iHT² Health IT Summit Atlanta - Case Study “Analytics Strategies to Improve Quality & Outcomes”

Developing an Analytics Strategy Framework that

Improves Quality and Outcomes

Developing an Analytics Strategy Framework that

Improves Quality and Outcomes

Trevor Strome, MSc, PMP

Analytics Lead, Winnipeg Regional Health Authority – Emergency Program

Assistant Professor, Dept. of Emergency Medicine, University of Manitoba

Blog: http://HealthcareAnalytics.info

Twitter: @tstrome

Developing an Analytics Strategy Framework that Improves Quality and Outcomes

“Every system is perfectly designed to get the results it gets.”

- Dr. Paul Batalden


Healthcare Analytics and the Information Value Chain

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Performance Objectives

Performance Objectives

Quality GoalsQuality Goals

Improvement Approach

Improvement Approach

DataData

Business Processes

Business Processes

AnalyticsAnalytics

What DID Happen

What DID Happen

What IS Happening

What IS Happening

What Will Happen

What Will Happen

Decisions & Actions

Decisions & Actions Outcomes

OutcomesEvaluation

Evaluation

Healthcare analytics is the system of tools, techniques, and people required to consistently and reliably generate accurate, validated, and trustworthy business and clinical insight.


Signs an Analytics Strategy is Required

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“We have all these dashboards, but why aren’t we seeing any improvement?”

“Why can’t I get the data that we need for our quality improvement project?”

“Those quality improvement experts ask for all this data and reporting but never seem to know what they need?”

Analytics Strategy Framework

Developing an Analytics Strategy Framework that Improves Quality and Outcomes 6

Analytics Strategy Overview

• A strategy that ensures analytics development and capabilities are in alignment with enterprise quality and performance goals– avoids the “all dashboard, no improvement” syndrome

• Helps to achieve optimal use of analytics– can mean the difference between a “collection of reports” versus

a high-value information resource

• Analytics Strategy helps align other relevant organizational strategies


Analytics Strategy Framework

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Business & Quality Context


Business Context: Enterprise Goals, Objectives, and Strategy

• Goals:– Are what the organization is aiming to achieve. – Define the performance and quality targets of the organization– Answer “why” the organization is (or should be) engaging in

certain improvement activities

• Strategy– Outlines how the organization expects to achieve its goals

• Analytics must provide insight into past, current, and anticipated future progress towards meeting the enterprise goals.


Aligning Strategic and Tactical Quality Objectives

• Analytics is the “glue” which ties strategic objectives and tactical activities together.

• Objectives of unit- or department-based improvement initiatives should, where possible, align with the quality objectives of the organization as a whole.– Prevents misdirected/wasted activity– Enables the HCO to monitor progress and evaluate outcomes

A reminder that the customer (“the patient”) is the ultimate reason for the work we’re doing.

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Voice of the customer


Quality Strategy / Improvement Approach

• Quality Strategy outlines the steps and approach the organization is going to be taking to achieve quality goals/objectives.

• Which QI approaches are utilized (i.e., Lean, Six Sigma) will impact what data is required, how it is analyzed, and how it is communicated.

• Analytics development teams and quality improvement teams must work closely together – to ensure that information requirements of users and the delivery

via analytics are in sync.

Stakeholders & Users


Stakeholder Analysis

• A stakeholder is a person (or group of persons) that are:– impacted by, users of, or otherwise have a concern (or interest

in) the development and deployment of analytical solutions throughout the healthcare organization.

• When developing an analytics strategy, it is important to understand what each of the likely analytics stakeholders will require, and develop approaches to ensure they are getting what they need.

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Common HCO Stakeholder Types

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Analytics Use Cases

• A use case is a brief description of how analytics will be used by a stakeholder. Analytics use cases can help to:– identify any gaps in analytics capabilities, and – reduce the likelihood that critical analytics needs will be missed.

• Analytics use cases help identify:– what data elements are most important and what indicators will

be necessary to calculate, and – what types of usability and presentation factors (such as

dashboards, alerts, and mobile access) need to be considered.

• TIP: Develop high-level use cases when outlining the analytics strategy, and drill down in more detail as new analytical applications are designed and built.

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Example Analytics Use Cases

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Processes & Data


Data considerations

• Data is the “raw material” of analytics.

• Modern computerized clinical systems (such as electronic medical records) contain dozens if not hundreds of individual data elements. – The potential exists for thousands of possible data items from

which to choose for analytics.

• An analytics strategy must consider:– how to determine which data is necessary for quality and

performance improvement– how the data is managed and its quality assured– how data links back to business processes for necessary

context.

