Who should own hospital analytics: the CIO or the CFO?
There are arguments to be made on both sides when it comes to who should own analytics in a hospital or health system: the CIO or the CFO. It’s different at healthcare organizations across the country. And it depends on varying factors. But there also is an argument to be made for shared ownership.
This is the story of how two healthcare providers – the University of Connecticut Health Center in Farmington and Northeast Georgia Health System in Gainesville – handle the ownership of analytics within their organizations.
Prior to picking a CIO or CFO
Before the question of ownership arises, who is it that does the majority of analytics work within the organization, the CIO or the CFO?
“As a prominent academic medical center, the University of Connecticut Health Center is committed to transforming healthcare delivery by developing a robust digital healthcare ecosystem that includes a multitude of digital services and platforms,” said Bruce Metz, CIO at the University of Connecticut Health Center. “The overall vision and strategy is driven by collaborative efforts of all key stakeholders that put patients and their communities at the center.”
As healthcare becomes more digitized, the collection, sharing and analysis of diverse, complex data forms the foundation of the ecosystem, including analytics initiatives designed to achieve cost, quality and patient experience objectives, he added.
“In view of this approach, clinical, operational and IT executives at UConn Health, such as the CFO and CIO, are equally involved in developing and deriving value from analytics capabilities,” he explained. “A partnership among the C-suite is considered essential to a unified enterprisewide program for data and information management that deals with organizational competencies and processes as well as the underlying technologies.”
This partnership enables each executive to take the lead in aspects of the analytics strategy closely aligned with their area of expertise. For example, the CIO provides leadership in reinventing the organization’s information architecture to support massive amounts of data produced and shared across the enterprise, he said.
Other C-level members, such as the CFO, provide leadership within an information governance framework for identifying analytics investments that yield the most significant contribution to clinical and operational performance, he added.
Chris Paravate, CIO at Northeast Georgia Health System, said analytics work at his organization is primarily supported out of both the informatics and technology services division as well as the finance division.
Informatics and technology services responsibilities include: quality and clinical performance metrics, dashboards and reporting tools; EHR dashboard tools, workflow integration and decision support for acute, ambulatory and business support services; predictive analytics including integration within the EHR; population health analytics for the health plan and ACO; and data management, including virtual and physical data repositories and lakes and data integration for decision support.
Finance responsibilities include: financial prospective, ROI analysis; volume and budget analytics; labor/budget/cost management analytics; costing, financial decision support; payer contract performance, at-risk contract performance management; and dashboard tools to support cost accounting, operating expense management.
Getting to common ground
Both of these healthcare provider organizations are doing a lot of analytics work on clinical, financial and other subjects. And there are many common reports from around the organization where analytics play an important role.
“Like almost every health system in the country, we are focused on reducing our costs and improving our access,” said Paravate of Northeast Georgia Health System. “We have developed several tools to support our acute care operations to improve our patient experience and reduce cost.”
These tools help benchmark inpatient care management and improve discharge planning. They also have developed several tools to improve patient experience in ambulatory care operations. By learning patient preferences, the organization has been able to optimize its EHR and improve access and delivery, Paravate said.
While analytics capabilities keep advancing, a central premise of the analytics program at UConn Health is balancing the latest technology trends with business-driven impact and measurable business outcomes, said Metz of the University of Connecticut Health Center.
“Key to this approach is a flexible, tiered service model where there is regular interaction among users who identify requirements; analysts who understand and can translate the business context; and developers capable of handling more complex requests,” he said. “These interactions can take different forms.”
"Launching a successful analytics program starts with an understanding that the undertaking is much more than a technology initiative, requiring the commitment and participation of all members of the C-suite."
Bruce A. Metz, University of Connecticut Health Center
For example, users might access support through designated reporting and analytics teams. Analytics teams can also advise on existing tools or reports, and develop new reports. Throughout the process, technical staff can concentrate on managing or enhancing data as well as analytics tools, while resolving problems and providing guidance.
“At this stage of UConn Health’s analytics journey, common reports span a number of major areas including: clinical, for example, clinical quality, outcome measures; financial, for example, revenue cycle tracking; operational, for example, measurement and management of daily activity; and enterprisewide, for example, organizational performance, metrics specific to selected organizational areas,” Metz said.
Methods for creating and publishing reports span a multitude of modalities ranging from straightforward lists to predefined templates with real-time data, large data sets (for instance, multi-year) analyses, specialized dashboards, and exports that leverage multiple datasets.
“The importance of each method stems from the ways that data is put together and presented to create information,” he said. “The analytic capabilities are at the core of providing new insights that get woven into operational activities to drive value and better decisions. As members of the C-suite and their teams become adept at descriptive, historical reporting, the goal is to move into predictive and prescriptive analytics that spot conditions, identify patterns and anticipate outcomes leading to even higher levels of performance for the organization.”
