10 Mar Will business intelligence tools become healthcare analytics solutions?
Orlando, Fla. – Can IBM, through its growing emphasis on data management and business intelligence, and its $5 billion acquisition of Cognos, help healthcare organizations convert massive amounts of information generated by information technology into usable, data-driven intelligence?
IBM used the annual HIMSS Conference to unveil this suite of healthcare analytics for several lofty purposes, including public healthcare quality reporting, personalized medicine, and even dramatic improvements in patient care outcomes.
But can the company’s suite of Enterprise Health Analytics products really become a rich source of clinical and business insight?
IBM believes the solutions fill a void in data integration and analysis that now are a barrier to transforming healthcare. Since most major health organizations have adopted a variety of disparate processes designed for optimal transactional performance, the disparity of the systems inhibit healthcare organizations from having an enterprise view.
These disparate systems also make it more difficult, IBM contends, to quickly respond to changes in the market such as pay-for-performance and the demand for quality reporting.
Dan Pelino, general manger of IBM’s Global Healthcare and Life Sciences Industry, said that we are on a front end of major movement and referred to the term “mega trend,” which was popularized by John Naisbitt, author of Megatrends and Megatrends 2000. Pelino noted that healthcare analytics go beyond the volumes of data that could be captured in electronic medical records (EMRs).
“This is the next big thing,” Pelino said. “Healthcare analytics are about how you look at data that is available and how you look at the behavior of patients that data reveals, and this will lead to predictive analytics.”
IBM has more than 20 years of experience in applying this technology in other industries, but healthcare is late to the game in terms of clinical use of analytics to improve the speed and quality of clinical reporting and workflows, Pelino said.
In referencing the relativity low market penetration rate of EMRs, and the cost and complexity of integrating and exchanging data between disparate systems, he suggested the industry not wait for higher EMR adoption rates while national standards are still being developed for health information exchanges and while the technology for analytics now is available at scalable costs.
IBM see this as a significant way to improve healthcare, so much so that it was one of the reasons it acquired Cognos, a Canadien developer of business intelligence software, to speed its penetration into this market. IBM has plans to integrate and embed Cognos software into its solutions suite, which will be independent of EMR. “We believe that as patients become more active consumers, they will demand more timely and accurate reporting.”
While it remains to be seen wither IBM can successfully integrate Cognos, the company believes the acquisition will dramatically increase its capabilities in health analytics. Its early focus will be on performance management and then deeper clinical analytics.
John-David Lovelock, a research director for Gartner, Inc., called the acquisition a strong purchase for IBM that will play well in its healthcare focus. He cautioned that while Cognos’ existing tools don’t completely plug the hole in healthcare analytics, they will go a long way toward filling that hole.
Lovelock called healthcare analytics “the first step in improving the overall efficiency of hospitals,” but given the complexity of building the enabling IT architecture, he said it won’t be easy to achieve.
“Healthcare doesn’t have a good handle on its data or how to mine it,” Lovelock said. “Healthcare data is stored in disparate systems and it lacks structure, so developing a repository that aggregates all the data sources is a very difficult task.”
IBM’s vision is that the application of these business intelligence tools will provide health systems with the ability to lower costs, inform consumers, and deliver better patient care outcomes.
With the metrics of lab results, medications prescribed, and basic demographics, this data could be analyzed in the quest for personalized medicine. According to Pelino, healthcare analytics also could help provide more risk assessment as patient populations are studied for results of healthcare screenings, colonoscopies, and when patients take low-dosage aspirin to lower the chance of heart attack.
Karen Knecht, who joined IBM when it acquired her company, Healthlink, talked about the evolution of the EMR from the early 1990s. Even at that time, she said there were cultural and workflow issues between clinicians and administrators.
Knecht, a former nurse, said the dramatic drop in the cost of complex computing power, coupled with the decline in mass storage costs and the pool of data that has already been collected, will advance healthcare through demographic computing.
She said the reason healthcare is late to the game in terms of applying these tools is because of the complexities of healthcare applications.
Mayo Clinic, along with Geisinger Health System in Pennsylvania, are working with IBM to analyze unstructured clinical and academic data by establishing clinical data warehouses. “We are early in this, but it will be a trend,” Knecht said.
