Business intelligence cures complexity, cost overruns in Canadian hospitals

When a recent outbreak of C. difficile – a common intestinal bacteria caused by the use of antibiotics – cropped up at Joseph Brant Memorial Hospital in Burlington, Ont. they had a new tool to help them fight it.

Usually, the hospital staff would’ve spent hours sifting through Microsoft Excel spreadsheets and patient record charts to determine where the outbreak started.

But now these laborious processes are no more than an unpleasant memory.

That’s because an analytics tool from Cary, N.C.-based SAS Institute Inc. ensures data is automatically audited and the answer delivered.

Before staff “weren’t able to do the rounds they wanted to and they weren’t able to do as many inspections,” says Mark Morreale, manager of decisions support at Joseph Brant. But the SAS pilot project has “increased the ability to do rounds, and staff’s [infection] tracing as well.”

It’s just one case of a wider trend in Canadian hospitals.

Health care facilities across the country are turning to Business Intelligence (BI) and predictive analytics software to help sort through a disparate patchwork of systems that house volumes of patient data.

To better stretch their resources and track indicators related to provincial funding formulas, hospitals are plugging in more advanced software. They’re also looking to it for help when an ageing population poses more healthcare challenges.

The BI trend has caught on like a cold in many industries, healthcare included, says George Goodall, senior research analyst with London, Ont.-based Info-Tech Research Group. But hospitals have a special kind of advantage.

“What’s different about the [healthcare sector] is a lot users are power users,” Goodall says. “You’re dealing with a user group that has plenty of experience with advanced tools and isn’t afraid of statistical techniques.”

By stealing a page out of the book of the manufacturing industry, healthcare is now looking to exchange data for knowledge on how to use resources more efficiently, he adds.

That’s what Toronto-based Bridgepoint Health hopes to do starting today. The specialized, complex chronic care facility becomes the latest amongst more than 50 other hospitals in Ontario to deploy a SAS product.

The BI and Performance Management Platform to interpret data from what used to be a hodge-podge of different systems and formats, says Steve Banyai, chief information officer (CIO) at Bridgepoint.

“When I started here five years ago, we had a chart that showed 123 separate systems,” he says. “It was crazy.”

Now, with a couple of exceptions, that has been consolidated down to just a single implementation.

The single vendor used is Boston, Mass.-based MEDITECH, and SAS software will mine the data. Hospital employees will view the data through a browser-based graphical front-end.

Integrating data from the multiple systems at play in any given hospital is a big pill to swallow, says Pat Finerty, vice-president of alliances and business development at SAS Canada.

“There’s no system in the world that can do a good job for you if the data isn’t organized well for analysis and decision making,” he says.

Combine that with the sheer volumes of data housed by hospitals, limited resources for IT projects and the reactive nature of an environment that works to save lives every day are the challenges of providing BI in healthcare, Finerty adds.

Yet SAS, a private company, has made a multi-year investment to the industry and it is one of its fasting growing lines of business, he says. “We’re growing more than twice as fast in healthcare as in other sectors.”

Ontario has been one main area of that growth thanks in part to the province’s SAS Health Care Advisory Council, a group of executives from across the healthcare system that help adapt the software. The user group was created in 2005.

The advisory panel is a common practice among software vendors who want to develop a specialized product, Goodall says.

“It’s an important bridge that allows a software company to get feedback and helps create a road map,” he says. BI tools are “great products… but if you have difficulty framing the questions, the tool’s not going to work.”

All the questions asked by the healthcare industry lead back to patient care. For Joseph Brant, a hospital of about 300 physicians and 1,400 caregivers and operations workers, quality patient care is about keeping staff informed.

“What’s great about SAS is that we’re able to do an in-depth analysis at the patient level,” Morreale says. “We’re able to calculate the amount of risk associated with a patient and report that to a nurse.”

The hospital used to calculate waiting times for major operations – hip and knee surgeries, for example – with spreadsheets alone. Now this Ministry of Health mandated indicator is tracked with the much faster SAS tool.

Starting today at Bridgepoint, Banyai hopes SAS will begin playing a major role in the way healthcare workers operate. “This organization will be forever changed by using the electronic tools for assessments and care,” he says.

“Part of our strategy is to get the right information into the right hands so they can make the right decisions,” he adds. “It’s about becoming a more informed patient care provider.”

Predictive modeling will help reveal trends among patients coming to Bridgepoint, Banyai says. You can’t just drop into the emergency room at this hospital, you must be referred to the hospital after being assessed with a complex set of multiple health problems – so decoding pattern can be difficult.

“We see an increase today in the number of people coming in with strokes, and at a reduced age.”

For instance, the Bridgepoint CIO says a greater number of people in their mid-30s are now suffering strokes, and they require different care than the usual elderly stroke victims.

New data collected – such as lifestyle and habits – on such issues might hint at underlying factors when mined by SAS.

“The ultimate goal of predictive analytics is prevention,” Banyai says. “To advise our patients, and to more importantly, advise others who aren’t there yet, but may be getting there because of the choices they’re making.”

Aside from helping doctors and nurses better understand patient issues, the publically-funded healthcare system in Canada will look to BI software to give it a boost in jumping bureaucratic hurdles. Provincial governments require an array of indicators is tracked, and the funding formula is based on the outcome.

“The whole system is under tremendous pressure to fulfill their accountabilities,” SAS’s Finerty says. When funding is tight, “getting smarter with the use of resources is an opportunity area.”

Taking a set budget and using it to predict the resources needed from the number of beds, to the amount of nursing hours worked, to running the department takes “a lot of hard core number crunching,” Info-Tech analyst Goodall says.

Those are exactly the kind of indicators that Bridgepoint will track, according to Banyai.

In addition, they will calculate a complexity score for each patient, and assign him or her an appropriate level of care based on that score. The aim is to use the hospital’s highly-skilled staff to care for the right people.

“It is making sure that people are in the right place, they’re in the right bed and getting the right service,” Banyai says.

At Joseph Brant, Morreale decided to implement SAS when he discovered the Canadian Institute for Health Information was using it to calculate the hospital’s standardized mortality rate – another key funding indicator. He worked with them to gain the capability to do the same calculations in-house.

“Before, we were just reacting to the results,” Morreale says. Now he knows the information before it is released by the institute.

Morreale plans to continue to leverage SAS to get rid of spreadsheets lying dormant on hospital desktops, and start tracking important results.

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Brian Jackson
Brian Jackson
Editorial director of IT World Canada. Covering technology as it applies to business users. Multiple COPA award winner and now judge. Paddles a canoe as much as possible.

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