six steps to healthcare business intelligence success© 2011 the center for business innovation and...

© 2011 The Center for Business Innovation and Resource Management Professionals

Six Steps to

Healthcare Business

Intelligence Success

July 2011

Scott Wanless


Agenda

1. The New World for a Typical Healthcare Organization

2. Research Results

3. Six Steps to Healthcare Business Intelligence Success

4. A Question for You


We want information! Now!


At the Front Door

Patients

Payers

Purchasers

Quality

Cost

Service


At the Side Door

Shareholders

Lenders

Credit Bureaus

Profitability

Cost

Productivity


At the Back Door

Regulators

Legal

Quality Organizations

Compliance Data

Evidence

Comparative Data


First Floor

Primary Care

Specialists

Nurses

Ancillary Staff

Decision Support

Patient Flows

Chart Reviews

Clinical Evidence


Upstairs

CEO

CMO

CFO

CNO

CQO

COO

CIO

Profitability

Cost Control

Revenue

ROI

Productivity

Risk Management

Compliance

Performance

New Markets

Quality

Investment Support


Basement

Clinical Research

Informatics

Process Improvement

Clinical Data

Operational Data

Financial Data

Normative Data


Solutions Abound

“You don’t have a

Parameter-Driven

Meta-Filtrational

Hyper-Aggregating

Whatcha-ma-hoozie?


Hiding Won’t Help


Research Results

Tom Ludwig Scott Wanless

49,000+ Conversations49,000+ Conversations

5000+ People 5000+ People

Clinical Operations Business Intelligence

30 years 30 years

260 Interviews + 7 Case Studies

Six Steps to Healthcare Business Intelligence Success


Six Steps to Healthcare BI Success

Strategic drivers for analytics specific to your organization

Business responses to address these challengesThis step usually missed

Analytical questions behind these business actions

Translating analytical needs into clinical, operational, financial and enterprise-wide business intelligence applications

Making BI and analytics part of the new normal for the organizationThis step also usually missed

Linking analytics back to the strategic drivers and delivering benefits


Use the steps to...

Challenge presenters at this conference

Challenge vendors

Challenge suppliers

Challenge your own organization

Even challenge those demanding analytical information


Step 1: Strategic Drivers

Increased Demand for Services

Increased access to information about health conditions

Comorbidities

Chronic Care vs. Episodic Care

Uncompensated Care

Public vs. Private View of Healthcare

Consumerism and Convenience Expectations

Resource Shortages

Physicians and Nurses

Administrators, Executives, Informaticists, et al

Compliance Requirements

Mandatory (regulatory)

Semi-Voluntary (contractual)

Voluntary (pay for performance, quality awards)

Financial Pressures

Revenue and Reimbursement Cuts

Cost Cuts

Risk Mitigation blocking Capital Projects

Pressure to Prove Value

Vertical and Horizontal Integration

Next Wave of Integrated Delivery Networks

Accountable Care Organizations

Rise in Cooperatives and Exchanges

Increased consolidation of hospitals, and physician group sizes


Step 2: Business Responses


Redesigning Care Models

Redesigning Treatment Mixes

Streamlining Patient Handoffs

Creating Facilitation Roles

Implementing Case Management

Resource Shortages

Multi-disciplinary Teams

Standardization

Physician Alignment Strategies


Reusable Compliance Databases

Chief Compliance Officers with Staffs

Compliance Governance

Financial Pressures

Aggressive Revenue Cycle Management

P4P

New Services, Extended Hours, Franchising

Reducing Readmissions

Checklists, timeouts

Lean, process redesign

Reducing Physician Preference Items (PPI)

Performance Contracts

Outsourcing and Offloading

Increased electronic information and workflow


Retail, quick and one-stop clinics

Telehealth methodologies

Mergers, joint ventures, divestitures

Standalone urgent and emergency services

Leading ACO formation

Cooperatives

Health Information Exchanges (HIEs)


Step 3: Analytical Questions

Chief Medical Officer Medical Management. Which docs are doing the best? Worst? What are best docs doing differently? Are

we cross-training effectively?

Clinical Performance. Which treatments are most effective? Which treatments are not providing clinical

payback? What is the persistency rate among patients?

Patient & Provider Satisfaction. How do the MDs, PAs, NPs, RNs get good results? Are patients

expressing delight or concern over their care?

Quality Accreditation Reporting. How are we doing against normative numbers for our quality

measures? How are we doing against normative numbers for our quality measures? How does disease

control correlate with screening? How does it correlate with other measures?

Quality Improvement Programs. What methods are producing the best results? What changes will

improve the results? What efforts are needed to effect these changes?

Chief Financial Officer Revenue and Productivity. How much revenue are we generating from efforts to control specific

conditions? Specialist revenue vs. primary care revenue? What is the trend? Where are we losing

revenue due to competition? Reimbursement cuts? Patients not coming in for treatment? Coding

problems?

