k a searchhealthit.com e-book +++++++++ for Providers Health care can use BI tools to track trends related to costs, revenues and resources, as well as to study the treatment needs of patient populations, assess care quality metrics and streamline the cumbersome billing and claims process. D Six Steps to Successful BI 10010100101000 10101010100110 01001010001010 10010010101101 01010101011110 10110100101001 01000101010101 00110010010101 10010100101000 10101010100110 01001010001010 10010010101101 01010101011110 10110100101001 01000101010101 00110010010101 10010100101000 10101010100110 01001010001010 10010010101101 01010101011110 10110100101001 01000101010101 00110010010101 10010100101000 10101010100110 01001010001010 10010010101101 01010101011110 10110100101001 01000101010101 00110010010101 D D 1 for Providers

k chapter 1 Given the amount of data required for meeting meaningful use stages 2 and 3, analyzing that data is difficult for health care executives. Implementing BI tools, however, can help organize that data. Here are six steps for successful BI implementation. By REDA CHOUFFANI the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 mandates the use of electronic health record technology for hospitals and other health care providers United States, with financial incentives for those providers who demonstrate the meaningful use of EHR by 2014. There are three stages of meaningful use. The first, which began on Oct. 1, 2010 at the start of the 2011 federal fiscal year, focuses primarily on electronic transactions such as e-prescribing and computerized physician order entry (CPOE). Stages 2 and 3, the former of which is expected to begin in 2014, place greater emphasis on using EHR technology to exchange patient data with other health care providers. With much of the focus falling on the clinical implications of what it takes become a meaningful user on a certified EHR system, CMIOs, CIOs and other executives are left with a daunting task collecting, analyzing and trending the information in order to predict, react to, and measure progress from the pre-captured clinical data. While there are still questions regarding the format of the questionnaires and surveys required to capture data related to patient activation, skills, knowledge, and level of 2 for Providers

k overall awareness all data capture requirements as listed meaningful use stage 2 criteria several organizations have started to create their action plan to gauge and record such measures. With all the data that will be available to support improved outcome measures comes the responsibility of using the right business intelligence tools to assist with the analysis and trending of the data required for meaningful use stages 2 and 3. In order to ensure that your BI efforts succeed, you will need to follow these six simple but critical steps: 1 Get the right data at the right time. As discussed earlier, it is critical to ensure that there is sufficient data available to plot your progress in certain areas. This would require analyzing the reports and trends not just what s required under meaningful use and then identifying at what frequency the data will need to be reported on for each department with organization. 2 Define where the data is. The majority of the analysis will be applied against existing data that has been collected through the hospital system and internal applications. But there are a few data sets that will need to come from third party entities and/or other public or federal groups. For example, when reviewing the suggested measures which will assess the appropriate use of medications based on standards of care for applicable conditions, you may realize that you are comparing data collected with hospital against standards that are outside the hospital s integrated delivery network (IDN). This clearly indicates the importance of knowing the origin of the other data collected. 3 Share the value with the rest of the group. Unfortunately, not everyone appreciates the power and value that BI provides. Sometimes, education can make a world of difference. In most successful organizations, the executive team realizes that, in order to keep the finger on the pulse, it needs near real-time exposure to stats, scorecards, and other meaningful measures even on mobile devices. It would therefore be beneficial to share with your management and executive team the capabilities and values of BI within your organization. Whether the team needs to apply it to accounts receivable (AR) analysis, the revenue cycle, quality metrics, general charge capture, patient satisfaction or marketing, there are 3 for Providers

k numerous areas that can benefit from this type of data analysis. 4 Define reporting and analysis intervals. For data to be properly analyzed and meaningful, it must query from the production system at different frequencies. This will store it at different processing data repositories. In order to avoid performance issues, one must plan the difference extraction and processing frequencies ahead. If you are reviewing the clinical services and perform a comparative analysis over a period of five years, for example, that s a job to be performed during non-peak hours and would most likely take many hours. If, on the other hand, you are reviewing a real-time ticker that displays patient admissions or discharges, then a simple query can be executed periodically throughout the hour. 5 Select the right tool. There are a variety of BI tools, ranging from spreadsheets to online analytical processing (OLAP), and many types of reporting tools. Some are open source, while others are provided under the Software as a Service (SaaS) model and others, of course, are proprietary. The tools that are right for you will depend on several things overall data size, current platform, in-house skill set, physical architecture, mobile application capabilities and support. It s also important to actually identify the analytical data model for your specific needs. Several third-party vendors specialize in business performance management tools that can help reduce the customization and building time for your organization. 6 Hire help if necessary. Many health care organizations have the talent needed to implement the BI widely available. However, given the ongoing complex requirements that require a deep understanding of data models, metadata, data integration, quality, analytics and different management metrics, it is usually recommended to work with a third-party vendor, if budgets permit, to ensure that at least the initial implementation is done right and in a timely fashion. It also ensures that your team is involved in all the steps so they can take over and ensure that future BI needs are met internally and kept in-house. Whether you focus on logistics, emergency room (ER) operations, AR analysis, or nursing dashboards, all these areas have meaningful data that will help ensure the organization s goals are met at all levels and that everyone stays in line with the objectives. n 4 for Providers

