JAMIA: Business intelligence leverages patient safety, financial efficacy

Targeted deployment of health analytics, or business intelligence applications, could improve patient outcomes, increase safety, enhance operational efficiency and reduce costs of healthcare, according to an article in the April edition of the Journal of the American Medical Informatics Association.

“Healthcare is increasingly dependent upon IT, but the accumulation of data has outpaced our capacity to use it to improve operating efficiency, clinical quality and financial effectiveness,” wrote Jeffrey M. Ferranti, MD, of the department of pediatrics at Duke University Medical Center in Durham, N.C., and colleagues. “Moreover, hospitals have lagged in adopting thoughtful analytic approaches that would allow operational leaders and providers to capitalize upon existing data stores.”

Business intelligence comprises an integrated array of IT tools that allow users to transform data into informed actions, utilizing a data warehouse as a central commonality among all business intelligence systems, and an interface between the human user and a central data repository, according to the authors.

Ferranti and colleagues examined the Duke University Health System (DUHS) and its use of Six Sigma performance improvement methodology to demonstrate how the integrated enterprise data strategy has been used to support patient safety, financial effectiveness and public health issues.

DUHS designed its voluntary safety reporting system and automated adverse drug event surveillance system to synergistically gather critical patient safety data, according to the authors, while the decision support repository and clinical data repository store and aggregate additional clinical information critical to DUHS quality improvement initiatives.

Using a web-based dashboard, Duke has previously reported on the proactive detection and subsequent amelioration of Clostridium difficile colitis rates at Durham Regional Hospital. Based on the authors' initial safety analysis, the proactive intervention prompted prevention of 157.8 potential cases of nosocomially acquired C difficile colitis per year. The authors calculated a prevented financial burden ranging from $3,669 to $7,234 in additional hospital costs per infected patient, for a “conservative” total savings of $578,968.

The authors also examined DUHS' division of neonatology intensive care nursery data warehouse, aiming to construct a model to identify parts of the revenue cycle that might prove amenable to targeted improvement efforts. This led to the identification and correction of process errors involving physician documentation, medical records and charge processing, which, according to Ferranti and colleagues, not only eliminated a projected $2.1 million deficit but led to a profit of $400,000 within four months.

“More importantly, these analyses resulted in the correction and resubmission of previously submitted accounts, subsequently returning over $12 million in additional revenues over the following fiscal year and establishing a precedent for future monitoring,” the authors stated.

Funding for HIT must be better allocated, noted Ferranti and colleagues, who said they believe traditional approaches to cost containment and quality improvements will not keep pace with the increasing demands being placed on healthcare systems.

“Active investment in health analytics, data integration and data sharing are crucial to creating efficiencies,” the authors wrote. “Business intelligence tools allow us to continuously monitor health system preference, separate signals from noise and scientifically evaluate the return on investment provided by quality improvements.”

Although Ferranti and colleagues noted that new approaches to data visualization and analysis are needed, they stated that their findings were limited in that relatively few U.S. studies have systematically examined health IT across the spectrum of healthcare providers--therefore, more research “is clearly needed to assess its merits in the clinical setting.”

“Careful deployment of health analytics tools can allow health systems, hospitals and clinical staff to maximize the value of clinical and administrative data, in many cases without extensive investment in additional health IT infrastructure,” Ferranti and colleagues concluded. “We believe that such active investment in health analytics will prove essential to realizing the full promise of investments in electronic clinical systems.”

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