What Is Clinical Business Intelligence? (Module 1)

You've seen the headlines that the US healthcare industry is on track to wreck the nation's economy through out-of-control costs. Reports by the Institute of Medicine have said that avoidable medical mistakes kill thousands of patients every year.  It is clear that major changes are needed.  In the context of ongoing healthcare reform, leaders of US hospitals and health systems recognize an urgent need to transform their care delivery systems.  

Clinical business intelligence is the use of data analysis to improve care delivery. Clinical business intelligence (i.e., clinical analytics) refers to a broad category of information technologies that gather data created during the delivery of medical care and analyze that clinical data to help managers and clinicians make better decisions.

Clinical business intelligence is an essential tool for health systems pursuing clinical transformation as they take action to dramatically improve their performance in terms of cost and quality. Improving performance requires insight into "what works" and "what does not work," as well as intelligent systems to ensure that the best care is delivered. Clinical business intelligence can provide insight and intelligence, making it an essential tool for health systems pursuing clinical transformation.

Clinical Performance Measurement

"You can't manage what you don't measure" is a management truism. One of the most important benefits of clinical business intelligence is the ability to better manage the care delivery process through the use of clinical performance measurement.  Clinical performance analytics are just as essential for health system management as the financial performance analytics that help manage the revenue cycle, the supply chain and the workforce. 

Clinical performance measures focus on specific processes and outcomes that are important to achieving the health system's overall organizational goals. Many hospitals and health systems have explicitly stated their overall mission and goals in terms inspired in part by the concept of the Institute for Healthcare Improvement's "triple aim,"

The components of the Triple Aim are:

  • Improving the patient experience of care (including quality and satisfaction)
  • Improving the health of populations
  • Reducing the per capita cost of health care

Many health systems track their overall performance using a balanced scorecard that includes specific quantifiable measures aligned with goals similar to those in the triple aim. Clinical performance measures may be selected to support these high level scorecard goals in the context of individual projects.  Clinical performance measures track progress towards improvement goals and help with accountability for results.

Examples:

  • A clinical performance measure important to hospitals is the "rate of central line-associated bloodstream infection" (CLABSI). In a real success story for clinical process improvement, concerted, coordinated efforts by U.S. clinicians have reduced the rate of these deadly infections to near zero at several hospitals that have made it a top priority.
  • One population-based clinical performance measure for primary care is rate of asthma emergency room visits. Numerous health programs around the country focus on these measures as they attempt to bring chronic conditions under control, which:
    • Improves the quality of life for patients
    • Avoids expensive hospital visits.

Clinical Decision Support

Clinical business intelligence can be used during the process of caring for individual patients to improve the decisions about care made by doctors, nurses and other clinicians. These applications of clinical decision support are often called predictive analytics because they look ahead and suggest treatments that will yield future positive outcomes.

Typical Analytics Profile

Clinical Decision Support

Clinical Performance Measurement

User / Decision Maker

Clinician

Manager

Time Frame

Current, Prospective

Retrospective

Scope Of Data

Individual patient

Aggregate population of patients

Example:

  • A rule-based logic module embedded in an order entry system that advises a physician on proper medication dosages of based on the individual patient's clinical data, using published scientific guidelines. We will look at additional examples in other articles in this series. More information about CDS is available in the HIMSS Resource Library  

Performance Improvement Process

Formal performance improvement processes are central to the management philosophy and culture at many health systems.  Methodologies can include:

  • Continuous Quality Improvement
  • Lean Six Sigma (DMAIC)
  • The Model for Improvement (PDSA, recommended by the IHI)
  • Other variations on process improvement methodologies.

Using Clinical Analytics to Support Process Improvement Steps

PDSA Steps Plan Do Study Act
DMAIC Steps Define Measure Analyze Improve Control
Roles for Clinical Analytics Prioritize Opportunities.

Define Measures.

Set Baseline.

Correlate causes and outcomes.

Benchmark best practices.

Evaluate pilot solution.

Implement Clinical Decision Support.

Measure result.

Monitor ongoing performance.

 

HIMSS Clinical & Business Intelligence Primer

Module 1: What is Clinical Business Intelligence (CBI)?

Module 2: The Urgent Need for Clinical Business Intelligence

Module 3: Types of Clinical Analytics

Module 4: Essential Technologies for Clinical Analytics

Module 5: Organizing for Success in Clinical Analytics

Module 6: Future Directions for Clinical Business Intelligence

Module 7: Opportunityies for Payers and Big Data