iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical...

58
Achieving Strategic Objectives Through BI Andrew W. Proctor, MS

Transcript of iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical...

Page 1: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Achieving Strategic Objectives

Through BI

Andrew W. Proctor, MS

Page 2: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

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.

Page 3: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Clinic Access

• Template Management

• Appointment Days Wait

• Appointment When Wanted

• Same Day Access

Page 4: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 5: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 6: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 7: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 8: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 9: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 10: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 11: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 12: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

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

Page 13: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

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;

Page 14: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Executive Quarterly Review

• Align strategic objectives

• Common scorecard platform

• Transparency

• Best practice sharing

• Continuous Improvement

Page 15: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 16: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 17: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 18: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 19: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Physician Name

Page 20: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

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

Page 21: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

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

Page 22: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Short Cycle

• Near “real-time”

• Quicker delivery to clinical

managers

• Summarized nursing unit

performance

Page 23: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 24: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 25: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Smoking Cessation

%

Page 26: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

HF Education

%

Page 27: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

SCIP: Hair Removal

%

Page 28: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

SCIP: Normothermia

%

Page 29: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

SCIP: Periop Beta-blocker

%

Page 30: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

SCIP: VTE Prophylaxis Orders

%

Page 31: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 32: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 33: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Physician Name

Page 34: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

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”

Page 35: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 36: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

ICU Operations

• ICU Ops Team created in 2006

• Expanded in 2009

- Oversight committee formed

- 30+ ICUs

- 350 beds

- 30,000 admissions/year

Page 37: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 38: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 39: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 40: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

ICU Hand Hygiene

Compliance

60%

70%

80%

90%

2007 2008 2009 2010 2011 2012

Compliance Target

Page 41: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

ICU CLABSI Rate

0

1

2

3

4

5

2008 2009 2010 2011 2012 2013

Rate

Page 42: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Blood Utilization

• Scarce resource

• High cost

• Clinical risk

Page 43: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 44: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 45: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Physician

Names

Page 46: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Example Physician

Page 47: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

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)

Page 48: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Predictive Analytics

“declare the past, diagnose

the present, foretell the

future” - Hippocrates

Page 49: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

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

Page 50: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Modeling Perspective

Hospital

Admit

Hospital

Disch

Physiology

and clinical Surgery

Demographics

Prob List

Page 51: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

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)

Page 52: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives
Page 53: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

1

1

Page 54: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

2

2

Page 55: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

3

3

Page 56: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

Estimating Relationships Among

Key Performance Measures

Measure

#1 is below

target

If Measure #1

meets target,

it positively

influences

Measure #2

and 3

Page 57: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives

• 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

Page 58: iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives