Published on 06-Mar-2012
Validated on 16 Dec 2013
"The welfare of patients and the provision of optimum medical care are always in the forefront. IBM Cognos technology has greatly helped in extracting additional potential from routine data while offering a competitive advantage to Universitätsklinikum Erlangen - not only economically but also in medical care and science." - Dr. Thomas Ganslandt, Director of the Office of Strategic Infrastructure Applications, Universitätsklinikum Erlangen
BA - Business Analytics, BA - Business Intelligence, Big Data & Analytics, Big Data & Analytics: Transform processes, Big Data & Analytics: Operations/Fraud/Threats, Information Integration, Smarter Planet, Optimizing IT
With the most modern operating theatre in the world, the latest medical equipment and innovative scientific diagnostic and therapeutic procedures, Universitätsklinikum Erlangen covers all areas of modern medicine with its 24 clinics, 19 departments and six institutes. Teaching, research and patient care are aligned to deliver the highest standards. Universitätsklinikum Erlangen’s facilities house around 1,300 beds. More than 6,850 employees assure optimal care provision to around 58,000 in-patients and approximately 390,000 out-patients per year.
Universitätsklinikum Erlangen needed a centralised reporting system that could support economic and medical decisions through metrics, reports and in-depth analyses. It also needed to be flexible enough to adapt to changes in the health sector such as new types of treatment or forms of care. It was also necessary to increase the profitability of Universitätsklinikum Erlangen through cost transparency, to improve the quality of patient care via high-value clinical research, and to identify additional revenue opportunities based on existing resources.
The hospital built a data warehouse and, with the help of IBM Business Analytics solutions, set up a reporting and analysis system that maps the full clinical value chain in an integrated solution. The system links the relevant operational systems, optimises information flow and supports the overall strategic control of the hospital through verifiable, fact-based decisions at the touch of a button.
The new solution provides members of the board and heads of department (as well as strategic decision-makers from hospital management, medical controlling, research and teaching) with sound decision-support information on a daily basis, relating to clinical, research-related, economic or medical questions. Meaningful, visualised reports as well as ad-hoc analyses provide guidance on the revenue and cost situation, and contribute to the development of clinical pathways and new research findings.
To read a German version of this case study, click here.
With the most modern operating theatre in the world, the latest medical equipment and innovative scientific diagnostic and therapeutic procedures, Universitätsklinikum Erlangen covers all areas of modern medicine with its 24 clinics, 19 departments and six institutes. Teaching, research and patient care are aligned to deliver the highest standards. Universitätsklinikum Erlangen’s facilities house around 1,300 beds. More than 6,850 employees assure optimal care provision to around 58,000 in-patients and approximately 390,000 out-patients per year. The revenue from the hospital’s services in 2010 amounted to more than €348 million.
The need for evidence-based decision-making
Enterprises in the healthcare industry are facing many challenges. The ‘diagnosis related group’ (DRG) system – which classifies medical cases into different groups depending on the treatment services used and the costs incurred – as well as new treatments and forms of care, increase the cost pressures on hospitals. In addition, service demands are rising, and competition for patients has increased.
Universitätsklinikum Erlangen faces the challenge of competing with other hospitals by optimising processes and documentation to increase efficiency, while simultaneously optimising the quality of patient care. The hospital must adapt its budget model to meet competitive pressure, optimise its supply and price structures.
Meeting new requirements
In the past, the hospital’s heterogeneous clinical system environments and increasingly complex diagnostic and management data flows had made it difficult to carry out evaluation for medical and economic decisions. The need for action was also influenced by the legal framework. “The introduction of the DRG-based system in 2003 created the impetus to build a comprehensive reporting system, first of all for medicine controlling,” says Dr. Thomas Ganslandt, Director of the Office of Strategic Infrastructure Applications at Universitätsklinikum Erlangen. “The existing reporting system was suffering from inconsistently defined variables and non-uniform dimensions; in addition ad-hoc queries from the ERP system were very slow because of transaction-oriented data management.”
There was an acute need for a new reporting system that would provide reliable information for managers working in the areas of financial control and patient care. The top priority was a central, reliable database: Thomas Ganslandt and his team wanted to produce a “single point of truth” through cross-system data fusion. To this end, the hospital decided to implement a reporting and analysis solution that would unify and accelerate economic and medical evaluations. Among other things, this solution needed to support the introduction of cost accounting as specified by the Institute for Hospital Reimbursement (InEK) in order to overview and deploy resources optimally.
