Texas Children’s Hospital Uses Healthcare Data Warehouse as an Alternative to EHR Reports

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For more than a decade, I have helped small physician practices and large hospital systems maximize the value of their electronic health record systems (EHRs).  I have witnessed the ups and downs of the challenging endeavor from installation to customization and utilization.   It is an expensive endeavor.  Without exception, the return on investment (ROI) for these healthcare IT systems is related to the proper management of the data they provide. When the data is managed properly it becomes a wealth of information for driving quality improvement and reducing costs. Getting data out of the EHR and transforming it into business intelligence is the next major movement in healthcare towards a smarter, more efficient system.

One of my clients, Texas Children’s Hospital recently made tremendous strides in this data-driven journey.  Getting data from their EHR in a timely fashion was difficult, time consuming and resource intensive.  Now, with the proper tools in place, namely a healthcare enterprise data warehouse, a suite of healthcare analytics applications and a process for information deployment, they have shifted the cost curve to drastically increase the availability and usability of information.

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EHR Data and EHR Reporting Problems

Myra Davis, M.E., Texas Children’s Senior Vice President of Information Services, articulates the problem well by stating that, “Our clinicians thought that the EHR would be a silver bullet to get the data they needed for quality improvement and operational reporting and they blamed IT when the information wasn’t forthcoming.”  Myra, like many of my clients, felt pressure from her healthcare colleagues who wanted data.  At the same time Myra’s staff felt like they were becoming a report factory. Instead of focusing business intelligence resources on strategic analysis they were spending their time developing reports.

Report definition and creation is an iterative process.  Clients don’t always understand what data is available. They review reports and think of more data or different views of the data when they see the first report. Typically a report request turns into multiple requests, particularly for clinical improvement projects.

Quantifying EHR Reporting Alternatives

Texas Children’s began looking for alternatives to get data out of their EHR that would be lower cost and free up resources to focus on analysis versus report writing.   They also wanted to reduce their EHR reporting turnaround time which could be longer than 4 months from an EHR report request to when a user received their first report.

John Henderson, Texas Children’s Director of Enterprise Systems, and his business intelligence analysts began researching the use of their healthcare enterprise data warehouse (EDW) as an alternative. Here’s what John and his team discovered:

  • The average time it takes for an analyst to build an EHR report is 97 hours versus an EDW report that takes 29.3 hours.
  • On average, each EDW report costs Texas Children’s 67 percent less to build than an EHR report. Given that the hospital was previously generating an estimated 1,300 EHR reports per year at an average cost of $4,832 per report, the savings are substantial.
  • In addition to these savings, every EDW report, on average is functionally equivalent to 10 EHR reports. Why? EDW reports are multi-dimensional and dynamic. Users get near-real time data they can filter and drill down into to answer their questions.

Sample EHR Report: Static, Single-Dimension


Compare the EHR report with an EDW report.

A Dual Approach: EHR and EDW

Is an EDW report the answer to every healthcare reporting need? No. Some examples where EHR reporting makes sense include real-time reporting and reports that are static, single-dimension.

Texas Children’s found was that by shifting many of their reports to the EDW they could increase the average delivery time of their EHR reports.  Average delivery time, defined as the time it takes from when someone submits a request for an EHR report to the time a report is delivered, is trending downward for Texas Children’s, from a previous window that exceeded 120 days to a current time frame of less than 90 days – a 25 percent improvement.

In addition to the benefits noted above, EDW reports provide a graphical visualization and have the ability to integrate clinical, financial, operation and patient satisfaction outcomes- a must for healthcare improvement program and operations.

The Healthcare Analytics Adoption Model

Reporting is one facet of the Healthcare Analytics Adoption Model (Source: Electronic Healthcare 2012), developed by a cross-industry group of healthcare industry veterans.  The model borrows lessons learned from the HIMSS EHR Adoption Model and describes an analogous approach for assessing the adoption of analytics in healthcare.  Learn how to use your data and reports to drive your healthcare analytics strategy across 8 levels of the Healthcare Analytics Adoption Model.

What impact did your EHR have on your demands for reports and analysis? What is your current backlog for reports? What other alternatives have you found?

Read more analytics success stories in healthcare.