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Data Considerations for Analytics Strategy

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Business Processes

• Business processes provide essential context to the data.

• Most quality improvement methodologies monitor progress and evaluate performance and outcomes using indicators based on process data. – This requires a strong alignment between key business

processes and the data that measures those processes.

• As part of the analytics strategy, you should consider:– if and how current business processes are documented, and – how data items are mapped to these documented business

processes.

• TIP: stacks of Visio charts becomes unmanageable very quickly!

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• Using appropriate indicators that align between tactical and strategic levels are necessary. – Tactical-level sub-indicators should align with strategic indicators– Some tactical-level-specific indicators might be necessary for

initiatives that are important at a program, department, or unit level, but don’t directly align with strategic goals.

Strategic Level

Tactical Level

Using Appropriate Indicators

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Example Strategic and Tactical Indicator Alignment

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Strategic Level

Tactical Level

Analytics Tools and Techniques


Analyzing The “Right Things” the “Right Way”

Past Present Future

Information

Insight

Notes:

Adapted from: Davenport TH, Harris JG, & Morison R. Analytics at Work. Boston: Harvard Business School Publishing Corporation, 2010.

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Common Analytical Applications

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Inventory of Existing Analytical Tools

• Analytical tools must meet the requirements of analysts building analytics solutions/applications, and the end-users who will rely on the resultant information and insight.

• Conduct an inventory of existing analytics tools to determine if:

– Capability is missing that will be required– Existing capability exists that may not be widely known

• Identify viable best-of-breed vendor solutions that meet requirements; custom-build from scratch if necessary or if participating in research.

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Team and Training


Team Development Considerations

• PEOPLE are a critical consideration when developing or expanding an analytics capability within a healthcare organization

• Although having the best tools are nice, having the best (and right) people is critical to achieving the goals and objectives of the HCO

• An analytics strategy must consider:– What kinds of people (and the skills they bring) are necessary– The optimal size and composition of the team– Roles and degree of specialization– What gaps in skills exist, and what training is required– How to attract the best analytical talent– How to retain the analytic talent within your HCO– Optimal organizational structure

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Organizational Considerations

• Different resource management models exist for analytics teams:– “centralized” analytics office– “distributed” analytics resources– “virtual” center of excellence / competency center (combines

best aspects of centralized and distributed models)

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Virtual Business Intelligence / Analytics Competency CentreVirtual Business Intelligence / Analytics Competency Centre

Technology and Infrastructure


Technology & Infrastructure

• Analytics and reporting are the tip of the iceberg in the business intelligence stack.

• The current, near-term, and long-term analytics needs of the HCO must drive how analytics-related technological capabilities are acquired. The exact complement of tools will depend on the overall needs of the HCO.

• The analytics strategy is an important input to IT hardware and infrastructure strategies and planning as hardware and other system upgrades are considered.

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Healthcare BI and Analytics Technology and Infrastructure

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Source:

Evelson, B. It's Time to Reinvent your BI Strategy. Forrester Research, Inc.

Reporting and analytics are the “tip of the iceberg” regarding the business intelligence technology stack.


Focus on Business

• An abstracted BI stack helps maintain focus on key components of analytics required to address business goals.

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Executing Strategy


Strategy Execution Summary

• It is important to implement and adhere to the analytics strategy

• Plan for and schedule activities to address identified gaps

– Establish a selection criteria to determine what projects will get emphasis in light of needs of the business and analytics strategy

– Prioritize activities and desired capabilities to balance resources as new (possibly conflicting) work arises

• Monitor progress towards achieving goals of the analytics strategy

• Ensure that the strategy is a living document that serves as a roadmap for guiding action and doesn’t become “shelfware”


Successes

• Increased coordination between management, QI teams, and analytics/BI developers.– Increased accessibility of analytics insight to QI practitioners– Rapid (in some cases real-time) monitoring and evaluation of

improvement initiatives– Senior management gaining more clarity into program /

department performance

• Have seen a focusing of QI efforts, by integrated multidisciplinary teams, that have achieved significant and sustainable outcomes

• Created a strategic information resource– Development efforts more focused / integrated– Dramatically increased use of “self-serve” of data

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Contact Information for Trevor Strome

– Email: [email protected] or

[email protected]

– Phone: 204-632-3395

– Twitter: @tstrome

– Blog: http://HealthcareAnalytics.info

– Book: Healthcare Analytics for Quality and Performance Improvement

http://HealthcareAnalyticsBook.com

(Published by John Wiley & Sons, Inc, and available on Amazon.com)