Health Care Business Intelligence: The Time is (Still) Now

Building Business Intelligence

Information Management Magazine, November 2007

William McKnight

This column is excerpted from the white paper, “Health Care Business Intelligence, The Time is (Still) Now” by William McKnight and R. Chris Christy, Global Health Care Marketing Director, Business Objects.

In my May 2005 column I stated, “Perhaps in no other industry, at any other time, was there such a need for business intelligence (BI) as there is in health care today.” Well, it’s two years later; and while we have moved the needle forward a little, by and large that statement remains true, only more pronounced. Some forward-thinking organizations in health care have seized upon the opportunity and have improved their access to cleanse and correct patient, provider and outcome metrics. Some have become the evidence-based culture mentioned then. But far too often, entrenched information is found in silos, and conservative cultures are working against progress.

Information exploitation could save health care from imploding. Consider what applications BI can support (along with commensurate processes) for a health care organization. This list would obviously be nuanced by the sector of the industry the company is in: provider performance, care provisioning, clinical research, staffing level optimization, billing accuracy, optimized claims routing, provider ranking and profiling, referral program effectiveness, occupancy rates and patient safety.

Indeed, these are the applications we strive for in health care, but the underlying foundation of quality, integrated, well-performing and corporately adjudicated information is usually found by deploying best practices in the disciplines of data warehousing (DW), BI and master data management (MDM); that’s right - three disciplines now, not one. We can collectively refer to the set as BI because BI is where the business benefit comes. However, the danger in doing that is ignoring the infrastructure requirements of MDM and DW. In addition, operational BI can and should be considered a fourth pillar of information value-add.

The preponderance of such a wide variety of information uses, perhaps the most diverse of any industry, and the speed with which they must be addressed, also perpetuates the problem of data proliferation. However, the speed of change in the industry, often demanded from governmental regulatory bodies, is an additional factor. Consider this decade’s initiatives in care quality, privacy, evidence-based delivery, automated adjudications, health savings accounts as well as the current transitions to individual responsibility and pay-for-performance. Change is almost guaranteed to continue, which is perhaps the most important reason to get the health care information foundation together as soon as possible.

Light integration in most health care companies has enabled basic analysis such as: number of procedures per doctor, hospital resource utilization, length of stay metrics and cost of care by category.

However, current struggles include the next level of analysis, which consists of patient relationship management, quality outcome support, patient flow metrics, diagnostic and treatment relationships, optimizing duration of patient stay, optimizing skill mix and resource allocation to care delivery and ability to predict and forecast referral patterns.

There is No Wrong Answer

There is no wrong answer as to where a health care company currently stands. There is only the reality. Every situation can be improved if conscious effort is applied. Sensible efforts should be guided by visionary strategy and targeted deliverables. An outside assessment can provide that function.

In health care, it’s not really as difficult to do the justification as some other industries. Nonintegrated silos present numerous opportunities for total cost of ownership (TCO) reduction - by far an easier justification than corralling the people throughout the information value chain and gaining quantification for the business monetization of BI. Patient record systems, coding standard systems, outpatient systems and national registry all typically have redundant feeds and data and therefore present an opportunity for reduction in TCO.

Some of the most important subject areas to master with health care BI include: provider care capabilities, locations, track record, cost and availability; encounter results, follow-ups, effectiveness, cost, timelines; conditions and treatment plans; patients, conditions, billing; labs; and care-giving locations.

The larger benefits accrue from the integration of this information. Without the integration, systems usually report only on the data that they generate, rather than all of the pertinent data available. It is only when key data elements are juxtaposed, such as “salary cost per diagnostic related group by admitting physician,” that true insight into operations is generated.

BI is rapidly becoming acknowledged as supporting health care’s boardroom goals. Knowledge worker preparedness is also high. Making progress, however, can be another story. Moving forward in the progressive next steps will likely include some system modeling, education of executive support, user profiling, tool need classification and code set determination - all within the aforementioned domains of data warehousing and master data management.

William McKnight is partner, Information Management, at Lucidity Consulting Group. William functions as strategist, lead enterprise information architect and program manager for complex, high-volume full life-cycle implementations worldwide utilizing the disciplines of data warehousing, master data management, business intelligence, data quality and operational business intelligence. Many of his clients have gone public with their success story. McKnight is a Southwest Entrepreneur of the Year Finalist, a frequent best practices judge, has authored more than 150 articles and white papers and given over 150 international keynotes and public seminars. His team’s implementations from both IT and consultant positions have won Best Practices awards. He is a former IT VP of a Fortune company, a former engineer of DB2 at IBM and holds an MBA. He can be reached at wmcknight@luciditycg.com

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