As patient care organizations nationwide prepare to report on meaningful use quality measures, those with enterprise data warehouses may find they have a head start. The more advanced among them are establishing workgroups to create dashboards to analyze progress and identify gaps that need addressing.
The University of North Carolina (UNC) Healthcare System in Chapel Hill, N.C., has been working on its Carolina Data Warehouse for Health for almost four years. And Donald Spencer, M.D., UNC's associate director of medical informatics, now sees the project as a necessity for meaningful use quality measure reporting.
“In an institution as big as ours, there is not one comprehensive program you can turn to in order to get a clear picture of what is going on,” Spencer says. Like many health systems, UNC uses different software vendors for its core electronic health record (EHR), lab system, radiology information system, and emergency department IS. “Getting data from all these diverse systems for hospital quality improvement reporting would be very laborious without a single data repository,” he adds.
BUSINESS INTELLIGENCE GIVES PROVIDERS THE ABILITY TO USE DATA TO BETTER UNDERSTAND PATTERNS RELATED TO QUALITY AND PATIENT SAFETY AND IMPROVE OUTCOMES.-LORIN BIRD
“Now, in a smaller system, if the vendor has a clinical warehouse where EMR data can be copied and put in a searchable database, you could get most of this information,” he stresses. “But I like that ours is more than just clinical data; we also have administrative data and ICD-9 diagnosis codes.”
Spencer is not alone in seeing back-end data warehouses and front-end business intelligence (BI) reporting tools as crucial to meaningful use efforts. In a 2010 survey of health system executives undertaken by the Orem, Utah-based KLAS Research, 69 percent of respondents said BI solutions would play an important or critical role in meaningful use. One provider told KLAS, “Never before have we been so carefully scrutinized, and the BI system helps us provide the information and reports needed to be successful.”
KLAS research director Lorin Bird says launching a BI effort, while important for meaningful use reporting, is also about creating a vision of improved performance and technology-enabled healthcare. “BI gives providers the ability to use data to better understand patterns related to quality and patient safety and improve outcomes,” he says. It can also help them marry financial and clinical outcomes data. With BI tools, they can prove that better clinical outcomes lead to a reduction in cost, and that more attention to chronic care can lead to savings, he notes.
Bird says very few U.S. health systems have sophisticated enterprise data warehouses that pull data from both clinical and financial systems and offer end-user reporting tools. “I would say it is somewhere between 50 and 100,” he says. But he projects that number will double in the next two years. “Based on how many people are telling us they plan to bring together clinical and financial data, I think if there are 100 now, in two years there will be 200. If they have a BI solution looking at general financials, by then they will be looking at the other side of the house.”
BI Tools in the Community Hospital Setting
An enterprise data warehouse may be a daunting project, especially for community hospitals. Paul Alcala, vice president and CIO of NorthBay Healthcare, a two-hospital system with fewer than 200 beds based in Fairfield, Calif., says he has seen hospitals find out the hard way that data warehouse projects are more complicated, time-consuming, and expensive than originally anticipated. “User expectations exceed their ability to deliver and they go over budget,” he says, “and a lot of projects fail.”