Five Tips to launching Hospital Analytics

Hospitals everywhere are driving to a new era of Data. Some are jumping in head first to the bleeding edge technologies that promise to deliver value and others are waiting until it’s been proven before even putting their toe in the water. There is not a magic formula to healthcare data and analytics yet, but there are emerging best practices that should lead us all to more effective uses of data in our hospital environments.

Saint Luke’s is a 10 campus 1303 bed Health System in the Kansas City area. They are near and dear to my heart since I have delivered at their beautiful East campus. They are well known in the area for being high touch and high quality. I have had the pleasure of working with several of their leaders on projects and knowing others in the community.

Debe Gash has been the CIO of the health system since 2006 and has lead the organization to be well respected and win awards such as Most Wired, and recently lead them through the selection process of a new EMR. Debe has been on an Analytics journey for the past 18 months as the health system identifies and defines analytics goals and usage for their facilities.

“Health reform has driven an emphasis to analytics. Health Systems must perform as efficiently as possible while delivering positive outcomes. The only way to do this effectively is by using analytics” said Gash

1)   Get an education

Gash started her journey by seeking out wisdom of those who have been down the road before her. Her memberships at CHIME and the Health Data Warehouse Association have been invaluable resources for her to gain wisdom from her peers.

“The Health Data Warehouse Association provides webinars to its membership where my peers are presenting…not vendors” said Gash.

In a good peer group you can get the good, the bad, and the ugly without any bias or spin based on the vendors needs to sell to survive. While vendors have provided insight into the process they should not define how or what you are doing.

2)   Create a Data Governance Strategy Board

The phrase “death by committee” is a fear for many CIO’s with a vision. Saint Luke’s determined not only that there needed to be a committee who was well informed, autonomous, and had authority but they also needed to create a new role (FTE) for the organization to manage it all.

“We put in place a Director of Data Governance who works with committees to define, prioritize, execute, and evaluate our Data Governanceneeds“ said Gash

The team is comprised of key stakeholders who were committed to identifying things that could be improved by applying data.

3)   Create a Data Governance Strategy

Data Governance covers a whole range of topics within the overlying umbrella that is analytics. It is the rules and goals for the organization which allows identification, prioritization, application, and evaluation of the information.

The Data GovernanceBoard is responsible to define and maintain the following pillars of data management:

· Collection
· Storage
· Distribution
· Display

“People struggle with what should I look at and what do I need to do with it and why is it important? Our Data Governance defines all of those things for our hospitals so we can align system wide goals with system wide information.”

While the health system does use committees for subject matter expertise the core responsibility for data governance falls on theBoard and Director and they are accountable for compliance with the set standards.

4)   Select vendors only AFTER you have defined a process, and require compliance with your data governance.

Data and Analytics are the buzz words on every vendor’s lips. Vendors believe to sell their product they must have a “dashboard” or information display. The challenge is with multiple dashboard, and proprietary methods it is challenging to drive end user usage compliance. Saint Luke’s determined that vendors will be evaluated by their ability to conform to hospitals defined governances for data collection.

“Big Data is how you manage the data not the “what” it’s the architecture behind it.”

A common faux-paux of health systems is allowing vendors or groups within the hospital to define their own path for data evaluation. The hospital must create a single source of truth for all data, then a consistent metric for real effectiveness.

5)   Drive Compliance & Usage by creating organization goals for outcomes and operational efficiencies

The only way to drive behavior change and consistent usage is to attach economics that mean something to the individual or team.

“Our health system’s ROI is not determined by how much data is collected, or how great your dashboard is – it’s defined with what you do with the information and how you are able to impact patient care by increasing efficiency and improving outcomes.”

Through engaged leadership Saint Luke’s is working to drive meaningful change in their organization to improve patient care. Debe’s leadership has created focused culture of accountability using real data to make informed decisions. We will keep tabs on Saint Luke’s progress throughout their EMR implementation and launch of its analytic dashboards.

 

Compiling and Comparing Data

I work at a lot of coffee shops.  It’s not that we don’t have an office but there is something about being in a space with music, coffee, and energy.    There are always people there meeting for business – to stop collaborate and listen.   I have done it dozens of times myself – reached out to people who have expertise in a specific area or have started a business and can give insight from a been there, done that perspective.   This blog is spattered with some of those stories.

