Analytics Stories: A Case Study from UMass Memorial Healthcare

As I indicated in Competing on Analytics, if you ask CIOs today about the importance of data to their enterprises, they will likely tell you about their business’ need to “compete on analytics”, to deliver better business insights, and to drive faster business decision making. These have a high place on the business and CIO agendas, according to Thomas H. Davenport, because “at a time when firms in many industries offer similar products and use comparable technologies, business processes are among the last remaining points of differentiation.” For this reason, Davenport claims timely analytics enables companies to “wring every last drop of value from their processes”.

So is anyone showing the way on how to compete on analytics?

healthcareUMass Memorial Health Care is a great example of an enterprise that is using analytics to “wring every last drop of value from their processes”. However, before UMass could compete on data, it needed to create data that could be trusted by its leadership team.

Competing on analytics requires trustworthy data

TrustworthyAt UMass, they found that they could not accurately measure the size of their patient care population. This is a critical metric for growing market share. Think about how hard it would be to operate any business without an accurate count of how many customers are being served. Lacking this information hindered UMass’ ability to make strategic market decisions and drive key business and clinical imperatives.

A key need at UMASS was to determine a number of critical success factors for its business. This included obviously the size of the patient population but it also included the composition of the patient population and the number of unique patients served by primary care physician providers across each of its business locations. Without this knowledge, UMASS found itself struggling to make effective decisions regarding its strategic direction, its clinical policies, and even its financial management. And all of these factors really matter in an era of healthcare reform.

Things proved particularly complex at UMass since they act as what is called a “complex integrated delivery network”. This means that portions of its business effectively operated under different business models. This, however, creates a data challenge in healthcare. Unlike other diversified enterprises, UMASS needs an operating model–“the necessary level of business process integration and standardization for delivering its services to customers”[1]— that could support different elements of its business but be unified for integrative analysis. This matters because in UMass’ case, there is a single denominator, the patient. And to be clear, while each of UMASS’ organizations could depend on their data to meet their needs, UMASS lacked an integrative view into patients.

Departmental Data may be good for a department but not for the Enterprise

Data AnalysisUMass had adequate data for each organization, such as delivering patient care or billing for a specific department or hospital, but it was inadequate for system wide measures. And aggregation and analytics, which needed to combine data across systems and organizations was stymied by data inconsistencies, incomplete population of fields, or other types of data quality problems between each system. These issues made it impossible to provide the analytics UMass’ senior managers needed. For example, UMass’ aggregated data contained duplicate patients—people who had been treated at different sites and had different medical record numbers, but who were in fact the same patients.

A key need for UMass creating the ability to compete on analytics was to measure and report on the number of primary care patients being treated across their entire healthcare system. UMass leadership saw this as a key planning and strategy metric because primary care patients today are the focus of investments in wellness and prevention programs, as well as a key source of specialty visits and inpatients. According to George Brenckle, Senior Vice President and CIO, they “had an urgent need for improved clinical and business intelligence across all our operations, we needed an integrated view of patient information, encounters, providers, and UMass Memorial locations to support improved decision making, advance the quality of patient care, and increase patient loyalty. To put the problem into perspective, we have more than 100 applications—some critical, some not so critical—and our ultimate ambition was to integrate all of these areas of business, leverage analytics, and drive clinical and operational excellence.”

The UMASS Solution

solutionThe UMass solved the above issues by creating an integrated way to view of patient information, encounters, providers, and UMass Memorial locations. This allowed UMass to compute the number of primary care physician patients cared for. In order to make this work, the solution merged data from the core hospital information applications and processed this data for quality issue that prevented UMass from deriving the primary care patient count. Armed with this, data integration helped UMass Memorial improve its clinical outcomes, grow its patient population, increase process efficiency, and ultimately maximize its return on data. As well UMASS gained a reliable measure of its primary care patient population, UMASS now was able to determine an accurate counts for unique patients served by its hospitals (3.2 million), active patients (i.e., those treated within the last three years—approximately 1.7 million), and unique providers (approximately 24,000).

According to Brenckle, data integration transformed their analytical capabilities and decision making. “We know who our primary care patients are and how many there are of them, whether the volume of patients is rising or decreasing, how many we are treating in an ambulatory or acute care setting, and what happens to those patients as they move through the healthcare system. We are able to examine which providers they saw and at which location. This data is vital to improving clinical outcomes, growing the patient population, and increasing efficiency.”

Related links

Solution Brief: The Intelligent Data Platform
Details on the UMASS Solution

Related Blogs

Thomas Davenport Book “Competing On Analytics”
Competing on Analytics
The Business Case for Better Data Connectivity
CIO explains the importance of Big Data to Healthcare
The CFO Viewpoint upon Data
What an enlightened healthcare CEO should tell their CIO?

Twitter: @MylesSuer

 


 

[1] Enterprise Architecture as Business Strategy, Jeanne Ross, Harvard Business School Press, Page 8

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