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Dashboard environment monitors flu, finance, HR, quality of care, growth and operational measures at five-hospital Kaleida Health network
By Doug Henschen
Nobody has time for reports. That's why Kaleida Health, a five-hospital system in Buffalo, N.Y., has rolled out 25 dashboards to monitor five core areas of performance. The flu-monitoring dashboard is the latest view added to the list. But with everyone watching for possible Swine Flu outbreaks, the newest display has called attention to Kaleida's wider business intelligence (BI) initiative.
As the largest healthcare provider in Western New York, Kaleida has plenty of data sources, ranging from an Eclipsis billing system to Lawson accounts payable, payroll and materials management systems and Cerner emergency room management and operating room scheduling systems. An Oracle data warehouse is at the core of the information management environment, but Oracle Discoverer wasn't hacking it as the front-end reporting tool.
"Discoverer is very report-centric, and we've added so many data sources over the years that nobody had time to run all the reports," says Dan Gerena, director of BI and corporate analytics at Kaleida. "We needed a more dashboard-centric strategy."
In late 2008, Kaleida upgraded to Oracle BI Enterprise Edition (OBIEE) to support that strategy. In March 2009, Gerena's four-person team embarked on a five-month project to build out a metadata layer, calculations and Balanced Scorecards covering five core areas: financial, HR, quality of care, growth and strategy, and operational performance. A metadata and repository-building project for an entire system of hospitals and clinics is no small task. But once the job was done, dashboards could be prototyped and rolled out in a little as a week.
In August 2009, Kaleida rolled out a total of 25 dashboards with detailed data on the five core areas monitored. In the quality of care area, for instance, dashboards offer drillable stats on mortality, falls, pressure ulcers and patient satisfaction. The financial dashboards have views including payroll, overtime, budget vs. actual, revenue life cycle and accounts receivable.
For now, the dashboards are still under review by roughly 50 top executives. In one example, feedback has led to tweaks in the Emergency Department dashboard to include more time stamps and details on turnaround time for acute cases. The review step is important, says Gerena, because Kaleida wants to make sure the displays have the right metrics before replicating them at a lower level for some 500 middle managers, as planned by the second quarter of 2010.
Though Kaleida's dashboards aren't yet fully deployed, they are already delivering positive results. For instance, the 10 worst-performing facilities or departments in terms of variance from budget or goals can be quickly revealed. Managers can take quick action to initiate improvements. "It has changed the paradigm to one-click, two-click analysis, whereas before we had to run the report, wait for it to finish, export it to Excel and then try to make sense of it," Gerena says.
The flu dashboard came about because the BI and analytics team was being bombarded with requests for information and reporting on flu cases, particularly from risk management and emergency room managers. The decision was made to tie all these efforts together for more consistent reporting throughout the system. The resulting flu dashboard attempts to deliver a 360-degree, covering patients as well as employees, starting with immunization and running through to symptoms, absences, staff planning, and reporting to New York State's Department of Health. The dashboard has been deployed to 20 key ER and hospital executives thus far, and it has already supported contingency planning.
"You don't want people with flu-like symptoms coughing in an emergency room next to someone with a broken leg, so we took a look at the data and determined the peak volumes in the Emergency Department," Gerena explains. With this insight, Kaleida has designated specific facilities for treatment of flu-like symptoms, adjusting hours and staffing accordingly.
Hopefully, H1N1 will wane as a topical healthcare concern. But Gerena says the lessons learned will prove useful for the next crisis that comes along. "We now have a template where we can react quickly, change the underlying criteria and push the required data out," he says. "Whether it's SARS or whatever else might come along, we're ready from a risk-management perspective for the next outbreak."
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