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CASE STUDY - Employing Business Intelligence to Achieve Operational Excellence at Poudre Valley Health System

Poudre Valley Health System (PVHS) provides a regional network of comprehensive, evidence-based care and wellness services throughout a 50,000 square-mile area spanning northern Colorado, southern Wyoming, and western Nebraska. The locally owned, not-for-profit institution has a single mission: to offer world-class healthcare.

Commentary by DaRon Zimmerman, Director of Decision Support, Poudre Valley Health System

Poudre Valley Health System (PVHS) provides a regional network of comprehensive, evidence-based care and wellness services throughout a 50,000 square-mile area spanning northern Colorado, southern Wyoming, and western Nebraska. The locally owned, not-for-profit institution, which employs more than 5,000 staff members and has over 500 physicians in approximately 40 specialties and disciplines on staff, has a single mission: to offer world-class healthcare.

PVHS is taking an aggressive and proactive approach to Medicare’s pay-for-performance program by raising awareness of improvements in clinical management and patient safety. The organization’s clinical quality efforts are centered primarily around medical chart audits, patient safety predictions, statistical analysis projects, and reports on clinical documentation compliance.

As the Medicare system moves toward reimbursing hospitals based on the quality of care delivered, rather than just the number of procedures they perform, PVHS wanted to find innovative ways to improve efficiency and promote best practices across the organization while maximizing reimbursements from payers to offset the impact of rising healthcare costs.

The WebFOCUS business intelligence (BI) platform from Information Builders was deployed to help PVHS make sense of the large amounts of data on patient safety and service quality that reside in the various clinical, financial, and human resources applications it maintains. The majority of staff members throughout the institution now have immediate access to important information that helps them track trends and evaluate performance at the facility, department, or employee level.

With WebFOCUS, PVHS has readily achieved its goals of improved care quality, enhanced operational productivity, and increased cost efficiency. In fact, the organization now ranks in the top 10 percent for inpatient mortality, heart attack care, patient and employee satisfaction, and physician loyalty, and its fees are consistently lower than those of its regional competitors.

Lower Payroll Costs

WebFOCUS makes timely and complete information available through a series of BI dashboards in conjunction with interactive drill-down reports and a balanced scorecard system. The business intelligence environment is tightly integrated with an application server that is used extensively by hospital administrators—not only to improve the quality of care, but also to reduce overhead expenses.

For example, approximately 200 managers and directors use the WebFOCUS FTE/ Payroll Dashboard to analyze premium pay scenarios such as overtime, double time, call backs, extra shifts, and on-call pay, all of which must be paid in addition to the staff’s regular salary costs. An HR dashboard helps managers compare budget amounts to actual expenditures to minimize the occurrence of these types of premium pay situations.

“The FTE/Payroll Dashboard saves the hospital money and helps us offset declining reimbursements,” said DaRon Zimmerman, director of decision support at Poudre Valley Health System. “In the six months that have transpired since implementing these, we have decreased our overtime hours by 16 percent, reduced contract labor, and decreased all premium pay hours by 25 percent, even though volume was over budget. The health system also saw improvements in IP hours/patient day productivity.”

More Accurate Clinical Reporting

Poudre Valley Health System is currently in the process of creating a number of clinical care dashboards aimed at closely examining clinical costs, patient safety efforts, and care documentation. Clinical information, derived from Meditech Hospital Information, is stored in a Microsoft SQL Server data warehouse.

“The insight we obtain from our clinical quality efforts guides corrective action within the organization and enables us to provide a higher level of care, such as a need for extra documentation or better training in certain areas,” Zimmerman explains. “WebFOCUS tracks compliance down to the facility, department, or user level to find recurring problems.”

In addition to the standard reports and dashboards, the organization sees tremendous value in using WebFOCUS Report Assist to audit medical charts, review electronic health records, verify documentation compliance, and study statistics on intervention, care volume, and other types of clinical activity. Documentation compliance is especially important because if information is missing, the insurance companies may deny a claim and refuse to pay the hospital. “Either we don’t get paid or we have to spend time and money to re-bill the insurance company,” said Zimmerman. “Doing it right the first time is more efficient for everyone.”

Creating a Safer Environment for Patients

Using business intelligence to examine electronic health records enables the hospital staff to quickly spot important trends and improve patient safety. Analysts use the WebFOCUS platform to carefully study five years of historical information contained in electronic health records. The ultimate goal of this research is to devise a safer environment for patients and minimize the costs associated with care delivery for the hospital. WebFOCUS empowers Poudre Valley Health System to learn and adapt, so it can achieve better care and ensure safer outcomes.

“Analyzing aggregate patient data helps the hospital spot trends easier, such as a higher-than-expected incidence of an unsafe situation,” said Mark Brown, a decision support specialist at PVHS. “The dashboard will display all of the data that’s required for each research initiative. Researchers can monitor the performance of the clinical care staff to determine whether they are following documentation standards. It gives the organization the tools they need to control quality.”

Hospital directors are taking a macro view, assessing critical metrics such as cost per unit of service, a ratio that compares patient volume, current expenses, and monthly budget projections. Several factors go into this calculation, including the number of services provided and the direct and indirect costs associated with salaries, laboratory tests, and equipment. “All this information has to be pulled together in a meaningful way,” said Zimmerman. “While the director might note a variance in the scorecard, he still needs to see where the variance occurred and what caused it.” WebFOCUS allows that director to drill down to the item level to quickly and effectively resolve the issue.

As more and more dashboards are completed and deployed, the number of WebFOCUS users across the organization continues to grow. “The staff is hungry for multi-click environments beyond static reports,” said Brown. “They want the flexibility of combining multiple sources of information from payroll, general ledger, and timecard management to give them multidrill task scenarios.”

These managers are able to drill into various types of data and then create consolidated reports for users in departments throughout the organization. PVHS also uses WebFOCUS ReportCaster to enable the dynamic sharing and distribution of important data to e-mail addresses. This further improves efficiency by freeing people from the need to log on to the system to locate and retrieve the required information.

Honoring Quality Initiatives

Poudre Valley Health System is one of only three organizations across the country to receive the prestigious 2008 Malcolm Baldrige National Quality Award, given by the National Institute of Standards and Technology to recognize firms in the manufacturing, small business, service, education, and healthcare sectors that demonstrate sustainable performance excellence. The award is the culmination of a 10-year journey during which the organization dedicated itself to improving every aspect of its healthcare business, including clinical quality, customer service, and staff, physician, and volunteer satisfaction. Throughout the process, PVHS has relied heavily on WebFOCUS business intelligence technology to measure and report on its progress.

“The award process involves analyzing a great deal of clinical and administrative information to benchmark progress against industry leaders, as well as to report on quality outcomes. Our goal was to be in the top 10 percentile for quality, patient satisfaction, employee satisfaction, and other areas of concern,” adds Zimmerman. “We will use business intelligence technology to assess our progress and measure areas of improvement within the organization.”

The award was presented to Poudre Valley Health System by Vice President Joe Biden on December 2, 2009. The organization was the only healthcare provider in the U.S. to be honored with this notable distinction. Biden acknowledged that PVHS leads the country for both patient loyalty and physician satisfaction for one primary reason: the organization is motivated to truly help people.

“One of the outcomes of the Malcolm Baldrige project has been an awareness of the need to strive for quality in everything we do,” concluded Zimmerman. “This motivation continues to drive us forward with our business intelligence initiatives.”

This article originally appeared in the issue of .

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