSoft staff, but the PeopleSoft system is not a proper BI tool. We get along quite well with the Oracle products, but we struggle with Oracle as a vendor. I would definitely rate them lower than other vendors. Oracle’s system is our big platform for admissions and scheduling in our surgical, emergency, homecare, and public health departments. The Oracle product just has some reporting tools in it, and it is not really a full BI tool. The reporting tools present data relatively easily. The way the data is presented is almost comparative to the way Cognos Enterprise presents data, but the PeopleSoft product from Oracle doesn’t have full BI capabilities. It can do a little bit for BI, though.


There is a lot of development that could be done on the Oracle tool in order to achieve better functionality. It will take a lot of effort to make the tool easy to use for creating dashboards, collecting data, manipulating data, and presenting data. Right now, it requires a lot of work to do those things. We are currently implementing the solution from Oracle. We are hoping it will help us manage much of our BI strategy and find out where we can improve. We are doing the best we can to mine data out of our EMR and use Oracle tools to create dashboards and run analytics. Sometimes we look at the delays in our outpatient clinics, and sometimes we look at how to predict no-show cases. Sometimes we look at the cost and efficiency of documentation and rejections. We look at how much money we are collecting and try to analyze why claims are being denied. We try to use the data we have and use the tools we have developed in-house in order to address our issues. We are in the process of developing our next generation data warehouse using the Oracle BI tool. It is doing okay. I haven’t had many complaints. We are sending both our financial and clinical data to Oracle Business Intelligence Enterprise Edition. We are using it to do some data stratification. We can see a very robust Oracle solution, which is different from the system that we remember from 10 years ago. And we can see things that are very meaningful. Oracle is selling us the technology and the intellectual property, so they give us the BI solution, and we don’t need to bother ourselves with what figures we want to end up with. The figures could be for HR, finance, or supply chain things. We don’t fully understand all of our gaps in our clinical care areas. Without the data to support those gaps, we have to work to get the senior management people to buy in to fixing those areas. I need to have the data to say that there is a problem and what the likely causes of the problem are, and I need that data to be easily understood by the senior management. We have to have BI functionality. We use an old, clunky data warehouse for our financial and administrative data. We are going to look at other tools. We use Oracle for a data warehouse and for our reporting tools. The data warehouse is behind Cognos Enterprise on the front end. We are also using some of the more basic BI functionality that comes in the PeopleSoft product. Those three things make up our solution at the moment. We use Oracle for the administrative aspects. But we don’t have a single tool that pulls business, administrative, and clinical data. We use the Oracle product for management overview. We use the Oracle product mostly for statistics. We don't use it for clinical outcomes.


We use the Oracle system for our financial and ERP data. We use the Oracle system for our financials.

Pentaho We use the Pentaho system for our clinical data.

Philips We use Philips Tasy for basic reporting.

Qlik For the time being, QlikView is taking care of all of our needs. We have it integrated with our QuadraMed system. I have a clinician dashboard that tells me what I am doing. It launches my surgical logbook for me and tells me my waiting list. That logbook launches within the QuadraMed system. Qlik has delivered some radiology reporting, and they are trying to concentrate on the stats reporting and business operational reporting. Funding is one of the issues we are facing, though. Qlik’s people aren’t the cheapest of people to employ. QlikView has a better product, cost benefit, and learning curve than our other BI product, and it is also more popular in our country. QlikView is a tool that our top management people use. Because of licenses, we don’t distribute the system to other staff members. The nice thing about Qlik is that we are not locked into using applications from specific vendors. We can get information from a lot of different sources. These days, flexibility, agility, and ease of use are key aspects of a system. We are going to use QlikView as a viewer for clinical and financial data. We are using QlikView for finance, accounting, and administration. We are using QlikView for our reports and analytics. We chose QlikView for our analytics. We looked at Microsoft, Tableau, and BusinessObjects. Microsoft said they wouldn’t be able to meet our needs, and Tableau was newer to the market. Qlik looked like the only vendor who was going to be able to meet our needs. Since we have been using QlikView, we have realized that we have been able to get a better view into our costs. If we wanted to get that view ourselves, it would have taken us years and would have been really cost prohibitive.


