The National Investment Center (NIC) recently spoke with Jeff Amann, Welcov’s Chief Operating Officer, about the company’s approach to tracking quality in an evolving health care system.

In the article Jeff was asked what kinds of specific data does Welcov use to make decisions.  He highlighted that they use the dashboard system primeVIEW, a product of Prime Care Technologies.  primeVIEW’s dashboard allowed them to review occupancy, cash collections, bad debt, labor hours, customer satisfaction, and key clinical metrics in real time.

Click here for the entire article.

Click here to see a 60 second overview of primeVIEW.

Data is everywhere; it’s pervasive. The challenge as well as the opportunity lie in retrieving the raw data and converting it into useful and actionable information. In the past, we have posted a number of blogs on a wide range of Business Intelligence (BI)/data mining-related topics - from Payroll-based Journal (PBJ) reporting to data-driven decision making, from BI’s role in helping providers stand out in the ACO crowd to how BI helps providers demonstrate value, and so on. But let’s step back and reexamine what has driven BI to become what it is today.

The challenge

Long Term Care (LTC) providers are sitting on a vast reservoir of data. However, many do not have the resources to tap into that data and to convert it into something useful to solve current problems, to seize emerging opportunities, and to plan for the future. But, where to start?

BI’s purpose

Let’s wrap our arms around what BI’s purpose would, could, and should be. Succinctly put, BI reports, provides online analytics, and delivers Key Performance Indicator (KPI) visualization and monitoring.

BI’s use

As we visit with our BI customers and industry leaders across the country, we’ve observed that decision makers use BI to measure, monitor, and act on clinical quality outcomes, financial analysis, operational performance, cost management, compliance, and market-specific information. Executives use such information to take direct action, as needed, and to work with their teams to better align performance with company and facility-specific benchmarks/goals.

BI drives development and market acceptance

The evidence is clear that no one thing has been the agitator for BI acceptance and growth. Rather, the following factors have each played a contributing role:

• Federal and state health reforms
• Availability of healthcare-related data
• The imperative to identify and control costs
• Quality Assurance and Performance Improvement (QAPI)
• The need to increase customer satisfaction
• The demanding and complex regulatory environment, such as PBJ reporting, HIPAA, etc.
• Cloud-based computing technologies
• The availability of data through IT adoption
• Health Information Exchanges (HIEs)
• New value-based payment models
• And others

BI Stakeholders

Who uses BI? Here is a “short list” of those who rely on and use BI:

• BI software and services providers
• Healthcare providers
• Healthcare payers
• Accountable Care Organizations (ACOs)
• Managed Care Organizations (MCOs)
• Health Information Exchanges (HIEs)
• Investors/lenders
• Federal and state governments
• Researchers

All of these entities and people have a stake in the BI world and they all have some influence on how providers conduct business.

What this means to you

If you haven’t yet fully caught the larger vision of what BI has become and could be, you need to do so now or you will be left behind. In today’s world, the old manual ways of gathering and processing data, responding to the information gleaned, and taking action are too slow and cumbersome. Besides, some stakeholders, such as government agencies, are not giving you a choice. I highly recommend that you conduct an assessment of your organization’s BI needs today and in the future and devise a plan to help you ramp up as quickly as possible. A sure bet, is to look at existing BI tools, like PCT’s primeVIEW, designed for LTC providers, like you.

Discover how easy it is to integrate staffing and census data with PCT's PBJ Reporting Platform

Our company promotes that with the right information, you, the provider, can make the right decisions, right now! But even if the information is right, timely, and relevant, rendered actionable (Gotta love that word), making “the right decision” is a skill. Is it a skill of the arts or is it a skill of science? In this blog, I would like to get to the heart of the matter (which by inference would mean that decision making is an art, but I prematurely pass judgment. J). But some who ask, “What do you think about a situation,” instead of, “How do you feel about a situation,” may justifiably consider it a science. Having served in a number of leadership and management roles, I may rationally argue with some feeling that it is possibly both. But where does business intelligence figure into this oft written about conundrum? Let’s see.

I am not a scholar by any means, but sometimes such topics as this give me pause to do a little research and I want to share with you, who are for all intents and purposes among the brightest decision makers in the business world, some insights I gleaned while searching the internet.

The science and art of decision making

From none other than a Harvard Business School blog, dated December 2, 2010, authored by Jim Heskett, entitled, “Making the Right Choices: Art or Science,” I gleaned the following nuggets of thought.

• Many concluded that (choosing/decision making) is (an art and a science), depending on such things as the level of complexity, stage of the decision-making process, the purpose of the decision, the context in which the choice is made, whether we are deciding or rationalizing the decisions we've already made, or our personal makeup.

• Creation of choices is more of an art … and evaluation (of alternatives) a science. (Italics added)

• One of my favorites - All we can do is use science to understand the uncertainty of choosing … while using art to sharpen the intuitiveness that goes into the moment of choice. (Italics added)

• The longer you take to make a decision … the further away you are from the reality that exists at this moment.

• A delayed decision, no matter the greatness of it, loses its sheen 

What these nuggets suggest about decision making

These latter two bullet points are particularly germane to our tag line of, “Right information. Right decisions. Right now.” Why? Because the fresher and more immediate the information, the more likely will be the brightness of the decision you make. (Yes, the use of “brightness” is an intended play on words.) Decision makers need current relevant information in order to deal with the realities that exist right now. With current information refreshed several times during the day, the science of evaluation more effectively stimulates the art of creating choices.

