Business Intelligence and the High-Performance Provider
Key Attributes of High-Performance Providers
Accenture has conducted extensive research into the components of high performance in other industries. This knowledge is largely derived from the Accenture Institute for High Performance Business, a focused group of experienced senior professionals. The institute runs rigorous, original research programs, all based upon deep inquiry and analytic skill, extensive business knowledge and creativity and Accenture’s thorough understanding of industry conditions and needs. These programs, in turn, are structured to deliver innovative and actionable strategic insight for senior executives.
Accenture is now leveraging lessons learned to apply the highperformance concept to help providers combat soaring costs and profitability pressures. In this environment, providers are under tremendous pressure to perform better than the competition. To do so, they need a strategy to rise above the rest – a road map to achieve high performance.
Accenture is combining healthcare research with experience
learned from for-profit industries to identify specific, key attributes
that demonstrate high-performance providers. For example, emerging
market trends are dictating that healthcare providers must
deploy new operational capabilities. Based on these trends, highperformance
providers can be defined by two broad categories of
performance that define operational superiority: improved outcomes
and increased business excellence (see Figure 1).
These two categories are further broken down into several key attributes (see Figure 2).
Outcomes are driven by improved clinical quality. Improved quality can be achieved through increased patient safety and satisfaction, and a focus on regulatory compliance. High-performance providers consistently accommodate evolving standards and deliver excellent patient care.
Higher ratings of customer satisfaction in a provider setting encompass a broad constituency, including the patients who receive medical services, the physicians who choose the hospitals for patients, the insurers who pay, as well as employees and the local community. High-performance providers strive to increase satisfaction among all-important stakeholders in a hospital setting.
Business excellence is driven by operational effectiveness that leverages information and communication technologies and resources to enable more informed clinical and business decisions. Improved decision making helps high-performance providers better achieve success.
Business excellence is also fueled by financial longevity, which includes a long-term view on capital funding and the balance sheet to ensure a sound financial platform for the future.
Defining high performance by these key attributes creates a set of guidelines for providers to measure their ability to consistently outperform competitors. The next step, then, for success is to develop strategies to monitor, track and trend performance. Measuring performance efficiently and effectively in a healthcare setting relies on the smart use of technology.
Technology – the Grand Enabler
Over the past 20 years, healthcare organizations have experienced radical changes in technology. Hailed as the ultimate performance enabler, information technology has indeed added efficiency in its replacement of manual processing.More recently, however, healthcare IT has come under greater scrutiny as new clinical information systems begin replacing disparate and redundant systems and aging technologies. As part of this trend, providers are taking a closer look at some of the outdated decision support systems that once tapped database resources to enable business decision making.
Despite investing millions of dollars in decision support software over the years, many healthcare organizations still cannot leverage and use the information they need from systems that track patient flow, clinical quality, patient and physician satisfaction and key cost indicators. To better leverage the data from the systems that measure and track high performance, providers need a new and improved methodology to provide more current and comprehensive information. That is just what can be accomplished through a fact-based support system called business intelligence – a set of concepts and methods that help improve business decision making. Decision support systems and enterprise information systems of the 1980s and early 1990s were forerunners of today's business intelligence tools.
Business Intelligence – How Your Business Is Doing
Similar to decision-support technology, business intelligence is
a group of tools that collect and analyze internal and external
data to generate knowledge and value for an organization. This
includes business process decision support at the strategic, tactical
and operational levels. Business intelligence already has been
used across many other industries with tremendous success. Just
recently, however, the concept of business intelligence has been
gaining traction in the healthcare industry.
A key component of a business intelligence solution is a data warehouse – a database populated with data from a variety of transactional systems optimized for information retrieval. A data warehouse can be used to deliver value in the areas of business projection, market trend analysis and cost minimization. In the healthcare world, these transactional systems include clinical information systems, enterprise resource planning systems, supply chain solutions, patient billing and accounting and many, many others.
Business intelligence software empowers users not only to access raw data, but to report and analyze these data efficiently. Business intelligence tools do far more than simply deliver reports from a data warehouse. Instead they provide large numbers of people – hospital executives, physicians, nurses, employees and payers – secure and simple access to the right information to satisfy their unique requirements and then to share that information accordingly.
Applying Business Intelligence to Achieve High Performance
Providers can use business intelligence tools to manage their business concurrently so they can take immediate action to address underperforming areas of the hospital and accrue the following important benefits:
- Effective measurement of performance;
- Improved agility and responsiveness to change;
- Alignment around common reporting and standards; and
- Increased organizational competitiveness.
Business intelligence can be used to specifically measure and monitor the already-identified key attributes of high-performance providers: clinical quality, customer satisfaction, operational effectiveness and financial longevity.
Clinical Quality
Hospitals capture reams of clinical data every day through existing information systems. Business intelligence tools can extract these data and allow a provider to drill down into various quality metrics, such as the Centers for Medicare & Medicaid Services’ core measures, to understand what affects underlying performance issues. For example, a provider trying to reduce medication errors can cull information from the pharmacy and/or medication administration systems to dissect problems and make the necessary changes to reduce error. Through business intelligence software, a provider can set performance targets, such as a certain error rate percentage based on the number of medications administered, and then compare the data to see how many medications are given incorrectly.
In response to growing public pressure to reduce medical errors and increase quality care, providers can also use business intelligence software to assess performance. Using powerful, comparative clinical treatment and cost databases, hospitals can gather comprehensive data to track clinical performance and quality improvement initiatives, and to identify trends and growth opportunities for patient care. Armed with this valuable information, hospitals can analyze and compare complication, mortality and readmission rates and outcomes against national, regional and peer group trends to improve clinical performance. For example, a not-for-profit, 547-bed academic medical center established a three-year road map for implementing a business intelligence strategy. The organization recognized the growing need for accurate and readily available information to manage the clinical area where they were experiencing increasing pressure to reduce variability and improve outcomes.