Costs and Waste. What are the cost of procedures, treatments? Are we wasting any money on

ineffective interventions? Are we wasting money on duplicate efforts?

Capital Decisions and Funding. Do we have facilities set up to achieve better results? How about

equipment and supplies to support this?

Pay for Performance (P4P). How are we doing against contract targets? What economic impact does

this have for purchasers?


Step 4: Analytical Applications

Patient Registries

Outcomes Analysis

Clinical Quality Reporting

Epidemiology Support

Clinical Trials Support

Care Management Support

Case Management Support

Clinical Guidelines Support

Patient Safety Reporting & Analysis

Disease Management

Physician Report Cards

E&M Coding Utilization

Revenue Cycle Management

Strategic Planning

Demand Prediction, Volume Analysis

Claims Analysis

Service Lines Analysis

Public Reporting

Reusable Compliance Reporting

P4P Pay-for-Performance Contract Fulfillment

Lean / Six Sigma Support

Value Stream Design

Operations Statistics

Efficiency & Cost Control

Staffing & Scheduling Analysis

Marketing / Sales Support

Access and Outreach Analysis

Clinical Applications Financial Applications

Operational Applications


Step 4: Analytical Applications

Enterprise Applications Specific Applications

Balanced Scorecards

Benchmarking

Long-Tail Analysis

Constraint-Based Decision Support

Accountable Care Organization (ACO) Analysis and Reporting

Health Information Exchange (HIE) Analytics

Regional Health Information Organization (RHIO) Analytics

Retail Clinics Analytics and Information Integration

Medical Tourism Analytics and Information Integration

Meaningful Use Incentives Capture


Step 5: Using Analytics

Selling the BI Concept to Your Organization

Champions

Compelling Business Questions

Show People a Brighter Future and the Path to Get There

Keep Selling the Concept

Project Roadmap

Systems Development Life Cycle (SDLC)

Ralph Kimball Methodology

Bill Inmon Architecture

Planning, Requirements, Design, Test, Implement, Support, etc.


Marketing the Application

Tips

Tours

Internal Case Studies

Strategy for Phase 2 and Beyond

Vision for BI



Step 6: Delivering Benefits by Supporting...


Redesigning Care Models

Redesigning Treatment Mixes

Streamlining Patient Handoffs

Creating Facilitation Roles

Implementing Case Management

Resource Shortages

Multi-disciplinary Teams

Standardization

Physician Alignment Strategies


Reusable Compliance Databases

Chief Compliance Officers with Staffs

Compliance Governance

Financial Pressures

Aggressive Revenue Cycle Management

P4P

New Services, Extended Hours, Franchising

Reducing Readmissions

Checklists, timeouts

Lean, process redesign

Reducing Physician Preference Items (PPI)

Performance Contracts

Outsourcing and Offloading

Increased electronic information and workflow


Retail, quick and one-stop clinics

Telehealth methodologies

Mergers, joint ventures, divestitures

Standalone urgent and emergency services

Leading ACO formation

Cooperatives

Health Information Exchanges (HIEs)


Six Steps to Healthcare BI Success

Strategic drivers for analytics specific to your organization

Business responses to address these challengesThis step usually missed

Analytical questions behind these business actions

Translating analytical needs into clinical, operational, financial and enterprise-wide business intelligence applications

Making BI and analytics part of the new normal for the organizationThis step also usually missed

Linking analytics back to the strategic drivers and delivering benefits


Help you deal with these guys...


Help you deal with these information

demands


Your organization can get back to its

day job


Now, let’s hear from you...

What do you want to make sure to get outof this conference?

...success stories?

...specific business applications?

...lessons learned?

...other?


Scott WanlessTitle: Consultant,

Healthcare Practice Lead,

Resource Management Professionals

Location: Appleton, WI

Phone: 920.585.9630

Email: [email protected]

photo

Book, Articles, University Courses and Presentations on Healthcare Business

Intelligence can be found in: Ark Group Report Business Intelligence and Analytics for Healthcare Organizations

BeyeNetwork (www.b-eye-network.com) Click on Healthcare channel.

BeyeUniversity (www.beyeuniversity.com/topics/business-intelligence/)

Healthcare Data Warehouse Association

World Research Group Predictive Analytics Conference

Patient Safety and Quality Healthcare

Continuing Care News

Healthcare Review

American Health Insurance Plans Coverage

Managed Healthcare Executive

DM Review

CIO Update

BetterManagement.com

The Center for Business Innovation

HIMSS Oregon Chapter

Healthcare Finance Management Association (HFMA)

Midwest Healthcare Business Intelligence Summit

http://www.b-eye-network.com/





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