Geisinger CEO gives tips for smarter BI

'There's almost no outcome that can't be improved.'
By Mike Miliard
10:54 AM
Geisinger CEO Glenn Steele Jr., MD, talks about business intelligence.

Glenn D. Steele Jr., MD, president and chief executive officer of Geisinger Health System, says the integrated delivery network's pioneering population health programs depend on insightful use of data to drive behavior change.

Serving 43 counties over some 20,000 square miles of northeastern Pennsylvania, Geisinger provides care for more than 2.6 million people; its innovative efforts to combat diabetes, coronary disease, COPD, hypertension and other chronic ailments have been held up as examples for the rest of the country.

When Steele delivers the keynote at the HIMSS Media Healthcare Business Intelligence Forum, April 16-17 in Washington, D.C., he'll offer lessons from Geisinger about deploying analytics tools to improve patient care and the bottom line. And he'll stress the importance of making sure that data changes behavior and thought processes – not just of patients, but of providers and payers, too.

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In a Q&A with Healthcare IT News, Steele discussed Geisinger's strategies for deploying analytics for care coordination, emphasized the "critical" importance of integrating clinical and financial data, pointed to specific cases where BI has borne fruit for Geisinger and offered advice for smaller providers looking to make the most of their data.

Q: We'll talk about Geisinger in a second, but first, from your point of view, how is healthcare in general doing these days when it comes to using business intelligence and analytics?

A: Well, we're probably about to enter the 19th century. (Laughs.)

Q: Baby steps, right? But why are we so far behind other industries? What's standing in the way of smarter use of data?

A: For all the reasons that you and I could talk about for a week. We have legitimate regulatory concerns, and I think they've always taken precedence over true innovation in terms of how we look at our data, how we analyze it, how we distribute it. How we use it to change behavior. I don't think the balancing act between innovation and regulation is correct in most areas of healthcare data.

We also have the intrinsic structural issue in healthcare, where it's been compartmentalized on both the payer and provider sides, and each of those seems to strive for an optimal function without actually any integrated structural aspirations. And that's changing as well, but obviously when you sell IT enabling into all those compartments, you're kind of handicapped right from the start.

We have a series of expectations, even in the biggest compartments that are most well-capitalized, the hospital-centrics; we have a series of expectations that up until recently were pretty simplistic: that if you put an electronic health record in it would automatically improve badly engineered and badly transacted systems. It doesn't work that way.

And then we have this great big divide between payer and provider where a huge amount of the data, which is collected on the transaction side, is kind of husbanded and treated as an intellectual property. And is either on-purpose not used, or inadvertently not-usable, whether because of a lack of timeliness or a lack of functionality.

We could go on for weeks talking about why we are where we are, but the good thing is, we're changing.

Q: What's finally bringing about that change? Improvements in the technology or shifts in attitudes and awareness?

A: Oh, I think it's both. I think it's both, and I think the more critical rate limiter is the attitudes and the intrinsic behavior, which, quite frankly, I think is amplified by a lot of the stakeholder business models, and it's also amplified by backward-looking regulatory issues. And I think we're going to have to blast through both of those things to get maximum functionality when you think about healthcare enabling through health healthcare information technology.

Q: Describe Geisinger's use of analytics. Is there a mission statement or overarching philosophy to how you use BI?

A: Well, our top strategic aim is innovation and quality. Our structural advantage that we talk about internally and externally over the past 15 years is this payer-provider sweet spot. We've tried to figure out how our version of vertical integration between payer and provider can really optimally mesh the information and the use and analysis of it from both side of the house. That's a 35,000-foot glib summary of what drives us, and continues to drive us.

But the end point is change in behavior. We realize that in order to capture the 30 to 40 percent of value which is now lost because of stuff in healthcare that doesn't help human beings, actually hurts them, in order to capture that, we have to fundamentally change behavior. And we have to change it on behalf of our providers as well as our patients. And on the insurance side of the house.

The way to change behavior is not just changing the incentives. Everybody has been – appropriately – whacking fee-for-service, and that's OK. I'm alright with that. You have to change the incentives but you also have to enable people with timely feedback about what they're doing, and the consequences of that, and what they should be doing. And that's all about data.

Again, we think that in order to achieve that continuing aspiration of innovation and quality, we've got to have, from both sides of the house, behavior change enabled by timely and usable data.

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