We have a few things going on in parallel. We have a big data warehouse product, and we also have QlikView. We have some other workarounds and lots of homegrown databases for reporting, but we don’t have a single system by any means. QlikView is probably the nearest thing to a single system that provides some level of dashboard functionality for our managers. We have a large number of initiatives underway to help us with our corporate performance and indicators. We are largely using a database we created that allows us to report to various parties who need data sets on a regular basis. We have QlikView for our BI work. We mostly use the system for the visualization of key disparate data sources. The dashboards look quite interesting. There are a lot of other systems out there, but we haven’t found any system to be better than QlikView yet. We originally thought we needed QlikView or some other fancy visualization tool. But after our initial enthusiasm, our end users stopped using it. The tool looked good in the presentation, but it wasn’t what the end users wanted. We use QlikView for financial purposes. We use QlikView for financials. We use QlikView mostly for dashboards. We use the Qlik product to help with the visualization of our Cognos warehouse, which houses our nonclinical data. We used QlikView as part of the Microsoft stack to visualize things in forms other than tables. After we did that, we wanted the data back in tables. We were too mature for the product; there wasn’t a need for it.

SAP SAP BW is an older system, and it is more specialized. We have to spend a lot of resources to train our staff on it, and the system demands a lot to get work done. We will be discontinuing our use of the product and using our other BI product exclusively. We are focusing on BusinessObjects and the tools for extracting data. We have been focusing on those things for quite some time. We have an expansive data warehouse. We have been working on getting things in place for close to 10 years. We started collecting financial information, but now we are collecting key clinical information as well. Our population health and risk stratification things are very limited. We do have a good database to make our reports, but we are not very strong on the analytics side. We aren’t doing any clever analytics at this time, but our plan is to include those kinds of analytics in the future.


We are using an SAP product to report on and visualize our data, which is mostly financial. We aren't doing anything in depth on the clinical side. We are using BusinessObjects Business Intelligence for our reports and analytics. We have a data warehouse, and while we can analyze the inpatient data, we don’t cover family care. We cover the emergency department and some outpatient and inpatient data. But the data warehouse does not include prescriptions at this point. So we can do lots of number crunching on the patients we see, but at this point, without the coded diagnoses, medications, and prescription administration information, we don’t have everything we need. We use an old version of SAP’s product as our EDW, and we use it to get our expenditures per DRG code. We use the SAP system for our financials.

SAS The advanced users are using the SAS tool for data visualization. SAS is a decent organization, and they are very supportive. They could do more, but we need to do a lot more first. Our clinical data warehouse is in a SAS environment, and it is populated with a lot of data from our key clinical systems. SAS helped us set that up, and they were really supportive and helpful. We wanted to create a clinical-research database to help clinicians find cohorts of patients more quickly. We are using just a few pieces of the SAS solution. It is such a big product that we don't actually have the strength to use all of its capabilities. We have an EDW, but the normal challenges faced with business intelligence are compounded in our case by the clinical costing data in terms of what gets allocated to a patient because we only have partial costing data. That makes looking at the profitability of a patient's care all but impossible to do. The Department of Health is struggling with this same concept. We are using a SAS system, but it is more statistical in nature. The interface is not as nice as the one in Tableau’s system. In addition, the reports we can see are always retrospective and 12–18 months behind. We need to have concurrent views.

Speedminer We do all of our data mining and reporting in a Speedminer system, and it is such a good product. We are reluctant to move away from it. It interfaces very well with our TrakCare system, and it builds things overnight. That way, we can interrogate any fields or any data we need to. We can also create ad hoc reports on the fly, and we can develop confidence reports. We use the Speedminer tool an awful lot.


Tableau The average users are using the Tableau tool for data visualization. The solution is used for data visualization. Visualization We analyze clinical information about the number of outpatient and inpatient visits and which procedures have been done. We also get financial information about revenue and costs. There are many things that we use Tableau Server for, such as focusing on improving outcomes in the weakest departments and seeing what we can do as doctors and nurses to bring in more data. Tableau is a great vendor and has excellent analytics software. We dabble a bit in analytics in terms of financial efficiencies. We occasionally pass data from the InterSystems database through the Tableau system to see a few things, but we don't fully use these tools. We are very new to the data model. The Tableau product is much better than Excel's pivot tables. We use a visualization tool from Tableau for our data analysis and presentations. We use the Tableau system mostly to improve our supply chain. We use the Tableau system to analyze data and get indicators from all of our clinical departments.

