Nobody has time for reports. That's why Kaleida Health, a
five-hospital system in Buffalo, N.Y., has rolled out 25 dashboards
to monitor five core areas of performance. The flu-monitoring
dashboard is the latest view added to the list. But with everyone
watching for possible Swine Flu outbreaks, the newest display has
called attention to Kaleida's wider business intelligence (BI)
initiative.
As the largest healthcare provider in Western New York, Kaleida has
plenty of data sources, ranging from an Eclipsis billing system to
Lawson accounts payable, payroll and materials management systems
and Cerner emergency room management and operating room scheduling
systems. An Oracle data warehouse is at the core of the information
management environment, but Oracle Discoverer wasn't hacking it as
the front-end reporting tool.
"Discoverer is very report-centric, and we've added so many data
sources over the years that nobody had time to run all the
reports," says Dan Gerena, director of BI and corporate analytics
at Kaleida. "We needed a more dashboard-centric strategy."
In late 2008, Kaleida upgraded to Oracle BI Enterprise Edition
(OBIEE) to support that strategy. In March 2009, Gerena's
four-person team embarked on a five-month project to build out a
metadata layer, calculations and Balanced Scorecards covering five
core areas: financial, HR, quality of care, growth and strategy,
and operational performance. A metadata and repository-building
project for an entire system of hospitals and clinics is no small
task. But once the job was done, dashboards could be prototyped and
rolled out in a little as a week.
In August 2009, Kaleida rolled out a total of 25 dashboards with
detailed data on the five core areas monitored. In the quality of
care area, for instance, dashboards offer drillable stats on
mortality, falls, pressure ulcers and patient satisfaction. The
financial dashboards have views including payroll, overtime, budget
vs. actual, revenue life cycle and accounts receivable.
For now, the dashboards are still under review by roughly 50 top
executives. In one example, feedback has led to tweaks in the
Emergency Department dashboard to include more time stamps and
details on turnaround time for acute cases. The review step is
important, says Gerena, because Kaleida wants to make sure the
displays have the right metrics before replicating them at a lower
level for some 500 middle managers, as planned by the second
quarter of 2010.
Though Kaleida's dashboards aren't yet fully deployed, they are
already delivering positive results. For instance, the 10
worst-performing facilities or departments in terms of variance
from budget or goals can be quickly revealed. Managers can take
quick action to initiate improvements. "It has changed the paradigm
to one-click, two-click analysis, whereas before we had to run the
report, wait for it to finish, export it to Excel and then try to
make sense of it," Gerena says.
The flu dashboard came about because the BI and analytics team was
being bombarded with requests for information and reporting on flu
cases, particularly from risk management and emergency room
managers. The decision was made to tie all these efforts together
for more consistent reporting throughout the system. The resulting
flu dashboard attempts to deliver a 360-degree, covering patients
as well as employees, starting with immunization and running
through to symptoms, absences, staff planning, and reporting to New
York State's Department of Health. The dashboard has been deployed
to 20 key ER and hospital executives thus far, and it has already
supported contingency planning.
"You don't want people with flu-like symptoms coughing in an
emergency room next to someone with a broken leg, so we took a look
at the data and determined the peak volumes in the Emergency
Department," Gerena explains. With this insight, Kaleida has
designated specific facilities for treatment of flu-like symptoms,
adjusting hours and staffing accordingly.
Hopefully, H1N1 will wane as a topical healthcare concern. But
Gerena says the lessons learned will prove useful for the next
crisis that comes along. "We now have a template where we can react
quickly, change the underlying criteria and push the required data
out," he says. "Whether it's SARS or whatever else might come
along, we're ready from a risk-management perspective for the next
outbreak."