Now comes Moneyball for health IT
An overarching theme from a vendor's first analytics conference is similar to something that that EHR vendors have been saying for years: workflow and organizational culture are at least as important as the technology itself when it comes to healing healthcare through IT.
"It's a whole cultural change from a clinician's point of view," Bryan Bohman, MD, associate CMO of Stanford Hospital and Clinics, as well as CMO of the Stanford-affiliated University HealthCare Alliance, said at analytics company Health Catalyst's inaugural Healthcare Analytics Summit last week.
"You have to understand that it's a process, that medicine is a team sport," Bohman continued. "That's a bridge too far for many physicians today," especially those trained to believe that their judgment should be the last word.
Physicians, of course, will fight any perceived incursion on their turf, but Bohman suggested framing workflow changes as a move to improve their quality of life. "It's nice to know that you're Superman, but it's very stressful," the practicing anesthesiologist said.
With this in mind, Health Catalyst invited Oakland Athletics General Manager Billy Beane — he of "Moneyball" fame — to keynote the opening session. (Beane's speakers' bureau effectively gagged the media on his speech, but other presenters referred often to the 2011 movie starring Brad Pitt.)
To get buy-in for analytics — or any project requiring cultural change — "invite people who aren't normally there," said Gene Thomas, CIO of Gulfport (Miss.) Memorial Hospital.
In the Hollywood movie, Pitt's Beane did this by having Jonah Hill's "Peter Brand" character loosely based on ex-Athletics Assistant GM Paul DePodesta, sit in on a meeting with skeptical, old-school baseball scouts to explain how Beane was employing analytics to assess the value of players. Thomas did this with clinical leaders prior to deploying a Health Catalyst enterprise data warehouse in conjunction with the rollout of a new Cerner EHR earlier this year.
In return, Thomas knew he had an important job to do for the clinical staff: Make analytics information relevant and useful. "Data has to be high-integrity, projectable and real-time," he said.
At the event, Health Catalyst released a document called the "Accountable Care Transformation Framework." It mentioned "workflow no less than 30 times.
And Health Catalyst CEO Dan Burton stated what many of the more than 500 people in attendance were thinking: Analytics can become the foundation for health transformation. "Let us resolve to act, to be true catalysts," he said.
The message seemed to resonate. In an informal, real-time poll of about 150 people in a breakout session about making analytics a strategic imperative, a slim majority said that their organization's analytics vendor is more important than its EHR vendor.
A possible reason? "Availability of data has never been a problem at Geisinger," said Geisinger Health System CEO Glenn D. Steele Jr., MD. The big issue there, and at so many other provider organizations, is usability of data.
Crystal Run Healthcare, a physician-owned multispecialty practice based in Middletown, N.Y., has had a NextGen Healthcare Information Systems EHR since 1999. Late last year, the 300-physician group installed its first enterprise data warehouse, bringing business intelligence not only to the billing department, but also to human resources and materials management. EHR data warehouses do not always do that, noted CMO and CMIO Gregory Spencer, MD.
"BI is moving more from IT to analysis," Spencer said, "and from financial reporting to clinical guidance." It is his job to figure out how and what to measure and to display the results in way that will be useful to his fellow physicians. And the job will only get more difficult, as Spencer expects to start integrating data from social media and genomics in the next 3-5 years.
[See also: Health Catalyst shows Midas touch.]
Mission Health System in Asheville, N.C., is in a similar position. "We are shifting our culture to use information to drive change, even without an EDW," said CIO Jon Brown. "The organization is finally ready for an EDW."
It took a while to get to this point, despite strong clinician and administrator demand for data in recent years. "Data became cool at Mission Health," said CIO Jon Brown. Everyone asked for it but nobody did much with it, so nothing changed.
As part of a nascent three-year plan, Mission Health launched an accountable care organization in July, and Brown hopes to have it operational in the next couple of months. The goal is to begin actively managing population health by January 2016 and to break even on Medicare patients in a rapidly aging community that is seeing an influx of retirees moving in from overcrowded Florida, Brown said.
[See also: Partners and Health Catalyst join forces.]
"Stay focused on the vision," Brown said, explaining that with data and analytics, more is not always better, and that fellow CIOs would do well not to get bogged down in producing reports for the sake of producing reports. "Data has got to drive change," he said.