TIBCO Jaspersoft has more advanced reporting tools that our other system doesn't have.


If you are planning to purchase any additional or replacement BI/analytics solutions in the near future, which BI/analytics vendors are you considering?

Allscripts Clinical Performance Management We are looking to get better analytics out of our EMR.

Cerner We anticipate implementing the data warehouse and tools that come with whichever enterprise HIS we choose. That will hopefully be complementary to what we already have. We are in the midst of choosing our EMR vendor. Once we make that decision, we will be in a better position to understand what they offer as part of their solution set. We are interested in leveraging our EMR to get reports on things like shoulder surgeries. We could look at the pain pump and recovery times, and we could leverage the reports to drive best practices. But data sovereignty is a challenge for us. We can’t do integrated web services because we don’t have a cloud. We will look more closely at Cerner’s BI tool since their EMR is our data source.

Dimensional Insight Dimensional Insight's BI product will work well with our current system.

Epic Our products will effectively provide reports on the clinical data that we need. We are considering Epic for our EMR. We would use them for our core analytics product to report our clinical data. We are in the midst of choosing our EMR vendor. Once we make that decision, we will be in a better position to understand what they offer as part of their solution set. We are going to implement the whole data warehouse from Epic. The policy here is that we bought Cogito and that we should use it. After a while of using it we can decide whether to do more, but we are not going to change Cogito. We are not going to eject it up front because we have some other product. We are using the Epic software, and we try to use everything there. We are not planning to fully implement the Cogito system. We will just use the standard data warehouse. But I don't completely understand where the Cogito tool begins and ends. I think the product is an umbrella that covers all of Epic's information tools. The Epic


system will provide a link to our current data warehouse and will deliver much more patient data and much better quality than our current system does. But we are in the very early stages of understanding the product and getting our people onboard with it. We have very little experience with it. The Cogito system was not a factor in our decision to go to Epic, but it will help us. Our current application environment is very fragmented, and the data is not very structured. The Cogito system will be a huge step forward, and it will help us have better operations and more effective information. We will look to expand the Cogito product suite and eventually replace our current data warehouse with it.

Health Catalyst We have looked at what Health Catalyst can do with data, and we are impressed.

IBM IBM's tool will be entail more of an expanded enterprise rollout.

IBM Watson We will use Watson for intelligent learning and decision support.

MEDITECH We will mostly report using MEDITECH data, both clinical and financial.

Microsoft Our current BI system is rather expensive when it comes to the licenses, so several hospitals are starting to work with a Microsoft solution. People want to be able to report on indicators to everyone in the hospital group, and they use the Microsoft product to reach that broader audience. We are considering doing the same thing at our hospital. We will look at Microsoft's cloud offering and data warehouse capabilities.

MicroStrategy We will likely purchase a system from MicroStrategy since they are aligned with MEDITECH. We will use their system for more advanced visualization of our data. We will use the MicroStrategy product for our back office. We would use MicroStrategy for our financials and back office.


MKM Health We don’t have an EDW yet, and we are just kicking off an initiative to get our data into a data warehouse. The system will incorporate both clinical and PAS data. We will use a system from MKM Health, an Australian vendor, for the EDW. We will look at all of the big vendors when we get closer to making a decision in a couple years.

Oracle We are going to keep QlikView and add the Oracle Endeca product so that we can have more functionality. We would use the Hyperion products for our financials and back office. We would use the Oracle product for financials.

Philips We are looking at a BI solution that will be radiology specific. We will probably end up going with a system from Siemens or Philips as a beta tester of some new, radiology-specific technology.

Qlik A BI product that many hospitals use is QlikView. It has a good user interface, and Qlik claims their product is fast because of the memory size and the ease of customizing things. It is a lot easier to use than the traditional BI tools like Cognos Enterprise. Right now, we don’t have very much data because we always scan things. But in the future, if we plan to have the EMR system and connect all of the data together to do some analytics and predictive functionality for the patient, we will need a BI solution. Qlik’s system is much more expensive than Tableau’s. Tableau’s system is more nimble. It gives us more ability to do on-the-fly reporting, but Qlik’s system is better at giving information in reports that have already been built. QlikView will be used for our back office. QlikView would be used for our financials and back office. Right now we use the BI functionality in Philips Tasy, but it is very basic, and we knew from the beginning that it would be. We are looking at a more robust solution to implement that will help us analyze our big data. We are considering using QlikView for visualization. We have built a powerful enterprise data warehouse. Now we need a strong visualization tool to support it.