k chapter 2 Health Care In the health care industry, business intelligence software is increasingly being used to address financial issues, as is the case with other verticals. are finding ways to apply BI to patient care as well. By BRIEN M. POSEY ever since the Health Information Technology for Economic and Clinical Health Act (better known as the HITECH Act) established meaningful use of electronic health record systems as a national goal and provided incentives for their use the health care industry as a whole has been steadily moving toward universal EHR adoption. Although electronic health records are generally considered to be a good idea, their true benefit is only now starting to be realized. EHRs can best be thought of as an unstructured collection of patient data. Although such data was initially intended to be used on a patient-by-patient basis, health care organizations are beginning to discover that additional value can be gained from the data when the entire dataset is analyzed as a whole by business intelligence software. BI software can assist health care providers in making important decisions ranging from patient care to the organization s finances. For example, I recently heard of one organization that is using its business intelligence software to track the staff s response time. When a patient presses the nurse call button, a record is created. When the nurse responds to the patient, another record is created. The organization used these records to determine the average response 5 for Providers

k time, which eventually became a benchmark used for improving patient care. Another organization I know about is using business intelligence to improve emergency room wait times. The organization analyzed historical data pertaining to wait times, the number of staff members onsite (doctors, nurses, etc.), and the number of patients waiting to be seen. By doing so, the organization created a mathematical model that could predict emergency room wait times based on a number of different variables. This mathematical model was applied in a way that helped the organization to decrease patient s wait times, while also improving patient satisfaction. for Financial Analysis Before business intelligence software began making its way into health care organizations, it was used in other industries to analyze financial data. Of course, health care providers must deal with financial data just like any other organization, so it is only natural that they have begun using business intelligence software for financial analysis. Financial data analysis in health care environments typically falls into two main categories. First, data is used for cash flow analysis. In any facility, there are certain costs incurred at the time that patient care is given. For instance, medical supplies are used during the patient s visit and physicians must be paid for treating the patient. However, Before business intelligence software began making its way into health care organizations, it was used in other industries to analyze financial data. patients rarely pay for services at the time they are provided. A patient usually makes a small co-payment, and the facility files a claim for the remainder of the bill with the patient s insurance company. Because the facility incurs expenses up front, but might not receive payment for quite some time, cash flow analysis is critical. BI software can create an accurate cash flow model by taking into account things such as the amount of time that it takes to process an insurance claim, the discount given to the insurance company, and the amount of money that is being spent to care for patients. 6 for Providers

k Spotting Long-Term Trends The other way that health care organizations use business intelligence data for financial planning has to do with anticipating patient needs. BI software is really good for spotting long-term trends. For example, such software might tell an organization that, every August at the beginning of youth football season, it typically treats 60 patients with broken arms. As such, the facility would be able to anticipate the number of casts and pain pills it needs to order. Similarly, patient demographic data as well as medical trend data could be used to identify the need for and justify the cost of new medical equipment. Of course, it isn t just the hospitals that are making use of business intelligence software. Health insurance companies are using business intelligence to improve claim response time and, in some cases, identify fraudulent claims. Patient demographic data as well as medical trend data could be used to identify the need for and justify the cost of new medical equipment. Although business intelligence is still in its infancy, especially health care industry, increased adoption of electronic health records will likely result in increased adoption of business intelligence across facilities to spot patient care, financial and supply chain management trends. At a time when health care costs continue to climb, the data that comes from BI software can help organizations trim costs while also improving patient satisfaction. n 7 for Providers

