HP's Top 10 Trends in BI (and HIT) for 2009: #4 No ROI, No BI | Marc D. Paradis | Healthcare Blogs Skip to content Skip to navigation

HP's Top 10 Trends in BI (and HIT) for 2009: #4 No ROI, No BI

July 8, 2009
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Sometimes vendors do get it (mostly) right. Hewlett-Packard put together a brief white paper in February of this year laying out their view of Business Intelligence (BI) for 2009 (and beyond). I think that they got it largely right. Their #4 trend is increased pressure on BI projects to deliver more value more quickly. Below is a summary of the trend, my thoughts on whether HP got it right and what the trend may mean for HIT.

HP predicts: BI and DWH projects will neither be approved nor funded without defined business objectives, quantified business value and analyses demonstrating rapid time-to-value (TTV). Further, contrary to all the buzz, HP states that Software-as-a-Service (SaaS) will not provide rapid TTV for BI due to data management, integration, security and control issues; instead managed, hosted and outsourced services will serve user’s needs while reducing risk.

The Verdict: Amen, brother! I have long been a proponent of explicit ROI and TTV analyses – a rarity in the BI world. Yea, verily! Perhaps my opinions are beginning to ossify in architectures of the past, but I just do not believe that SaaS is anywhere near production-ready for large, complex, high data volume, analytically demanding, tightly SLA driven, mission-critical applications like today’s DWHs. This is especially true as DWHs begin to reach deeper and deeper into the operational and transactional systems (or perhaps it is that the operational and transactional systems are expanding borg-like into the ivory tower world of DWH). And right on! Managed services, although I believe more around hardware, virtualization and analytics than HP’s prediction of data integration, reporting and data modeling, will be on the rise.

HIT Impact: In 2009, minimal. HIT budgets are already tight, enacting ROI and TTV discipline can only be a good thing, but it is hardly new. By the beginning of 2011 though, look for SaaS packages bundled with light-weight management consulting and cultural transformation services which will provide a complete, turn-key, and therefore rapid to deploy, ARRA compliant web solution. These solutions will be targeted at small- to mid-size practices and clinics first, and gradually work their way up-market.

Disclaimer: The opinions expressed herein are my own personal opinions and do not represent my employer's view in any way.



Interesting post.

Do you think that the "bundling of cultural transformation services" is because clients are unlikely to achieve ROI and TTV without them, or because it's too hard to sell them as a line item, or both?

Senior Editor Daphne Lawrence wrote an article on business intelligence earlier this year, which may be of interest.

It will be interesting to see what Deloitte has to say. Note: you must be a Scottsdale institute member to attend these webinars (at least I am pretty sure that is the case).


July 30, 1-2 p.m. CT
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Stimulus Package: What Impact Will it Have?

Dr. Bob Williams, and Tom Foley, Deloitte Consulting. The Health Information Technology for Economic and Clinical Health (HITECH) Act of February 2009 provides $36 Billion in incentive funding to accelerate the adoption and interoperability of electronic health records (EHR), as well as significant penalty provisions for non-achievement. The stimulus funding, combined with extremely low rates of current EHR usage in U.S. hospitals (about 10% per a recent study), will drive significant and unprecedented spending increases on electronic health record technology and related IT modernization over the next five years, with corollary demand for high-quality consulting assistance. Based on recent estimates of current healthcare IT annual capital spending, if the $36 billion is spent directly on technology, overall spending will increase by 52% over the next six years. It is likely that the actual spending necessary to qualify for the incentives will be a 3-5 times multiplier of the $36B. Deloitte presents their assessment of industry challenges related to the HITECH ACT within healthcare providers. For example, HITECH does not provide a mechanism for the significant direct capital and operating funds needed to implement an EHR - providers will have to examine operational priorities and explore financial options for funding. Also, the definition of "meaningful use" and exact timelines and eligibility, as well as other provisions of the act, are still being defined by the Federal Government.

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Now that it looks like incentives will be on an "adoption-year" schedule rather than a "calendar-year" schedule, I amend my previous comment.

If this recommendation becomes policy, much of the FUD that "clever vendors" would use to create and sell into the panic, will be greatly diminished. There is still a play for this type of bundling, but the burning bridge has largely been extinguished.

