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Using Business Intelligence to Improve Healthcare Access

Healthcare providers don't need to reinvent the wheel when it comes to improving access. They can use examples from other industries that have successfully used business intelligence to become more efficient, shed bureaucracy and reduce costs.

Finding New Ways to Reach Your Patients
If you place a rubber ball on the floor and set an anvil on top of it, two things will happen. First, tremendous pressure and heat will build up in the core, changing its shape, size, density and even its composition. With enough weight, it could collapse entirely. The second thing that happens is that the edges will bulge out in every direction in order to relieve some of this pressure.

This is the state that healthcare providers find themselves in today. And there is not just one anvil on top of these organizations, but many. Quality and safety demands, cost and profitability pressures, regulatory and standards requirements, and staffing and workload pressures are just a few of the weights that providers must deal with. But of course, there is always the upward pressure of the floor to provide effective, proactive, gentle and convenient care to patients.

The core is in danger. Hospitals, family practice, emergency rooms and even surgery are all at risk of imminent collapse in the U.S. Their shape, size, density and composition are sure to change dramatically. For these types of providers, efficiency and standardization of services will become the watchwords critical to success. Business intelligence can help.

The edges are bulging in a number of directions as providers are finding new ways to reach patients, provide services and make money. Some examples of emerging healthcare operating models include retail clinics, luxury services and accommodations, employer-provider partnerships, and the increasing amount of remote care and health information being delivered to patients. Business intelligence can help at the edges as well.

Using Business Intelligence at Healthcare’s Core
The core of the healthcare provider industry segment includes those organizations that were essential to successfully building the immense healthcare infrastructure that we Americans now enjoy, and sadly now take for granted. What’s even worse is that these are now under attack from all sides – political attack, economic attack, consumerism attack, regulatory attack. Traditional provider organizations such as family practice clinics, emergency rooms and large central hospitals are under pressure to become more efficient, to shed bureaucracy and to strip cost out of their operations.

This is not a new situation. Traditional manufacturers, distributors, retailers, financial institutions and communications businesses have all lived through this. It is just healthcare’s turn. Business intelligence has been tremendously helpful in those other industries over the past few decades, so it just makes sense to use this same tool to help transform core healthcare providers and release some of this pressure. Business intelligence applications that address these issues include:

  • Throughput and Efficiency Measurement. Process improvement methodologies such as Lean, Six Sigma, Total Quality Management (TQM), Just-in-Time (JIT) and the Theory of Constraints (Goldratt) all rely on a constant, consistent supply of operational data in order to find improvement opportunities and to evaluate the payoff from making improvements. The healthcare provider industry is beginning to use these methodologies in order to combat the pressures of cost control and efficiency improvement. The data needed to measure the operations and to evaluate improvements often comes from a variety of systems. Business intelligence is critical to combine this data and provide this constant, consistent flow of information to make these efforts successful.
  • Activity-Based Management & Analysis. Healthcare organizations are quickly learning that their survival and success is dependent not just on the central medical activities involved in making patients well, but also in all of the other aspects of delivering care to patients. For instance, the central activity in surgery is medical, but a patient spends more time and consumes at least as much resources in the activities that surround this central activity. It is essential for healthcare organizations to understand the cost of this time and these resources in order to get a comprehensive view of their cost and profitability picture. Business intelligence has long been a key source of data for manufacturers, insurance companies, supply chain organizations and others with their initiatives to get a total cost and profitability picture. Healthcare provider organizations are much more complex than other types of industries, so it is critical that they use business intelligence to understand their activities and how they contribute to total cost.
  • Customer (i.e., Patient) Segmentation. Every patient is different, and their needs and situations are unlike any other patient’s needs and situation. For healthcare organizations, however, grouping patients and understanding the trends and patterns across these groups is essential to developing care programs and delivering care effectively, efficiently and in a timely manner. Business intelligence applications such as patient registries can be used to slice, dice, sort and sum patient groups in different ways in order to provide this care.
  • Staffing and Labor Management. Once you understand your patient groups, your demand volumes and flow patterns, and your activities in response to this demand, then you can begin to apply staff to address problems and take advantage of opportunities in you organization. Business intelligence is the key to combining the data from numerous sources and standardizing measures of demand and cost in order to make intelligent resource application decisions.

The point is that business intelligence has worked for other industries at their core, so don’t reinvent the wheel for healthcare.