Following the independent development of a data warehouse, Universitätsklinikum Erlangen decided to call on the support of external experts for the new version of the reporting system. With the help of consultants from IBM Global Business Services and the IBM Analytics Solution Centre (ASC), the project team developed a customised, professional and technical approach to information management. The conceptual work resulted in an integrated solution based on IBM Cognos Business Intelligence software and hospital-specific metrics, tailored to the German healthcare market. The solution can be easily integrated into the existing infrastructure of a hospital.
“High usability and flexibility were key factors in choosing IBM Cognos technology. The software allows data from different sources to be easily integrated and evaluated via an intuitive portal,” says Thomas Ganslandt. “In addition, the collaboration with IBM consultants was very productive.”
The team integrated the relevant medical and administrative data sources and implemented IBM Cognos tools for reporting and analysis in close collaboration. The first reports were produced in the new information system in early 2011.
Centrally aggregated clinical analyses
“Clinical Analytics” is the name of the tailor-made solution based on IBM Cognos technology, which provides approximately 80 users with the information they need. Senior physicians and managers from the fields of finance and DRG controlling use it to answer medical and scientific questions. The data management is largely centralised and the relevant hospital systems are networked: there are over 200 dimensions and 300 fact and report tables for the various reporting requirements, as well as a total of around 650 million records in the data warehouse.
Users can log on to their workstations via an information portal and, provided they have the correct authorisation, can access the desired data in the form of reports and analyses. Reports that integrate and process data from several hospital systems are now produced automatically and updated on a daily basis. “The effort of data processing has been greatly reduced. The integrated reporting system improves the flow of information and ensures high data quality thanks to the central data integration,” says Thomas Ganslandt. The IBM Cognos solution provides sophisticated tools to control access to cover the requirements of data protection.
Controlling finances and boosting efficiency
The new cross-system and cross-functional information system has standardised and significantly accelerated Universitätsklinikum Erlangen’s reporting processes. Reports and analyses help users gain valuable insights, act more economically, increase the quality of patient care and differentiate the hospital from the competition. Among other things, the areas of finance and revenue controlling benefit from the new insights. Clinical Analytics integrates heterogeneous data streams and thus positions the financial reporting system on a sustainable basis. The revenue and cost situations, including DRG documentation, are available to the revenue controlling department in an automated, daily updated and transparent form.
The solution also supports cost unit accounting that is fully compliant with the InEK process; this helps financial decision-makers assess the cost-effectiveness of patient care. In addition, supplementary charges, which might be generated across several clinics, can now be transferred between internal cost centres automatically. Users can perform detailed analyses interactively at any time, enabling them to determine the reasons for changes in the revenue situation and support hospital budget negotiations. In addition, decision-makers can be more confident in the accuracy of their plans: they can optimise revenues because the new solution also provides for changing conditions through constantly updated revenue reports. Last but not least, the new solution reduces administrative overhead. It supports quality assurance, especially with respect to patient surveys and the preparation of statutory quality and annual reports that assess the performance of the university hospital.
“In a word, internal hospital services can be precisely coordinated. Universitätsklinikum Erlangen can draw out additional benefits from data collected in the context of routine health care and open up further potential for efficiency. This ultimately benefits our patients”, says Thomas Ganslandt. “For example, those responsible for analysing and optimising the duration of patient treatment can evaluate trends and optimise the time required between stations.”
Benefits for clinical research
It is now possible to perform scientific data queries much more quickly, which helps in the preparation of clinical studies. Physicians can gain insight into root causes much more easily. What similarities do certain patient groups exhibit? Why did some patients who were undergoing gallstone treatment spend significantly longer in treatment than others? Special case visualisation software, developed by the Chair for Medical Informatics of Friedrich-Alexander University Erlangen-Nuremberg, uses the IBM Cognos platform to enable comparative interpretation of similar cases over time. Abnormalities are immediately recognisable, so that optimisation potential can be easily identified. The new findings can be incorporated in the research and development of new and improved treatment pathways. As a result, health risks can be reduced in the long term.
“The welfare of patients and the provision of optimum medical care are always in the forefront,” said Thomas Ganslandt. “IBM Cognos technology has greatly helped in extracting additional potential from routine data while offering a competitive advantage to Universitätsklinikum Erlangen - not only economically but also in medical care and science. We therefore plan to continue to benefit from this information advantage.”
About IBM Business Analytics
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Products and services used
IBM products and services that were used in this case study.
Cognos Business Intelligence
GBS BAO: Business Intelligence and Performance Management
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