IBM’s goal is real-time information on demand at the point of care, Knecht emphasized. The company believes that nurses, doctors, and other clinicians can all have at their disposal customized demographic dashboard portals, with real-time information about their patient populations.
Another important benefit of collecting healthcare analytics will be to speed clinical and epidemiological trials. This theoretically would provide better decision analytics for clinicians and healthcare CEOs because the data can be distributed in many forms and customized for the specific user and application.
IBM also is working with Marion Ball, co-chair of the TIGER Initiative’s executive committee, to look at clinical workflows and processes to better define roles ands responsibilities. TIGER stands for Technology Informatics Guiding Educational Reform, and the initiative was established to help practicing nurses and nursing students fully engage in digital healthcare.
“We want to target large integrated clinics and community-based hospitals with healthcare analytics,” Knecht said. “We want to go out and pick programs such as diabetes monitoring. We would monitor new medications, patient satisfaction, and medical reimbursement. These will result in better reporting of quality metrics and increase competition between hospitals.”
Business intelligence is top of mind
In a recent Gartner survey, 1,500 CIOs worldwide identified the implementation of business intelligence applications as their top technology priority over the next three years, beating out other top 10 technology priorities like ERP, CRM, legacy modernization, and security technologies.
In Wisconsin, business intelligence was second only to mobile applications among state CIOs contacted for a recent WTN survey. In that survey, conducted in December and January, technology managers were asked which three technologies would be the biggest part of their IT implementation strategy in 2008. Mobile applications were the choice of 40.8 percent of the respondents, while business intelligence was the choice of 35.5 percent, and server virtualization was third at 34.2 percent.
Ravi Kalla, president of the Madison-based Symphony Corp., said meaningful data mining via healthcare analytics is achievable, and he cited strong clinical and business cases for them in an era where there is a groundswell for healthcare institutions to compete on quality. When health systems move beyond the current static, straight-line reporting capabilities and move into the actual aggregation and mining of data, Kalla said it would enable them to predict and model the future cost and quality of their systems based on historical data.
That could mean drilling into chronic care populations like diabetes patients to determine where costs are coming from and to create intervention models where decisions are made on how to optimally treat them and how best to conduct disease management. “The only optimal way to manage these diseases is stratification and segmentation of populations with similarity levels, and then create intervention models,” Kalla said. “That is more of a quality case, but where that will help providers is to plan their capital and resources for these intervention models.”
Kalla took issue with IBM on one point, saying analytics should not be deployed by organizations without fuller implementation of the technology, like EMRs or picture archiving and communications systems (PACS), that will be used to gather the data. “As the saying goes,” he said, “in the absence of data, all opinions are good ones. That’s the current situation in health analytics.”
Former Meriter Hospital CIO Peter Strombom, president of Strombom Associates and a fellow of CHIME, isn’t sure healthcare analytics will gain traction. With databases from EMRs starting to contain significant data on clinical trends, he said there is no question about the need for a more integrated approach to analytics. However, Strombom wonders if IBM’s thrust is something new or a rehash of previous approaches to data warehousing and data mining.
“The ROI will have a strong bearing on the acceptance of IBM’s new strategy,” he noted. “At a time when expenditures from IT are under great pressure within healthcare organizations, it may be difficult for the providers to elevate this initiative on their list of priorities.”
Barry Chaiken, chief medical officer for DocsNetwork, Ltd., said the IBM announcement is encouraging in that it reaffirms the belief in using surveillance of processes and reporting of outcomes in useable dashboards. He noted, however, that this approach in healthcare is not necessarily new because managed care companies have used these metrics to monitor and influence the utilization of services.
Whether it’s called business intelligence or health analytics, Chaiken said every system, including healthcare technology systems, need metrics and reporting of those metrics to keep processes tailored to delivering the most efficient and effective care. At the moment, he said most organizations have not identified the appropriate metrics, nor have they devised a system to collect and report on those metrics to clinicians so they can modify care delivery in ways that impact health outcomes.
“The test for IBM and other organizations that work to foster the use of business intelligence is their ability to deploy it in a manner that truly impacts patient care as measured by vetted and respected metrics,” Chaiken said.
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