k chapter 3 BI tools let executives and other users view data and make informed decisions away from the office. The feature sets of these offerings vary greatly; some may not work for mobile users or for health care professionals. By Reda Chouffani business intelligence has become increasingly accessible through many of the mobile device platforms. As a result, BI on the go has been one of the latest features that many business intelligence vendors have been promoting as part of their product offerings. With many health care executives so often on the go, this access to dashboards provides up-todate data for evidence-based decision making. BI, also known as mbi, is the availability of gauges, dashboards, scorecards and key performance indicators (KPIs) directly from a smartphone or tablet. In the past, most BI intelligence tools gave access to information either through desktop applications or Web portals. With BI vendors rolling out applications for different mobile platforms, users can now get immediate access to different dashboards and charts directly from their devices and drill down through the data to identify causes for any of the trends. There are several benefits to mbi tools. n Data visualization. Charts accessed via native or Web-based applications provide up-to-date reporting. n Real-time feedback. access 8 for Providers

k lets users view real-time data and get alerts related to changes in trends and data immediately. This allows for quick response. n Drill-down capabilities. Some mobile BI applications bring performance information to tablets and mobile devices. This lets users drill down and get a detailed view of exceptions or causes related to specific information. n Ease of use. Many mbi tools bring a graphical user interface (GUI) to mobile devices. With intuitive navigation and customizable dashboards, these available products become the chosen tools for making critical business decisions on the go. BI is solving a lot of challenges faced by many health care professionals not only through the immediate access to data, but also with improved usability so that it is no longer a burden to actually view the data and interact with it. How Can BI Be Used? BI is being offered in two models. First, there are BI applications with a hosted back-end data repository. Many BI vendors offer hosted BI services for their clients. By offering a subscription model when the data is manipulated and analyzed offsite, vendors can offer as part of that package access to the data via mobile apps. Some of these firms have also provided customers in specific markets with comparative analysis against aggregated data from other clients. Second, there are BI apps that connect to an internal or enterprise private data repository. This model is common, as larger organizations tend to implement their own data warehouse. These organizations receive mobile apps connected to their data repositories as part of their BI platform. What Types of BI Should Be Avoided? While many BI vendors are actively marketing the mobility feature of their BI suite, it is very important to avoid products that display graphs on mobile devices but otherwise offer very limited capabilities and usability. These types of applications are not true mbi tools and include the following. n Applications with flat reports that do not allow the user to drill down to review data and sub-charts. n Applications that do not connect to an online analytical processing (OLAP) source. 9 for Providers

k n Applications that do not allow for customizing and profiling of the dashboards. n Applications that lack gauges, scorecards, KPIs, bar charts, trending, radar plots and other commonly used data BI visualization models. n Web-based applications that only offer access to a traditional Web portal and do not use the native feel of the familiar ios and Android mobile platforms. BI vendors are continuously looking for differentiators to include ir products. Some of the new functionality identified in recent releases includes the following: n Smart system response. This push notification sends certain users feedback and alerts based on specific data triggers. n Comparative analysis. Here, client data can be compared against other de-identified data sets. n Domain-specific data. BI vendors are increasingly offering best practices and preset dashboards and thresholds for health care organizations. This provides clients with a baseline, as well as a set of usable widgets. As more mbi applications enter the market, taking the appropriate steps to select the right mobile solution for the organization becomes very important. Overall, mbi tools are designed to bring transactional data to life visually. They are gaining wider adoption and helping users identify and react to specific situations. For health care executives, these lightweight analytics can provide visibility into clinical, financial, compliance and administrative performance. However, as more mbi applications enter the market, taking the appropriate steps to select the right mobile solution for the organization becomes very important. n 10 for Providers

k about the authors Reda Chouffani is the co-founder and vice president of development at Biz Technology Solutions Inc. Brien M. Posey is a Microsoft Most Valuable Professional for his work with Windows 2000 Server and IIS. He has served as CIO for a nationwide chain of hospitals and was once in charge of IT security for Fort Knox. for Providers is a SearchHealthIT.com e-publication. Brian Eastwood Site Editor Linda Koury Director of Online Design Reda Chouffani Brien M. Posey Contributing Writers Jean DerGurahian Editorial Director Anne Steciw Associate Site Editor Craig Byer Assistant Site Editor Don Fluckinger Features Writer Stephanie Corby Associate Publisher scorby@techtarget.com TechTarget 275 Grove Street, Newton, MA 02466 www.techtarget.com 2012 TechTarget Inc. No part of this publication may be transmitted or reproduced in any form or by any means without written permission from the publisher. TechTarget reprints are available through The YGS Group. About TechTarget: TechTarget publishes media for information technology professionals. More than 100 focused websites enable quick access to a deep store of news, advice and analysis about the technologies, products and processes crucial to your job. Our live and virtual events give you direct access to independent expert commentary and advice. At IT Knowledge Exchange, our social community, you can get advice and share solutions with peers and experts. 11 for Providers