People, Process, Then Technology – How Henry Mayo Architected A Roadmap For BI Success

By Cindy Peterson, Henry Mayo Newhall Memorial Hospital and George Dealy, Dimensional Insight

Henry Mayo Newhall Memorial Hospital is a 238-bed not-for-profit community hospital and trauma center based in Valencia, CA. The hospital, which serves the fast-growing Santa Clarita Valley, employs more than 1,300 people and has received a long list of accolades and awards for excellence in medicine and healthcare delivery.

As part of its vision to create an ideal patient-centered environment, Henry Mayo embarked on a multi-year journey toward becoming a “digital” hospital. The process started with Henry Mayo’s decision to replace its mainframe-based computer system with a MEDITECH Client/Server Healthcare Information System. This implementation was broken down into two phases: Phase 1 replaced admissions, order entry, pharmacy, lab, and patient billing functionality; and Phase 2 implemented advanced clinical applications, including Emergency Department Management (EDM).

In the midst of all these technology deployments, Henry Mayo recognized it had a resource, information access, and reporting gap. As a result, hospital leadership agreed that success would ultimately depend not on the technology alone, but on the hospital’s ability to execute in the following four areas:

1. Create a dedicated department to support the organization’s information needs.
2. Resource this new department with the best data experts – individuals with an in-depth understanding of the relationships within the data and an analytics-focused background.
3. Align the department’s charter with the hospital’s strategic plan and use this to prioritize business intelligence (BI) development projects and goals.
4. Task this team with the selection and deployment of a BI platform capable of providing a unified view into dozens of disparate applications and systems.

Achieving ROI in 12 Months
Henry Mayo implemented an accelerated timeframe for the project and wanted to achieve ROI from its BI tool within 12 months. These four steps helped it achieve that ROI.

1. Start small
   In order to stay focused at the beginning of the project, Henry Mayo created a small, dedicated group responsible for developing and creating any BI content. This single department had buy-in and involvement from hospital administration, which accelerated project roll-out and process improvement efforts that required tapping into data from multiple areas. The organization avoided the temptation to throw too many elements into the initial project, which would have made it unwieldy and difficult. Henry Mayo knew that if it did so, the concept of a “quick win” would head right out the window.
2. Stick to the strategic plan
   Henry Mayo had a strategic plan that provided context for day-to-day activities and gave employees and departments a sense of how their contribution fit into the larger picture. It also provided a succinct outline of exactly which areas needed to be measured and where the hospital had to focus its energy. Henry Mayo made sure to stick to this strategic plan to prioritize its list of projects and ensure it was working on things that would ultimately drive value for the organization.
3. Adopt a single tool environment
   End-user adoption is critical to success, but it can only be achieved if there’s confidence in the data. By consolidating development of BI content to one group and standardizing on one tool, Henry Mayo was able to maintain data integrity, apply business rules consistently and systematically, and focus on taking action instead of worrying about the validity of specific numbers. In addition, by standardizing on a single tool, Henry Mayo was able to accelerate development productivity as its analysts became more proficient in using a standard tool set. The organization was also able to minimize training costs and nearly eliminate bottlenecks due to varied skill sets.
4. Use consulting services for knowledge transfer
   Rather than training its end-users as part of the core roll-out, Henry Mayo used its BI vendor’s consulting services as a form of “immersion” training. The hospital’s team didn’t want to be left with a new tool and a long project list, so it used initial consulting time to help kick-start projects that would have been difficult for the team to tackle at the beginning of the learning curve. The Henry Mayo team was able to shadow individuals with greater expertise in the new tool set, thereby shortening ramp-up time. This approach allowed initial projects to get completed more quickly, built confidence in the selected tool and led to greater staff satisfaction.

Results
One of Henry Mayo’s first projects was to improve patient flow in the emergency department (ED). By pairing the data experts in the decision support team with the subject matter experts in the ED, the organization could understand which metrics were important, and then track them to identify and reduce bottlenecks during the triage process.

Here are the results of this project:

• Average “door-to-doctor” time is now under 10 minutes.
• ED Entry to Triage, 80 percent improvement.
• Triage to Room, 60 percent improvement.
• Room to Physician, 63 percent improvement.
• 50 percent year-over-year decrease (past two years) in patients leaving the ED unseen (Now < 1 percent of total visits).
• $1M/year in increased revenues attributed to the reduction in patients leaving and wait time improvements.

Another project focused on identifying length of stay (LOS) trends to pinpoint physicians whose practice decisions routinely put patients over the accepted LOS threshold or whose use of resources far exceeded those used by their peers caring for similar patients.

With its selected BI tool, Henry Mayo collected data across several clinical and financial systems to isolate these data points for further discussion and resolution by medical staff and physicians. This led to a $3M improvement in Medicare reduction in length of stay.

In addition, Henry Mayo recently had to secure funding for a sizable expansion and other capital improvement projects. In preparation, Henry Mayo’s CFO had to prepare a number of financial reports to demonstrate the relative health of the organization. As a result of the organization’s performance and the ability to clearly and succinctly provide deep and detailed views of its financial and operational performance with its BI tool, Henry Mayo was able to secure investment grade bonds saving the organization substantial financing costs.

Lessons learned
One important lesson that Henry Mayo learned was that it is best to centralize development and reporting into a single group. When access to information is viewed as an advantage, nobody wants this capability “taken away”. While many organizations inherently understand the importance of centralizing the integration and data validation process, when it comes to reporting, this capability tends to spread far beyond a single group.

For Henry Mayo, creating a centralized group built consistency into the report creation process and provided business users and executives with a trustworthy single version of the truth. In addition, it prevented resource confusion that can often exist in a highly decentralized environment. Under a centralized group, Henry Mayo found that users could quickly get answers to their questions and data integrity could always be maintained. This is because the decision support group was able to pull in additional feeds from other systems when needed and was aware of any specific business rules that had to be applied to deliver an accurate view of issues.

About the authors
Cindy Peterson is VP and CIO of Henry Mayo Newhall Memorial Hospital in Valencia, CA. George Dealy is VP of healthcare applications at Dimensional Insight, the 2014 “Best in KLAS” winner for business intelligence/analytics.