How to Build a Successful Clinical & Business Intelligence Roadmap

By Natalie Dion, Director, Enterprise Data Management, Texas Health Resources, Member, HIMSS Clinical Business Intelligence Data and Analytics Task Force

Dion, Natalie

Source: HIMSS Clinical & Business Datga and Analytics Task Force

October 31, 2013

Health care reform is driving the need to manage the health of populations of patients across the care continuum to improve clinical outcomes and quality, reduce medical costs, increase revenues for services, and improve patient satisfaction. New payment models require new care processes and demand innovative reporting requirements.    

Texas Health Resources (THR) is a large, integrated healthcare system that has grown and diversified through acquisitions. The THR system includes 14 wholly owned hospitals, hundreds of physician practices, and various joint venture hospitals and specialty clinics. As a result, THR has multiple EMRs, several patient management systems and various other operational and financial systems. To achieve the health care reform objectives, THR recognized the need to integrate data across these disparate systems into a centralized data warehouse to provide longitudinal patient analytics.  

This article outlines the steps THR followed in creating its Clinical & Business Intelligence (C&BI) Roadmap.  A successful C&BI roadmap consists of people, process and technology that enable enterprise analytics and are ultimately driven by an organization’s strategic plan.  A roadmap sets the direction for a C&BI strategy and can be adjusted based on the current realities.  

Identify a senior level executive sponsor who has a stake in the clinical and business intelligence program's success. This executive should be well respected within the organization and someone who will evangelize and support the program.

Create a steering committee consisting of senior level executives from across the organization. Be sure to include representatives with a clinical background on the team who can identify the clinical needs and establish "buy in" for future adoption of analytics technologies.

The steering committee provides active sponsorship for the C&BI initiative across the organization. Establish the committee's charter, defining its purpose, mission, vision, goals and objectives. Elements of a steering committee charter frequently include the prioritization and funding of analytic projects, as well as ensuring alignment with the organization’s overall strategic objectives.  

The steering committee should define guiding principles for the C&BI program which direct the design, development and use of the C&BI system.The principles lay the foundation for building the C&BI program from an enterprise view versus a departmental perspective. Examples include:

  • C&BI is the single trusted source of integrated analytical data across the organization.
  • C&BI will source data from the master source system for that subject area.
  • C&BI will use standard definitions for data elements and metrics.
  • C&BI will develop role-specific user interaction, based on subject area.

Identify the analytical subject areas the C&BI program will deliver.  This is accomplished by interviewing key executives and individuals from across the organization to understand what information they need in order to accomplish their business goals.  Using the information gathered from the interviews, collate the feedback and identify the common themes that can be framed up as uses cases.  The use cases should be aligned with the organization's overall strategic plan.   Describe the use case objectives and project the return on investment based on information elicited during the interview process.  This information will feed into the roadmap creation step.  

A second round of interviews with key stakeholders may be needed to drill down into the requirements for each use case.  At this stage, you need enough information to identify the data elements and measures, the information sources, the historical data requirements, the number and types of users that will access the analytics and the general types of analytics that will be performed.  Be sure to include the security and compliance stakeholders in the interview process so their requirements can also be incorporated into the roadmap.

Using the requirements, assess the technology needed to deliver the C&BI program.  Typical technologies are depicted in Figure A below, but also consider the security and compliance needs and other advanced requirements such as text analytics.  Look at your existing portfolio of technologies before deciding to make a new investment.  If you need to purchase technology, follow a standard Request for Proposal process using the requirements as input. 

Figure A:


Create a roadmap that allows for an iterative delivery schedule, preferably no longer than 90 day delivery cycles, so value can be realized early and often. Propose the priority in which the use cases will be delivered.  Factor in the benefit of the use case to the organization as well as the data required to deliver the use case.  Try to find low hanging fruit that can be delivered early - a use case that provide high value but does not require too many sources of data.  Profile the data needed for each use case to ensure it exists.   Map out the sequence the data will be acquired into the data warehouse and the sequence in which the use cases will be delivered.  An example is provided in Figure B below.  

Figure B:

Roadmap Figure B


             Present the C&BI Roadmap to the C&BI steering committee for approval.  Include the use cases, their description, the anticipated ROI and roadmap sequence for presentation to and approval
             by the C&BI steering committee.

Ideally, the C&BI roadmap would also include a formalized enterprise data governance process.  Unfortunately, because of the overwhelming change and transformation taking place at THR, and the lack of resources available, THR initially took a grass-roots approach. Population health management requires the definition of various populations and measures, as well as the attribution of the relationships between providers, patients and populations.  It is important that the data be managed from an enterprise view so there is common definition, accurate data capture in the source systems and efficient operational processes to store and maintain the data.  Once the data was visible to THR via C&BI, the organization saw the direct alignment with operational system data capture and the dashboard reporting and interest grew to expand the data governance model. 

Lastly, the C&BI roadmap should be reviewed and validated periodically and modified as the organization needs change. 



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