We have talked to people who use QlikView and to people who are subject matter experts on Spok dashboards. We currently don't have any feedback, but I hope we will within the next few months. We are considering engaging with Qlik and Spok to look at our data and demonstrate how the dashboards might look. This is a big initiative of ours. We need to see in real time where each patient is on a pathway, but we also need data that retrospectively shows what percentage of our patients have met the agreed standards for relatability. Allscripts is not able to deliver a system that meets this need. We will keep the Tableau tool, but we want to add more functionality and will very likely start using two other solutions. But we won't do that until we complete our EMR implementation. Our EMR implementation is planned to be done in 2017. Our big data project will come right after that. We would use either QlikView or Tableau Server for financials.

SAP We want to get SAP’s newest upgrade for our new data lake. That would give us more accurate data, and the data would be easier to access quickly. The system would include a clinical data set from our EMR and a clinical data set from our financials system. We would use the tool to generate length-of-stay reports. We will use the product for the cloud offering and data warehouse capabilities.

SAS The product will be used for visualization. We are considering using the SAS tool for visualization. We are going to bring in more solutions from SAS in order to get text mining and other functionality that we have been analyzing. We would use the SAS product for financials.

Siemens We are looking at a BI solution that will be radiology specific. We will probably end up going with a system from Siemens or Philips as a beta tester of some new, radiology-specific technology.


Tableau No one in our organization has good data to use. We have started to look at Tableau’s system. PwC consulted with us and gave us a view of the options. The Tableau system produces pretty graphs and has lots of flexibility. Everyone wants data now, and we can't keep up with the requests we get. It is hard to find the report we need with over 600 different reports. We want to have an interface so people can get the views they want out of the reports and pull their own information. Our initiative will be clinically focused. Tableau Server will be used for our back office. We are going to get the Tableau system for visualization. We want to have much stronger self-reporting tools. The Tableau system will allow us to have a better self-service review of the world. We looked at Qlik’s product, and it was really similar to Tableau’s product. Our decision came down to personal preference, and we liked the Tableau system more. We would like to get a single solution that can combine KPIs from our two systems and make correlations between our spending and our healthcare provisions. For instance, I want to be able to look at the spending of my physician resources, how much they are benefiting from our solution, and how productive the resources are being. That is the kind of solution I am looking for. I need somebody who is going to share the combined dashboard, show us how to connect the financial things in healthcare, and come up with a number that indicates how efficient my resources are. I have seen demos of the Tableau product, and I have been very impressed. But the budget cuts mean we have to defer in purchasing a solution. But Tableau is a vendor we are considering.

Truven Health We are looking at replacing our analytics product with a product from Truven Health or Manteq.

Transmit Health We will add on top of our EDW the visualization layer being used at a certain cancer center. That will help us view our clinical and PAS data.

Other For a national BI system, there is a national preprocess for a number of services and diagnostic imaging. We will be ensuring that there is an extract function or a data feed from the BI solution into the central warehouse whenever the BI solution is fully functional. Our BI system will act as our EDW, and it will be largely focused on clinical information.


Right now we have a data warehouse being built, and that is where the focus is. Also, depending on whether we choose to get a new EHR vendor, we might have to find a solution that fits with a new vendor. We are looking at a few systems, but we are still open to any vendor at the moment. We need a system that is easy to use and easy to get needed information from. We currently have to use several reports in order to get the information we need, so we hope to deploy a BI system that will facilitate our access to that information. We are working with Advisory Board to select a product, and we call them each month to talk about how to work in the BI area. We want to get clinical outcomes from using the analytics tools. We currently focus too much on financial efficiency. We need a data warehouse to consolidate all of our information. Right now, we have information from cardiology in one place, information from radiology in another place, and so on. In order for us to truly leverage a solution, we need somewhere to store data so that we can extract it when we need it. We just invested a lot of money in new equipment, so we are just starting the process of figuring out which BI vendor can fill the data warehouse gap for us. We want a core analytics product we can use to report our clinical data. We are thinking about getting Cerner’s EMR system to fill that gap. We will start with maximizing what we are doing and then what remains to be done. We want to modernize our technology stack. We are very early in our BI strategy, so we have a lot of work to do. Our new tool will include an information reservoir that we can use to run analytics.

