Applying Business Intelligence to the Needs of Healthcare Organizations

Mark LaRow, for HealthLeaders News, July 17, 2007

With the increasing challenges faced by the healthcare industry, providers must keep up with or stay one step ahead of the competition. Business intelligence can help healthcare agencies, payers and hospitals increase competitive advantage by devising smart business solutions and enabling better business decisions every day.

Business intelligence software allows companies to tap into their many databases and deliver easy-to-comprehend insight to employees, management, and business partners. Business intelligence software is already being used by thousands of companies to find new revenue opportunities, reduce costs, reallocate resources, and improve operational efficiency.

When properly applied to data within healthcare organizations, business intelligence provides the insight needed to increase revenue, reduce costs, and comply with industry regulations and standards. In addition, organizations are given the tools they need to make the best use of the vast amounts of information available to them, allowing them to operate more efficiently and improve patients' well-being.

Whether starting with one or several applications, healthcare providers can evolve to utilize business intelligence applications unique competencies: an easy-to-use unified Web interface with extranet and intranet capabilities, access for thousands of users, reporting and analysis of tremendous amounts of data across multiple sources, graphical dashboards and boardroom-quality reports, unconstrained analytical flexibility, and industry-leading security architecture.

Applying business intelligence to healthcare
Premier, Inc. is a healthcare alliance owned by 200 not-for-profit hospital and healthcare systems in the United States. It is dedicated to improving patient outcomes while safely reducing the cost of care, and serves 1,700 hospitals and more than 46,500 other healthcare sites. MicroStrategy supports Premier's data applications that help more than 500 of its hospital clients monitor clinical quality and patient safety, business and market strategy, clinical resource utilization, operational performance, and productivity.

Below are numerous ways healthcare providers can leverage a business intelligence platform to make smart decisions across myriad challenges in the healthcare industry.

Financial analysis
Healthcare organizations need visibility into the full scope of financial operations.

• Business intelligence enables healthcare providers to drill from reports into detailed analyses of costs and revenues, view data underlying cash flow statements, and compare planned versus actual income and margin.
  
• Analytical capabilities allow providers to analyze current care practice patterns to identify unnecessary or under-utilized services, execute cash flow analysis, forecast collections, and monitor underwriting requirements.
  
• Reporting capabilities enable healthcare organizations to meet statutory reporting requirements and ensure accountability from financial analysts to business unit management, executives, and directors.

Quality performance and safety analysis

• Business intelligence can analyze an individual's history and risk profile to determine the likelihood of increased resource consumption based on information such as accelerated use of healthcare services, drug use and patient demographics.
  
• Providers improve performance by leveraging evidence-based performance data, tracking variations in quality, providing patient dashboards, setting alerts, and checking drug interactions.
  
• Performance comparisons across quality, patient access, patient satisfaction, utilization, and financials are made possible by monitoring the quality of their care according to the Health Plan, Employer Data and Information Set (HEDIS) standards established by the National Committee for Quality Assurance.

Marketing analysis
Reporting on patient satisfaction supports the goal within healthcare organizations for increased accountability among healthcare providers, and it can also be leveraged for marketing purposes.

• Providers use business intelligence to analyze the success of marketing efforts designed to demonstrate the clinical effectiveness of their products and services, create an increased feeling of overall wellness, and reduce workplace absenteeism.
  
• Advanced analytics allow providers to determine the most cost-effective marketing techniques by tracking campaign costs against budget, calculating the ROI for campaigns, and comparing performance against goals.
  
• Healthcare providers use dashboards to show which products and services are profitable in specific patient segments and measure how their marketing efforts and corporate communications alter brand perception and affect brand performance.

Claims and clinical data analysis
By analyzing and monitoring claims, business intelligence can help healthcare providers and payers determine the biggest risk areas and devise the most effective rate structures.

• Properly managing claims information also allows healthcare organizations and payers to optimize pricing, improve response time to claims, and thwart fraudulent claims.
  
• Advanced analytical capabilities offer predictive analysis that enables healthcare organizations to analyze risk across the network, detecting anomalies tied to errors or fraudulent claims, increasing predictability of claims-payment flows, and identifying loss potentials for specific geographical areas.
  
• The software is also used for call center solutions, with analysis down to the individual call detail record, helping ensure high levels of patient support while controlling costs.

BI platforms provide a unified framework for clinical data analysis to facilitate information sharing and collaboration.

• By delivering analysis from multiple sources at once, organizations can track large amounts of information stemming from clinical activities and identify the most efficient practices. This helps providers identify trends and anomalies, and analyze risk in clinical care.
  
• Physicians, hospitals, and healthcare organizations are discovering that they cannot provide the best care by operating autonomously as independent silos. Centralized administration and bullet-proof security assure that healthcare providers have industry-leading security measures at every layer of the architecture.
  
• With secure, essential clinical information, individual practitioners can diagnose and prescribe more quickly and provide top quality care with greater peace of mind.

Patient care analysis
By increasing information sharing with patients and offering patients self-service functions, organizations using business intelligence allow patients to take ownership of their care, leading to improved outcomes.

• Business intelligence enables the right people to access the right information at the right time, delivering a single platform to healthcare providers for sharing information with patients for better decision-making and connecting patients across hospital, nursing home, physician office, and community social support settings.
  
• Support safe care delivery, assists clinicians in evidence-based clinical decision-making, and facilitates seamless care coordination across clinical settings.
  
• Providers have the ability to monitor and forecast patient diagnoses and use of healthcare services in order to improve patient care, reduce wait times, and administer more effective treatments.

Operational performance and cost management
Healthcare organizations can respond to the intense pressure to cut costs by employing information solutions that monitor opportunities to improve operations, spotlighting inefficient uses of resources
and unnecessary overhead costs.

• Providers identify areas that are underperforming and need immediate action. In addition, with so much emphasis on controlling costs, healthcare providers need to closely monitor expenditures and determine the best allocation of funds.
  
• With analytical capabilities, providers drill down into unusual costs, ascertain best practices of the most profitable business units, and identify utilization patterns.
  
• Web-based reports enable providers to measure employee and physician performance and productivity, while dashboards allow them to track the success of pay-for-performance initiatives.

Healthcare organizations must ensure proper management of resources, including personnel, equipment, supplies, and transportation.

• By monitoring inventory and managing supply chains, providers eliminate waste, better allocate insufficient resources, and make better decisions regarding supplier usage.
  
• Strategic analysis of compensation, performance benchmarks, workforce productivity, turnover and retention, staffing and employee relations, and employee recruitment and development.
  
• With labor costs as one of the largest expenses for most healthcare organizations, human capital management is a critical application of business intelligence.

The applications of business intelligence in the healthcare industry are far-reaching and can become the platform upon which the organization assesses performance and makes critical decisions. Those organizations that leverage effective BI platforms for superior analytics, flexibility and impressive information delivery capabilities, are unquestionably ahead of the game.

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Mark LaRow is vice president of products for the the McLean, VA-based MicroStrategy Inc.