Metrics That Matter
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Although many healthcare systems are new to data warehouses, Schooler isn't. As far back as 1988, he was implementing data warehouse technology in the telecommunications industry.
"When you think about the concepts of accountable care, and that many of us are going to end up managing a population of patients, multiple populations, and at some point we're all going to be assuming some level of risk to keep them well or risk to effectively manage the care we have to deliver, there's no way to survive without these kind of tools," Schooler says.
Uses of analytics
One of the key uses of analytics in healthcare is to improve the quality of clinical outcomes. At Allina Health, Chief Clinical Officer Penny Wheeler, MD, and her team used analytics to look at the timeliness of breast biopsies. "We could tell that some sites were doing same-day breast biopsies when a concern was raised with a worrisome breast lump, and some of our sites were doing it up to 10 business days later," Wheeler says. "That was able to guide an initiative and have us give oversight over timeliness of breast biopsies."
Analytics also revealed that 14% of the time, Allina Health clinicians were electively inducing labor before 39 weeks. It meant too many babies going to intensive care and too many cesarean sections, Wheeler says. In the past year, by putting analysis of this data in the hands of the clinicians who knew best, 235 women did not have to have C-sections, she adds.
As much preparation as these analytics systems require, they have become more automated than before. "Knowing that times are tough and knowing that more and more measures are being required of us, we couldn't laden the organization with hundreds of FTEs that were in the measurement and analysis area," Wheeler says. "Much of the business case for this was to actually rightsize the measurement and analysis team by creating automated platforms to get the information we needed."
With 11 hospitals and 82 clinics in Minnesota and western Wisconsin, Allina Health generates $3.5 billion in annual revenue. To build its current analytics system, Allina hired Healthcare Quality Catalyst in Salt Lake City, a consulting firm run by two former executives of Intermountain Healthcare.
Then Allina added another analytical layer using QlikView business intelligence software by Radnor, Pa.–based Qlik Technologies, Wheeler says. "It allows people to look at the data and interpret it without needing to wait four weeks for an analyst to do so," she says.
There have been measureable returns on Allina's investment, she says. For instance, Allina netted $1 million to $2 million in a pay-for-performance initiative from payers wishing to reduce unnecessary C-section costs.
"But remember, we've given up revenue to do that, when you're not doing as many cesarean sections," Wheeler says. "If you don't have this infrastructure and capabilities in place, then as we move to outcomes per dollar spent, you're kind of hosed." But with that infrastructure comes greater confidence of success because the leaders know how to focus their efforts.
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