None We will look at all of the big vendors when we get closer to making a decision in a couple years.


Are there any other innovative BI technology or vendors that you’ve seen in your market? Alteryx, Predixion Software Hitachi Data Systems is doing some very interesting things in the healthcare industry to help organizations understand enterprise data warehouses. They have an innovative approach that will change the game, and we are excited about that. I am getting a team ready to implement a BI solution. From what I have seen so far, Tableau is the most innovative vendor. They have a tool that is more intelligent than the other products I have seen. I am not sure what tools there are in the market. But it would be good to know where the business intelligence market is heading and who the leading vendors are. I don’t experience using the Cerner solution because we don’t have it. But I have seen presentations on it in some conferences, and it looks fantastic because it is cloud based and not a closed solution like the Millennium systems. It takes information from other EMRs, aggregates it on the cloud, and keeps all of the information of the patients and doctors in a really nice view. On a 1–9 scale, I would rate that Cerner solution as a 10, but I am sad because we cannot afford it. From what I have talked about with people, that solution would be really good for organizations that cover millions of people, but not for a hospital like ours. In the Pentaho system, we use the MySQL database. Now we are trying InfiniDB, and we are getting good results. MicroStrategy and Microsoft are technologically innovative. One thing we are not good at as an organization is having data-driven management. In the past we have created fancy BI tools and pulled data over, and no one has used the tools any more than we do now. We already have a data warehouse, which pulls all the data from the different systems into one container. From there we have an analytical team that builds the reports people expect to get out of the data warehouse. We have a fancy front-end program people want to use to tell which patients we should be discharging and to understand what our outpatient capacity is like. All of those things are coming out of the data warehouse, which we have managed to maintain the integrity of. Oracle Endeca Information Discovery is a more complete solution than what we have, and we need to add more functionality. There are no other innovative BI technologies or vendors that I have seen in our market. There has been nothing particularly innovative in the standard packages offered by IBM, Oracle, and Qlik. We haven’t looked at any of the big data things at all. I am aware that we


are perhaps a little bit behind the curve with the big data things, but a few people I have talked to haven’t gotten tremendous value out of big data in our industry yet. So I might not be as far behind as I think I am. There are sort of two Watson systems these days. There is Watson for analytics, and that rebrands some of the analytics capabilities, and there is true Watson, which will eventually start to drive healthcare forward in terms of clinician support. The clinician decision support things look really good, but those things are a bit high end for us at the moment. The clinician consultants don’t work for us, so things are a little bit difficult for us. We have talked about Watson and explored it a little bit, but it is just a little bit out of our reach at the moment. But I think it will be great. I think IBM has really good early-stage delivery with Watson. I don’t know how they will commercialize it properly. It is still a bit of a high-end technology, and I don’t know how we bring it down to our level and really drive it to be a volume-commercial product. I haven’t quite envisaged that yet. I am sure IBM will get there, and I am sure that Watson will work. There are what we call teaching hospitals and high-end research hospitals. I can see them using Watson, but for most hospitals, I think Watson is more of a commercial proposition. We are a small hospital with limited resources, and that makes it difficult for us to implement a robust solution, but we are looking into adding more tools than MV offers. We are about to sign a contract with a BI vendor. We need a solution that integrates well with Philips Tasy. Today, it takes several days to create all of the monthly indicators we need at the hospital, and we have to search for the data in multiple places and also get some of the data manually. It is a laborious process. We want to improve our processes for getting our indicators, and we are hoping that a new BI tool will solve the issue. We are implementing Cogito. We feel that system will provide the best reporting for our Epic data. We understand that we will have to use QlikView in a few areas for our other data, but we feel that we will have strong data analytics between the two systems. We are not looking to purchase anything different than what we currently have. We are replacing our EMR, so we will be deciding in the next few months which BI system to get. We want to wait to make that decision until we have our EMR because some of the EMR vendors we are considering also offer BI solutions. We have had a decision support system in place. We are just now implementing BI tools, and we have QlikView. Things remain to be seen. Nothing has stopped the BI implementation, and in the future, we may get some specific, higher-level reports. Some individuals want to get into things right away, but we don't know much of anything yet. We have purchased Clinical Performance Management, but we have not implemented it yet. We are hoping to have it up within the next year.


