Jul 3

Jul 3 Clinical and Business Intelligence in Healthcare By Arif M. Rana, Jerome Niyirora, Sara Albright & Daniel W. Gilmore

If you travel abroad, you'll likely return home with a pocket full of foreign currency you can't actually spend, making it "worthless." But you know it has potential, so you toss it into the "miscellaneous" drawer, not the garbage can. It's money – it's real money, but until you convert it into something that has meaning at the local coffee shop, you might as well have a handful of pebbles rolling around in your pocket. Data works much the same way: it is a very valuable resource when you can make use of it by extracting and communicating its meaning. In the case of euros or pesos, the meaning is worth. With data, the message is new knowledge and information that can improve decision-making and better performance in any given industry. In the healthcare field, especially, there is a constant need to improve patient outcomes by developing safer and more cost-effective practices that can improve public health and, ultimately, save lives.

Clinical and Business Intelligence (CBI) solutions play a big part in capturing needed data and enabling new knowledge and information. One notable advantage of CBI is that data can be collected, evaluated, and analyzed in real-time. Customizable key performance indicators (KPI) on dashboards can help uncover patterns and facts necessary for complex decision-making by such individuals as front-line workers, department heads, executives, and board members. With CBI, health care organizations (HCOs) can move from cumbersome manual, paper-based operations to automated ones, thus accelerating the clinical decision-making process and reducing high labor costs associated with the paper shuffle.

The benefits of CBI are clear. However, several barriers prevent the widespread use of this technology. For example, depending on an HCO, cost, preparedness, and the willingness of staff to adopt new technologies can be significant obstacles. To address these obstacles, the US federal government has established an incentive program known as the "Meaningful Use" to promote the implementation of Electronic Health Record (EHR) – a pre-requisite technology to CBI for HCOs. The Meaningful Use program, still in operation, is funded under the American Recovery and Reinvestment Act of 2009 and is managed by the Centers for Medicare and Medicaid Services (CMS, 2011). It is the hope that this incentive program will allow more HCOs to transition from outdated paper-based and clunky EHR systems to more robust ones that facilitate CBI.

Despite barriers to the digitalization of clinical, administrative, and financial data, HCOs have been making strides in tapping into the potential of CBI. Indeed, many HCOs are increasingly using CBI in their clinical and administrative decision-making. More recently, CBI tools have been instrumental in helping some hospitals cope with complex resource allocation due to COVID-19 hospitalizations (Cleveland Clinic, 2020). For example, CBI methods helped reveal that, in some instances, the most critical resource for COVID-19 patients was neither the beds nor ventilators but instead staffing allocated appropriately.

Besides improving clinical decision-making in HCOs, CBI can also help capture, process, archive, and retrieve healthcare information rapidly to assist with public health concerns. An example of this is how the Centers for Disease Control and Prevention (CDC) declared COVID-19 a pandemic on March 11, 2020, partly due to the CBI-enabled analysis of the COVID-19 real-time and historical data. CDC and other public health agencies continue to rely on CBI to develop the best strategies to manage COVID-19 and protect the public (Alford, n.d.). A case in point is the recommendation for COVID-19 patients to lay prone (on their stomachs) instead of their backs to improve respiratory distress (Medline, 2020). CBI has also proven to be valuable in revealing healthcare disparities. In particular, researchers studying COVID-19 patient data have found that people of color and those with chronic diseases have higher rates of hospitalizations and deaths caused by the virus (CDC, 2021). This knowledge has and continues to help policymakers and other public officials develop strategies to combat COVID-19, given different risk factors. At the local level, the Oneida County Health Department (OCHD) has been able to use data to target census blocks that have low vaccination rates. OCHD has collaborated with the Community Foundation and the Mohawk Valley Health System to provide outreach and vaccination opportunities to these census blocks with the goal of increasing the vaccination rate for Oneida County, New York.

In conclusion, HCOs are encouraged to adopt technologies that allow CBI to better care for their patients and move forward strategically. KPI on dashboards, with the added value of real-time analysis, has the potential to support the organization's clinical, operational, and financial goals. Inconsistent or outdated data can lead to skewed information and knowledge that is amiss, leading to potentially ineffective standards or practices. In healthcare, the objective is to take timely actions to care for patients and save lives. CBI solutions can play a key role in helping HCOs achieve this lofty goal.

Dr. Arif M. Rana and Dr. Jerome Niyirora are faculty members in the undergraduate Health Information Management and graduate Health Informatics program at SUNY Polytechnic Institute, College of Health Sciences, Utica, New York

Ms. Sara Albright is the Director of Business Development at Bassett Healthcare Network, Cooperstown, New York

Dr. Daniel W. Gilmore is the Director of the Oneida County Health Department

Special thanks to The Genesis Group for facilitating this article. The Genesis Group is a civic organization that unites Business and Community Leaders working to advance regional Economic, Social and Cultural interests, and to foster unity and cooperation in the Mohawk Valley region of Upstate New York. For more information on this type of analytical and analysis and data collection technologies, please visit the Genesis Center for Analytical Analysis website at TheGenesisGroup.org