About the Book
Accountability and transparency are now major priorities for the healthcare sector. There are new rules and regulations, pressures, threats and new opportunities for healthcare providers today, but in order to address challenges and reap rewards, healthcare organizations need to have a clear and thorough understanding of existing and potential BI capabilities. Many healthcare organizations are struggling and one key difference between the winners and losers is their propensity for analysis and for using their analytical capabilities to improve clinical quality, operational efficiency and financial strength. The differentiator is how they use the data they already own to become smarter, stronger and faster. It is business intelligence (BI), analytics and informatics. Business Intelligence and Analytics for Healthcare Organizations provides a BI roadmap, guiding organizations to position it as a key player in overall business goals and strategies, so as to address topical and challenging issues including demand issues, resource shortages, compliance requirements, financial pressures and integration issues.
Business Intelligence and Analytics for Healthcare Organizations will allow you to: * Understand BI and analytics applications already being developed and used by healthcare providers; * Maximize existing BI capabilities to improve clinical quality (patient care), operational efficiency and financial strength; * Develop and implement BI systems and projects to increase revenue and patient care and attract more patients; * Improve overall business strategies by including BI as an effective business tool in order to drive revenue and organization's growth/competitive advantage; * Implement a roadmap to implement and maximize BI systems and strategies; * Gain buy-in and executive sponsorship; * Improve communications/relationships between internal/external staff; and * Quickly improve project management to ensure BI projects remain business driven and feasible.
This report contains case studies from a variety of organizations around the world including the likes of: * Upstate Neurology Consultants, Albany, New York - Specialty physician practice; * Wisconsin Collaborative for Healthcare Quality, Madison, Wisconsin - * A voluntary consortium of 27 healthcare organizations; * Advocate Health Care, Oakbrook, Illinois - Integrated health care system; * Good Hope Hospital, Birmingham, UK - Member of the National Health Service (NHS); * Scott & White Healthcare, Temple, Texas - Integrated health system; * Denver Health, Denver, Colorado - A 'safety net' institution that integrates acute hospital and emergency care with public and community health services; and * United States Air Force Medical Operations Agency, San Antonio, * Texas - Supports healthcare operations for 75 medical treatment facilities.
Business Intelligence and Analytics for Healthcare Organizations provides a roadmap to help healthcare organizations understand BI and its benefits from a strategic and business perspective particular to the healthcare industry by providing valuable and innovative examples of BI applications for improving clinical, financial and operational success.
Table of Contents:
Executive summary...IX The healthcare industry's new world...IX About the authors...XIII Acknowledgements...XV Part One - Bridging the gap between healthcare informatics and BI Chapter 1: Challenges facing the healthcare industry...1 Increased demand for services...2 Resource shortages...3 Compliance requirements...4 Financial pressures - ...5 Vertical and horizontal integration...6 Chapter 2: Key decisions in healthcare organizations...9 Increased demand for services...9 Resource shortages...13 Compliance requirements...13 Financial pressures...13 Vertical and horizontal integration...16 Chapter 3: Business intelligence and data warehousing...23 Driving sector business with BI...23 Insurance...23 Investment...24 Manufacturing...24 Retail...25 Utility organization...26 Public sector...26 Analytics...27 Chapter 4: Healthcare informatics...31 Specialization in healthcare informatics...32 I V Contents Reducing administration to a utility role...33 Emerging healthcare informatics topics...34 Chapter 5: The common denominator - Analytical questions...35 Clinical analytical questions...35 Operational analytical questions...38 Financial analytical questions...41 Chapter 6: Business intelligence architecture...47 Industry-standard data warehouse architecture...47 Component one - Operational systems...47 Component two - Data repository...48 Component three - Analytical applications...49 Chapter 7: Responsibilities of key decision-makers...51 Chief medical officer...51 Chief quality officer...52 Chief research officer...52 Chief financial officer...53 Chief operations officer...53 Chief marketing officer...53 Chief information officer...54 Marrying BI and informatics...54 Part Two: Implementing BI for clinical, financial and operational success Chapter 8: Business intelligence applications for clinical success...59 Business process efficiency...59 Patient registries...60 Outcomes analysis...64 Quality program reporting - ...64 Care team support...68 Patient safety and risk management reporting and analysis - ...71 Patient satisfaction...75 Chapter 9: Business intelligence applications for financial