We have seen the IBM Watson tool. We are interested in having predictive analytics in the future, but we have quite an investment to make in our own maturity first. We haven't seen any other BI technologies or vendors in our market. We hear about the success that Health Catalyst has had in the US, so we will probably explore the Health Catalyst product more. We need something like Microsoft's HealthVault system that has personally owned records and that can connect with gadgets and hospital systems. It should be possible to build something with HealthVault that would satisfy the needs of the people. There are a lot of private laboratories and doctors that have their own portals to send things to, but that information is separate. We are evaluating our options, and we going to start working with a public EHR. The system does not have a central architecture, and it will work very slowly. There is a lot of opposition from our doctors and pharmacists because they think they will be controlled by using the system. We talked with Cerner about some approaches to population health, but we are just in the beginning stages. We are looking at tools like Watson, and we will probably get something in the next two to three years. We think EMC and Aquarela have innovative BI technologies. The VORTX solution from Aquarela looks good. We will likely purchase a system from MicroStrategy since they are aligned with MEDITECH. We will use their system for more advanced visualization of our data. We would like to get a single solution that can combine KPIs from our two systems and make correlations between our spending and our healthcare provisions. For instance, I want to be able to look at the spending of my physician resources, how much they are benefiting from our solution, and how productive the resources are being. That is the kind of solution I am looking for. I need somebody who is going to share the combined dashboard, show us how to connect the financial things in healthcare, and come up with a number that indicates how efficient my resources are. I have seen demos of the Tableau product, and I have been very impressed. But the budget cuts mean we have to defer in purchasing a solution. But Tableau is a vendor we are considering.


If you are not considering any BI/analytics vendors in the near future, why?

Agfa HealthCare We are staying the course with our strategy to use the BusinessObjects product. Depending on government regulations, we may change our strategy for reports as the need to incorporate more clinical data becomes relevant.

Allscripts Our strategy is set. If our needs change, we will procure things as needed. The Oracle BI tool is something we will continue to use for now. The biggest challenge for us is consolidating the various data points into a new data warehouse. That process is ongoing and will take us the next couple of years to complete. We are happy with the functionality in QlikView for now. There may be a closer evaluation in a few years, but right now we are fairly busy with our EMR implementation. We will look closer at an analytics solutions after we are further with our EMR journey.

Cerner The problem is that I have no support from my top management. I am looking at BI tools a bit, but there is nothing planned. We already have an analytics vendor, and we have no plans to add anything more. We are focused on maximizing what we can get out of our current tools. We are not currently considering any BI vendors because of our budget. We aren't considering any other BI and analytics vendors for the future. We just started using IBM, and our relationship is still pretty new. We have been with them a little over a year.

ChipSoft We will not be looking for a BI solution until 2018 or 2019, after our merger with another organization has been finalized. We are not doing much with BI today, and we don't have any indication of who we might choose.

CSC We may look at other vendors in the future, but right now our strategy is set.


Epic Our BI development is in a nascent state. We haven’t been doing anything BI related on our own. We are very new, so we haven’t had much time to do things for BI. Our focus has been on going live and stabilizing our solutions. We haven’t spent much time on BI. We have Oracle right now, and that is about the only BI solution we are using right now. Our BI work has been focused on the business data, not the clinical data. We are quite well established for our business data. We have spent a lot of time making definitions clear and identifying key performance indicators. We have a minor project with integration of clinical data, but there isn't much integration. For the future, we need further development of clinical intelligence. The problem is that SAS and IBM cost a lot of money. It will be interesting to see what is going on with IBM Watson and which models are offered because we are a smaller hospital and don't have a lot of money. We are sticking to the Cogito functionality for now. If that proves unable to meet our needs, then we will look elsewhere. We believe that we have already solidified our strategy with the vendors that we have. We will focus our early efforts on the Cogito product, and we will see where the gaps are after that.

Homegrown We are in the process of selecting a new EMR system, so that is our focus now. We might consider another BI solution after that, but that is not on our radar at the moment. We may look at other vendors in the future, but BI is not a current IT project for us.

InterSystems We already have a BI system, and our limited budget doesn't allow us to implement another solution. We already have BI vendors. We are not considering any BI vendors because we already have one.

