Using Analytics as the Basis of Decision-Making

Enhanced ROI and Emergency Response

Enhanced Emergency Department Management

The implementation of a new emergency department dashboard in Dimensional Insight provides valuable insights into turnaround time metrics, facilitating efficient ED operations and supporting the hospital’s improvement goals.

Data-Driven Decision-Making

Dimensional Insight serves as the basis for data-driven decision-making by providing executive dashboards and standardized key performance indicators (KPIs) that are vital for daily monitoring, improving patient care, and reducing operational costs.

Improved Response to Natural Disasters

Dimensional Insight’s real-time data capabilities helped the hospital respond effectively to Hurricanes Irma and Maria, enabling the allocation of resources to areas of greatest need and ensuring better patient care despite limited staffing.

Enhanced Admissions Rate

By identifying and addressing the issue of lower admission rates from the ED at the Carolina facility, Doctors Center Hospital has doubled its ED admission rate, improving daily census and potentially increasing revenue.

Optimized Metrics Measurement

Doctors Center Hospital gained insight into the critical importance of metrics like average length of stay (ALOS) and other quality indicators through the use of Dimensional Insight, enabling more effective data measurement and performance improvements.

Reduced Report Turnaround Time

Diver’s real-time reporting capabilities allowed the hospital to receive its reports within 10 days after the end of the month, facilitating quicker decision-making and financial management.

Cost Savings through Efficient Implementation

Doctors Center Hospital noted that Dimensional Insight’s analytics solution was the most cost-effective solution, as it did not require the hiring of additional data analysts or database administrators for report creation and maintenance.

Key takeaways

Following Hurricane Maria in September 2017, with Diver®, the hospital was better able to see its census numbers and understand where patients were in its overcrowded facilities.

Diver has enabled Doctors Center Hospital’s Carolina facility to double the number of admissions from its ED due to the improved insight.

A new emergency department dashboard will provide insight into turnaround time metrics that will help the hospital meet its improvement goals.

Background

Doctors Center Hospital is a four-hospital health system located in Puerto Rico with 650 total beds, making it the third-largest health system on the island. The organization is headquartered in Manatí, which is about 30 miles west of San Juan.

Doctors Center Hospital strongly believes in the value of technology, and it is the only hospital in Puerto Rico to reach Stage 6 on the HIMSS EMR Adoption Model. The hospital’s mission is to offer patients health services with quality, commitment, love, dedication, and efficiency. It operates with values that include honesty, respect, teamwork, leadership, and maintaining a positive attitude.

In September 2017, Puerto Rico was hit by two hurricanes in succession — Hurricane Irma and Hurricane Maria. The hurricanes devastated parts of the island and impacted operations at Doctors Center Hospital’s four locations.

Pedro Ríos-Mercado, IT Director, Doctor’s Center Hospital

The challenge

Like many hospitals, Doctors Center Hospital has an abundance of clinical, operational, and financial data that it needs to more readily understand in order to improve decision-making. In 2014, the organization implemented a MEDITECH EHR and as a result, could access a lot more patient information. However, decision-makers often found that they would walk into meetings and be working with different numbers than those that their peers were working with. The hospital needed not only the ability to view data in a more user-friendly way, but it also needed access to governed data. This would ensure that stakeholders were all looking at the same data in the same way.

In addition, Doctors Center Hospital faces challenges in how it is reimbursed for services. About 30-40% of its payment is capitated, meaning that insurance provides a set payment for services rendered. Insurance companies in Puerto Rico are also trying to steer patients away from obtaining services in a hospital setting and instead have them visit independent provider groups. All of this means that Doctors Center Hospital must be smarter about its revenue and costs, and it must work to improve patient care by providing the best treatment. This will, in turn, reduce measures such as average length of stay and readmissions. Data lies at the core of this strategy.

“Dimensional Insight was the only vendor that talked about data governance and how to achieve that using CMS numbers. In addition, Dimensional Insight had the most turnkey solution with our MEDITECH EHR and the dashboard was the easiest on the eyes.”

 Pedro Ríos-Mercado

IT Director, Doctor's Center Hospital

The goal

Doctors Center Hospital sought to implement a healthcare analytics solution with the following goals:

Provide an executive dashboard that the hospital’s management — and particularly its president, Dr. Carlos Blanco — could look at and get a daily pulse on the hospital’s key metrics, including census, admissions, and discharges at its four locations.

Provide a dashboard that would capture key metrics for each hospital’s emergency department (ED) such as turnaround time and total visit time.

Enable the hospital’s nursing staff to make better informed decisions about staffing and treatment options for patients through the use of data.

Provide data governance through the use of centralized business rules and metrics that would ensure all stakeholders are looking at the same data in the same way.

The solution

Doctors Center Hospital implemented Dimensional Insight’s Diver Platform following an extensive search for a healthcare analytics solution. Pedro Ríos-Mercado, the hospital’s IT director, first looked at the top four vendors in the annual “Best in KLAS” rankings and visited each of their booths at the annual HIMSS trade show.

“Dimensional Insight was the only vendor that talked about data governance and how to achieve that using CMS numbers,” says Ríos-Mercado. “In addition, Dimensional Insight had the most turnkey solution with our MEDITECH EHR and the dashboard was the easiest on the eyes.”

