Analytics in Community Hospitals: Embracing Data to Thrive in the New Era of Value-Based Care
The term community hospital conjures up several images: a hospital serving a given populous, providing a significant community service; a stand-alone facility with ambulatory care clinics working in concert with one another; perhaps even a government-subsidized facility caring for the poor and underserved.
However it’s defined, the majority of community hospitals operate under extremely tight margins. Most don’t have access to the same research dollars to innovate as academic medical centers. Data analytics has been deemed a “nice to have if we can afford it.”
The transition to value-based care has altered the healthcare landscape, making it difficult for some community hospitals to compete. Using data and analytics is no longer a luxury. Community hospitals are having to embrace analytics, making it a part of their culture and incorporating it in everyday decision making.
Analytics and Small Hospitals
As Health Catalyst continues to partner with community hospitals around the country, some common themes have emerged from organizations that have successfully implemented a data and analytics strategy.
New Roles and Responsibilities
In order to execute on the vision of value-based care transformation, healthcare organizations are recognizing the need for new roles and skill sets to support the transition. Senior leaders are coming to realize their organization can drive improvement by building teams that have the skills to bring together analytics, best-practice clinical content, and process improvement and organizational adoption techniques to spread across the system.
A recent survey by AMN Healthcare reports that 86 percent of healthcare organizations are keenly aware of the need for new types of healthcare professionals. However, it also revealed that a much smaller percentage is actively recruiting executive and frontline employees with value-based care experience.
Successfully staffing an enterprise data warehouse (EDW) initiative is no small feat. The technical prowess required to build the EDW and derive continued ROI from it, requires highly specialized skill sets. Translation? These professionals are difficult to recruit and expensive to hire.
Thriving community hospitals realize, however, they cannot begin to identify areas for improvement, let alone implement a plan of action, without these competencies being available. In most instances, the technical staff is made up of existing resources, allowing healthcare organizations to maintain a low-cost entry point for the EDW’s ROI.
An interesting trend among thriving community hospitals is a deliberate decision to outsource select IT capability. Outsourcing some technical capabilities, such as extracting, transferring, and loading data, or data integration, frees up capacity for the team to maximize those skill sets that are most important to the implementation and adoption of the EDW. Professionals with skills such as SQL development for data mining, data modeling, data analysis and BI development (visualization) are the essential roles necessary to drive outcome improvement.
Community hospitals run under very narrow margins so efficiency is imperative. Leadership partners with IT to drive iterative value in short cycles. Together, they frontload exploration and planning, identifying areas to reduce waste in the system. Data analysts quantify the waste and assist the team in prioritizing focus areas to eliminate it.
IT’s contribution is to build the measurement system that accurately reflects the current workflow and measures the impact of any changes made to it. The permanence of the application artifact to continually measure performance allows teams to disband when needed, increasing efficiency. Developed in partnership with clinical and operational leadership, the applications are intuitive and enable physicians to engage in a seamless, natural manner.
The idea of using data and analytics as a means of providing better patient care may be new for some physicians; it can be perceived as too impersonal. Successful, innovative community hospitals with high physician engagement are developing creative ways to reward physicians who engage in continuous quality improvement.
Some hospitals opt for monetary compensation, recognizing that time away from the clinic means lost revenue for the physician. The value physicians bring to the improvement process outweighs the money spent to compensate them for the time they could be spending treating patients.
Hospitals that may not have the monetary resources are rewarding physicians, committed to process improvement, the opportunity to have greater influence in prioritizing and participating in improvement initiatives. Many physicians, passionate about improving care delivery, choose the latter scenario.
Access to credible data that provides visibility into their work is often payment enough for community physicians mindful of hospital budget constraints.
Analytics Make All the Difference
By and large the CEOs of community hospitals are not physicians. They are business men and women dealing with the realities of local board, budget, and political pressures. The CEO must balance long-term goals with short-term pressures while continually striving to deliver superior care to the patients in the communities they serve.
Analytics play a critical role in these organizations as they strive to compete with the medical centers and integrated delivery networks. These organizations typically have resources that surpass those available to a community hospital. Community hospitals tend to be relatively flat organizations, enabling the CEO to engage in the details of the analytics, identify opportunities for improvement, and take action.
Thibodaux Regional Medical Center, with an IT staff of 18 and recently awarded the top spot in this year’s Health IT News, Best Hospital IT Departments, is one example of a successful, analytics driven small hospital.
Thibodaux Regional has historically used lean principles to identify opportunities for cost savings and achieve improvement. Today, as Thibodaux Regional entered the shared-risk market, it was critical to bridge any gap in trust between the affiliate physician-led groups and the administration. Over the last year, Thibodaux Regional’s leadership has focused on improving engagement with the physicians and strengthening the organization’s culture of continuous improvement.
Thibodaux Regional is empowering clinicians to lead the improvement process, allowing them to identify areas for improvement. Using lean principles and KPAs, the physician-led team identified early recognition of sepsis patients as an area for improvement. While the organization was already outperforming the national average, the team set aggressive goals:
- Reduce overall mortality by 25 percent
- Lower costs by 20 percent
- Maintain patient satisfaction rate of 99 percent
A cross-functional team established a triage protocol in the Emergency Department and created three and six hour sepsis bundles. Physician-to-physician education, training, and live practice sessions were critical to the successful implementation of the protocols. To date, the team has reduced sepsis mortality by 11 percent, and is poised to reduce the rate of sepsis mortality by an additional 25 percent.
Thibodaux Regional exemplifies the positive returns a community hospital can achieve when physicians and senior leadership partner and use analytics as building blocks to drive long-term, sustainable change.
Community hospitals are having to embrace analytics as they contend with transitioning to value-based care while striving to stay competitive in the communities they serve. Incorporating data in to the culture and ensuring it’s a part of everyday decision making will enable community to not only survive, but thrive.
Would you like to use or share these concepts? Download this quality improvement presentation highlighting the key main points.