For years, the hospital depended on enterprise reporting to provide critical business intelligence (BI) via financial and operational reports. Yet, many IT challenges remained, and there was room for improvement in operational efficiency.

Today, the organization is standardizing its reporting environment, with new BI dashboards and self-service analytic applications for executives, clinicians and administrators. The 1,200-bed care facility on Manhattan’s Upper East Side has rolled out a BI and performance-management environment that helps physicians deliver high-quality care, while adhering to institution-wide cost and performance standards.

Mount Sinai has successfully used business intelligence technology from Information Builders for many years. So, when it decided to standardize its reporting environment, decision makers at the hospital chose WebFOCUS from Information Builders.

Mount Sinai’s primary BI application targets an outpatient group of 1,000 physicians known as the faculty practice associates (FPA). Dubbed the FPA Dashboard, the new WebFOCUS application provides information about growth, productivity and revenue-cycle metrics, along with sophisticated analytic tools. Physicians and administrators use the dashboard to run their practices more productively, and managers use it to align operational objectives with corporate strategy.

"Business-intelligence technology plays a crucial role for any hospital trying to meet financial and quality-of-care objectives," says Gad Malamed, director of enterprise reporting at Mount Sinai Medical Center. "Without implementing a comprehensive framework for managing performance, there is no easy way to incorporate operational effectiveness and efficiency into an institution’s overall goals."

Malamed says the most important people to engage are the physicians and medical staff, since they have the largest impact on overall care, as well as on a hospital’s profitability. Therefore, the medical center makes the dashboard and associated analytics available to all FPA physicians. Malamed explains that this wide distribution of the information system has allowed the hospital to engage physicians in the business side of their clinical practices – the starting point for improving organizational performance.

Presenting the Data to Users

Identifying the metrics and indicators that guide the organization is the first step. Step two involves presenting that data to users, so they can be held accountable. For example, if charges fall off unexpectedly from one month to the next, with no changes in provider availability or volume, a division manager might use the dashboard to determine the reason.

"The dashboard allows managers to analyze measures and perform root-cause analysis to respond to unexpected changes," Malamed explains. "For example, in the event there is a sudden change in charges, a manager can compare the data by insurance, location, patient type, provider and other variables in order to focus on the root issue."

Administrators, financial personnel, practice managers and care providers all use the FPA Dashboard to run metrics, combine reports and do custom reporting within specific parameters. About 265 people in the department of medicine, for example, are using it to monitor an incentive plan based on work-relative value units.

"Thanks to the dashboard, providers have more data on hand to make decisions about their practices," notes Dominique Archer, FPA business manager for the department. "They can drill down to service locations, payer mixes, population of ambulatory visits and many other variables."

Some physicians use the tool to set goals and monitor progress on a month-to-month basis. Ultimately, Archer says these exercises have a positive impact on the quality of care for patients. "It allows us to see what types of services are being requested in each division, so we can schedule the optimum number of staff," she explains.

To create the FPA Dashboard, Mount Sinai involved various constituencies, from programmers and information specialists to physicians and business users. Led by Phong Bui, the business owner for the project, each group identified the key performance indicators that would be most valuable and the report formats that would be most useful to users.

Julie Zhu, a senior developer with expertise in reporting, took point on the project. She and her team spent about three months in the first phase of the development cycle, gathering information from IDX Group applications and building a reporting database.

"Previously, it could take a week to get reports," Zhu says. "Now, using a standard Web browser, authorized users can view pertinent information whenever they want, and display or analyze data in easy-to-read bar graphs."

Today, approximately 1,000 healthcare professionals have access to the FPA application, including 70 administrators.

Problems Recognized Immediately

"The FPA Dashboard saves an enormous amount of time tracking down information," Bui says. "We can immediately recognize problems and address them, or drill down to find out why certain conditions exist. For example, if payments are lower than normal within a certain department, a manager might ascertain that work-productivity units are low because there are new doctors in that department."

The finance group uses WebFOCUS Active Reports to analyze information, filter it into specific cost centers and create charts. Active Reports includes a preselected "payload" of data to help recipients pinpoint issues and track trends.

Another new BI project involves working with clinicians to identify important clinical metrics. "We want to make that information available internally, so we know what is going on within the hospital," Malamed says. "But we also want to share that data with the public to show that we are accountable for the quality of our care."

According to Malamed, Mount Sinai plans to create other Active Reports to help the institution develop a holistic view of performance across the enterprise. "We’ve gotten our arms around some key financial measures," he says. "Now we plan to expand to clinical and operational measures so we can analyze recurring costs and pinpoint cause-and-effect relationships."

Mount Sinai is also using WebFOCUS for hospital administrators and billing personnel to analyze charges. The medical center recently identified more than $5 million in missed charges, rebilled for them and recouped close to $3 million in a single year from insurers who underpaid patient bills based on their contractual obligations.

The BI tools help accounts-receivables personnel analyze patient accounting data from an Oracle data warehouse, which stores information about closed accounts. Using the dashboard, these employees can identify opportunities for rebilling.

Each year, Mount Sinai bills for about 50,000 in-patient admissions and 450,000 outpatient visits, and generates operating revenue in excess of $1 billion. Malamed says the hospital will continue to use the BI tools to hunt for undiscovered revenue or cost-savings opportunities throughout the enterprise. "At a hospital the size of Mount Sinai, there are tens of thousands of unique charges," Malamed says. "It can be like finding needles in a haystack. WebFOCUS makes that process easier."

From the Catalog

According to www.informationbuilders.com : WebFOCUS is a comprehensive and fully integrated enterprise business-intelligence platform; its architecture makes any data available, accessible and meaningful to every person or application needing it. The WebFOCUS operational business-intelligence platform contains: self-optimizing autonomic servers (workload and traffic management and capacity planning eliminate complexity, improve system performance, and reduce TCO); super-linear scalability through multiple technological advantages; a unifying integration infrastructure that accesses, reconciles, cleanses and prepares any and all data for business-intelligence use; service-oriented architecture support, with the ability to create, consume and publish Web services; and simplified developer and end user interaction, with advanced visualization and deep integration with desktop products, such as Microsoft Excel and Adobe PDF.

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