CIO vs CFO: Making the call
So now knowing who does what, why, and how, the big question is who owns analytics, the CIO or the CFO?
“Ownership of analytics does not fall on the shoulders of one leader, business analytics is a core competency for every leader,” said Paravate of Northeast Georgia Health System. “The role of IT is to enable these tools in such a way that the operations can incorporate analytics into both the strategic and daily decisions.”
One way of helping to achieve adoption of analytics is to move this type of decision support into the EHR, he said. By moving this information closer to the decision path, this information is consumed and acted upon with greater frequency, he added.
“It’s no longer acceptable for IT or finance to simply provide a report or a dashboard and expect users to find time to use another tool,” he said.
Data governance plays a key role to insure that all stakeholders agree on a common definition of data, the source of truth, and provide oversight for how the data is used and represented, he explained.
“We have created a multi-disciplinary approach to data governance staffed with individuals who traditionally provided reports,” he said. “These individuals are working to catalog definitions, sources and tools to support our analytics.”
Metz at the University of Connecticut Health Center said the central role of analytics in enabling better outcomes as well as process improvements makes shared responsibility among C-suite members a cornerstone of program success.
“The active participation of the entire executive team is essential for creating an organizational culture that is data-literate and values information as a strategic asset,” he said. “It is one thing to support business initiatives by performing data analyses and generating reports. It is quite another matter to realize maximum potential from analytics capabilities and keep pace with future trends by building a data-driven culture characterized by data and analytics competencies diffused throughout the enterprise.”
Achieving this outcome requires the C-suite to weave data and analytics into the entire scope of their organization’s activities, ensuring that data is readily accessible and there is transparency into how decisions are made and priorities established, he added.
“Viewing information as a strategic asset also means that the idea of ‘ownership’ is replaced by the concept of ‘stewardship,’” he explained. “The notion of ownership suggests that a particular location or organizational unit controls certain data and its attributes. A level of control implies a restriction of access and representation of the data as the source of truth.”
This approach can limit the ability to share data and runs counter to the type of open architecture inherent in successful analytics programs, he stated. The stewardship model, on the other hand, upholds that individuals in different areas of the business are responsible for ensuring that adequate data quality is maintained and the data is freely shared, he explained.
“Every part of the business has a stake in appointing stewards so all C-suite members are involved,” he said. “The outcome is an organization that is in a much better position to capitalize on data-driven opportunities that come from a collaboration of multiple perspectives and that cross organizational boundaries. Interestingly, these opportunities typically provide the most value.”
Analytics roles for other top execs
With shared ownership and stewardship in mind, then from the CIO’s perspective, what does the rest of the C-suite – everyone, not just the CFO – need to know about the hospital analytics program, about responsibility for analytics?
“Launching a successful analytics program starts with an understanding that the undertaking is much more than a technology initiative, requiring the commitment and participation of all members of the C-suite,” said Metz of the University of Connecticut Health Center. “With healthcare becoming increasingly digital, C-suite members would also benefit by recognizing that data and analytics today go beyond reporting and basic analytical purposes.”
The capabilities are best viewed as an enterprise layer that enables a digital business to develop new business models and operate in smarter ways, he added.
“While the CIO can provide the technologies for an analytics program such as systems, services and platforms that deal with data and information, the C-suite needs to provide leadership in addressing the myriad of non-technical factors that ultimately determine success,” he stated.
Primary factors, he said, include creating a comprehensive data and analytics vision and strategy that recognizes information as a key asset; developing an information governance framework based on stewardship rather than ownership; identifying desired outcomes, benefits, use-cases and analytics investments that yield the greatest value; building a data-driven culture and managing organizational change throughout the process; allowing for innovation to capitalize on emerging trends such as advanced analytics and artificial intelligence; and ensuring that members across the organization have the necessary skills, competencies and data literacy.
“Staying focused on all the factors and collaborating at each step will help ensure that an organization’s analytics journey is a successful one,” he concluded.
Paravate at Northeast Georgia Health System said most of the work around analytics is not very exciting, it’s just a lot of hard work over time to build the capability.
“Equally as challenging is fostering adoption of the tools and moving away from the temptation to say just give me a report,” he said. “There are tradeoffs when moving from reporting to analytics and making the transition can seem impossible.”
He shares with his peers a simple approach that seems to work: As one is managing their day, write down what information one wishes they had.
“For example, if you’re meeting with one of your managers, what would help you be better prepared?” he asked. “What questions do you have about their area of responsibility? Commonly, I say just write it on a post-it note and keep them somewhere. After about two weeks, I have one of my staff come and collect the post-it notes. Within a few days we can customize some tools to provide the dashboard.”
This simple approach opens the door toward a transition to better operational performance, and decision making, he concluded.
Focus on The Business of Healthcare
In December, we take a deep dive into what top business decision makers need to know about digital transformation.