Channeling the Data Stream

How analytics can radically improve clinical performance.

Back in the old days, the treatment of cancer was based on a simple premise: If patients could survive the treatment, perhaps they would survive the disease. As a result, many care regimens were based on flooding the entire body with enough poisons to stunt the growth of tumors without irrevocably harming the person being treated. Today, advances in medical technology have made it possible for doctors to deliver highly targeted treatments to specific cells that are not only more effective at stopping the disease, but also allow patients to suffer far fewer side effects.

How analytics can radically improve clinical performance.

Improvements in technology have not only given doctors better tools to treat their patients one-on-one, but have also dramatically changed how healthcare practitioners and organizations can access and analyze data to improve their overall quality of care and financial condition. Instead of having to dig through thousands of files and documents to find the proverbial needle in the haystack, forward-thinking healthcare and physician executives can now use advanced analytic tools to improve clinical performance.

The Value of Data
Healthcare executives require large amounts of information to determine where they are and where they want their organizations to be in areas as diverse as patient safety, financial performance and operational efficiency. Quantitative information is critical to defining which areas need to be focused on to have the most impact with the least amount of time and resources.

This is more than just a theoretical argument: If only one or two patients a year develop staph infections while in the hospital, as opposed to dozens who develop pressure ulcers, chances are that decision makers are going to want to make fixing the latter problem a top priority. However, without reliable data, it’s almost impossible for senior managers to have the facts they need to make these kinds of determinations and identify the parts of their operations where they want to focus their efforts.

Top healthcare executives echo these sentiments. Troy Smith, CEO of Renown Health, says, “Our community, our members, and our providers expect and deserve healthcare delivery of the highest quality. To accomplish this, our management team needs focused information that allows them to instantly understand where to focus their attention for opportunities that continuously improve our customers’ healthcare experience—regardless of where that information is generated or physically resides in the network.”

What healthcare providers need is an immediate solution that is flexible enough to access data across a broad and changing mix of data sources.

Of course, the key ingredient here is quality data. Hospitals are awash in myriad reports, statistics and other information, but without an easy way to access and integrate the numbers, their utility is severely limited. In most healthcare institutions today, there is no practical way to stack up data from a variety of sources and transform them into action.

Precision Targeting
Healthcare practitioners collect millions of pieces of data every year with the intention of using this information to improve the quality of patient care and overall performance. It’s a good start, but numbers and statistics are only as good as the ability to analyze them. The reality is that data is stored in so many different forms and places that it’s almost impossible to collect it in one place for easy analysis. If you’ve ever tried to aggregate patient survey data from an SQL database, safety statistics from an Excel file, and historical trend information from the NIH Web site, you know the challenges of trying to get apples and oranges to look the same.

This is where precision targeting comes into play. Precision targeting is a management technique that has been extensively used to improve compliance, R and D, marketing effectiveness and production optimization in industries such as defense, financial services, consumer products and technology. This proven approach holds great potential in healthcare because it relieves the pain that system executives feel every time they have to collect and analyze data.

Simply put, precision targeting allows them to determine the high impact/high priority issues within their existing processes for everything from patient care to profit-and-loss accounting without being overwhelmed by mountains of data. Figure 1 shows how this process gives decision makers the ability to determine the things we absolutely have to get right to execute our strategy.

This includes determining which individuals are in the best position to influence the successful outcome of an initiative as well as key processes with the greatest impact on its success. Additionally through this process, system executives can determine the systems, policies, procedures, and other guidelines that will affect the outcome. The next step involves identifying the actions, measures and risks, thereby allowing the most trusted, relevant data sources to be identified to feed the reporting and decision-making process.

A great example of precision targeting at work is the care of insulin-dependent diabetics. In a perfect world, patients would stay well through diet, proper blood sugar testing and maintaining regular insulin shots. In the real world, however, emergency rooms are filled with diabetics who are in crisis because they haven’t followed their treatment regimens. As a result, hospital costs skyrocket and patient well-being is compromised. It’s a losing situation for everyone involved, and just about every hospital administrator would want to correct the problem as soon as possible.

Quality In, Quality Out
Determining how to fix the root cause of a situation in the most cost-effective way while creating the most benefit for patients is almost impossible without good data. Should more community educators be sent into the field? Should the hospital encourage the use of testing kits that are easier to use? Should all diabetic patients receive ongoing nutritional counseling? Without knowing why a high number of people with diabetes are ending up in the ER, there’s no way to figure out the right answer.

“We need ready, real-time access to clinical information from a variety of different sources, only some of which currently contain digitized data,” says Susan Hawkins, VP of planning and performance improvement at Henry Ford Health System. “One of the biggest challenges lies in harnessing and delivering actionable information to our clinicians in ways that are integrated into their everyday decision-making and, ultimately, results in improved care to our patients.”

Few people who are involved with initiatives related to clinical excellence, pay-for-performance, consumer-driven healthcare and patient safety would dispute the value of adequate information and analytics in identifying, measuring and monitoring clinical performance. In fact, a healthcare organization’s ability to compete successfully depends on both their ability to excel at accessing and managing clinical knowledge and the ability to execute on that information. Unfortunately the volume and storage formats of digitized information continues to increase faster than decision makers can access and act on them. As a result, executives are being stymied by information overload.

Virtual Data Access
Healthcare companies can avoid getting buried by an avalanche of numbers and the proliferation of stovepipe data sources through the use of virtual data access technology. This approach breaks the gridlock by integrating information from databases, spreadsheets, applications, Web sites and other data sources without programming, interfaces or changes to existing systems.

It not only allows non-IT staff to amalgamate calculations, summarized values and other data in one place, but it also empowers them to combine this data with information from other internal and outside sources. Figure 2 shows how virtual data access technology integrates disparate information from databases, spreadsheets, applications, Web sites and other data sources without programming, interfaces or changes to existing systems.

Some organizations are pinning their hopes of information consolidation into enterprise data warehouses (EDW), but this approach basically involves using transaction-oriented information systems that can take 5-10 years to implement. While EDWs do have validity for certain applications and processes, they are based on a static model that does not adapt easily to change. To compensate for these shortcomings, many organizations still rely on manually driven reporting processes, spreadsheet based applications and other reporting tools to deliver the information they need to manage the various clinical and non-clinical processes.

What healthcare providers need is an immediate solution that is flexible enough to access data across a broad and changing mix of data sources. As a result of the high cost and inherent limitations of EDW-centric approaches, healthcare organizations, regulators and vendors are increasingly taking a hard look at implementing more flexible solutions capable of accessing information across disparate, heterogeneous and changing data sources in a way that yields immediate results without the hefty price tag. That’s where virtual data access can play a vital role in helping them reach their performance goals.

Conventional data warehousing technologies have left healthcare organizations unable to use data to improve performance and demonstrate increased value to their target audiences. Organizations that lead the way in the coming decades will be those that know how to harness the raw data that’s available to them from internal and external sources. Precision targeting and virtual data access, which have been used successfully in other industries to help improve productivity, are keys to creating this competitive advantage by allowing healthcare groups to focus their efforts on specific areas and processes where improvements can be made quickly and efficiently.