ATLANTA – Much attention is paid to the transformative potential for clinical IT to improve care and increase patient safety. But non-clinical technology is just as important.

 

Lately, providers and payers have been finding some new and innovative uses for enterprise, financial and business intelligence software, helping to make themselves more efficient and effective organizations.

 

As Chilmark Research analyst John Moore wrote on his Healthcare IT News blog earlier this year, keeping the words "effective" and "efficient" in mind is "increasingly critical as the industry moves to bundled payment models with shared risk."

 

Calculating that risk, he wrote, "will require data and lots of it." It also means using IT to process and interpret all that data – and make it all mean something actionable.

 

Several vendors lately have been happy to fill those needs.

 

At HIMSS11 in February, for example, Siemens touted advances in it Soarian Financials technology, its new "next-generation" enterprise approach to revenue cycle management – enabling the streamlining of data for acute, post-acute, ambulatory and physician providers and making for a less fragmented approach to managing revenue cycles as it supports payment reform initiatives that require consolidated billing across the continuum of care.

 

"Healthcare organizations will be facing greater accountability for the quality and cost of the care they provide, and incentives may be tied to outcomes and structured to provide a benefit to organizations that coordinate treatment, eliminate redundancies and reduce costs," said John Glaser, CEO of the health services business unit at Siemens Healthcare. "Such changes in the reimbursement process will make it critical for providers to have tools that not only handle bundled payments, but that also employ a level of business intelligence that allows them to optimize the entire revenue cycle and improve operating margins."

 

At Children’s Hospital of Atlanta, Radnor, Pa.-based QlikTek has helped the 510-bed non-profit organization streamline its operations, finance and research analysis with its QlikView technology. Enabling users to leverage data that had been squirreled away in dozens of different locations, CHOA has reduced report generation time by approximately 65 percent, officials say.

 

The ability to run that analysis in few minutes – as opposed to perhaps waiting a week – has paid big dividends, said Michael Thompson, CHOA's director of business intelligence.

 

"The best data-based strategy cannot yield positive results without the proper tools to visualize information," he said, adding that "QlikView was able to expose the potential inconsistency that may exist in siloed data sources to the end-user/decision makers – quickly forcing a discussion on proper master data management governance strategies. The software allows users to decide what data they want to collect, rather than sort through a rigid information hierarchy."

 

Thompson said "accelerated rollout of new applications have been a key success metric" and that recent months have seen CHOA "able to quickly delivery both financial and clinical analytic applications at a more rapid pace than we have seen in the past."

 

Creating everything from multiple revenue dashboards to quality scorecards to "a wide spectrum of ad-hoc data visualization applications," he said, has helped position the hospital for success in a brave new "accountable" world.

 

"In the current healthcare climate, it is more difficult for us to predict the types of questions that will be asked of our data," said Thompson. "This is a challenge to most BI tools that work in a linear fashion – assuming that users follow a predictable and hierarchical pattern."

 

CHOA's business and clinical users "need the ability to self-serve – heuristically searching across databases and looking for causalities that are often hidden from view in non-integrated data stores," he said. QlikView is helping hospital staff access "insights in the data more effectively and efficiently.”

 

One consequence of the move toward ACOs and bundled payments may be for "healthcare organizations to develop closer partnerships with payers," Moore wrote on his blog. "For if it is one thing that payers understand, it is calculating risk."

 

One payer that's seeking to optimize patient care through smarter use of data is the Capital District Physicians' Health Plan in Albany, N.Y., which has enlisted business intelligence tools from HP to connect its financial, claims and clinical data with information from third-party systems.

 

Linda Navarra, the CIO of Capital District Physicians’ Health Plan, said HP helped it build a "member-centric warehouse that really starts to put information together about our members' health."

 

That gathering of enterprise data from multiple sources has helped CDPHP "start to leverage business intelligence and analytics" she said.

 

"We take information from various sources, from our transaction processing systems – from Caremark, from the pharmacy, from our lab vendors, and we put that all into what we call a landing zone," Navarra said. "And we churn through that information and we come out into a warehouse where we've summarized it. We put analytic tools on top of that information in the warehouse, where we've applied business logic to it."

 

Allowing these tools to drill into that data – gauging members' health, discerning whether they've had preventative services or whether they've had their prescriptions filled – enables CDPHP to "identify gaps in care and try to reach out to our members on how best to change the outcomes of their health," she said.

 

When CDPHP moved to implement HP's data warehouse, it was undertaken with "health value strategy and providing appropriate care for our members" first in mind, said Navarra. ACO wasn't a "buzzword," she said, and the big push toward bundled payments "wasn't really in play."

 

Now? "We're positioned perfectly" for a post-reform world, she said. "I'm very happy about that."