Like any other business today, ThedaCare, a Wisconsin-based health-care company with five hospitals and more than 20 primary-care clinics, is swimming in data. Nuggets about patients’ demographic features, diseases, and treatments are buried in electronic medical records. Payroll tracks the hours employees spend working overtime or on call. The billing system knows how many patients have private insurance and how many rely on government programs like Medicare and Medicaid, which reimburse ThedaCare at a lower rate.
Even from these few examples, you can start to see how it would be possible for ThedaCare to spot trends and deal with them in a more cost-effective way—if those tidbits of information weren’t trapped in isolated programs and databases.
Brian Veara, ThedaCare’s manager of decision resources, worked for retail and manufacturing companies before he moved into health care more than eight years ago. Health care lags about 10 years behind other industries when it comes to information technology, he says, so he wasn’t surprised to find how long it took to produce reports. But he knew something needed to change.
A major part of the solution: “business intelligence” software. That’s a type of program that pulls together information from disparate systems, builds relationships between data sets, and lets users explore the information by searching and clicking around through tables, charts, and graphs.
In June 2009, Veara bought a business intelligence program called QlikView from Qlik Technologies. The company has been around since 1993, but until about five years ago, computers were too sluggish to make its software model feasible or affordable for most customers. QlikView’s “in-memory” approach means it stores a copy of all the aggregated data in a computer’s local memory instead of going back to retrieve information from the disparate systems as needed, so customers can work with it in real time. Among QlikTech’s other customers are fire departments, newspapers, consumer products companies, and insurance providers. Individuals can download a free version of the software; some people connect it to their iTunes music library to analyze their listening habits.
Before QlikView, ThedaCare produced about 9,000 reports a month, ranging from descriptions of the patient population (meant for internal use) to assessments of ThedaCare’s performance that the government could compare with state and national averages. Every time Veara wanted to pull information for one of those reports, he needed to know ahead of time exactly what he was looking for and where to find it. Asking the wrong question might yield irrelevant information or even a blank document. And each request could take up to 15 minutes to process.
With QlikView, he can browse without knowing exactly what he’s hoping to find; when he does need to track down a particular fact, he doesn’t need to build a report because the information is available instantly. “You can now see patterns of information that you couldn’t see before,” he says. Now, he adds, the question becomes “How do we use it to provide better care and more effective care?”
ThedaCare is pursuing many answers to that question. In the oncology department, QlikView provides a snapshot of where each patient is in the cycle of diagnosis, treatment, and recovery. The department is particularly focused on making sure there aren’t unnecessary delays between steps in that cycle; QlikView makes it possible to identify missed goals immediately and start uncovering the reasons for the problem.
ThedaCare is using QlikView to investigate outliers of all sorts. For example, the health-care industry as a whole has guidelines describing how long patients should stay in the hospital following certain procedures. When a patient stays longer, the hospital may have to eat the cost. QlikView makes it easier to spot an extra-long hospital stay and figure out what went wrong. Was the treatment itself the cause? Would a nurse with different skills have made a difference? Was there a glitch in the discharge process?
Labor is ThedaCare’s single biggest cost, accounting for 50 to 60 percent of expenses. The company is using QlikView to predict, on the basis of past patterns, when patient volume will be heaviest in certain departments or locations and then staff accordingly. For example, a surgeon’s busy schedule one day could send ripples through the system in the days that follow. And patients might regularly flood one of ThedaCare’s radiology departments on certain days while another location might be empty. Veara says the company wouldn’t have been able to spot such patterns before, but now it can move staff between neighboring hospitals instead of paying overtime at one place and cutting back employees’ hours at another.
Veara declined to say how much the company spent on the software, but he says it paid for itself in the first year. This year, he expects QlikView to help the company cut overtime pay by $750,000. It is also expected to save about $400,000 by making employees more productive while they work.