When looking at the potential uses for a system under the BI umbrella, there seems to be virtually nothing they can’t do as they collect, massage and deliver data for clinical, financial, administrative and operational purposes as well as for payer negotiations.
“The potential for BI is nearly limitless,” said Susan Merrill, Wayne, Pa.-based clinical epidemiologist for ICW. “It provides the ability to identify patterns to the most minute levels, ascertain risks with enough time to intervene, conduct precise and more holistic analysis as more data sources are able to be integrated.”
With the explosion of data in the healthcare industry, BI has evolved to allow the extraction of useful information from some of the available data for clinical, financial, and operational purposes, Merrill said.
For clinical purposes, “BI may allow us to truly predict patients who are at risk for developing disease or worsening conditions by the smallest degree, conduct population and care management at a more granular level with more appropriate care pathways, link costs more specifically to treatments and programs, and perform comparative effectiveness studies within and across healthcare entities. Eventually, business intelligence will provide a means to better understand genomic information, particularly in combination with clinical data.”
Indeed, the BI system specializes in all types of data and delivers it to wherever it is needed, says Caleb Decker, vice president for healthcare solutions for Vienna, Va.-based MicroStrategy.
“It starts with mobility – accessing information anywhere and anytime,” he said. “Mobility is most important and is very exciting. We have customers who use BI for web-based reporting and have migrated to mobile devices. It is an incredible boost for access to information when they are out in the field.”
Physicians are big users of iPads and similar devices, and are clamoring for more functions and options, Decker said.
“They want more apps and access to medical record systems and we’re seeing that happen,” he said. “Where we have a bright future is in ACO model. It is where healthcare is going and is an opportunity for the physician to have a series of patient panels on their devices so they can see where the gaps in care are. Mobility is not just a cool thing, but it helps the system with the transparency of data and ultimately to deliver better care.”
Nashville, Tenn-based Parallon Business Solutions has been partnering with MicroStrategy on its new revenue cycle management solution and CIO Nicole Tremblett promises it will raise the BI bar a few notches.
“Data is power and the faster we can get info into the hands of decision-makers the better off the industry is,” she said. “Instead of being reactive, they can be proactive to manage their operations.”
Among the financial metrics the HCA dashboard tracks are unbilled days, denial patterns, discrepancies, days outstanding and accounts receivable analysis; it also conducts payer profiles and manages the data points all along the revenue cycle.
“By receiving this information, hospital executives have the transparency to ask key questions,” Tremblett said. “We can do the analysis for them as needed.”
One area that has been overlooked as prime data sources are medical devices, says Dave Dyell, founder and CEO of Panama City, Fla.-based iSirona.
“Our focus this year is how to use BI to drive better care,” he said. “So we are putting the technology into the hands of providers to give them the tools and analytics to make key decisions.”
Within the company’s software apps, one is focused on device integration itself, capturing all the data available, Dyell said.
“With a heart monitor, ventilator, infusion pump or anesthesia delivery system, for instance, there are hundreds of pieces of information and maybe only eight or nine pieces are inscribed in the record, so that is a huge amount of data to lose,” he said. “We capture all that in regular 30-second intervals.”
Health information exchange vendor ICA of Nashville is responsible for channeling data across internal and external healthcare sites. Chief technology officer Jeff Cunningham says his company’s association with Vanderbilt University has produced a “very nice” model for disseminating data across all systems and treatment settings.
“It provides a basis for assessing patients and supporting care across the environment,” he said. “We have expanded the technology in a couple directions – application for a multiple site scenario and building more interoperability to support standards for electronic medical records. Our platform has the base capability of aggregating informatics to data while providing a broader scale of data distribution.”
‘Analysis by paralysis’
Taylor Moorehead, regional partner with Newport Beach, Calif.-based Zotec Partners, is focused on helping physician clinics gain bargaining leverage with payers and says data is the key to securing better contracts.
“We arm our clients with information that they don’t have time to deal with due to ‘analysis by paralysis’ – they don’t know what they are looking for,” he said. “It’s a game of slicing and dicing information, such as determining why denials occur and whether they are patient- or physician-related. For example, about 5 percent of the claims we see rejected are simply because the payer calls for a copy of the patient’s report and expects the request to go unanswered so the claim doesn’t have to be paid. We tear apart all those data elements to find out what game they’re playing.”
Physicians traditionally have had a difficult time bargaining with payers, Moorehead says, because they don’t have a firm grasp of the information they need to support their arguments.
“Because we are a national provider for radiology services, we have 30 groups in my area so we know all the carrier reimbursement models,” he said. “Physicians typically get hit much worse than hospitals, so we try to level the playing field by giving them the transactional-based data they need.”
BI’s ‘true potential’
The uses for business intelligence appear to be limitless, vendors say. How it will continue to develop going forward depends on acceptance, deployment and utilization, says Ken Chow, chief medical officer for McLean, Va.-based LogiXML.
“The true potential for BI will be achieved when organizations fully integrate intelligence with action,” he said. “That is, many of today’s BI implementations don’t deliver useful data when and where people can act upon it. End users typically have to interact with a separate BI system and then use that information later when they interact with critical operational systems. The next phase of BI will deliver information to users directly and seamlessly inside the mission-critical processes and applications that they use and that their operations rely on.”