MEDITECH We do some things with our BI solutions, but we mostly use them for statistics. They don't actually help us with our clinical outcomes. We expect that the EHR we select will help us use the data to improve our clinical outcomes. We currently utilize Oracle's BI solution, and it is very costly. It does the job, but we are starting to move toward self-service BI systems and Microsoft's Power BI system. The EHR we select might be the answer to


everything. We use a BI tool to create reports, and there is a cheaper solution for doing that. BI tools are too complex for general users, so we have to employ business analysts to work with them. Even then, the systems are inefficient at creating value that would generate more money than we paid for them. We don’t have a BI solution from a financial perspective. We have been talking with our LHIN. All of our funding comes from the LHIN through the government, and the LHIN provides support for regionalized projects, so hospitals in one area can share and benefit from projects. That is a shared concept. The LHIN has suggested that we use a regionalized version of a BI tool that has been developed and produced out of a hospital that we can join in the future. The BI tool has already been deployed at a number of hospitals in different LHINs within the area, so there are probably some standards that have been developed in our state and have been proven to work. We are interested in moving in that direction, especially because that will help us maintain provincial and government reporting standards. We just chose a BI solution, and we are currently implementing it. So we aren’t currently considering other vendors.

Philips We already have a solution. We are a small organization, and we do not have complicated BI needs yet. We do wish, however, that our current vendors' tools were easier to use. We were using SAP BW for a number of years, but now that we have gotten QlikView implemented, we will discontinue our use of SAP BW as soon as we have everything working on QlikView.

QuadraMed We will not add any BI product until we have a new EHR system. We want to wait for the EHR system first to see what will work well with it.

Other For analytics, we are doing everything through Tableau. They are number one. Lots of vendors have sent us a ton of info on why we should choose them, but we like what we have and what we are doing with Microsoft. Our current solutions are meeting our needs. We already have enough BI systems. We are building out our existing platforms.


We are planning to keep using QlikView for the near future. We are working on optimizing our current environment and working out getting quality data into our warehouse that we can trust. Currently, a lot of our challenges are because we do not get information on each individual encounter. We only get a summation of encounters. We need to figure things out with that first. We will eventually implement something new. We need to think about the architecture to create a real corporative BI system that has a clinical component as well as a governance component.


Additional Comments

Agfa HealthCare We have a business warehouse and a BI platform from SAP. We are thinking about getting a big data platform. In our country, there is a big analytics project. That project is a challenge for us, but it is important. We have ambitious plans for BI, but that will only come to be after we sort out the clinical data side of the house. With our Agfa implementation, we made great strides in terms of getting a lot of clinical data, but we must make sure that the data we have is the data we want before we can rely on it for any sophisticated reporting.

Allscripts Allscripts has a very week analytics offering. So we go to third-party vendors to help with our BI needs. We have a lot of data, and not all of it is easily accessible or used to its maximum potential. We are in the early days of creating a data strategy. We are a large institution with a unique profile and patient population, and we have a very large research institute. There are a number of moving parts in the analytics space, including the development of higher-performance computing in the cloud. We have other major databases with analytics in some of our specific departments, such as our cardiology and cardiovascular surgery departments. We have a number of cross-hospital opportunities around creating a shared secondary-use platform. We have a shared EHR for our provincial pediatric centers. We are looking at how to put a framework around the data architecture and governance for our different entities so that we can get more value out of those data assets, and then we want to fill our gaps with other tools. I am a bit reluctant to go out and just shop for tools. We need to have a bit more direction around our data assets and what we want to be able to do with them.

Cerner Our biggest issue is the horsepower. The data is growing, and we can't crunch the numbers quickly. We don't get many complaints about the Microsoft product, but when we do, it takes 30 seconds for the page to refresh. We developed and implemented our BI solution in conjunction with the vendor. But in our country, we collect a lot of data without billing for services. If we don't capture the billing data, we can't do extremely robust costing analysis. Our drivers are different from those in the US. We don’t have a single system that is currently being used. Business intelligence is one of the areas that we currently would like to improve; business intelligence and data management are crucial for making the right decisions. We are undergoing a big evaluation


by Accenture Health for analytics tools. We have multiple tools that are currently being used, but they are not sufficient to serve the needs of our enterprise organization.

