Jonathan Sharr, Senior Decision Support Analyst, Middlesex Hospital
A community hospital based in Middletown, Conn., Middlesex Hospital strives to provide the safest, highest-quality healthcare, and the best experience possible for our community. Our position as the state’s first Mayo Clinic Care Network member demonstrates our commitment to improving care through innovation and collaboration. To do that, we need actionable data not just within the hospital, but also across our physician practices. Multiple disparate systems complicate the ability to gain this insight, causing us to look toward business intelligence and enterprise analytics to deliver greater visibility across the organization.
Middlesex Hospital began using PrecisionBI for business intelligence for revenue cycle management in 2009. Previously, we had to extract data from our GE Centricity system and manually manipulate Excel files to get needed information. This was a cumbersome, manual process that prevented quick access and tied up resources from pursuing projects that were more organizationally beneficial.
Once we started using PrecisionBI, people were wowed by the insights gleaned and the speed at which analytics could be performed — examining various metrics, calculating length of stay, cash collection data, days in A/R, as just a few examples. Custom reports are now easily created. Through business intelligence, we can report on key business and clinical metrics from several data sources, identify areas for improvement and increase revenue. Better information allows for more accurate and informed decisions.
We currently use analytics across operational, financial and clinical areas of the hospital and physician practices, connecting more than 30 systems. As each practice has its own database, comparisons across the organization are more complex. PrecisionBI, in essence, merges these into one database so we can quickly toggle between systems.
This approach exposed eClinicalWorks data, our outpatient EHR, alongside side Centricity, giving us unprecedented visibility into visit level and physician productivity information that directly impacts our STAR ratings and reimbursement levels. Cerner is also used on the in-patient side along with our Infor ERP system for payroll data, as well as Press Ganey and HCAHPS scores. Enterprise business intelligence delivers a more holistic view of the organization so we can see the entire picture instead of a siloed slice of it.
We utilize the payroll integration several ways. The payroll data that comes from the Infor ERP into the enterprise data warehouse (EDW) and shown in PrecisionBI is necessary for one of our highest-used Access Centers, which displays a rolling 26 pay period history for all departments that is filterable. Department leaders can use this to monitor labor utilization on a bi-weekly basis.
Middlesex Hospital also flexes the labor budget for various departments. Nursing, for example, has a target for productive hours per patient day. Every pay period, we compare the actual hours used against what was forecasted based on the number of patient days. Department leaders analyze the variances to monitor how well staff levels were controlled.
From a human resources standpoint, our policy is that no department can post a position without getting approval from the Labor Steering Committee with whom the results from this dashboard must be shared and reviewed. For this reason, our Chief Nursing Officer has made PrecisionBI access mandatory for nurse managers. It is also valuable to have aggregated payroll information, displayed by job classifications and not employee, available in the ad-hoc environment.
A key to the success we have achieved is how easy the system is to use and learn. We have empowered many users to access the information they need with little training. Due to parameters we set, we do not have to worry about data integrity. We are able to make the data objective by putting parameters around definitions to make apples to apples comparisons.
Further, providers are getting productivity reports so they understand how well they are delivering on key metrics and can pinpoints areas for improvement, if they exist. This is a good indicator for both operational and clinical success. Role-based permissions and membership ensure that everyone has access to the information they need to perform their job. This has resulted in teams accessing the required data when they need it, without submitting a request, while freeing up technical staff to work on more clinically critical projects.
Business analytics have improved key metrics. Middlesex Hospital has satellite emergency rooms. Our goal is that any patient who needs in-patient care will be transferred to our hospital but sometimes they choose a competitor facility even though we offer quality care. By using PrecisionBI to analyze and monitor these “lost transfers,” we better understand the reasons why patients do not choose our hospital and prevent as many transfers as possible. The same goes with understanding throughput metrics like discharges before 11:00 a.m. and 2:00 p.m. We have this information on monitors so the statistics can be addressed. Visualizing data for our leadership via clean dashboards makes the information easier to act on.
PrecisionBI eliminates the need for multiple tools, which is cumbersome. Our information is now comprehensive, clean and predefined with reduced errors, and accessed with increased speed. We are able to choose our initiatives wisely to reduce unnecessary services, lower costs and improve patient satisfaction.