Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.

1. Achieving Strategic Objectives
Through BI
Andrew W. Proctor, MS

2. Business Intelligence
• The use of information that enables
organizations to best decide,
measure, manage, and optimize
performance to achieve efficiency
and financial benefit (Gartner)
• Focus on operational process
improvement and business use of
information
In 1989 Howard Dresner popularized "BI" as an umbrella term to describe a set
of concepts and methods to improve business decision-making by using fact-
based support systems.

3. Clinic Access
• Template Management
• Appointment Days Wait
• Appointment When Wanted
• Same Day Access

12. Digestive Disease Access
Initiative
6
8
10
12
14
16
18
Q4 '07 Q1 Q2 Q3 Q4 '08
DaysWait
55%
60%
65%
70%
75%
80%
Apptwhenwanted
Days wait Appt when wanted

13. Appointment When Wanted by Days Wait
June 2010 through December 2012
Lowess Smoothed Regression
Spearman Correlation:
New Visits: -0.181, p < 0.001; Established Visits : -0.098, p < 0.001; New Institute Visits: -0.192, p < 0.001;

14. Executive Quarterly Review
• Align strategic objectives
• Common scorecard platform
• Transparency
• Best practice sharing
• Continuous Improvement

19. Physician Name

20. Main Campus
Doctor Communication
61
0
20
40
60
80
100
2008 2009 2010 2011 Jan - Feb
'13
%tile
Peer (3) Peer (1)
Peer (2) Peer (4)
CC 50th

21. Main Campus
Overall Rating
93
0
20
40
60
80
100
2008 2009 2010 2011 Jan - Feb
'13
%tile
Peer (3) Peer (1)
Peer (2) Peer (4)
CC 50th

22. Short Cycle
• Near “real-time”
• Quicker delivery to clinical
managers
• Summarized nursing unit
performance

25. Smoking Cessation
%

26. HF Education
%

27. SCIP: Hair Removal
%

28. SCIP: Normothermia
%

29. SCIP: Periop Beta-blocker
%

30. SCIP: VTE Prophylaxis Orders
%

33. Physician Name

34. 30-Day Readmission Data Flow
30 minute updates 30 minute updates
Patient readmitted to
Cleveland Clinic
ADT system captures
readmission
Web application
captures readmission
for review
Aggregate monthly
reports
Short Cycle dashboard
reports readmission in
“real-time”

36. ICU Operations
• ICU Ops Team created in 2006
• Expanded in 2009
- Oversight committee formed
- 30+ ICUs
- 350 beds
- 30,000 admissions/year

40. ICU Hand Hygiene
Compliance
60%
70%
80%
90%
2007 2008 2009 2010 2011 2012
Compliance Target

41. ICU CLABSI Rate
0
1
2
3
4
5
2008 2009 2010 2011 2012 2013
Rate

42. Blood Utilization
• Scarce resource
• High cost
• Clinical risk

45. Physician
Names

46. Example Physician

47. Cleveland Clinic Blood Use
per 1K patient days
2008 2009 2010
150
200
250
300
350
Oct
Dec
Feb
Apr
Jun
Aug
Oct
Dec
Feb
Apr
Jun
Aug
Oct
Dec
Units
2
2.1
2.2
2.3
2.4
2.5
CMI
Blood use per 1K pt days Case Mix Index Linear (Case Mix Index)

48. Predictive Analytics
“declare the past, diagnose
the present, foretell the
future” - Hippocrates

49. Predicting Length of Stay for
Scheduled Surgeries
• Reliable prediction of hospital length
of stay for future patients
• Generalizable framework for similar
initiatives
• Downstream strategic operational
impact
- Occupancy forecasting
- Clinical decision support

50. Modeling Perspective
Hospital
Admit
Hospital
Disch
Physiology
and clinical
Surgery
Demographics
Prob List

51. Population and Data
• CC Main Campus TCI cases age >18
- 2010-2012
• Data source: EPIC medical record
• Demographics, physiology, labs, comorbidities,
CPTs, work RVU, readmit
- All data ≤90 days prior to procedure
• Surgical CPTs grouped using validated
taxonomies (NSQIP)

53. 1
1

54. 2
2

55. 3
3

56. Estimating Relationships Among
Key Performance Measures
Measure
#1 is below
target
If Measure #1
meets target,
it positively
influences
Measure #2
and 3

57. • CIO, CFO, CMOO
• Meets monthly with Leadership Team
• Critical for executing on strategy
Executive
Team
• Executive Directors from IT, Finance, Medical Operations
• Meets with Executive Team & Strategic Council
• Manages BI resources & BI program overall
Leadership
Team
• Representation from several clinical & operational areas
• Meets with Leadership Team
• Provides project ranking recommendations
Strategic
Council
EBI Governance