Whether you’re watching the nightly news, reading the paper or perusing your favorite news site, it’s likely that you will stumble upon a segment or article about the healthcare industry in the United States. Escalating medical costs, double-digit premium increases and a convoluted system of reimbursement, have pushed the healthcare industry into a glaring spotlight. Patients, providers and payors (both government and commercial) agree in principal on the major issues: reducing medical expenditures, expanding access to care, reducing the number of uninsured and improving the quality of care. It doesn’t take a healthcare expert or fortune teller to realize that the status of the U.S. healthcare system needs to be improved. As a result, new healthcare initiatives, programs and legislation have been created, both in the private and government sector, that are aimed to improve the quality and efficiency of care. Most of the healthcare industry will likely feel a positive in the long-term, but in the short-term, the industry is hurdling towards a breaking point.
Business Intelligence to the Rescue
Nevertheless, the situation isn’t all doom and gloom despite the intricate challenges of managing the delivery of healthcare in the United States. There are several information technology advances that can help. To properly set the context, the remainder of this article will focus solely on business intelligence (BI), which can best be described as both a concept and a type of information technology. The way in which healthcare is delivered (ex. MRI) has advanced, both on the hardware and software side, but that will not be the focus of this article. BI technology comes in many shapes and sizes, but its benefits can be felt by healthcare executives, managers, physicians and analysts across the entire continuum of care. Utilized properly, BI applications can provide actionable intelligence for the financial, clinical, and operational aspects of healthcare. The intersection of healthcare and BI is long overdue and has unlimited potential to improve the healthcare system by identifying negative or abnormal patterns and trends, as well as potential areas for improvement. The result of BI technology permeating the healthcare industry has led to many exciting opportunities and is increasing in popularity among both small and large healthcare organizations. In fact, the opportunities apply both to payors as well; although the remainder of this article will be a spotlight on why BI is so important to the provider side.
So, why is BI becoming so important to the healthcare industry? To answer this question, we must briefly examine the definition of BI, how the technology is utilized, and what problems it can solve. According to Wikipedia, “Business Intelligence (BI) refers to skills, processes, technologies, applications and practices used to support decision making.” By understanding the definition of BI, its implications and possible applications to healthcare issues and challenges cannot be overstated. The healthcare industry is fraught with reporting challenges in the areas of data quality, integration, and reporting distribution. BI applications, dashboards and the process of defining and measuring Key Performance Indicators (KPIs) serves as the catalyst for deriving value and providing actionable intelligence to end-users. The remainder of this article will explore how the technology is utilized and why its popularity will continue to grow to the point that it’s considered a core IT application for healthcare providers.
BI Solves Reporting Challenges
The visual nature of BI tools and dashboards give end-users an “at a glance” solution to often complex and challenging business questions. When comparing BI applications, dashboards and reporting capabilities with traditional text based reports and even spreadsheets, it’s easy to “see” why BI-based data visualization tools provide high-levels of analytic capabilities and value to end-users: most people comprehend and develop more insight when observing visuals such as pictures, images, graphs, etc. For this reason, BI serves as the bridge to connect users with their data in ways that users have never previously experienced. For example, end-users can intuitively interact with their data via BI dashboards, drill down into aggregated data, and can finally start to ask follow-up questions in real-time with a click of a button.
Comparing this approach to traditional reporting, BI makes it possible for end-users to interact with the actionable and summarized data. The healthcare industry is notorious for generating a significant amount of critical financial, clinical and operational data. To exacerbate the situation over the next 5-10 years, providers are required to implement and generate even more data and reports from Electronic Medical Record (EMR) and Computerized Physician Order Entry (CPOE) systems. The implementation of EMR’s and CPOE’s required per the HITECT Act and “Meaningful Use” measures, will result in a healthcare tidal wave, which will leave providers struggling to maintain and develop new reporting and information distribution channels.
Despite being overwhelmed by the current volume of healthcare data and numerous reporting requests, hospital IT departments and business and clinical personnel view BI applications and dashboards as critical tools for different reasons. First and foremost, BI dashboards provide another mechanism for report and information distribution to end-users. Once properly constructed and tested with end-users, BI dashboards are essentially self-service in nature and require minimal IT support. As a result, the volume of IT reporting requests and support work is reduced, so IT reporting and programming staff can be re-allocated for other projects. For example, resources could be redeployed to ensure successful adoption of ICD-10, international coding used to classify diseases and other health problems, and to ensure the compliance with “Meaningful Use,” which has a direct impact on the financial bottom-line of a hospital.
Healthcare providers across the United States are inundated with data and suffer from poor data management policies and techniques. Regardless of the number of beds, revenue, payor mix, etc., healthcare provider organizations have evolved their reporting immensely in the last 30 years, but still are hamstrung by their inefficiencies in data management, data extraction and integration challenges, simplistic analytic capabilities and information distribution challenges. BI tools, applications and dashboards address these challenges by offering assistance to both IT and business users in the following areas:
- Integration of disparate data sources
- Extraction of data from databases, reports, etc.
- Enhancement of metrics and analytic capabilities
Moving forward, the challenges identified above will grow exponentially due to the upcoming changes in how healthcare will be measured and reimbursed. To measure and quantify the quality and efficiency of care, BI technology will need to be at the forefront and lead the charge in creating mission critical applications and dashboards. Therefore, end-users can spend more time analyzing and monitoring trends, patterns or data anomalies that may signal adverse effects on patient outcomes, quality of care or medical expenditures.