At North Memorial Health, “The CEO and CMO jointly said, “We need to do a better job of this… let’s invest in this clinical integration work... and reallocate existing resources… to facilitate this.” Dr. Berg went on to say, “Because there was that executive level support, the other clinical stakeholders… understood that this was a priority, and we were able to really get their buy-in.”
Barbara Baldwin, vice president and chief information officer at Anne Arundel Medical Center also emphasized this point, “The whole focus as we began to evolve with total cost of care, population health really just strengthened the importance of what analytics needed to do to help our organization progress. And so I can say that this was really not a difficult concept to bring to the leadership in the organization from the CEO to the CMO to the CFO. They have been ready and embracing of the concept that we take the analytics and continue to evolve it as a product of the organization and not just a by-product of IT. … As a leadership team, they were like ‘Come on. We’re ready. Bring the concept forward.’”
“The executive buy-in has been key. I don’t think it would have worked without it,” according to Dr. Berg. Ms. Baldwin agreed, “Here’s the secret, I can say I’m keeping my executives informed, or they’re engaged. But if your executives are not hungry for this, it’s very difficult to lead them to water… The organization and the executive leadership have to be at that level if you’re really going to excel.”
Dashboard Development is a Team Sport
Each program’s leadership emphasized the importance of collaboration between the clinical and operational project sponsors and the analysts who build the dashboards and applications and the. At North Memorial Health, “One of these analyst is at the table even at the very beginning when we’re developing hypotheses, and then they are doing the build sort of in real-time along with that so that we can do hypothesis testing in the analytics platform.” Dr. Berg continued, “Otherwise, we develop these hypotheses that cannot be answered given the structural limitations of data. …we develop these great questions, but we haven’t framed them using the right language, and so they’ve been unanswerable and all of a sudden you’ve wasted dozens of physician hours.”
Analytics development is clearly an iterative process, and it is most efficiently done with frequent face-to-face meetings. Similar approaches were used at all of the other programs. At the UW Health Dr. Flood described the build-show-build cycle of dashboard development. Dr. Mathew emphasized the importance of getting all the stakeholders at the table, “It’s important to get the big picture. Make sure you get advice from multiple angles. That’s why it’s so important to have a team that is looking at it from multiple perspectives. …Having the ability to engage with the end users and making them feel a part of the solution I believe is absolutely key.”
While not specifically described as an agile methodology, the rapid cycles of building and validation used at North includes many of the elements of agile. Both Mercy and AAMC explicitly utilize agile methods in building their apps and dashboards. At AAMC, Mr. Lehr described the benefits, “The agile process is an important part of what we do. So many people get caught up in putting out fires and not thinking about what they really want to accomplish in an intermediate term and a long term view.” Ms. Baldwin added, “Or the flip of that: perfection is the enemy of good, and you’re so into analysis paralysis that you don’t deliver. Agile helps you past that.”
It is also important to keep the big picture in mind. As Mr. Lehr put it, “We wanted to make sure that we weren’t building 100 dashboards that each had one user. We’d rather build just one dashboard that has 101 users. That’s a better use of our time and a more efficient way to get your information out there.” Ms. Baldwin offered, “…that means taking a more expansive design for those dashboards and really saying, ‘OK, what else would be utilized in this particular line of questioning?’”
The medical intelligence and analytics program at Mercy is based in the Revenue department and has produced applications in the clinical, operational and financial domains but with a primary focus of transforming complexity of data into insight, process efficiency and workflow automation. One such popular application helps improve charge capture for nursing procedures such as IV infusions. It transformed a 30 to 90-minute complex charge capture process down to a few minutes. Training individuals to consume a complicated application would be a costly endeavor. The solution? “We’re moving more and more toward designing applications that are a lot more intuitive—it’s minimal to no training—and that’s been our focus. Make sure the app itself requires no hand-holding, because, if it does, then we’ve probably failed in our design somewhere,” said Dr. Mathew.
At AAMC, maintaining a consistent and engaging design for all of their dashboards has been a focus since the beginning of the program. Mr. Lehr: “We brought in a group called Draper & Dash …to train our developers on their UI/UX design philosophy, and then we took it from there.” By enforcing a consistent style guide in design, end users have a consistent experience across all of the dashboards.
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