Customer Satisfaction
Healthcare providers use a variety of clinical information systems to collect patient data. High-performance providers can measure the efficiency of this process using business intelligence tools. For example, patients who are repeatedly required to provide basic patient information often grow increasingly frustrated. In addition, the more times patient information is recorded, the greater the chance for record-keeping error. Business intelligence allows a macro view of the data collection process and can report, for example, the number of instances information is recorded and the number of times errors occur due to repetitive information gathering.
Market segmentation data gathered through business intelligence tools can also help hospitals cultivate relationships with patients and families over time. By creating a comprehensive log of customer interactions and by identifying important hospital customers and prospects, hospitals can create, for example, a maillist generator for use in marketing campaigns that automatically measures ROI against campaign costs and revenue. This might be used to mail reminder cards to diabetics to regularly check insulin levels or to send heart-healthy recipes to cardiac patients. Hospitals benefit from increased customer loyalty and higher ratings of customer satisfaction.
Physician satisfaction is also key to provider high performance. Physicians can, after all, send patients away from hospitals they deem as lower in quality of care measures, such as emergency department patient flow or ambulatory care appointment wait times. High performers also try to increase their physician retention rates, actually offering technology support and connectivity to local physicians’ offices.
High-performing providers also implement pay-for-performance programs that use federal-government-supported and payersupported incentives to encourage evidence-based practices to promote better outcomes. Performance measures also help highperforming providers increase public reporting, which better positions their offering to the surrounding community.
Operational Effectiveness
Because the majority of provider information systems are siloed, collaborative information sharing rarely occurs using outmoded decision support software. Business intelligence tools, however, reside on top of these systems, allowing healthcare executives to look into separate systems in the interest of improving work flow and increasing efficiency. This view, for example, could allow a provider to redesign the patient management process to decrease the length of hospital stays and improve patient flow. Business intelligence information could also be applied to decrease admission wait times and reduce the number of patients who leave without being seen by a physician, thus boosting a hospital’s operational efficiency.
Business intelligence tools also can leverage both internal and external operational and financial databases to allow hospitals and health systems to compare operational and financial performance at the system, hospital and departmental level to control costs. Organizations can then use such comparative data to identify key opportunities in cost, utilization and productivity, and to set fiscal and operational benchmarks to improve performance. The data also help providers set realistic budgets and financial plans. Armed with this important information, a hospital can initiate the precise degree of change essential to keeping its organization financially sound.
For example, a multihospital health system with over 55,000 employees operating in more than 20 locations wanted to update its technology architecture and strengthen decision making. The extremely competitive market to improve margins required constant operational streamlining, and business decision makers needed more powerful analytical tools to maintain market leadership. Accenture collaborated with the health system to create a single platform that supported growth, decreased month-endclose processing time and increased analytical capabilities for decision making at the end-user level.
Financial Longevity
Hospitals using outdated decision support systems must wait for information to be populated into various financial databases – sometimes waiting until the end-of-month close to run various performance analyses. Conversely, a business intelligence platform performs concurrent processing, so information is reported immediately. Business intelligence software extracts data from transactional systems on a more current basis, so providers can look at both historical and current information for predictive financial planning.
Business intelligence tools can also monitor timely financial indicators, such as day’s outstanding receivables. In addition, the software can drill into clinical product or service line information to determine, for example, how a certain cardiology program is performing. These tools can help a hospital determine financial outcomes in a timely manner, which drives financial performance.
Hospitals can also use rich market segmentation data garnered through business intelligence tools – stratified by gender, age, socioeconomics and payer status – to identify how consumers will respond to marketing and when, where and how they will use specific services. This helps hospitals target consumers more effectively to maximize return on investment and boost the bottom line.
The key to truly improving financial longevity is for high-performing hospitals to look beyond this year’s margin to big picture items like capital funding and the balance sheet to ensure that the organization’s long-term focus is on financial success to support future generations of leaders and patients.
The Future
While other industries have embraced business intelligence to advance reporting, planning and operational decision making, healthcare providers are “behind the curve” in adopting and using this technology. Hospitals that embrace this diagnostic tool set to address trends can gain a competitive advantage for achieving and sustaining high performance.
Using business intelligence tools to transform data into actionable insights, healthcare providers can better measure, manage and improve how they do business. To this end, providers will create a list of parameters to monitor and compare with established benchmarks to measure high performance. This list of measures can be compiled into an “executive dashboard” to show on a timely basis how a hospital is performing on key performance indicators, such as quality, customer satisfaction, operations and financials. These high-performance healthcare organizations will, in turn, drive business growth, manage costs more effectively and deliver higher levels of quality care.
Industry Trends Impacting Business Intelligence
Several important industry trends will impact business intelligence functions as healthcare organizations increasingly adopt this new tool set, including:
- Emergence of new clinical programs and new models to deliver and manage healthcare that make a consolidated view of outcomes and operating results difficult for many providers;
- Increasing medical costs that make it harder for patients to afford quality care;
- Changes in compensation models driven by pay for performance that create new requirements for data capture within clinical and administrative work flow and the ability to aggregate and report outcomes against key performance indicators;
- Advances in information processing infrastructure that create the potential for greater information analysis, which is hard to harness in practice;
- An increasing need for data sharing across healthcare applications and entities and incorporating healthcare data from many sources; and
- Heightened focus on consumer healthcare information, both in terms of transparency initiatives and privacy and security requirements.
