Metrics That Matter
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Pulling in data from 42 HCA hospitals, Platt and Perlin's team brought together information about infections, cultures and sensitivities, antibiotics, and changes in practice. The results, to be released in October, will suggest a definitive way to avoid MRSA infections in hospitals, especially for patients in intensive care, Perlin says.
"We conducted a study over 42 hospitals in three interventions to detect which was the best to reduce MRSA," Perlin said. "The benefit of large-scale information systems spread across a large number of hospitals is to study more than 70,000 patients in more than 240,000 patient days to identify definitively the best way to avoid MRSA in hospitals."
A third HCA study, still unreleased, analyzes different pain medications used in and around anesthesia. "We find that certain medications allow the patient to go home earlier than other medications," Perlin says. This study may yield not only clinician guidance for a better patient experience, but also allow HCA to deliver the best care as efficiently as possible, he adds.
"Good quality is good business," Perlin says. "We believe that good quality in healthcare has to be supported by robust information, supporting the day-to-day decisions with insight that derives from analytics."
The Joint Commission designated 76 of HCA's facilities as being among the 405 top performers in the country last year, Perlin says. "That's a disproportionately good representation in terms of the positive performance, and demonstration to the power to be able to use clinical analytics to drive focus on clinical performance and improve outcomes," he says.
Obstacles to analytics
The difficulties in implementing business intelligence mean that not every healthcare organization is able to jump right in. The scale of data being fed into today's healthcare data warehouses can be astronomical. HCA attested to Stage 1 of meaningful use at virtually all of its 145 hospitals nationwide in 2011. HCA records more than one billion medication administrations annually, Perlin says.
"We want to put tools and information in the hands of clinicians and business leaders. We want to move as much as possible from a library metaphor to an Internet metaphor," Perlin says. By that, he means, "We want to move from something you have to go to a certain individual with a certain set of skills to answer every question to really provision users with the capacity to check out data and perform analytics, obviously in an appropriate, secure, and private fashion."
Complicating the move to these tools are migrations from point solutions that many healthcare systems have adopted under the influence of what Schooler calls "the tyranny of the urgent."
For years, technology providers have supplied analytics packages that explore one large but siloed system of information, such as revenue cycle, supply chain, or performance management of physicians.
"Ask the average organization to show you their enterprise data warehouse platform from which they do enterprise analytics on their data," Schooler says. "Ask someone to show you where that's all integrated in one spot, and you'll find few and they're far between.
"This is a discipline that our industry has to embrace and adopt and has to master going forward," says Schooler, who was named CIO of the Year for 2011 by the Healthcare Information and Management Systems Society and the College of Healthcare Information Management Executives.
Care management platforms, such as patient registries or disease registries, will also need to feed data into these data warehouses, Schooler says.
Another hurdle to implementing analytics is that all healthcare organizations also have to wrestle with both structured and unstructured data, says Jesse Spencer-Smith, director of clinical analytics with the clinical and physicians service group at HCA.
"Administrative data is coded and clear," Spencer-Smith says. "Data elements are highly structured. Some of our clinical data may be less structured and needs to be mapped. That's an ongoing project. Each of these presents its own challenges in terms of analyzing the data."
Schooler has some advice for hospitals trying to harness the power of analytics—particularly smaller community hospitals that lack funds to install expensive IT systems.
"Governance and prioritization are absolute keys," Schooler says. "As a standalone 250-bed community hospital, you may not need to invest in a separate platform. You may be running your entire organization off of one health information system."
Next, look for market partners, he says. For instance, two or three different vendors provide well-established physician performance technologies and can help providers fill gaps in their current data collection.
In a world where speed of insight is where healthcare providers keep their competitive edge, metrics that matter and the tools to create them will continue to provide that edge.
This article appears in the September 2012 issue of HealthLeaders magazine.
Scott Mace is senior technology editor at HealthLeaders Media.
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