success...79 Demand data slicing...79 Types of demand data...80 Revenue cycle management...81 Pay for performance...84 The payoff of P4P...87 Reusable compliance reporting...88 The growing challenge of compliance demands...88 Business Intelligence and Analytics for Healthcare Organizations V Chapter 10: Business intelligence applications for operational success...91 Increasing speed and efficiency...91 The value of lean initiative support...92 Lean increases capacity...93 Business intelligence improves lean...94 Making healthcare convenient...95 Improving service timing...98 Predictive analytics...99 Predictive analytics requirements...101 Spending story analysis...102 Chapter 11: Business intelligence applications for enterprise-wide success...105 Emerging business structures - Health provider cooperatives...105 Emerging offerings - Service line management...107 Emerging practices - Promoting EHR adoption using analytics...109 Improving the ROIs of EHRs...110 Emerging patient needs - Chronic condition surveillance...112 Levels of chronic condition surveillance...112 Emerging competitors - Medical tourism...115 Medical tourism proponents...117 Emerging business models - Retail clinics...120 Retail clinic analytics...121 Part Three - The journey Chapter 12: Selling the concept of BI in your organization...127 The importance of executive sponsorship...127 Timing is key...127 Essential elements in selling the BI concept...128 Essential roles in selling the BI concept...130 The basic selling process...132 Chapter 13: Business intelligence project roadmap...133 Business intelligence assessment...133 Planning stage...135 Requirements gathering stage...135 Design stage...137 Development/construction/build stage...137 Testing and data validation stage...138 Implementation stage...138 Training stage...139 Warranty support stage...139 Business intelligence application marketing...139 Chapter 14: Growing the organization's BI capabilities from a business perspective...141 Marketing the BI application...141 Developing a sustainable strategic plan...144 A vision for the BI capability as a whole and the impact on the organization...146 Vision...147 Ears...148 Relentless service experimentation...148 Comprehensive event-response planning...148 Many levels of BI...148 Conclusions...149 Part Four: Case studies Case study 1: Advocate Health Care, Oakbrook, Illinois...153 Enterprise-wide balanced scorecard...153 Marrying organizational objectives and goals with technology...153 Case study 2: Denver Health, Denver, Colorado...155 Integration boosts continuity of care...155 Data warehouse evolution...155 Electronic quality scorecard project...155 Overcoming challenges...156 More efficient and customized patient care...157 Case study 3: Good Hope Hospital, Birmingham, United Kingdom ...159 Using BI and analytics to improve service delivery...159 Financial challenges...160 Computer simulations are key...160 Case study 4: Scott & White Healthcare, Department of Surgery, Temple, Texas...161 Developing a customized dashboard tool...161 Successful problem-solving during the piloting stage...161 Case study 5: Upstate Neurology Consultants, Albany, New York...163 Centralizing data with BI to boost efficiency...163 Case study 6: United States Air Force...165 The advantages of a single electronic health record...165 A fresh approach to data analysis...166 Case study 7: Wisconsin Collaborative for Healthcare Quality, Wisconsin...167 United approach improves performance measures...167 Improving data collection...167 Overcoming challenges...168 VI Contents Business Intelligence and Analytics for Healthcare Organizations VII Case study 8: Advocate Health Care, Oakbrook, Illinios...169 A physician report card supports clinical integration...169 Steps to develop a customized report card...170 Further reading...171 Index...173
About the Author :
Scott Wanless is the healthcare business intelligence practice lead for Resource Management Professionals (www.yourrmp.com) and an industry researcher, consultant and business analyst in the healthcare business intelligence field. He has more than 30 years' experience in business intelligence strategic planning, informatics and analytics development, financial management, economic development and process improvement. His vast industry experience spans healthcare providers, hospitals, long-term care, primary care and specialty physician practices, healthcare payers, laboratory research, retail pharmacy and optical, insurance, financial services, banking, manufacturing; and state and local governments. Tom Ludwig is president and CEO of Forward Healthcare Solutions, LLC, a consulting firm that specializes in working with physician practices (www.forwardhealthcaresolutions.com). Having worked in the medical environment for 35 years, Tom started his career as a Navy Corpsman and also worked as a medical assistant and as a staff nurse. His 20-plus years' experience as an administrator have been in roles from front-line manager to program director to chief operations officer. He is a member of the Medical Group Management Association and the American College of Medical Practice Executives (ACMPE) and currently serves on the ACMPE Board of Directors. Tom is a Board certified medical practice executive and a fellow in the American College of Medical Practice Executives.
