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Achieving Strategic Objectives
Through BI
Andrew W. Proctor, MS
Business Intelligence
• The use of information that enables
organizations to best decide,
measure, manage, and optimize
performance to achieve efficiency
and financial benefit (Gartner)
• Focus on operational process
improvement and business use of
information
In 1989 Howard Dresner popularized "BI" as an umbrella term to describe a set
of concepts and methods to improve business decision-making by using fact-
based support systems.
Clinic Access
• Template Management
• Appointment Days Wait
• Appointment When Wanted
• Same Day Access
Digestive Disease Access
Initiative
6
8
10
12
14
16
18
Q4 '07 Q1 Q2 Q3 Q4 '08
Da
ys
Wa
it
55%
60%
65%
70%
75%
80%
Ap
pt
wh
en
wa
nte
d
Days wait Appt when wanted
Appointment When Wanted by Days Wait June 2010 through December 2012
Lowess Smoothed Regression
Spearman Correlation:
New Visits: -0.181, p < 0.001; Established Visits : -0.098, p < 0.001; New Institute Visits: -0.192, p < 0.001;
Executive Quarterly Review
• Align strategic objectives
• Common scorecard platform
• Transparency
• Best practice sharing
• Continuous Improvement
Physician Name
Main Campus
Doctor Communication
61
0
20
40
60
80
100
2008 2009 2010 2011 Jan - Feb'13
%ti
le
Peer (3) Peer (1)
Peer (2) Peer (4)
CC 50th
Main Campus
Overall Rating
93
0
20
40
60
80
100
2008 2009 2010 2011 Jan - Feb '13
%tile
Peer (3) Peer (1)
Peer (2) Peer (4)
CC 50th
Short Cycle
• Near “real-time”
• Quicker delivery to clinical
managers
• Summarized nursing unit
performance
Smoking Cessation
%
HF Education
%
SCIP: Hair Removal
%
SCIP: Normothermia
%
SCIP: Periop Beta-blocker
%
SCIP: VTE Prophylaxis Orders
%
Physician Name
30-Day Readmission Data Flow
30 minute updates 30 minute updates
Patient readmitted to Cleveland Clinic
ADT system captures readmission
Web application captures readmission
for review
Aggregate monthly reports
Short Cycle dashboard reports readmission in
“real-time”
ICU Operations
• ICU Ops Team created in 2006
• Expanded in 2009
- Oversight committee formed
- 30+ ICUs
- 350 beds
- 30,000 admissions/year
ICU Hand Hygiene
Compliance
60%
70%
80%
90%
2007 2008 2009 2010 2011 2012
Compliance Target
ICU CLABSI Rate
0
1
2
3
4
5
2008 2009 2010 2011 2012 2013
Rate
Blood Utilization
• Scarce resource
• High cost
• Clinical risk
Physician
Names
Example Physician
Cleveland Clinic Blood Use per 1K patient days
2008 2009 2010
150
200
250
300
350O
ct
De
c
Fe
b
Ap
r
Ju
n
Au
g
Oct
De
c
Fe
b
Ap
r
Ju
n
Au
g
Oct
De
c
Units
2
2.1
2.2
2.3
2.4
2.5
CMI
Blood use per 1K pt days Case Mix Index Linear (Case Mix Index)
Predictive Analytics
“declare the past, diagnose
the present, foretell the
future” - Hippocrates
Predicting Length of Stay for
Scheduled Surgeries
• Reliable prediction of hospital length of stay for future patients
• Generalizable framework for similar initiatives
• Downstream strategic operational impact
- Occupancy forecasting
- Clinical decision support
Modeling Perspective
Hospital
Admit
Hospital
Disch
Physiology
and clinical Surgery
Demographics
Prob List
Population and Data
• CC Main Campus TCI cases age >18
- 2010-2012
• Data source: EPIC medical record
• Demographics, physiology, labs, comorbidities, CPTs, work RVU, readmit
- All data ≤90 days prior to procedure
• Surgical CPTs grouped using validated taxonomies (NSQIP)
1
1
2
2
3
3
Estimating Relationships Among
Key Performance Measures
Measure
#1 is below
target
If Measure #1
meets target,
it positively
influences
Measure #2
and 3
• CIO, CFO, CMOO
• Meets monthly with Leadership Team
• Critical for executing on strategy
Executive Team
• Executive Directors from IT, Finance, Medical Operations
• Meets with Executive Team & Strategic Council
• Manages BI resources & BI program overall
Leadership Team
• Representation from several clinical & operational areas
• Meets with Leadership Team
• Provides project ranking recommendations
Strategic Council
EBI Governance