Many business intelligence and analytics (BI&A) programs fail to deliver the positive, measurable impacts needed to significantly and sustainably improve results.
All too often, healthcare organizations waste untold time and resources chasing the persistent symptoms of weak BI&A programs – including stakeholder dissatisfaction, proliferation of DIY tools, inconsistency in metric definitions, low usage of solutions and even compliance risks - rather than the underlying root causes. And, many BI&A programs lack the strength of strong business and clinical leader ownership. This approach is an inadequate foundation for success.
Increasing demand for BI&A in health management
What makes building a successful BI&A program so important? BI&A programs are being asked to deliver more tangible value and more actionable insights in a timelier manner to more decision-makers than ever before. Many forces fuel this escalating demand, such as advanced population health management, maximized fiscal arbitrage under at-risk contracts, increased emphasis on service excellence due to competitive pressures and consumerism, and demands for ever-increasing operational effectiveness. At the same time, the technology landscape is undergoing a major metamorphosis, not the least of which is the matter of realizing the ROI promises of huge EMR investments.
Despite all these changes and the significant challenges they pose, the fundamentals of a high-performing BI&A program remain the same. If the underlying BI&A program foundation is suspect, then it cannot succeed: the noisy symptoms of a flawed foundation will only grow louder and investments in new, advanced BI&A technologies cannot yield the required benefits.
Six critical aspects of a successful BI&A program
While there’s not a one-size-fits-all approach for healthcare organizations, every successful BI&A program is built on six critical aspects. These fundamental factors should be addressed in a somewhat sequential, yet iterative, manner to build the strongest possible foundation. It’s not enough for a healthcare organization to have one solid aspect, such as the latest technology resources. All foundational aspects work together where the whole is greater than the sum of the parts. Without a rock-solid foundation, an organization invariably finds itself in an endless game of “whack-a-mole” with the pervasive symptoms, rather than reaping the benefits of success. Here are the six essential components of a successful BI&A program:
1. User profiles and requirements. Too many healthcare organizations simply lack a fact-based recognition of what their stakeholders need (not want) in BI&A solutions – outputs and offerings made available to consumers to meet their pressing needs. The starting point for improvement, therefore, is a candid and complete understanding of current and anticipated user needs—but it is often an overlooked step. The most obvious symptoms of this common flaw in a BI&A foundation are an entrenched Excel culture and mindset, along with each department “doing its own thing.”
Organizations must take the time to fully understand, articulate, and categorize the various types of consumers based on their BI&A requirements—mapping them into defined, documented profiles based on characteristics of needs such as data type and breadth, update frequencies, analytic complexities, etc. Doing so must become a periodic habit. A by-product benefit of a formal process in defining consumers’ needs is improved engagement and ultimately buy-in into required changes in the BI&A program.
2. Program governance and integrity. It is surprising that conversations about BI&A with many healthcare leaders center on highly advanced topics when they cannot even get basic metrics standardized across their enterprises. For today’s healthcare organization, data is the currency used from which success is acquired. As such, analytics and data governance, along with an explicit data quality and literacy plan, cannot be an afterthought. It takes time to define, establish and maintain effective governance for BI&A, given that it centers on stewardship and ownership including vital concepts such as consistency, integrity, timeliness, reproducibility, accessibility and auditability.
Solid BI&A governance – which is separate and distinct from IT governance - is concerned not only with the quality and integrity of data, but also with the analytics used to transform data into information and insights. In doing so, governance must keep up with changing source systems, compliance demands, and business needs. A rock-solid foundation for BI&A program success demystifies governance and puts it into action with direct aim at maximizing data currency and its transformational potential.
3. Demand management and prioritization. The fastest way to a failed BI&A program is a poor request intake process. Stakeholders are frustrated when they aren’t sure who (and how) to ask for new or modified BI&A solutions, lack visibility into how their requests are handled, and perceive that their requests fall into a large black hole. Not surprisingly, this situation leads to disenfranchisement and the damaging proliferation of DIY tools and solutions.
Perhaps most importantly, a common “kiss of death” for any BI&A program is routinely devoting scarce resources and attention to stakeholders who shout the loudest. A highly disciplined, single-point-of-intake approach leveraging clear BI&A enterprise priorities is required—using the enterprise business strategy as the beacon. All incoming requests are not created equal in terms of value. A reasonable rule-of-thumb is that something is amiss with the BI&A demand management if a significant percent of requests are not turned down. Learn to say No.
