The CMS Meaningful Use program has required hospitals to report clinical quality measures. Many hospitals are still stuck in the dark ages of reporting, using Crystal Reports and SQL stored procedures to collect and analyze for Meaningful Use and other quality measures. The days of basic reporting using data from single relational databases are long over in many industries; the healthcare industry is finally catching up with visual analytics tools such as Qlik Sense for healthcare. I recently got the opportunity to talk to David Bolton, Senior Director of Global Market Development in the Public Sector to learn more about how Qlik Sense is helping healthcare organizations explore clinical, financial and operational data, leading to improvements in care and reduced costs.
Qlik Sense allows hospitals to turn complex data into simple visual analytics that any member of the team can comprehend. Qlik Sense supports three main domains of healthcare the clinical side, the operations side and the corporate side. Hospitals look to Qlik to solve many clinical pain points such as challenges in the emergency room or utilization within the operating room. Some healthcare organizations in the United States have forty to fifty different Qlik visual analytics solutions. The product can be used to find and remove bottlenecks or unwarranted clinical variation. Qlik has a program in a UK hospital with twenty operating rooms which found that every one percent utilization increase was worth around $15,000 a week in additional revenue. Operating Rooms that are not running at one hundred percent utilization can use analytics and big data to determine what is causing low utilization and fix it.
Qlik is about unlocking complex data systems and connecting big data in a way that allows you to see where the challenges are. Qlik can pull data into its database from disparate systems with its scripting tool which can collect data from any message type or source. Over 15,000 healthcare providers currently use Qlik, including providers at Children’s Healthcare of Atlanta, Allina Health, and Healthsouth Rehabilitation Hospitals. These hospitals are using Qlik to measure HCAHPS, ambulatory quality measures, CGCAHPS, potentially preventable readmissions, PQRS and patient waiting times.
The screenshot below shows an example dashboard created in Qlik Sense that can be used to determine clinical variation. This dashboard shows the costs and profits of each provider, which allows hospital staff to determine which providers are most profitable for the hospital. Armed with this data the hospital staff can study the workflows of certain providers to gain insight on what is causing the discrepancy between the most and least profitable providers. Doctors who know that their hospital is keeping track of profitability and have access to the data will be motivated to improve their efficiency and seek help from more efficient colleagues if necessary
It is also important to note that the difference in profitability could be due to the type of patients each provider is seeing and not due to provider efficiency or workflow. In this example all of the least profitable providers are OBYNs so it would be prudent to look at their patient population further to determine why the costs are so high. Below is a sample dashboard that allows users to view information about the population of the patients along with the costs and profits associated with those patients. Because this particular group of patients are obstetrics patients, it comes as no surprise that the most expensive patients are the older patients. The current view of the costs by age group is highlighting fifteen to twenty-seven year olds, however if you look under the “Costs by Age Group” graph you can see the two red bars which is where the older more expensive patients are.
From this view you can drill down even further into the data to determine the DRGs associated with the forty-five to forty-six year old patients that are more expensive. Again, there is no surprise here that caesarean sections and caesarean sections with complications are more expensive than natural childbirth. Caesarean Sections have become more popular in the recent years and women will sometimes have a C-section when it is not medically necessary. Graphs such as the one below can be used to convince providers to not suggest certain procedures when they are not medically necessary and can help hospitals get away from a fee for service payment methods and reduce medical waste.
The next screenshot breaks down the costs of an individual patient that underwent a caesarean section. The most significant costs are coming from the hospital room itself. Hospitals that see that their number one expense for certain procedures is the hospital room itself could use this information to focus on strategies to keep patients in the hospital for a shorter periods of time or maybe even introduce home care when possible. Hospitals are rampant with MRSA, C-diff and other dangerous bacteria, so in many cases it is safer to care for patients in the home. Data insights such as the one below prove that patient care in the home could be financially advantageous as well which could encourage hospital administrators to disrupt their current care model.
There is a government mandate that any patient in the UK has to be seen and treated in less than four hours. The data below is from a large teaching hospital in the UK which shows how often this hospital is breaching the four hour mandate and gives an idea of when most patients are coming into the emergency room. From the graph it looks like the peak time for hospital admission is 8:00 PM. The dashboard also shows conversions,how many patients are converted to inpatient, in this case around thirteen percent of patients are converted to inpatient.
If the user wants to gain more insights from the breach and conversion data visualization, they can look at another view of the same data that highlights arrival mode, source of referral, treating doctor and age group of the patient.
With the amount of quality measures hospitals and providers now have to track it makes sense to use a visual analytics tool that can allow you to make changes on the fly and delve deeper into the data with a click of the mouse. Performing the analysis above in SQL or Crystal would take fifty hours or more of work by a two-hundred dollar an hour technical consultant. With Qlik, organizations can visually analyze and explore relationships among electronic medical records, clinical systems and finance systems to unlock insights that could otherwise go unseen or be very expensive to monitor.