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Health care providers are starting to utilize BI across their operations. Key contributors to new health care BI applications include interoperability of technology applications and medical devices, provisioning of an integrated, standardized, enterprise view of information for BI analysis and the growing focus on the electronic medical record (EMR). Collecting patient information electronically will also contribute to the growing role of BI by making more information available for analysis in near real to real time. Key analysis capabilities enabled by the information collected and integrated into a single patient medical record include:

• Patient demographics, medical history, medication history and adverse drug events.
• Care protocols for the clinician, including warnings against potential hazards such as medication errors.
• Variations in patient stay and treatment within a facility across physicians, including length of stay, utilization of hospital resources and outcomes.

Let's look at a few examples of these innovative BI applications.

Improving Outcomes, Saving Lives

One nonprofit community clinic exists to serve Medicaid patients and the underserved population. In addition to its primary care practice, it also provides a dental practice, a behavioral health practice and comprehensive maternity support services. Pharmacy, radiology and chronic disease management departments are the clinic's most recent service enhancements.

Several years ago, the organization implemented EMRs in the hopes that collection of this data would enable them to eventually aggregate patient care information. The objective of the EMR initiative was to enable clinic staff to more easily access and analyze patient information to provide better care. Over time, the clinic collected huge amounts of clinical data, but it was impossible for clinicians to assemble information about discrete patient populations. They felt it was time to combine that information with their collective expertise to provide more proactive patient care and improve health outcomes.

The initial focus was on using the information to move toward a case-based treatment protocol, which is currently being developed using the BI environment. Clinicians will use the platform to perform what-if scenarios and to run studies on different patient populations so the clinicians can assess the success of different medical protocols. As an example, this means they can use the information they have on all their diabetic patients to identify which protocols worked well and which ones didn't. They can then modify treatments to proactively improve health outcomes for diabetic patients before they present the treatments for care in the clinic. They foresee many additional uses for the BI environment. The use of dashboards will help to manage patient flow and improve the clinic's ability to comply with the open-access policy that ensures a patient gets an appointment on the day he or she calls. The dashboards will also provide key performance indictor management.

Aiming for Value

A large university health organization needed to provide greater visibility into financials, physician performance, and educational and research data. With separately maintained data sources, such as Excel spreadsheets and assorted financial and clinical databases, they sought to establish a BI reporting and analysis system that would integrate its numerous data systems, consolidate information and provide the hard-hitting analysis executives require for effective business decisions. Today, they have a comprehensive data warehouse environment that incorporates data from 17 source systems and includes clinical dashboards, financial dashboards, asset distribution dashboards and a wide range of other applications, typically viewed by VPs, department chairs and administrators.

The organization uses the BI solution not only for analysis but also to change business processes and drive toward the value-driven health care vision. They now assess clinical efforts and view billings and collections for individual doctors over a fiscal year, along with relative value units, a guideline commonly used for assessing physician productivity. This shows decision-makers exactly how physicians are doing in terms of their scheduling and overhead. Executives can look at the top-performing current procedural terminology (CPT) codes by count, and the top 10 charges for CPT codes and similar reports.

An instructional dashboard gives department chairs information about the courses a physician teaches, how many students attend each course, how the students evaluate each course and the instructor, and other information of interest to administrative decision-makers. A research dashboard highlights the efforts physicians put into clinical and basic science research, including grants and funding, and helps department chairs see how well doctors are doing based on the effort they're expending on research. The organization feels that the BI solution is truly changing behavior, labeling the change as transformational leadership.

Note: The examples described in this column are consolidated from the case studies available for view at www.businessobjects.com.//

Lisa Loftis is a senior vice president of Intelligent Solutions, Inc. She coauthored Building the Customer-Centric Enterprise and has spent the past 20 years working with business and IT executives to develop BI and CRM solutions. She may be reached at lloftis@intelsols.com.