Epic The Cogito product will be the central focus of our BI efforts among our Epic systems. We are doing a massive consolidation of systems as we implement Epic products, so the Cogito system will cover a large amount of data within our organization. At some point, we will see whether we can also use the Cogito tool to ingest non-Epic data. We are unsure of how that will work, but we will deal with it when the time comes.

Homegrown One challenge is that Oracle won’t give us one overall account manager. We have one account manager for every Oracle product we have. Every time I want to speak to someone, figuring out who to speak to takes a while. Oracle’s process for license compliance is infuriating. Oracle worked with us on and off for a license-compliance audit for a year. We were pretty much 100% compliant. What we weren’t compliant on was due to a mistake; we weren’t avoiding being compliant on anything. Several weeks ago, someone from Oracle emailed me about license compliance and said that Oracle wanted to come out and check on our licenses again. I don’t have the people, the time, or the money to bring Oracle back in. So I refused that request. I didn’t like that. Generally, Oracle doesn’t seem to want to work with us in a constructive fashion. Oracle and IBM are two different vendors in that way. Oracle wants to sell things to us, but IBM actually takes a genuine interest in driving our business forward.

MV We wanted to have our BI tool already implemented, but we really need to get our team ready for it. Right now, we don't have the human resources we need to have a successful BI tool up and running, so I am waiting until I get my team ready before we move forward with a BI solution.

Philips QlikView is a great product and easy to use. The Qlik team is very attentive to our needs and takes good care of us. We are using the QlikView product more on the administrative side of our business, but we have plans to starting using it on the clinical side. We are in the process of upgrading our EMR to the new version, but we are also looking at a BI solution for next year. It is still early to decide on a vendor, but the ones we will certainly be considering are Qlik, Tableau, Oracle, and SAS. Other


Other Billing in our country works differently than it does in the US. We developed our own billing system many years ago, based on an ancient form of the Oracle system, but we are trying to replace it. We recently did an RFP, and the finalists are SAP, Oracle, and Connectis Group. We have both SAP ERP and the Oracle system in one of our hospitals, and that is a problem. We have to put a billing system on top of an ERP system, and we are trying to determine which system will be better for that. We run an Oracle system, a SAP system, and a MicroStrategy system, and we are trying to consolidate. That is going to take a while, though. We are trying to concentrate on a few key components. Our ancient revenue cycle applications are the main barrier. Qlik has been really good to us. We have a good working relationship with them. We are really desperate to see whether our application was a best-practice application worldwide. Since we couldn’t really join forums in other countries because of different time zones, we were feeling isolated. Qlik brought some people in to help us know about current trends and best practices. We have been able to drive down the cost of care at a number of hospitals by using the tools from Qlik. We can clearly see how often patients come to the hospital. In addition, we can look at hospitals and see their patient mix. QlikView gives us a lot of information that we can use to keep costs down and make changes. We can ask our analysts to build something in QlikView, and they can build something in a few hours instead of a few days. We use QlikView, but our analysts use Qlik Sense, which is even more user friendly than QlikView. In the beginning, Qlik had challenges understanding and dealing with government entities. Qlik was under a lot of pressure due to their quarterly deadlines. They didn’t understand the time it takes to close a deal with a government entity. They didn’t fully comprehend how much time it takes to go through the different steps. We decided people didn’t really need the ability to slice and dice the data. They really just needed more dashboard types of views. So we bought QlikView, and now we are developing more web-based functionality in it. We can develop the product quickly, although we had to put a lot of thought into our initial design. The system is not child’s play, but we like the tools it comes with. We like the way we can drill into the data. Also, we can allow some users to drill into the data and allow others to just have a high-level view. QlikView is not as technically adept or detailed as BusinessObjects Business Intelligence, but it protects its data in a similar way. It is enough for us as an end-user tool that is very easy to use. The licensing model for QlikView is quite tricky. We don't like the model, but we do understand why QlikView uses it. When sites get their license patent wrong or do the build wrong, that can end up costing a lot of money. We end up with higher costs when single users need access to multiple dashboards; each user license has to be paid for per user and


per dashboard. So it is expensive enough to provide a user with his or her own single dashboard that works. But if sites get the design wrong and have to do additional things, then the costs end up being way too high, and that makes the system not worth it. So people have to be really careful with QlikView. We like it, though. On the whole, we have been pleased with it.

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