From Business Intelligence to Enterprise Information Management at Cleveland Clinic Mike Zuschin Director, Decision Support & Business Intelligence Slide 1
Copyright Scottsdale Institute 2015. All Rights Reserved. No part of this document may be reproduced or shared with anyone outside of your organization without prior written consent from the author(s). You may contact us at scottsdale@scottsdaleinstitute.org / 952.545.5880. Slide 2
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FHC Elyria Family Health Center FHC Lorain and Avon Family Health Centers FHC Westlake Family Health Center H H Lakewood Hospital Fairview Hospital FHC Lakewood Family Health Center H Lutheran Hospital FHC Cleveland Clinic Independence Family Health Center H H Euclid Hospital Marymount Hospital FHC Huron Health Center H South Pointe Hospital Beachwood Family Health and Surgery Center FHC Solon Family Health Center H Ashtabula County Medical Center FHC Willoughby Hills Family Health Center H Hillcrest Hospital FHC FHC FHC Strongsville Family Health and Surgery Center FHC Brunswick Family Health Center FHC Wooster Family Health Center Chagrin Falls Family Health Center FHC Slide 4 Twinsburg Family Health Center\
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Mars Slide 6
5.5 million patient visits 157,000 admissions 202,000 surgical cases Cleveland Clinic 4,450 inpatient beds 75 outpatient locations 42,000 employees 3,000+ physicians and scientists Slide 7
Cleveland Clinic Group Practice Model Physician-led, not for profit enterprise Staff physicians employed & salaried Annual professional reviews/ reappointments No volume incentives Expectation of excellence Slide 8
Cleveland Clinic s Partnership with Harris Cleveland Clinic and Harris Healthcare Solutions have a long relationship developing tools to drive performance improvement Harris Healthcare Solutions is the Cleveland Clinic's exclusive partner for commercializing the Cleveland Clinic s Enterprise Business Intelligence (EBI) dashboards Slide 9
How do we take incredibly complex data and information and make it relevant, meaningful, and actionable? Slide 10
How do we take incredibly complex data and information and make it relevant, meaningful, and actionable? From The Wild, Wild West to Enterprise Business Intelligence to Enterprise Information Management & Analytics Success Factors Lessons Learned Challenges New Directions Slide 11
Our Evolution In the Beginning Rev Coding Md CIS Billing ORIS GL DSS ODS Crystal Excel Mkt SC Data Sources Data Stores / Applications Information Access / Display Slide 12
CIO Slide 13
What We Didn t Do Rev Coding Md CIS Billing ORIS GL Enterprise Data Warehouse Mkt SC Data Sources Slide 14
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Enterprise Business Intelligence CIS Finance Billing Med Ops ORIS Others Others Others GL SC Data Sources Distributed Enterprise Data Warehouse Slide 16
Enterprise Business Intelligence CIS Finance Billing Med Ops ORIS Others Others Others GL SC Data Sources Distributed Enterprise Data Warehouse Consistent Information Access / Display Slide 17
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Dashboard Architecture Finance Statistics Patient Access Quality Patient Experience Executive Dashboard High Level Indicator Driven Visual & Intuitive Focused Flexible Finance & Statistics Quality Patient Access Operational Operational Dashboards Dashboards Summary P&L by Entity Financial Metrics Key Statistics Reports Service Line Summary Core Measures Patient Experience Hand Hygiene Outpatient Access Days Wait Appt when wanted Physicians Institute Chair Department Nursing Clinical Operations Patient Support Services Slide 19
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Case Study Outpatient Clinic Access Challenge Improve patient access and wait times for appointments Traditional measures of access ineffective Approach Integrated patient access dashboard developed showing physician template management, days wait until appointment for new patients, and patient satisfaction with appointment Performance reviewed at quarterly CEO meetings. Slide 21
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Days Wait Appt when wanted Case Study Outpatient Clinic Access Results Outpatient Visit Increase: 1,000 additional slots per week added Multi-million dollar impact Improved satisfaction with appointment wait times 18 16 14 12 10 8 6 Digestive Diseases Institute Q4 '07 Q1 Q2 Q3 Q4 '08 Q1 85% 80% 75% 70% 65% 60% 55% Days wait Appt when wanted Slide 24
EBI Phase I Wins Enterprise Alignment Domain Ownership Single Access Point/Process Success Factors Consistent Interface Leadership & Clinical Endorsement Incremental Approach Challenges Scale & Demand Management Dashboards not the Only Solution Needed to be More Actionable Slide 25
Case Study Quality/Core Measure Compliance Challenge Improvement in core measures compliance Cycle of improvement with existing process too long Approach Combine traditional dashboard showing core measures performance with near-real-time or Short- Cycle information accessed by those who can make change Slide 26
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Smoking Cessation (AMI/HF/PN) 100% Pre Post 80% 60% Jan Jan Jan 2009 2010 2011 Slide 30
SCIP: Periop Beta-blocker 100% Pre Post 80% 60% Jan Jan Jan 2009 2010 2011 Slide 31
Pneumonia Vaccination 2009 2010 2011 Slide 32
Total Hip and Knee Care Coordination: Likelihood of Hospital Discharge to SNF Surgery scheduled in next 60 days Model inputs from standardized documentation Updated daily and posted back to EHR in a standardized snapshot report Slide 33
EBI Phase II Wins Significant, Measurable Outcomes From Descriptive to Prescriptive Success Factors Get Data to People Who Can Do Something With It. Clear Target/Action/Feedback Loop Challenges Needed to be More Actionable Scale & Demand Management Slide 34
New Challenges Scale: We Can t Do this for Everyone! - Never-ending queue of projects - Data duplication, sprawl, underground BI - We ve become the pushbackers! Slide 35
New Challenges Scale: We Can t Do this for Everyone! - Demand Management - Less Centralization - More Self-Service Leverage department capability Back to the Wild West??? Enterprise Information Management Slide 36
New Challenges Enterprise Information Management - Data Assets Quality/Lineage/Certification Master Data Management Data Rationalization/Governance - Structure for Federated BI Best Practices Technology Framework Slide 37
Questions? Michael Zuschin zuschim@ccf.org Director, Decision Support Services & Business Intelligence Cleveland Clinic 6801 Brecksville Rd Independence, OH 44131 (216) 636-7463 Slide 38