Business Intelligence Brings Health Care Advances

Opinion: John Halamka discusses how advances in medicine are also in discovering new ways to manage and improve health care via information technology.

What is business intelligence in the health care field? This was the question I asked John Halamka.

Heres his reply and accompanying visuals that illustrate how advances in medicine are not only in the discovery of new disease treatments, but also in discovering new ways to manage and improve health care via information technology.

John D. Halamka, MD, MS, is chief information officer of Harvard Medical School, chief information officer of Beth Israel Deaconess Medical Center, chairman of the New England Health Electronic Data Interchange Network, chief information officer of the Harvard Clinical Research Institute, and an associate professor of emergency medicine at Harvard Medical School.

"Running a health care operation is all about workflow. We need to understand the daily dynamics of inputs, outputs, processes and events in real time. Rather than use traditional business intelligence tools which provide month or quarterly trending, weve implemented real time dashboards that show all patient flow in the emergency department, including all actionable events. In the attached example, there are 40 people in the ED; three have pending labs, four have pending X-rays, and five were admitted. A bed just became available, so the patient should be transported and the ED room cleaned.

"This kind of business intelligence requires data gathering that is a byproduct of our usual work processes.

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"As a patient walks into the emergency department, an RFID tag is attached to their bed, a bar-coded wrist band is applied and a clerk wirelessly registers them at the bedside.

"As the patient is moved through sites of care, the business intelligence tools instantly report on the patient location via RFID geolocation over our wireless network.

"As medications are given and the wrist band is scanned, workflow dashboards are instantly updated with the latest information about patient treatment.

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"With this information, we can report on lag times in care processes such as antibiotic administration for patients with pneumonia.

"Business intelligence must be accessible to every staff member in the organization, not just senior management. On our intranet portal, every staff member can see flows in and out of the hospital in real time so that we know how to staff and can anticipate changes in workflow (such as a full hospital or resource constraints) before they happen, making it much easier to rapidly react to events.

"Finally, business intelligence in health care also requires cross organizational data gathering.

"For detection of biosurveillance we need to understand every person in Boston who has a cough and fever, not just the last three patients who visited Beth Israel Deaconess.

"Weve created a region-wide business intelligence system for monitoring outbreaks and bioterrorism events that gathers registration data from every emergency department and creates a visual display of near real-time trends events across throughout the state. An outbreak in shown in yellow.

"Thus, business intelligence has evolved from hypercubes of multiyear trend data to knowledge about real time events delivered just in time to empowered employees who can react instantly."

eWEEK magazine editor in chief Eric Lundquist can be reached at eric_lundquist@ziffdavis.com.

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