Medical Center Meets Performance Objectives

Oct. 29, 2009

At Mount Sinai Medical Center, delivering critical cost metrics to doctors and administrators was the missing piece of the puzzle.

Administrators at Mount Sinai Medical Center
struggled with getting critical information into the hands of
healthcare professionals quickly. Some staff members were
accustomed to waiting a week for reports about administrative
and quality-of-care issues. Administrators and billing personnel
also wrestled with accurately analyzing and identifying charges.
Revenue and cost-savings opportunities were slipping through the

For years, the hospital depended on
enterprise reporting to provide critical business intelligence
(BI) via financial and operational reports. Yet, many IT
challenges remained, and there was room for improvement in
operational efficiency.

Today, the organization is standardizing its
reporting environment, with new BI dashboards and self-service
analytic applications for executives, clinicians and
administrators. The 1,200-bed care facility on Manhattan’s Upper
East Side has rolled out a BI and performance-management
environment that helps physicians deliver high-quality care,
while adhering to institution-wide cost and performance

Mount Sinai has successfully used business
intelligence technology from Information Builders for many
years. So, when it decided to standardize its reporting
environment, decision makers at the hospital chose WebFOCUS from
Information Builders.

Mount Sinai’s primary BI application targets
an outpatient group of 1,000 physicians known as the faculty
practice associates (FPA). Dubbed the FPA Dashboard, the new
WebFOCUS application provides information about growth,
productivity and revenue-cycle metrics, along with sophisticated
analytic tools. Physicians and administrators use the dashboard
to run their practices more productively, and managers use it to
align operational objectives with corporate strategy.

“Business-intelligence technology plays a
crucial role for any hospital trying to meet financial and
quality-of-care objectives,” says Gad Malamed, director of
enterprise reporting at Mount Sinai Medical Center. “Without
implementing a comprehensive framework for managing performance,
there is no easy way to incorporate operational effectiveness
and efficiency into an institution’s overall goals.”

Malamed says the most important people to
engage are the physicians and medical staff, since they have the
largest impact on overall care, as well as on a hospital’s
profitability. Therefore, the medical center makes the dashboard
and associated analytics available to all FPA physicians.
Malamed explains that this wide distribution of the information
system has allowed the hospital to engage physicians in the
business side of their clinical practices – the starting point
for improving organizational performance.

Presenting the Data to Users

Identifying the metrics and indicators that
guide the organization is the first step. Step two involves
presenting that data to users, so they can be held accountable.
For example, if charges fall off unexpectedly from one month to
the next, with no changes in provider availability or volume, a
division manager might use the dashboard to determine the

“The dashboard allows managers to analyze
measures and perform root-cause analysis to respond to
unexpected changes,” Malamed explains. “For example, in the
event there is a sudden change in charges, a manager can compare
the data by insurance, location, patient type, provider and
other variables in order to focus on the root issue.”

Administrators, financial personnel, practice
managers and care providers all use the FPA Dashboard to run
metrics, combine reports and do custom reporting within specific
parameters. About 265 people in the department of medicine, for
example, are using it to monitor an incentive plan based on
work-relative value units.

“Thanks to the dashboard, providers have more
data on hand to make decisions about their practices,” notes
Dominique Archer, FPA business manager for the department. “They
can drill down to service locations, payer mixes, population of
ambulatory visits and many other variables.”

Some physicians use the tool to set goals and
monitor progress on a month-to-month basis. Ultimately, Archer
says these exercises have a positive impact on the quality of
care for patients. “It allows us to see what types of services
are being requested in each division, so we can schedule the
optimum number of staff,” she explains.

To create the FPA Dashboard, Mount Sinai
involved various constituencies, from programmers and
information specialists to physicians and business users. Led by
Phong Bui, the business owner for the project, each group
identified the key performance indicators that would be most
valuable and the report formats that would be most useful to

Julie Zhu, a senior developer with expertise
in reporting, took point on the project. She and her team spent
about three months in the first phase of the development cycle,
gathering information from IDX Group applications and building a
reporting database.

“Previously, it could take a week to get
reports,” Zhu says. “Now, using a standard Web browser,
authorized users can view pertinent information whenever they
want, and display or analyze data in easy-to-read bar graphs.”

Today, approximately 1,000 healthcare
professionals have access to the FPA application, including 70

Problems Recognized Immediately

“The FPA Dashboard saves an enormous amount
of time tracking down information,” Bui says. “We can
immediately recognize problems and address them, or drill down
to find out why certain conditions exist. For example, if
payments are lower than normal within a certain department, a
manager might ascertain that work-productivity units are low
because there are new doctors in that department.”

The finance group uses WebFOCUS Active
Reports to analyze information, filter it into specific cost
centers and create charts. Active Reports includes a preselected
“payload” of data to help recipients pinpoint issues and track

Another new BI project involves working with
clinicians to identify important clinical metrics. “We want to
make that information available internally, so we know what is
going on within the hospital,” Malamed says. “But we also want
to share that data with the public to show that we are
accountable for the quality of our care.”

According to Malamed, Mount Sinai plans to
create other Active Reports to help the institution develop a
holistic view of performance across the enterprise. “We’ve
gotten our arms around some key financial measures,” he says.
“Now we plan to expand to clinical and operational measures so
we can analyze recurring costs and pinpoint cause-and-effect

Mount Sinai is also using WebFOCUS for
hospital administrators and billing personnel to analyze
charges. The medical center recently identified more than $5
million in missed charges, rebilled for them and recouped close
to $3 million in a single year from insurers who underpaid
patient bills based on their contractual obligations.

The BI tools help accounts-receivables
personnel analyze patient accounting data from an Oracle data
warehouse, which stores information about closed accounts. Using
the dashboard, these employees can identify opportunities for

Each year, Mount Sinai bills for about 50,000
in-patient admissions and 450,000 outpatient visits, and
generates operating revenue in excess of $1 billion. Malamed
says the hospital will continue to use the BI tools to hunt for
undiscovered revenue or cost-savings opportunities throughout
the enterprise. “At a hospital the size of Mount Sinai, there
are tens of thousands of unique charges,” Malamed says. “It can
be like finding needles in a haystack. WebFOCUS makes that
process easier.”

From the Catalog

According to : WebFOCUS is a comprehensive and fully integrated enterprise business-intelligence platform; its architecture makes any data available, accessible and meaningful to every person or application needing it. The WebFOCUS operational business-intelligence platform contains: self-optimizing autonomic servers (workload and traffic management and capacity planning eliminate complexity, improve system performance, and reduce TCO); super-linear scalability through multiple technological advantages; a unifying integration infrastructure that accesses, reconciles, cleanses and prepares any and all data for business-intelligence use; service-oriented architecture support, with the ability to create, consume and publish Web services; and simplified developer and end user interaction, with advanced visualization and deep integration with desktop products, such as Microsoft Excel and Adobe PDF.

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