How to Evaluate and Implement Business Analytics for Your Laboratory" Dennis Winsten Dennis Winsten & Associates, Inc Tucson, AZ www.dwinsten.com Hal Weiner Weiner Consulting Services, LLC Eugene, OR www.weinerconsulting.com
Notice of Faculty Disclosure In accordance with ACCME guidelines, any individual in a position to influence and/or control the content of this ASCP CME activity has disclosed all relevant financial relationships within the past 12 months with commercial interests that provide products and/or services related to the content of this CME activity. The individuals below have responded that he/she have no relevant financial relationship(s) with commercial interest(s) to disclose: Dennis Winsten, MS, FHIMSS, FCLMA Hal Weiner, BS, MBA
What is Business Analytics (BA)? Why is it important for the lab? Examples of use Considerations for evaluating BA How do you implement? Vendors in the market? Questions
Determine the potential value and benefits of business analytics for your laboratory. Assess and evaluate the characteristics and capabilities of various BA alternatives Describe the key differentiators in selecting the best fit business analytics system for your laboratory Review implementation considerations and strategies
Courtesy of Jim B-Reay, Aspen Advisors, 2014
o Business Analytics (BA) is a set of computer-based tools that provide organized, well structured and understandable views of laboratory operational and financial data. o BA refers to a variety of software applications used to analyze an organization's raw data. BA, as a discipline, is made up of several related activities, including data mining, online analytical processing, querying and reporting.. o BA is the set of techniques and tools for the transformation of raw data into meaningful and useful information for business analysis purposes. o The goal of BA is to allow for the easy interpretation of large volumes of data allowing for quicker and better management decisions.
Characteristics of BA Software that works with your LIS Extracts and organizes existing laboratory data and presents it in useful, actionable formats Provides snapshots of sorted and categorized data indicating comparisons and trends May provide alerts if limiting criteria met
BA systems may contain one or more of the following capabilities: Extraction and reformatting of laboratory data Multidimensional aggregation and allocation Normalization of disparate common data Realtime reporting with analytical alert Statistical inference and probabilistic simulation Key performance indicators monitoring Management dashboards
With reduced reimbursement, laboratories are under increasing pressure to optimize business practices, improve utilization and cut costs. BA can greatly assist management to better understand their laboratory operations and make well founded, prudent decisions to meet laboratory objectives. BA can assist in creating value propositions for patients and MD s. It can help strengthen relationships, improve quality and monitor service levels.
A 2014 Survey by Price Waterhouse Cooper of 1,344 Healthcare CEO s BA UTILIZATION PERCENT Recognize need to implement 12 Developing strategy to implement 22 Concrete plans to implement 32 Implementation underway or completed 36
The following are examples of types of dashboards and reports that have been provided by various BA companies. Note none of these examples represent real data
COURTESY OF HC1.COM
Alerts and Predictive Analytics on Physician Behavior COURTESY OF VIEWICS
COURTESY OF HC1.COM
COURTESY OF ALTOSOFT
Monitor trends in test utilization by physician to identify ordering issues Utilization Overview - Thyroid Thyroid Utilization Dashboard Count of T3, T4, & TSH - by Physician Detailed Physician Analysis Test Name Test Name / Physician Code Physician C.. FREE T4 INDEX T3 UPTAKE TSH FREE T4 INDEX T3 UPTAKE TSH 46049 1,283 1,800 2,175 Requisition.. P4076232 Order Date 2/7/2014 7:05:00 PM 01795 01795 01795 48182 248 1,311 1,743 P4076247 2/7/2014 7:10:00 PM 1 1 1 01795 772 772 1,057 P4076251 2/7/2014 7:11:00 PM 1 1 1 04957 429 431 81418 318 318 5,182 2,560 P4076284 P4076291 2/7/2014 7:21:00 PM 2/7/2014 7:22:00 PM 1 1 1 1 1 1 00494 142 193 682 P4125966 2/12/2014 6:04:00 PM 1 50303 81 188 46957 183 184 12474 167 172 1,395 2,585 3,983 P4145828 P4176567 P4186213 2/14/2014 6:26:00 PM 2/17/2014 7:55:00 PM 2/18/2014 8:05:00 PM 1 1 1 33620 132 168 259 P4196755 2/19/2014 8:44:00 PM 1 02778 129 162 2,208 P4207193 2/20/2014 10:00:00 PM 1 56335 158 160 785 02535 146 146 508 P4246466 P4256821 2/24/2014 6:53:00 PM 2/25/2014 8:23:00 PM 1 1 00000 83 138 1,235 P4276413 2/27/2014 8:38:00 PM 1 Physician Code 01795 Test Name FREE T4 INDEX T3 UPTAKE TSH Physician Code / Month, Year of Order Date 01795 100 28 31 30 29 28 33 35 40 32 34 34 42 31 Co 50 0 September 2014 December November 2013 2013 September 2013 December November 2012 2012 September 2012 December November 2011 2011 Septembe February January 2014 2014 October 2013 February January 2013 2013 October 2012 February January 2012 2012 October 2011 August 2014 March 2014 August 2013 March 2013 August 2012 March 2012 Augu June 2014 June 2013 May 2013 April 2013 June 2012 July 2014 May 2014 April 2014 July 2013 July 2012 May 2012 April 2012 23 23 28 28 31 21 21 29 13 13 20 13 13 17 31 32 14 14 19 30 33 31 31 21 21 27 19 19 20 15 15 17 19 19 22 17 17 18 34 35 25 25 29 20 20 18 21 21 28 32 32 34 39 42 45 23 23 25 33 37 40 43 29 31 28 33 35 35 23 23 25 20 20 25 21 21 33 11 11 22 27 21 27 33 31 29 10 COURTESY OF VIEWICS
A B B COURTESY OF TABLEAU
Deliver quality performance in a sustainable manner COURTESY OF VIEWICS
COURTESY OF HALFPENNY TECHNOLOGIES
Analyzing Performance and Use of Reference Partners COURTESY OF VIEWICS
01 Improved TAT from ED so that STAT s no longer need to be ordered, while reducing order entry errors by 22% 02 03 04 05 Counseled MD s who ordered inappropriate Cardiac Panels and Genetic Cancer Panels about best practice protocols, saving $120,000 per year Reduced supply order usage by 18% thru evaluating MD s who ordered supplies but not tests. Improved revenues and profitability by 9% through monitoring MD ordering patterns vs diagnosis and payor Improved customer service satisfaction by 61% by monitoring key indicators by client.
