Business intelligence use cases for health care organizations

In health care as in other verticals, BI software is increasingly being used to address financial issues. Organizations are finding ways to apply BI to patient care as well.

Ever since the HITECH Act established meaningful use of electronic health record systems as a national goal -- and provided incentives for their use -- the health care industry as a whole has been steadily moving toward universal EHR adoption.

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Although electronic health records are generally considered to be a good idea, their true benefit is only now starting to be realized. EHR systems can best be thought of as an unstructured collection of patient data. Although such data was initially intended to be used on a patient-by-patient basis, health care organizations are beginning to discover that additional value can be gained from the data when the entire dataset is analyzed as a whole by business intelligence software.

Business intelligence use cases for improving patient care

BI software can assist health care providers in making important decisions ranging from patient care to the organization's finances. For example, I know of one organization using its business intelligence software to track staff response time. When a patient presses the nurse call button, a record is created. When the nurse responds to the patient, another record is created. The organization used these records to determine the average response time, which eventually became a benchmark used for improving patient care.

Another organization I know is using business intelligence to improve emergency room wait times. The organization analyzed historical data pertaining to wait times, the number of staff members onsite (doctors, nurses, etc.), and the number of patients waiting to be seen. By doing so, the organization created a mathematical model that could predict emergency room wait times based on a number of different variables. This mathematical model was applied in a way that helped the organization to decrease patient's wait times, while also improving patient satisfaction.

Business intelligence use cases for financial analysis

Before business intelligence software began making its way into health care organizations, it was used in other industries to analyze financial data. Of course, health care providers must deal with financial data just like any other organization, so it is only natural that they have begun using business intelligence software for financial analysis.

BI software can assist health care providers in making important decisions ranging from patient care to the organization's finances.

Financial data analysis in health care environments typically falls into two main categories. First, data is used for cash flow analysis. In any facility, there are certain costs incurred at the time that patient care is given. For instance, medical supplies are used during the patient's visit and physicians must be paid for treating the patient. However, patients rarely pay for services at the time they are provided. A patient usually makes a small co-payment, and the facility files a claim for the remainder of the bill with the patient's insurance company.

Because the facility incurs expenses up front, but might not receive payment for quite some time, cash flow analysis is critical. BI software can create an accurate cash flow model by taking into account things such as the amount of time that it takes to process an insurance claim, the discount given to the insurance company, and the amount of money that is being spent to care for patients.

The other business intelligence use case for financial data in health care has to do with anticipating patient needs. BI software is really good for spotting long-term trends. For example, such software might tell an organization that, every August at the beginning of youth football season, it typically treats 60 patients with broken arms. As such, the facility would be able to anticipate the number of casts and pain pills it needs to order.

Similarly, patient demographic data as well as medical trend data could be used to identify the need for (and justify the cost of) new medical equipment. 

Of course it isn't just the hospitals that are making use of business intelligence software. Health insurance companies are using business intelligence to improve claim response time and, in some cases, identify fraudulent claims.

Conclusion: Using BI software to make the most of patient data

Although business intelligence is still in its infancy, especially in the health care industry, increased EHR adoption will likely result in increased adoption of business intelligence across facilities to spot patient care, financial and supply chain management trends. At a time when health care costs continue to climb, the business intelligence use cases described above can help organizations trim costs while also improving patient satisfaction.

About the author:
Brien M. Posey, MCSE, is a Microsoft Most Valuable Professional for his work with Windows 2000 Server and IIS. He has served as CIO for a nationwide chain of hospitals and was once in charge of IT security for Fort Knox. Write to him at editor@searchhealthit.com or contact @SearchHealthIT on Twitter.

This was first published in March 2012

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