• Business Analytics: Measure, Learn, and Declare

    May 25, 2012

    By Timothy R. Zoph Timothy R. Zoph 

    We need to harness information to guide care, study what works, and demonstrate value.

    Analytics is the discipline that aggregates information, informs and empowers users, and enables the next stage of improvements in cost, quality, and patient safety. Forward-looking healthcare organizations are taking new approaches to business analytics so they can take advantage of the new wealth of digital information. They are moving beyond the prerequisite stage of clinical systems installation to the disciplined capture, aggregation, and use of information.

    Why Analytics Matter?

    You can use business analytics to influence the future of health care in three ways.

    Measure to anchor continuous improvement. An ongoing vigilance to cost and quality is needed to survive market and reform changes. Improvement efforts need to be anchored in measurement. We need facts to know what works, where opportunities abound, and how to quantify the impact of change. In parallel, we need to create and sustain cultures of improvement-a passion throughout your organization to be better, if not the best.

    Share and learn from leading organizations. For the benefit of others, communicate the evidence of your experience. Embrace best practices and collectively become an industry that operates from measured, scientifically-based practices. Our safety standards and cost performance demand a quantum leap forward; it is imperative that we learn and grow from one another.

    Declare results to inform patients. Analytics create the opportunity for you to go public with your performance with a growing set of national measures. Be committed to engaging your patients in healthcare decisions and get comfortable with transparency; celebrate where you excel and be honest about your areas of sub-standard performance.

    Transparency drives trust. Our patients need a basis to make informed choices about where, and with whom, to receive their care. And, of equal order, patients need to more clearly understand the consequences of behavioral choices in managing their health.

    Our Story

    As an early IT adopter, Northwestern Memorial Hospital achieved advanced use of electronic health records in 2007. This decade-long commitment, coupled with a growing institutional culture of safety and improvement, created a growing appetite for information. We increasingly discovered that we did not have the tools to feed the enterprise.

    In 2008, we created an enterprise data warehouse (EDW) that would become our campus-wide repository for patient care and research information. The process of understanding the data sources, creating extracts, and building governance structures took about three years. Our EDW was the first certified for meaningful use and public reporting.

    Today, we have aggregated information for 2.3 million patients. Annually, we generate 1,825 unique reports and complete 275 research projects. In 2011, our hospital sponsored 23 improvement projects, touching more than 400,000 patients, with savings of $24.9 million.

    And, finally, we are using this tool to publish more than 375 quality ratings on our website for patient use.

    Readmissions Example

    Recently, Northwestern used analytics to reduce our own hospital's aggregate readmission rates by 20 percent for the key clinical diagnoses of acute myocardial infarction, heart failure, and pneumonia. Technology was enlisted to enable the change:

    • Queries were created to analyze the key drivers and trends stratified by patient unit, discharge disposition, physician, and demographics
    • Operational dashboards were developed to track monthly performance of readmission rates, compliance with follow-up appointment orders, and clinic visit outcomes
    • Follow-up appointment orders were built and coordinated with the online discharge process, alerting schedulers to execute follow-up appointments with patients pre-discharge

    As a result, we achieved a 13 percent aggregate improvement within one year of initiating the program.

    Your Journey

    As you move ahead with business analytics, I would encourage you to consider these imperatives:

    • Capture information digitally as a byproduct of care: once, accurately, and completely
    • Create a single-source warehouse of information
    • Improve the quality and standardization of data; your initial steps in creating a warehouse is an act of discovery of replicated and missing information
    • Develop organizational competency in use of analytical reporting tools-and drive this capability to the edge of your institution
      • The users closest to your processes, as well as patients, will benefit most from the information
    • Build and sustain a culture of improvement; create the passion everywhere to improve

    Finally, get started, go public, and celebrate your performance!  

    Timothy R. Zoph is senior vice president, administration/CIO, Northwestern Memorial HealthCare, Chicago (email Zoph via mvandyke@hfma.org).