Using Business Intelligence at Healthcare’s Edges
As mentioned, the number of directions in which the healthcare provider segment is bulging is potentially infinite. Great creativity is being applied to find new business models in which healthcare providers can operate successfully, and profitably. For purposes of this discussion, I have chosen four emerging business directions that are making the news in the healthcare industry. These four are based on certain aspects of consumer (patient) behavior that are taking precedence over other factors that were more important in the past. These are:

  • Convenience and the Retail Clinic. Many bemoan the growth of the chain-store clinic, but it is a trend that has evolved into an economic steamroller. It is coming, and providers need to decide whether to be in the driver’s seat, off to the side or a pancake on the road. There are currently about 150 of these types of locations across the U.S., but it looks like the retail giants will get into the act and blow this number up into the thousands. Other professional organizations have been operating in retail settings for decades. I worked for a regional retailer who has had retail pharmacies since 1962 and retail optical stores since the late 1970s. Banks are another example of professional organizations that have benefited from making the retail jump. All of these types of business need to gain the trust of customers in terms of providing privacy, comfort and a personal touch. Retail clinics need to look to these types of businesses for ideas on how to provide good service and make money in a retail setting, instead of reinventing the wheel. Business intelligence is key to making this jump successful, since the data will have a new slant on it to account for this added convenience factor.
  • Personal Attention and the Luxury Hospital. Luxury services and accommodations are growing at a tremendous pace for those willing to pay for them. Get this: A person will complain about receiving a physical exam at a traditional clinic that costs him or her $25 in out-of-pocket expenses, but will gladly pay up to $1,000 for an all-day, personalized physical exam and pampering service that provides essentially the same result. Luxury is growing in hospitals as well in the form of improved service, food, attention and a soothing environment to make a hospital less of a conveyor belt for healthcare services and more of a destination for patients. The hospitality industry (hotels, restaurants, resorts, etc.) can provide models for how these services can be effectively and profitably marketed and delivered. This industry has made great use of business intelligence to understand their guests, their operations and their results. These types of organizations should be consulted for success stories about using information effectively before ramping up your efforts to transform your hospital, clinic or other healthcare facility into a luxury destination.
  • Cost Control and the Employer-Payer-Provider Partnership. As more of the cost of healthcare shifts to consumers through higher deductibles and reduced coverage, employees and employers are forced to take matters into their own hands. Employers, health plans and healthcare providers are partnering to provide services and information to increase a patient’s compliance with health guidelines and subsequently reduce long-term costs. My neighbor, for instance, receives a grade (just like in school) for her health condition, and her health plan premiums are based directly on this grade. To improve her grade and reduce her premiums, she quit smoking, improved her diet and activity levels, and is learning ways to manage the stress of being a working, single mom. This is the direct result of a new three-way partnership between her employer, her health plan and her provider organization. The complexity of such an arrangement is probably unique to the healthcare industry, but the basic model of partnership, mutual trust and information sharing is common to a number of industries. For instance, I worked with a consumer goods organization that sold apparel through discount retail stores. By working together to identify purchasing patterns across its men’s, women’s and children’s lines, we were able to double their sales volume over a span of three years. Data sharing was essential to success and at first caused suspicion on both sides. But once that issue was solved, it became a rich relationship where everybody, especially the customer, benefited.
  • Knowledge Richness and the Healthcare Web Site. Healthcare consumers are becoming ravenous consumers of information about medicine, healthcare and healthcare trends. I read recently that there are more than 23,000 medical information Web sites to choose from, and more being added every day. The healthcare organizations that are successful in the future will know not only how to be effective in delivery of healthcare services, but also in the aggregation, analysis, editing and dissemination of information. These are all functions of effective business intelligence. Editorial and educational content has always been a tremendous marketing and sales tool for any type of industry. Healthcare organizations are in a prime position to differentiate themselves using such content to help their patients and patients’ families make wise choices regarding their health.

This article originally appeared on the BeyeNETWORK

Next Steps
Healthcare provider organizations of all types are under tremendous pressure to be better, faster and stronger. We need to look at the ways to strengthen the core as well as succeed at the edges. Either way, business intelligence can help. We have all heard that the healthcare industry is behind in terms of technology. This is for the most part true. If so, then we need to look at the appropriate segments of other similar industries for business models and data-utilization models in order to catch up. The time is now, and the success of your organization is at stake.

Thanks for reading. I look forward to your comments.

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