Can Business Intelligence Help Heal Health Care?


Creating a national electronic medical records (EMR) system is a laudable goal. But it won't be easy, as IT Business Edge blogger Loraine Lawson wrote earlier this year. She covered some of the key challenges of creating an EMR system, and shared a few ideas for surmounting those challenges, by citing the example of Kaiser Permanente, which snagged an award from Healthcare Information and Management Systems for EMR implementation at several of its hospitals.


Though a national EMR seems to be a long way off, I found an encouraging example of business intelligence being used to improve health care in this BeyeNetwork item about the Centers for Medicare and Medicaid Services' (CMS) release of data regarding readmission rates at the nation's hospitals. Many hospitals will respond by using BI tools to analyze where they stand in relation to competing hospitals, writes BI consultant Scott Wanless.


Such analysis will hopefully help show whether and how much actions such as weight assessment and nutrition counseling, childhood immunizations, breast cancer screening and cholesterol management for patients with cardiovascular conditions affect readmission rates. Further analysis will likely be performed to determine which actions seem to lower readmission rates. Among the data hospitals will analyze: hospital processes, medical interventions, patient demographics and post-discharge patient actions. Writes Wanless:

This means that clinical performance measurement will come full circle. In doing so, clinical performance measurement will mirror financial performance measurement. No business would have its financial analysts measure investments or operational activity without evaluating them in terms of the results on the bottom line. Nor would that business simply report the financial results without a thorough analysis of the causes for those results. We take this for granted in financial management. We will now be seeing more of this cause and effect analysis in clinical performance management as well.

I am a sucker for examples of BI helping to solve societal problems. I think the hospital readmission example is a especially good one, considering that any kind of health care reform is going to involve efforts to bring down costs.


Wanless adds that BI will become even more important to hospitals as such measures are "increasingly linked to reimbursement and revenue." It seems BI vendors will benefit from federal spending initiatives, as most stimulus funds carry with them a requirement for transparency in how the monies are used.