4. Solution development and sustainment. A disconnect between BI&A solution consumers and creators undermines any BI&A program foundation. Throughout many organizations, a tangible tension exists between those developing BI&A solutions and the stakeholders using them. Part of this tension inevitably is rooted in a one-size-fits-all or undisciplined demand management process, as mentioned above. Much of this tension, however, is fueled by a poorly devised process to develop and sustain BI&A solutions.
Two key characteristics of strong BI&A solution development are essential: creator/consumer collaboration, and stakeholder ownership for their own solutions. To the former, a highly collaborative BI&A solution development approach should be used, one that incorporates Lean philosophy and agile methodologies coupled with rapid prototyping of use cases. This workshop-like approach to developing (at least major) solutions, while taking more up-front time than consumers simply tossing incomplete and cryptic statements of their perceived needs over the wall at BI&A creators, pays high dividends in the long term. To the latter, too many stakeholders think “it’s their job over there” to produce impactful solutions and disengage from participation in solution design, development and testing. A solid BI&A program foundation must include clear stakeholder accountability for their own solutions.
So far, the crucial elements of a BI&A foundation have been “leading.” The last two factors shouldn’t be tackled until the previous four steps are completed or at least well in hand.
5. BI&A leadership and organization. There is no one ideal BI&A organization model. While many organizations have well-balanced hybrid models, others can be highly successful with strong programs in decidedly centralized or decentralized models. The trick, of course, is to make sure the model matches the environment and nature of the BIA& program foundation, and to view the current model (whatever it is) as transitional by nature and expected to migrate over time. The best-for-now BI&A organization model should be defined when the prior critical aspects are fully contemplated and being addressed. The personnel, skill sets, and organization structure on the supply side of BI&A must support these aspects – more specifically their actionable path toward improvement – not the other way around.
The most common question asked related to BI&A leadership and organization is where should it reside. Highly successful BI&A programs reside in different areas such as IT, Finance, Operations Excellence and even matrix approaches. The right question, therefore, is not where should it reside but where can it thrive. That answer depends heavily on an organization’s unique environment and challenges but is greatly influenced by leadership prowess, strategic direction and political baggage.
6. Technology platform and infrastructure. Without question, it is far better to have a solid BI&A program foundation with a so-so technology stack than the other way around. In fact, too many organizations turn to technology investments to fix an inadequate BI&A program only to be gravely disappointed. Still, the correct technology platform and infrastructure can go a long way toward elevating an already sound BI&A program to the next level. The evaluation and selection of new technology is a highly customized activity. The right technology depends upon an organization’s direction on each of the foundational aspects described above. In other words, the BI&A technology must fit the program, not the other way around
The challenge for most BI&A programs is determining how best to leverage existing investments in technology platform and infrastructure – including investments in EMRs – not make new ones. The crucial concept in this common situation is to maximize the value and usage of the investments, and to reflect the realities (capabilities and limitations) of the investments in the BI&A improvement roadmap.
A strong foundation works together
To be clear, very few BI&A programs get all of these critical aspects perfectly “right.” They don’t have to (and there’s not really a perfect “right” anyway). A high-value, high-ROI program is achievable as long as all aspects are addressed reasonably and those most pivotal to an organization’s unique situation and goals are strongest. All too often, however, multiple aspects are completely missed– or their interrelationships ignored - thereby undermining the foundation to the point where many of the noisy symptoms mentioned above persist and proliferate.
It is important for an organization to craft its own well-defined, tailored path toward an increasingly mature and impactful BI&A program based on an objective, comprehensive assessment of its current state. Build a rock-solid BI&A program from the ground up, starting with all six critical aspects of its foundation. This is true even for BI&A programs that are largely getting the job done today but face new challenges and demands in the years ahead.
Bill Leander serves as the Chief Strategy Officer of Santa Rosa Consulting and brings 20 years of professional services, analytics and technology experience in the healthcare industry. As Chief Strategy Officer, Bill leads the Strategic Advisory Services consulting practice and growth innovations across all Santa Rosa business units. Bill holds an MBA/MSIA from Carnegie-Mellon University and a BS in Operations Research/Industrial Engineering from Cornell University.
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