As the volume of data and financial pressure to use it to improve outcomes and decision-making have risen, so have demands on the time of clinicians. How can hospitals harness the power and promise of their data to improve patient care delivery, positively impact health outcomes and benefit the bottom line?
Clinical decision support systems provide a way to convert large amounts of data into meaningful information, reports and alerts that hospital administrators and clinicians can use to indicate performance. These systems pull data from the electronic medical record and other data streams into a central database. They then apply algorithms to provide an historical view of patient trends clinical care performance.
Given the increased adoption of value-based payment and the push toward risk-sharing models, hospitals have tremendous incentives to track their performance against clinical care metrics and expected costs. Clinical business intelligence and clinical decision support systems can help by tracking key performance indicators,1 such as:
- Cost, resource and efficiency measures that track the use of drugs, procedures and imaging against the payments and costs for those resources
- Process measures that assess the level of compliance with specific standards of care, such as use of appropriate antibiotics for specific infectious organisms, conversion of IV drugs to oral medications when appropriate and use of DVT prophylaxis for acute stroke patients
- Structural measures that provide insight into operational functions, such as the percent of prescriptions transmitted electronically, the volume of antibiotics prescribed by physician or the number of procedures performed
- Outcomes measures that monitor patient health and safety as well as care delivery, including mortality rates, blood glucose level control, and healthcare-associated infections
- Patient experience measures track patient responses to survey questions that probe patient perceptions and satisfaction with the care received and the facility
- Provider measures that evaluate: the cost and outcomes of episodes of care that may include rehabilitation costs, readmission rates, infection and other complication rates and return of function metrics; adherence to best practice and hospital guidelines for treatment and follow up; antimicrobial stewardship practices; and patient outcomes
- Pharmacy measures that track rates of adverse drug events, compliance with medication management goals, pharmaceutical costs, and data related to specific clinical services such as antimicrobial stewardship
Clinical decision support systems use these metrics to produce reports that give administrators and providers feedback on how initiatives or policies are working and where additional training or analysis may be needed. By integrating clinical and business data, the reports provide a basis for determining where investments are needed and which ones are providing the highest return.
Is your hospital using clinical business intelligence? How has it affected your practices?
- Clinical Business Intelligence Primer. HIMSS. April 2013.