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Enterprise Business Intelligence. Ben Kimmel Assistant Director, Fiscal Services. Cleveland Clinic. 3.6 million patient visits 160,000 admissions 42,000 employees 2,700 physicians and scientists. Current EBI Infrastructure. Phase I implemented 2006 SQL Server platform
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Enterprise Business Intelligence Ben Kimmel Assistant Director, Fiscal Services
Cleveland Clinic • 3.6 million patient visits • 160,000 admissions • 42,000 employees • 2,700 physicians and scientists
Current EBI Infrastructure • Phase I implemented 2006 • SQL Server platform • Business Objects presentation layer • 18 TB data • 40 FTEs • 93% data load frequency < weekly • 6,000 total users, ~1k/week
Agenda • Cleveland Clinic performance management evolution • Example dashboards • EBI infrastructure • Governance
Web Based Wheels Dashboard Tools and Data Warehouse Monthly Wheels Institute Scorecards Executive Dashboard Monthly Operational Indicators Continuous Improvement Summits Short Cycle Daily Dashboard PM DSS Dept DBs EBI The CC EBI Evolution 1993 1995 1998 2002 2004 2005 2006 2008 2010-12
EBI & performance management Performance Management • Using data to manage business • Feedback loops & accountability • Predictive modeling • Enterprise level Business Intelligence • Using DW data in fact based analytics • Augment data with KPIs, business imperatives & scorecarding • Key metrics & trending analysis • Division / function specific Data Warehouse • Automated processes that feed a central data warehouse with data from disparate source / transaction systems • Single source of information • Initiative driven Functional Systems • Stand alone, functionally specific applications • DSS applications • Financial consolidation tools
Dashboard Architecture Finance & Statistics Quality Patient Access Operational Dashboards Operational Dashboards • Summary • P&L by Entity • Financial Metrics • Key Statistics • Reports • Service Line • Summary • Core Measures • Patient Experience • Hand Hygiene • Outpatient Access • Days Wait • Appt when wanted • Physicians • Institute Chair • Department • Nursing • Clinical Operations • Patient Support Services • Finance • Statistics • Patient Access • Quality • Patient Experience • High Level • Indicator Driven • Visual & Intuitive • Focused • Flexible Executive Dashboard
Executive Quarterly Review • Align strategic objectives • Common scorecard platform • Transparency • Best practice sharing • Continuous Improvement
Clinic Access • Template Management • Appointment Days Wait • Appointment When Wanted • Same Day Access
Short Cycle • Near “real-time” • Quicker delivery to clinical managers • Summarized nursing unit performance
Smoking Cessation (AMI/HF/PN) 2009 2010 2011
Pneumonia Vaccination 2011 2009 2010
HF Education 2009 2010 2011
SCIP: Hair Removal 2009 2010 2011
SCIP: Normothermia 2009 2010 2011
SCIP: Periop Beta-blocker 2009 2010 2011
SCIP: VTE Prophylaxis Orders 2009 2010 2011
ICU Operations • ICU Ops Team created in 2006 • Expanded in 2009 • Oversight committee formed • 30+ ICUs • 350 beds • 30,000 admissions/year
ICU CLABSI Rate Rate 50% reduction
Blood Utilization • Scarce resource • High cost • Clinical risk
Physician Level Detail
Cleveland Clinic Blood Use per 1K patient days 2008 2009 2010
Information Delivery Environment Before EBI Previous environment characterized by: Heavy reliance on packaged technology solutions with limited integration Data stores developed and owned by independent departments – duplicative and expensive Inefficient and untimely delivery of information Disjointed approach to information access & display (reports, online tools, excel, crystal, etc.) Multiple representations of data with inconsistent definitions – no single source of truth DSS Billing ODS ORIS Crystal Excel GL SC CIS Data “Stores” / Applications Information Access / Display Data Sources
Current Information Delivery Environment Current environment characterized by: Coordinated approach regarding: Data ETL and storage Data visualization and reporting Data stores developed and owned by independent departments Efficient and timely delivery of information Coordinated representations of data with consistent definitions – moving towards a single source of truth Billing ORIS GL SC DSS CIS Medops Others Others Others Consistent Information Access / Display Distributed Enterprise Data Warehouse Data Sources
Key Areas of Responsibility Source ETL: IT Warehouse: Finance Dashboard: Med Ops Infrastructure: IT • Distributed Functionality for Flexibility • Marts • Dashboards • Tools Infrastructure Configuration & Access Infrastructure Configuration & Access