“To keep up with the data needs of a healthcare organization at this time when everything is changing so rapidly — new care delivery models, more regulatory reporting, an increasing need for business agility and an imperative to understand your performance across a number of clinical domains — there is simply no other way to do all this without an enterprise data warehouse.”
– Greg Spencer, MD, Chief Medical & Chief Medical Information Office
A decade ago, Crystal Run Healthcare — a physician-owned medical group in New York with more than 300 physicians in 40 medical specialties — decided to develop its own data warehouse and analytics solution. This solution proved to be a key factor in Crystal Run earning a reputation as a national leader in the delivery of integrated, coordinated care. The practice was among the first 27 healthcare organizations in the nation to participate as an Accountable Care Organization (ACO) in the Medicare Shared Savings Program (MSSP). However, Crystal Run realized over time that its homegrown solution wouldn’t scale to satisfy the growing needs of an ACO. This paper outlines why Crystal Run made the decision to set aside its legacy enterprise data warehouse (EDW) in favor of a commercially available solution that could provide a scalable, cost-effective and viable platform for meeting its long-term accountable care and population health management goals.
Because the physician group has had its own EDW solution in place for almost a decade, its culture is one that relies on and expects data. In fact, all aspects of the Crystal Run organization rely on information from the business intelligence (BI) team. The organization recently began growing even more rapidly, making it more difficult for the BI team to deliver data to the increasing number of people who need it. The organization’s information needs are also growing because of an increase in regulatory, licensing and accreditation reporting. Crystal Run recognized that they would not be able to meet the increasing demands for information with their existing data warehouse design and BI staffing levels. Instead, they needed a solution that would empower individuals throughout the organization to get the data they required in a more self-service fashion. Developing a self-service model would not only provide insight to individual clinicians and staff but would also enable the BI team to spend more time on processes and business analytics, helping the organization to achieve their strategic goals.
The ability to quickly and easily integrate clinical, financial, operational and other data is a must for managing the health of an ACO population. In fact, data from various source systems — including EMRs, human resources, radiology, pharmacy, patient satisfaction, accounting and cost systems and more — is required for population health management. Crystal Run’s legacy EDW struggled to integrate data from a variety of source systems. Manually integrating the data from these systems required significant coding and expertise in developing complex ETL (extract, transform and load) processes — a requirement that taxed the BI team and was untenable for future success. The legacy data warehouse also lacked a well-defined or standard data model. The solution also lacked automation tools and took considerable time and effort to maintain. Massive time was spent on extraction, transformation and loading (ETL) of data because full copies — terabytes worth of data were loaded every night. And most of the reports generated by the solution were static in nature and did not enable users of the information to easily drill down to the more granular information they wanted without having BI create another report.
Crystal Run’s executive and BI leaders examined the increasing need for data and the strain on their current system and determined that their legacy system wasn’t sufficient. Once they decided they needed a new solution, they had to decide whether to build or buy it. The following are reasons why, despite their experience with building a data warehouse, they opted to buy a solution:
Once Crystal Run leaders decided that buying a solution made the most sense, they had to choose the right solution. Many of the options on the market were ‘black box’, turnkey EDWs from companies that used traditional enterprise data models. From their own experience developing an in-house solution, the Crystal Run team was skeptical of claims that any kind of turnkey solution could meet its needs in the rapidly evolving healthcare environment. In fact, they found that many of these companies had little to no healthcare experience, nor were they transparent with their data model — an important factor for a pioneering ACO that wanted to take ownership of its analytics processes. Not surprisingly, the focus of many of these turnkey solutions was on long-term services, something Crystal Run was not interested in. They wanted a vendor that would partner with them to set up the EDW platform and then help them quickly become independent in using the platform to transform healthcare.
Crystal Run was looking for an innovative solution — and a partner that could implement that solution rapidly. They needed a partner who understood and lived in the healthcare world and had a proven track record of success. They found Health Catalyst and its Late- Binding™ healthcare EDW platform. The following were principal factors in Crystal Run’s decision to adopt the Health Catalyst EDW:
Although still in the early stages of the project, Crystal Run and Health Catalyst have already seen impressive results. They designed, built and launched the core healthcare EDW platform in just 54 days. They are now working to implement financial and clinical improvement initiatives on that EDW foundation — which includes creating permanent cross-functional teams focused on deploying and monitoring the effectiveness of improvement efforts in specific clinical areas. Importantly, Crystal Run’s BI team will no longer tied up with producing reports. Instead, the team will be empowered to focus on its real mission: developing processes to manage and improve every aspect of the business.
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