Actionable Analytics: A Marathon or a Sprint?

Data analytics in healthcare requires a significant investment, and the right decision can make or break your bottom line.

Running a marathon is a decision that must be given much forethought and planning. Like any goal worth achieving, it requires a significant investment—of cost, effort, and time. A prospective marathon runner needs to invest in the right shoes, clothing, headphones, and fitness tracker; invest weeks and months in training; and invest effort, staying diligent about habits like healthy eating and cross-training.

For years, investment in data management and analytics solutions in hospitals and health systems has been a lot like marathon training—a very large investment in cost, effort, and time up front, with no real view of the finish line in sight. Only, for health analytics, that payoff is not merely weeks or months away as it is for the marathon runner, but rather years—or even decades—into the future.

Hospital systems are complex, often running as many as a hundred software programs just to keep daily business flowing smoothly. With multiple disparate systems throughout the hospital, it can be extremely difficult for the various stakeholders in need of information to pull out the right data, make sense of it, and take action in a timely way.

Many years of speaking with hospital executives and departmental leaders has taught me that the challenges they face fall into three general categories: difficulty accessing consistent, reliable, integrated data; labor-intensive analytics with long turnaround times; and difficulty engaging physicians and staff (Figure 1).

Figure 1: Primary Challenges in Health Information Technology (IT)

Rather than the isolated challenges that some hospitals and health systems may experience occasionally, these 3 obstacles are interconnected and pervasive. If stakeholders don’t have a platform that provides easy access to consistent, reliable, and integrated data, then discovering any actionable insights becomes a marathon slog—a labor-intensive effort with long turnaround times before seeing results. And these long turnaround times, in turn, affect providers and patients, because without actionable evidence that the current way of doing things can be optimized, nothing will change on the front lines of care. In this model, challenges flow forward and negative consequences flow backward—quality of patient care, physicians trying to move toward value-based care, IT teams with inefficient software, and the hospital’s bottom line all experience the ramifications.

Traditionally, healthcare IT spend has been focused on large, long-term investments. Hospitals often spend 7 or even 8 figures on their own enterprise data warehouses, plus major electronic medical record investments that frequently cost hundreds of millions—or sometimes billions—of dollars. Implementation cycles can last 1 to 5 years before these systems are ready to go live. And even then, the data still aren’t integrated and actionable; hospitals do not see any kind of return on investment (ROI) or measurable results for a long, long time. The marathon runner starts slow, the race is long and grueling, and the athlete is hoping that that they’ve got enough stamina to make it to the finish line.

Picking Up the Pace

Today’s healthcare climate, though, isn’t built for marathon runners. The reality is an industry with continually rising drug costs, pressure from payers around value-based reimbursement, a focus on patient-centered care where the patient is an informed, demanding consumer, and continued advancement of precision medicine with specialty pharmaceuticals. With the race clock ticking away, it’s time to sprint.

What does that look like in health IT? It’s all about investing in data solutions with an emphasis on transitional workflows and automation. What’s needed to make it to the finish line at the head of the pack is a system that can focus on 4 key elements:

  • Data governance and modeling — Near-real-time feeds that combine data from disparate systems into a single, consolidated and normalized model, enabling pharmacy to conduct cost, quality, and revenue analysis that decision-support systems historically have not been able to provide
  • Data validation and visualization — Implementation analysis that can, for example, identify large-scale errors related to internal drug conversion ratios and mappings (resulting in significant annual savings).
  • Resolution workflow — Empowering pharmacy end-users to correctly purchase drugs across all classes of trade to maximize both savings and compliance.
  • Stratification & automation — Using comparative analytics to determine factors such as locations, departments, cabinets and clinicians dispensing certain medications (revenue integrity/drug diversion); the ability to track reimbursement by drug over several years to determine changes in overall reimbursement by payer.

Suffice it to say there’s still a place in the industry for long-distance runners. What’s needed is a balance between marathon and sprint investments, so that while hospitals wait for their long-term interests to pay off, they don’t get left in the dust by the competition. Much like investing in the stock market, it’s important to diversify; smart investors understand the balance of risk and reward, and put their money in investments that are likely to pay off in both the short and long terms. Table 1 illustrates some of the primary features of both marathon and sprint training in health IT.

Table 1: Marathon vs. Sprint Training in Health IT

Marathon Training

Sprint Training

Investments

  • Significant upfront costs
  • Large ongoing maintenance
  • Requires balance and organizational discipline

  • Look for comparatively lower up-front costs
  • Reduced IT lift
  • Minimal to no “on premise” deployment

Risks/Rewards

  • Long view to break-even point (BEP) and ROI
  • Less certainty of returns
  • More organizational disruption

  • High % yield, but $ yield may be lower
  • Rapid Opportunity Identification à Rapid Results
  • Requires resource capacity and “culture of action” to succeed

Recommendations

  • Balance marathon IT investments with sprint initiatives

  • Cross-departmentally focused solutions, look for win-wins

Reaching the Finish Line

Sprint-style investment success stories can be found across the country. Several examples of health systems that decided to invest in data management solutions that emphasize transitional workflows and automation include:

  • A northeastern academic medical center captured $230,000 in additional net revenue in just 30 days with automated revenue integrity analytics and workflows.
  • A southeastern rural community hospital identified more than $1 million in combined drug cost savings and revenue improvement opportunities that they began executing on in less than 90 days.
  • In its first week, a southwestern independent delivery network identified an opportunity to reduce costs by 37% for a cancer therapy through lower drug costs and better alignment of care settings.
  • In the first 45 days, a west coast independent delivery network reduced 1460 labor hours per year and increased data accuracy using analytics to help update costing of its pharmacy charge master pricing file.

To apply our analogy, while running a marathon is an admirable goal, success comprises many small victories along the way. A hospital can’t afford to wait for yet another expensive data analytics solution requiring long implementation times and large time commitments from its staff. Rather, the hospital needs a real-time platform to make actionable changes now. A wise hospital executive must understand when a series of short-term wins may be a better strategy for achieving their ultimate long-term goals.