Doctors Center Hospital first implemented an executive dashboard that tracks key KPIs that the hospital’s president looks at every day. The organization’s KPIs are provided through Measure Factory®, which is an add-on to Diver. They are based on CMS rules — but are also customizable — and provide a standardized way that all departments across the hospital can look at data. The metrics include the census at each facility, the number of admissions, the number of discharges, readmissions, average length of stay, and other quality metrics.

“Dr. Blanco looks at the dashboard first thing every morning, and from there he starts asking questions. He also looks at it throughout the day to see how the numbers have changed,” says Ríos-Mercado. “The dashboard is the basis of our decision-making.”

Dr. Blanco says, “As president of a four-hospital system, I need to keep abreast of the daily operations to maximize the resources needed for my business. The dashboard has been instrumental in allowing the daily overview needed to manage this complex operation, and it gives me immediate access to the kind of detailed information needed to run the operation.”

That prompted an investigation into why that was the case, and the hospital found that the Carolina facility wasn’t using doctor consults as much as the other hospitals were. Although the facility still has room for improvement, it has since doubled its admission rate from the ED and has improved its daily census.

Doctors Center Hospital is now also better able to understand the metrics it measures and understand which ones best correlate with improvements. As Santiago explains, “Before implementing Diver, we thought that census was the most important metric. It is still very important, but we also realized the criticality of improving the average length of stay (ALOS). It’s important to keep patients here for the appropriate amount of time, but to not go over that.”

Once the executive team is armed with information, they filter it down to the medical director and physicians. From there, the team can start making improvements. In his role, Santiago is also pleased with the real-time data that Diver provides.

“We previously had to wait a long time to report on what happened in our hospitals in the previous month,” says Santiago. “Now we have all of our reports in less than 10 days after the end of the month, which helps us from a financial standpoint.”

“As president of a four-hospital system, I need to keep abreast of the daily operations to maximize the resources needed for my business. The dashboard has been instrumental in allowing the daily overview needed to manage this complex operation, and it gives me immediate access to the kind of detailed information needed to run the operation.”

Dr. Blanco

President, Doctor's Center Hospital

The results

Shortly after Doctors Center Hospital got its Diver executive dashboard up and running, Puerto Rico was impacted by Hurricanes Irma and Maria. In the immediate aftermath of Maria, the hospital had no power and had limited generator capabilities.

Within a few days of the hurricane, Doctors Center Hospital found that it had an influx of patients, but limited staff to help them, as the staff members couldn’t get to work. The Diver dashboard, however, was able to provide some insight.

“We had just gotten the census numbers up and running, so we were able to see how many patients were in the hospital, and which areas of the hospital they were in,” said Ríos-Mercado. “Even though we had limited staff, we were able to see the areas of most pressing need within the hospital.”

Now that the ED dashboard is up and running, Doctors Center Hospital will be even more prepared should another storm hit in the future.

In addition, even though the Diver implementation is relatively new, the hospital has been able to see some quick results. For example, once executives could view the census and admissions numbers for each of the four hospitals, they noticed that its hospital in Carolina was admitting patients to the hospital from the ED at a rate that was one-fourth that of the other hospitals.

That prompted an investigation into why that was the case, and the hospital found that the Carolina facility wasn’t using doctor consults as much as the other hospitals were. Although the facility still has room for improvement, it has since doubled its admission rate from the ED and has improved its daily census.

Doctors Center Hospital is now also better able to understand the metrics it measures and understand which ones best correlate with improvements. As Santiago explains, “Before implementing Diver, we thought that census was the most important metric. It is still very important, but we also realized the criticality of improving the average length of stay (ALOS). It’s important to keep patients here for the appropriate amount of time, but to not go over that.”

Once the executive team is armed with information, they filter it down to the medical director and physicians. From there, the team can start making improvements. In his role, Santiago is also pleased with the real-time data that Diver provides.

“We previously had to wait a long time to report on what happened in our hospitals in the previous month,” says Santiago. “Now we have all of our reports in less than 10 days after the end of the month, which helps us from a financial standpoint.”

“When I added all the costs together, the other solutions had a higher total cost of ownership. I wanted to use our knowledge and staff towards the adoption process of the product, not towards having to build and maintain the product. Dimensional Insight allows us to do that and use our resources where they provide the most value.”

 Pedro Ríos-Mercado

IT Director, Doctor's Center Hospital

What’s next

Ríos-Mercado believes that other healthcare organizations seeking to implement analytics need to consider all the costs of a solution – not just the upfront technology costs. During his vendor vetting process, he asked vendors about the support their solutions would need from his staff. In all cases except for Dimensional Insight, he would have had to hire a data analyst or database administrator in order to build new reports.

Ríos-Mercado says, “When I added all the costs together, the other solutions had a higher total cost of ownership. I wanted to use our knowledge and staff towards the adoption process of the product, not towards having to build and maintain the product. Dimensional Insight allows us to do that and use our resources where they provide the most value.”

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Organization

Doctors’ Center Hospital

Industry

Healthcare

Location

4 locations in Puerto Rico

Beds

650

Employees

2,500

EMR

MEDITECH

Customer since

2017

Website

www.tuhospitalfamiliar.com

Solution

Diver Platform with Measure Factory

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