Thanks Anthony - I just read the article. BI is a tricky beast.

To do it right and complete is a big budget, big project. Very few organizations can afford to do it this way.

To do it successfully under time and/or budget constraints, the key is scope. Keep the scope focussed, utilize in house resources and skillsets first, and remember to forward- and reverse-engineer your design. Spectacular failures occure when you don't work from both ends towards the middle.

Thanks Joe,

since you give me the option, I choose both. Seriously though, I believe that after the ONC goes "run silent, run deep" in about a week, there will be a creeping unease that will snowball into a self-reinforcing hysteria within 6 months of their final statement in December of this year (unless the requirements come out on the incredibly lax end of expectations).

Clever vendors will bundle hardware, software, services and support (emotional, hand-holding support, that is) and sell into the panic. Because the margins can't be high on this for the large number of small and medium practices and clinics, this turnkey solution will have to be delivered remotely over the web where the incremental cost of each new customer and each new page served to a provider, supplier or patient is essentially zero.

Large practices, clinics and most full-fledged hospitals will probably look to an onsite solution provided by one or more of their HIT vendors.

One of the top 5 hot topics in BI right now is Data Quality (DQ). DQ is at the root of many BI/Enterprise Information Integration (EII) failures. Furthermore, DQ in terms of the state and content of source data is perhaps the greatest challenge to realizing the potential of "meaningful use" and a return-on-value for EHR implementations.

Both of your three step models are good. Personally, working with the data and the technologies while challenging and frustrating at times has been a largely rational process. Working with the end-users is almost always a completely irrational process - that is until you put yourself in their shoes. Then all of the irrationality appears to be on the data and technology side!

BI implementations are much like the consulting maxim - perception is reality. If the end-users don't perceive value in the BI implementation, then that implementation will be a failure. So, data and technology are necessary but not sufficient end-user perception is both necessar and sufficient!

At an earlier part of my career, I thought of healthcare provider-side BI as essentially a three-step dance.

1) Get the data.
2) Find actionable opportunities.
3) Take action.

Most interesting questions were locked up in the Get the data phase. Long before the ETL step, there was the problem that the data was illegible, in free text, on paper, that was somewhere else. And that was the good case. The bad case was that the data was in the providers head, at the time they made the decision and not recorded. Humans being humans and all, you cannot go back several months later, ask the provider for a brain dump, and expect any fidelity. Our shared vision of HIT, and specifically HIS and EMRs had a serious bottle neck at step one. And, by the way, step 3 is no picnic (which I'm interpreting to be part of your "cultural transformation services" point.)

At the time, a physician executive who was clearly senior to me said, "Joe, it's all about intentionality. What did the provider intend when they placed that order, documented that result, etc. That's what you really need to know."

It wasn't clear to me whether the white paper's "Trend 10: Complex Event Processing (CEP) comes of age" was about episode-of-care grouping, something more operational like the lifecycle of specific orders (such as antibiotics, a huge cost and outcomes driver), or something else. I was hopeful that it somehow recognized intentionality as part of the complex event (of CEP).

My three-step model was revised when an even more senior physician executive, who was a senior VP and board member, shared the following. It _IS_ a three-step model, but not yours. Here are the three steps to using BI:

1) Collect and review the data, with an eye toward actionable opportunities.

2) Once you think you've found an opportunity, go to where the data was collected and validate that the data means what you think it does. Too often, data is entered thoughtlessly, unevenly, or with a different semantic than you thought. ... and then, if the opportunity holds up ...

3) Talk to the person or people who the data reflects on, openly, and before you truly reach judgement. In Steven Covey language, seek first to understand, then to be understood.

I was wondering if you'd care to comment on either of those 3 step dances of BI, or offer your own?

Quoting from the most recent issue of the Scottsdale Institute Inside Edge (http://www.scottsdaleinstitute.org/Documents/IE/InsideEdge.2009-08.HITEC...):
"within physician organizations it's often doctors who are above a certain age who also feel it's not worth it. The only solution for some of these facilities may be if a vendor comes forward with a relatively simple solution or one based upon an open-source code."