Senior executives, quality leaders, clinician leaders, and IT leaders at ThedaCare in Appleton, Wis., have been busy visioning the future, both internally, and collaboratively with leaders of other patient care organizations nationwide. Not only have leaders at the five-hospital integrated health system been at the forefront in adopting the principles of Lean management in the healthcare delivery setting; they’ve been working to share their learnings with leaders of other organizations through the work of the ThedaCare Center for Healthcare Value, whose CEO, John Toussaint, M.D., was until recently CEO of the ThedaCare health system, but who is now devoting his efforts at implementing Lean concepts in healthcare, fulltime, through the Center, which was created in 2008.

Toussaint and his colleagues from the ThedaCare Center for Healthcare Value were among the core leaders involved in presenting the Lean Healthcare Transformation Summit that was held June 4-6 at the Hilton Lake Buena Vista in Lake Buena Vista (Orlando), Fla.

Indeed, the leaders at the ThedaCare Center for Healthcare Value are so committed to spreading its message of continuous process improvement across healthcare that they are leading a relatively new initiative, established in March of this year, called the Clinical Business Intelligence Network (CBIN), whose mission is to “unite healthcare leaders who are responsible for the content, flow and access of information to support and accelerate their organization’s journey to become a high-value delivery system.”

To date, nine U.S. patient care organizations and two Canadian organizations have become members of the CBIN. They are:

o ThedaCare, Appleton, Wis.
o St. Mary’s General Hospital, Kitchener, Ont.
o North Bay Regional Health Centre, North Bay, Ont.
o Lucile Packard Children’s Hospital, Palo Alto, Calif.
o Bellin Health, Green Bay, Wis.
o Salem Health, Salem, Ore.
o Oregon Health and Science University, Portland, Ore.
o City of Hope, Duarte, Calif.
o Southern Illinois Health, Carbondale, Ill.
o Bon Secours Health Systems, Richmond Va.
o Martin Health, Stuart, Fla.

During the Lean Healthcare Transformation Summit, HCI Editor-in-Chief Mark Hagland sat down with Julie Bartels, executive vice president of national health information at the ThedaCare Center for Healthcare Value, to talk about the CBIN initiative and the goals of the leaders of the ThedaCare Center with regard to healthcare continuous performance improvement. Below are excerpts from that interview.

Tell me a bit about the core mission of the ThedaCare Center for Healthcare Value.

Our focus initially was on care redesign, to remove waste and focus on quality patient outcomes. We soon discovered that if we didn’t have a constant information flow, relevant to the decision-making process you’re trying to affect, interest wanes quickly. So my goal at the Center is to lead the transparency work. Karen Timberlake leads the payment reform work. And Mike Steckline is the director of the delivery system redesign work. The Center fosters peer-to-peer learning. And we’ve just kicked off the Clinical Business Intelligence Network in March.

You have a broadly based collaborative both from across the U.S. and from Canada, correct?

Yes, we have 11 pioneer organizations from all over the country and in Canada, a group of organizations committed to peer-to-peer learning events to accelerate the learnings around clinical business intelligence functions and processes, and to adapt them to support the work of their own organizations.

So in March, there was a meeting of the pioneer members, and we spent some serious time trying to understand the current state. The members did a self-assessment using two different models. One was the Gartner Analytics Ascendancy Model; the other self-assessment tool they used was the Dresdner Cultural Maturity Model. The Gartner model helped people to understand where they were in terms of the types of analytics they were using; the Dresdner model measures aspects of decision-making processes, accountability, skill sets to work with analytics, that type of information.

So people came together, shared their self-evaluations, and talked about the obstacles they faced on this journey. So today, the work is focused in three areas: one is to create a white paper to capture the collective knowledge of the group on how to capture executive engagement for this work; the second is to build a guide to support clinical business strategy development and road-mapping; the third element is to create a learning library of videos and documents to support this work.

When do you expect all those things to happen?

They already have a first draft for the white paper and the library. We don’t have a roadmap yet. We meet four times a year as a network, twice in person and twice by conference call.

What kinds of “aha moments” have there been so far in group discussions and interactions?

There have been lots of “ahas” already about clinical business intelligence. One is that there is no clinical business intelligence standard for the way that resources are organized or work is prioritized, or the importance of information flow within an enterprise. As a result, everything that every one of these organizations is doing is leading-edge; there’s no model to follow, and we have no idea what best practices look like in clinical business intelligence.

How big will you get as a collaborative?

Just as big as there’s interest. What we’ve found is that we’ve had far more interest than was anticipated. We’ve had people knocking down our doors with interest.

What would your advice be for CIOs and CMIOs reading this, who might want to pursue clinical business intelligence development and performance improvement work?

My number-one observation is that healthcare treats its data as though it’s a burden rather than an asset. People have to collect it and use it, but don’t know what to do with it. So as a CIO, you should first realize that data is an assert for which you are responsible. And how does a healthcare organization treat an asset? It treats it as a resource, and builds a strategic plan around it. And by leading that process, you will demonstrate your value to the organization. There is no value to IT unless it’s used strategically in an organization. So this concept of asset management or leveraging, I think, is the key to the potential impact of clinical business intelligence.

In my opinion, the success of the IT department as a whole but especially in the clinical business intelligence work, should be around how fast and well people are able to do their work. There’s no purpose to finance, either, except to support the work of the organization. Everything really should be focused on removing waste and improving overall quality and efficiency. As a CIO—and my background is in IT—I was in charge of applications development—the only way, I think, to show your worth, is to go out and understand what your customers are trying to do, and then to go out and get that done.