- Database-do you have to alter yours? - Is your DB used for accessing data or is a separate BA DB created? - What data sources can be tapped, e.g. databases (Oracle, SQL, Caché), Excel, Web pages, etc? - Where does the DB reside? Cloud? Servers at your lab? - How frequently is the BA DB updated? Realtime? Hourly? Daily? - What is the impact on performance with DB updates?
- How secure is your data? - What is the scope of BA? Financials. e.g. revenue by client? Operating data, e.g. TAT, utilization, quality, outreach services? - Clinical results? - What is the granularity of the BA data-sufficient detail? - How easy is it to create BA query templates? - How much staff time required to set up BA? To support changes to BA for lab staff, I.T. staff? Will you require a DBA? - Alerts based on rules (Limits, ranges, Boolean logic, etc.) with link to backup data triggering alert - How is the BA application priced? Subscription? License?
Traditional Projects Process-Centric Definable requirements Stable requirements Value often quantifiable BA Projects Data-centric Unknown requirements Evolving requirements Value often difficult to quantify Courtesy of Intelligent Solutions, Inc.
COURTESY OF JIM B-REAY, ASPEN ADVISORS, 2014
Five considerations for BA Projects: o The level of commitment and sponsorship of the project from laboratory management o The level of the laboratory s need for creating a BA implementation o The amount and quality of laboratory data available o Budget sufficiency to license/subscribe, install and support a BA system o Staff availability to implement and support BA operations and support provided by BA vendor
Establishing a need for an investment in BA: o Reporting needs to be done manually in Excel and it s time consuming takes weeks not seconds o Difficulty pulling and joining data from multiple data sources o Inability to access and utilize the data collected to see insights to help identify root causes of performance issues o Need for visualization of data in real-time
Phased Approach: BA systems are launched within your hospital, department by department, until the entire hospital has access. This may extend to client access as well. Immediate Implementation: Your hospital is in dire need of BA and wants to implement an effective business Analytics solution immediately. Executive Dashboards: The BA project is limited to those at the C-level to offer a real-time and big-picture look at how the hospital is performing. OEM, Embedding : BA is added to a current software choice such as an LIS within your hospital to expand functionality. Clients Only: Only end users are provided with BA tools to perform selfservice reporting and provide your laboratory the opportunity to illustrate KPIs and individual successes to clients
o Data sources-how many? What types? o Data size, complexity (structured or unstructured) and location (multiple sources) o The number of people running queries at the same time o The number of licenses needed o Ease of use of the software (for lab users or IT needed)
Top Level Leadership MUST HAVE Set commitment, direction, enforcement of standards and goals Leadership and approval IT Leadership Data Experts working together on data definitions, standards, and delivery. Emerging roles: Data Stewards, Chief Analytics Officer Knowledge and standards Working Team Partnership of analyst and lab management on single goal: o Workflow improvement, patient care enhancement, financial improvement
SUBSCRIPTION Minimal upfront cost Typically, SaaS resident in the Cloud Annual renewals option to discontinue if unsatisfactory Support and maintenance costs built into the annual subscription cost Minor and major upgrades are included in the subscription cost LICENSING Substantial Upfront cost Annual fees of 18% to 20% of the initial purchase price for support, releases and upgrades Software operates on your servers, under your control Potential for integration with other applications
Pricing for Business Analytics based on a number of factors: Number of Users Number of System Data Sources (LIS, AP, A/R, EMR, etc.) Scope of BA (Operational, Financial, Clinical) Implementation/Integration Complexity Annual Test Volume
Alterx Altosoft Hc1 Qlik Rhodes Group SiSense Tableau Viewics Visiun Others BA part of LIS or EWS
BA can be a significant benefit to laboratory management, and requires top level commitment BA can be obtained from BA specialist companies, from your LIS or EWS vendor Careful evaluation of the characteristics of any BA system before its selection is imperative