My one regret is how I have managed all the information that I have gathered in the last few years.  I take really crazy notes mostly with doodles and pictures.  When people say a picture speaks a thousand words- they are right (plus it’s easier to remember a picture).  The team jokes I have an addiction to spiral notebooks, there are about 50 in my office full of “valuable” information.   While I have gotten better about giving the algorithms to Kristal to be properly documented for evaluation, testing, and roadmapping  – there is a lot of information that is not that square – not a number, not an equation, more anecdotal but still important.   Those feelings that are just as important as a data point. 

I once had a friend describe working for a startup and watching the CEO of that company change in the years of its build.  The story itself was not uncommon to many I have heard before, but for some reason his words describing his perception of the emotional state of the CEO were.  Perception of the event or process – feelings – are as important as hard data.

We are working on ways to capture those thoughts of caregivers and nurses so that the square data can be compared to squiggly line data – thoughts, impressions, and ideas.  Active comparison to perception vs the reality of a situation will help to create more accurate benchmarks….just because you can be staffed to have a 10 second response time….is it necessary?  That was a hard question for me – my gut says YES of course if we can and we should but reality is there is always a cost associated with the movement.  I almost hate to say it but in this dynamically changing industry…. Is that worth the cost….

The balance between delivering the hospital leadership perception of service excellence and delivering an “Always” can be two different things. 

The “Always” can be more accurately attained if you understand the reality of the perception of the patient – if you create an expectation and meet it.  The “Always” cannot be obtained when we set unreasonable expectations with our patients, or we fail to meet a basic level of expectation.

Best Coffee Shops in KC for Working....

Mildreds in The CrossRoads District
Roasterie in Brookside
Latte Land in Briar Cliff

Haven't found any I love out South so open to suggestions....

HIMSS12 ReCap

I liked how Colin Hung (@Colin_Hung) put it in his blog “white space dominates” at HIMSS12  - I was afraid maybe it was just me – was I working too much and not looking hard enough for the new and exciting.   So, I have waited an entire weekend before writing my final blog HIMSS12.  I went back and reread some of the blogs I posted after HIMSS11 including two of my favorites The Patient as a Consumer and The New Economy.   Ironically, not most heavily trafficked but a good glimpse into the way I see things.

I debated back and forth about what to post – I could blast a few people and companies for same-o-same-o booths, technology that is still behind the times, promising more than they can deliver, or when people said or did things that were “just business” but were frankly just wrong.    It seems like everyone was focused on refinement of existing ideas instead of pushing anything new.   The most disappointing comments I heard circled around “proprietary” databases and not sharing information.   I wish I would have had the gumption to say…… brrring brrring – that’s the 80’s calling and they want their proprietary database back.  Or quote my friend Epatient Dave "Give me my Darn Data" (this is a G rated blog so I changed the wording a bit)  I know that sounds a little childish as a response but after I got over being angry (which for me equated to tears) – I realized that companies that believe that it’s better to stifle innovation are going to get left behind at some point.  Proprietary databases are just pride lived out in our geekery.

The most exciting things were announcements from the government on ICD-10 and MU #2 – I read a great blog about this by @JohnSharp  http://healthworkscollective.com/node/29411

“Big Data” we are generating more data than ever before – the EMR is just part of it – the tip of the clinically documented iceberg.   I was enamored by @ReginaHoliday ’s profound statement that her husband posted 6 different times on his facebook conditions that could have indicated he had kidney cancer.    We document our lives to 400 of our closest friends….if the data were analyzed what would it tell us?   I have a fb friend who's husband is manic depressive and you can tell distinctly when he is not taking his medication by her status updates.  The scary thing – that’s just a second subset of self-reported data.   How about the 5 medical devices that are hooked to you when you are in the hospital – how about fitbit – how about (you fill in the blank) etc.  I could more than 20 areas where data resides that “could” tell us something about an individual health.   I live in the acute care space because that’s where my data resides today – but the lines are blurring which is a good thing.   To me – this is really the most consuming part of my career.  Do you devour information in a manner that let’s you apply it into other learning? 

Before my head explodes – I want to share with you my favorite comment at the HIMSS show.  I was able to meet a Kevin from North Shore LIJHC.  He comes from outside of healthcare into a fast changing world – which he likened a lot to the other industries he has been in where technology and data changed the way we do things.  As we started talking about big data – medical device data – EMR reference data - my hands were waving as I got more and more excited…… He replied with a fantastic east coast mixed with Irish accent – “Kourtney, you are trying to win the Super Bowl when today all we need is a first down.” 

Folks, don’t let big data scare you.  We each have a subset of information that we are good at – that we know and understand better than anyone else.   Today – by the next HIMSS – we need a first down.  We need to gain 10 yards.   Sustainability will be driven by our ability to work with others.