Business intelligence drives the science of decision making

In another posting, dated March 27, 2013, on the “Awesome Mind Secrets!” site, I found the blog, Decision Making: Is It An Art Or Science? In summary it states, and I quote,

The Decision Making Process

There are several scientists, psychologists and management gurus who have created outlines of decision making processes. One of the best ways to describe a decision making process was outlined by Dr. Pam Brown. According to him, decision making involves the following steps:

1. Clearly outline the goal
2. Collect information that may help in arriving at the conclusion (Italics added)
3. Use brainstorming or other techniques to find out alternatives
4. Once you have alternatives, then look for pros and cons of each option
5. Choose the best alternative
6. Implement the decision
7. Evaluate the effectiveness of the decision, and take it as learning (Italics added)

Business Intelligence tools, especially those, like PCT’s primeVIEW designed for LTC decision makers, contribute significantly to “right decisions” by enabling them to “collect information” and to “evaluate the effectiveness of the decision” with regularly refreshed actionable information.

Science supports the art of decision making

Bottom line, what matters is that you have the right information (the science) so that you can employ the skill of decision making (the art) right now to make the right decisions, decisions that can have an immediate impact on the quality of the services you and your team deliver and subsequently on the bottom line.

In our recent blogs, we’ve highlighted how Business Intelligence (BI) can help providers more effectively tell their stories to stakeholders, investors, and referral sources. However, providers have another key audience to whom they could effectively present data-driven demonstrations of value and quality – ACOs. In an article published by Healthcare IT News, the author identifies, among other critical success factors, that ACOs need to align the payment model with value and to develop the data model, IT infrastructure, and tools to support reporting and analytics.

Aligning value with payment models

One of my co-workers likes to use the cliché, “Keep it real. In that spirit, because payment model and value alignment are important to ACOs, providers need to understand ACO requirements and to tie their quality improvement initiatives to that payment model. BI can help providers identify and share the results of these initiatives with ACOs, demonstrating payment model-relevant value and service quality.

Developing the data model, IT infrastructure, and tools to support reporting and analytics

Key to successful ACO participation is a dynamic BI tool, the backbone of which is readily interoperable with other systems. Being able to integrate data from various data sources into one common data warehouse will help open lines of communication and care coordination within the payment model parameters. To the extent that LTC providers, with ambitions to participate as a valued and contributing ACO member, have the infrastructure in place, they will be able to more readily integrate their data into the ACO’s existing platform.  

Let me add our two cents – talking the talk; walking the walk

In marketing, we use the term “buyer persona”, which means that for us to effectively communicate, we need to understand who our targeted audience is, their concerns, their interests, etc., and to tailor our communication and engagement efforts accordingly. Likewise, providers need to understand the ACO stakeholder persona(s) and to craft their interactions with those stakeholders by talking their talk and walking their walk. Addressing their concerns with relevant information goes a long way.

Summary

Within the last couple of years, ACOs have begun to recognize that the inclusion of post-acute care providers can contribute to major cost savings and quality care improvement. LTC providers who have BI and data integration technology in place are better positioned to solicit and participate as viable ACO members. Are you one of them? Is ACO participation on your strategic radar screen? If so, having BI and analytics tools to help you demonstrate value in harmony with ACO payment models will help you to stand out among the crowd of ACO membership “wannabees”.

As the reimbursement world changes from fee-for-service to pay-for-performance models, demonstrating value is key. To be able to compellingly demonstrate value compliant with payment model expectations, providers need to be able to know how well their facilities are performing today. The technology needed to effectively identify and communicate such value is available through business intelligence (BI). As mentioned in a previous post, BI can also be useful in helping providers share information with stakeholders, investors, and even referrals sources.

Let’s assume you’ve identified a particular hospital which shows considerable potential as a referral source to one of your facilities for patients requiring the kinds of services that facility specializes in. With BI, you can effectively tell your story with data-driven information, easily retrieved and configured for presentation. You can bring demonstrated improvement trends in rehospitalization rates tied to clinical best practices and specific diagnoses. Statistically, you can also show how competently your facility treats in-house as well as community-acquired pressure ulcers, physical restraints, falls/accidents, significant weight loss, medications, infections, etc.

You can confidently share with the hospital’s executives discharge information length-of-stay and admissions/discharges information, Five Star ratings compared to peers, and inspection results, such as fines and deficiencies, and quality measures you can present in chart or graph form with trends and benchmarks to state averages. A further indicator of quality within the context of Five Star ratings is labor. BI gives you the opportunity to compare your staffing to 5-Star, 4-Star, and 3-Star requirements.

If your clinical software enables your clinicians to uniquely identify hospitals, you can specifically demonstrate to your audience how well you serve the patients they have discharged to your facility.

What’s most useful is that BI already generates this information for you automatically. You can export it and reconfigure it to meet your audience’s needs. So, what’s required? A BI tool tailored to your organization’s mission, objectives, and best practices, and the opportunity to share your story, to demonstrate your value to the community and the care continuum you serve.