Analytics Adoption Model Assessment

How is access to data managed?
- IT grants and removes access; bias is to limit access in the interest of security
- Clinical and business owners recommend access based on legitimate need; IT grants and removes access based on recommendations
- Clinical and business owners act as data stewards to grant and remove access based on legitimate need, and audit utilization; bias is to grant access and audit utilization

How is data from disperate transactional systems integrated. (e.g. EMR, Cost, Patient Satisfaction)
- Analyst manually integrate data into spreadsheets
- We use one of our transactional systems (e.g. EMR or Financial) to integrate a limited subset of data for some transactional systems for key operational reports
- We have implemented an Enterprise Data Warehouse Platform, fully automated load runs daily which integrates common linkable identifiers (e.g. patient and provider IDs), with near-real time load for selected data elements

How is consensus reached on the inclusion and exclusion criteria for patient registries? 
- We have not been able to reach consensus
- We rely on others to define the registries (e.g., EMR vendor, specialty societies, regulatory/accreditation agencies)
- We have organized permanent interdisciplinary teams and have an organized system to build consensus based on available evidence and expert consensus to define patient registries

How do you standardize calculations and definitions for internal reporting
- We don’t have standards and spend a significant amount of time reconciling similar concepts in different reports
- We have written standards for a few, common metrics and calculations (e.g., LOS calculations, cost/case, patient census, patient days)
- We have an electronic library of standard metrics and calculations covering the majority of common, reusable measures which can be leveraged across a multitude of reports and dashboards

Who manages the quality of data?
- No team owns data quality
- Quality is managed at the report level. Individual analysts manually "scrub" data before reports are distributed.
- Data Governance has been established by giving clinical and business owners the role of data stewards to identify source system errors and correct problems at the source.

How do you capture missing data elements for external reporting?
- Our analyst receive abstracted data on paper forms or e-mail which they manually add to reports
- Our analysts create desktop databases or spreadsheets to capture missing data which must then be manually integrated into external reports
- Our analysts create secure web-forms to capture missing data which is automatically integrated in our EDW for automated external reporting

How are teams organized to improve the quality of care and sustain improvements?
- We have ad hoc improvement teams organized on a project basis in a reactive mode (e.g., to respond to a TJC sentinel event)
- Our Quality Resources Department provides support to Service Lines and Departments apply quality improvement and workflow principles to improvement initiatives. Some individual units and facilities may focus on quality but dispersement of improvements to all units and facilities is limited
- We have organized permanent interdisciplinary cross facility teams, which include clinical and technical subject matter experts with process improvement skills; these teams permanently own the quality, cost, safety and satisfaction of their care delivery domain

What types of standardized content have you implemented to support Population Health Management?
- We have not standardized content to support PHM
- We have begun to use CPOE to implement standardized order sets (e.g., provided by our EMR vendor, or purchased from commercial vendors) NOTE (Workflow OR Clinical content… not both. Good would be both)
- We have implemented standardized content to manage ambulatory and inpatient care management (e.g., ambulatory treatment algorithms, order sets, bedside care protocols) and utilization criteria (e.g., diagnostic algorithms, triage criteria, indications for referral and intervention)

What technical tools do you use to move your organization away from reactionary, emotional decisions toward data driven decisions?
- We don't have any technical tools to help us with data driven prioritization
- We use some spreadsheet analysis and reports to evaluate options but opportunities are still typically selected based on politics, a crisis or the most vocal advocate
- We have robust applications which provide our centralized clinical and operational governance team with objective criteria for use in prioritizing improvement initiatives, including identifying our key processes based on size and variability

What methodology do you use to allocate costs to clinical care delivered?
- Our finance department personnel allocate costs to individual items on the chargemaster retrospectively (e.g., on a quarterly basis) using spreadsheets and/or desktop databases; costs are spread based on averages;
- We have a financially oriented costing system (e.g., EPSi) which allows us to associate costs with charge codes using traditional accounting methods for allocating costs (e.g., cost to charge ratios); cost allocation is evaluated on an annual basis;
- We have a clinically oriented, resource-based relative value study for bedside care, which captures resource utilization; the atomic-level elements are clinical descriptors of bedside care activities (e.g., basic cares, medication administration); the system is used to drive multiple applications (e.g, costing, billing, bedside care staffing); costs are refreshed each time a change is made to a clinical or operational process; Paradigm shift from revenue to cost

How do you ensure that patients receive the right treatment from the right provider across the continuum of care? (i.e., who determines indications for utilization of services)
- We rely on the judgment, training and experience of individual physicians who belong to our network
- We have a series of traditional insurance-based utilization management criteria (e.g., precertification, care management, case management); our system is centralized and may be viewed by physicians as adversarial (e.g. "rank and spank"), disruptive to their workflow and even aimed at denying needed care
- Our permanent clinical teams, led by physicians, have developed diagnostic algorithms, criteria for triaging patients to the appropriate venue of care across the continuum, ambulatory treatment algorithms, indications for referral and indications for intervention; the physicians own the utilization management system, which has been integrated into their workflow, and they believe it helps ensure optimal care

What technical tools do you use to create and test prescriptive algorithms for evidence based care delivery?
- We have no tools to build or test prescriptive algorithms.
- Our algorithms are developed manually using specialized tools (e.g. SAS, R, SPSS) or using advanced functions in spreadsheets (e.g. Excel) by analytic experts (e.g. medical informaticists or statisticians)
- We have robust applications to aid analysts in developing and refining algorithms, which are integrated into our EDW platform
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