Care IQ presentation at Big Data Expo - healthcare session
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Practical experiences with 'little' big data in healthcare, equipment utilization improvement and operations management / integral capacity planning. Start using available little data first and make sure you align with enterprise goals operationalize results.
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Care IQ presentation at Big Data Expo - healthcare session
- 1. Getting ahead with ‘little’ big data Neem een voorsprong met ‘little’ big data André van Est Founding Partner Care IQ Group Big Data Expo - 1 Oct 2015
- 2. Reasons why big data projects fail • Lack of clear business goals • Inefficient tools and processes • Failure to operationalize results © Care IQ Group BV 2 h"p://www.lavastorm.com/assets/OvercomingBigDataChallenges9Whitepaper.pdf==
- 3. Reasons to start with little data first • Available in abundance, but mostly unused! • Can be leveraged quickly! • While preparing for next steps © Care IQ Group BV 3 “He$who$refuses$the$small$is$not$worthy$of$the$large”$ “Wie$het$kleine$niet$eert$is$het$grote$niet$weerd”= h"p://www.care9iq.com/nl/care9iq9informs9financial9health9care9managers9care9iq9informeert9financiele9zorgmanagers/==
- 4. Care IQ Group 150 years of experience in healthcare and data driven improvement 4
- 5. Healthcare planning & engineering 5 across the health continuum… concentrated on…
- 6. Examples 6 • Radiology equipment utilization • Operations management (incl. new hospital design)
- 7. Equipment utilization experience • Relevance: imaging diagnostics involved in nearly all patient pathways • Helping customers optimize their business – Capital equipment utilization – Tool & process development – Make use of existing ‘service’ data • Proven benefits – Increased efficiency, reduced access times, enhanced patient & staff experience © Care IQ Group BV 7 Courtesy=of=Philips=
- 8. Significant=performance=variaEon=despite=similar=technology= Top=performers=more=effecEve=in=managing=complexity= Global benchmark insights 8 !Philips!1.5T!Systems! == == == == == == == == == !2013! BEL! CAN! CHI! DEN! FRA! GER! ITA! JAP! NL! SWI! SPA! SWE! UK! USA! !Procedure!Ime! 26! 40! 25! 43! 26! 32! 36! 39! 34! 47! 39! 46! 35! 58! !Scan!Ime! 17= 23= 13= 21= 16= 19= 21= 18= 18= 24= 22= 22= 20= 25= !Scans!per!exam! 7.8= 8.7= 7.6= 8.1= 8.2= 8.5= 9.1= 8.9= 8.0= 8.6= 9.0= 8.5= 9.9= Source:$Philips$U>liza>on$Services== 1.5T!Germany!by!pracIce! type! Procedure!Ime! Average! Best! Private! 31! 16! Hospital!<500!beds! 43! 21! Hospital!>500!beds! 52! 20! Academic! 64! 20!
- 10. Trend and pattern recognition 10Keep=measuring=to=know=that=improvement=is=durable!=
- 11. Insight: start by optimizing the most used not the most complex examinations! 11
- 12. Data is not information, Information is not knowledge, Knowledge is not understanding, Understanding is not wisdom. Clifford Stoll 12 How=to=implement= and=operaEonalize?= Think= differently= Organize= differently= Work= differently=
- 13. Kaizen event 13 • Team work • Fact based • Solution driven • LEAN / DMAIC !Deliver! !Report! !Interpret! !Exam! !Perform! !Exam! !Prepare! !Exam! !Receive! !PaIent! !Confirm! !Exam! !Schedule! !Exam! Receive! Order! Quality== of=care= Cost= effecEveness= PaEent=&=Staff= experience= KAIZEN!EVENT!
- 14. OHSU Portland OR NIC Las Vegas, NE The Netherlands (Rijnstate Arnhem, 2x Catharina Eindhoven, Antonius Nieuwegein, Viecuri Venlo, Elkerliek Helmond, 9x UMC Utrecht) Japan (Yaesu Clinics) Austria (Neusiedl, Klagenfurt, Kapfenberg) Denmark (2x Herlev Hosp. Kopenhagen, Herning Hosp.) Turkey (Yeditepe University ) Saudi Arabia (NGH Riyadh, PSCC Riyadh, Bakhsh Hospital Jeddah) UA Emirates (Al Zahra Hosp Sharjah) Southern Open MRI FL DMI Palm Springs CA 2x St Barnabas Livingston NJ China (Renji Hospital) Sweden (2x Lund Uni Hospital, 2x Unilabs Göteborg) France (La Porte Verte Versailles, La Pitié Paris) UK (North Staffs Univ Hosp. Germany (2x BrüderKH Trier, 2x Asklepios Barmbek Hamburg, MRT Schwerin) Norway (AHUS Oslo, Molde Hospital, Ålesund Hospital, 2x Unilabs Oslo) 60+ Kaizen events worldwide Spain (2x La Fé Valencia) 14 Switzerland (2x Unilabs Geneva)
- 15. Jan Hörnström (CEO Radiology Business): “Care IQ ran!several!Kaizen!events!in!our!European! imaging!units!to!idenIfy!efficiency!improvements! and!enhance!paIent!experience.!I!highly! recommend!them!for!similar!exercises!in!other! healthcare!operaIons!” Care IQ services: • Facilitating rapid workflow improvement events (Kaizen events) and quick scans at imaging centres in Unilabs’ main markets, Norway, Sweden and Switzerland. • Creating best practice improvement examples for sharing within the Unilabs’ community. • Establishing a Unilabs internal performance benchmark, thereby helping to set goals for a.o. average procedure time and scan time, procedure mix and variation. • Educating Unilabs’ imaging centre managers from across Europe during Unilabs’ annual leadership conference, and providing training workshops. • Pan-European diagnostic services leader • 5000+ employees, of which 300+ medical doctors • 46 imaging centres, 1,1M imaging exams per year • 120 laboratories, 85M laboratory medicine analyses per year © Care IQ Group BV 15
- 16. Examples 16 • Radiology equipment utilization • Operations management (incl. new hospital design)
- 17. Operations management experience • Relevance: how to match hospital agreements or ambitions with available budgets? • Optimizing operational processes (or model) – Linked to enterprise goals – Method & tool development – Smart use of available (operational) data © Care IQ Group BV 17 Courtesy=of=Orbis=MC=
- 18. General= PracEEoner= ConsultaEon= center= InvesEgaEon= center= Treatment= center= Nursing=center= Follow=up= Benefits of integral planning • Creates the power to transform data insights into better collaboration and performance • Enables transparent communication about budgets, actuals, and causes • Actively involves staff in decision making and process control • Increases patient experience – Shorter access times – Better process flow – More quality time • Increases staff satisfaction – Improved work schedules – Better work - life balance – Lower absenteeism 18
- 19. Resource IQ© dynamic capacity planning - Demand forecast & production targets - 96% predictability - 93% repetition - Annual production & capacity planning*) - Seasonal demand forecasting - Annual staff planning - Operational week monitor - Load balancing - Harmonised working hours - Daily pt. planning © Care IQ Group BV 19 Annual plan (mgmt.) Seasonal plan (dept. head) Weekly plan (unit head) Daily schedule (carer & central planning) Think= differently= Organize= differently= Work= differently= Surprisingly=high=degree=of=predictability=and=repeatability=
- 20. Harvesting a 9% average opportunity • Departmental and pathway planning • No staff reduction but capacity waste reduction! – Predicting demand – Matching demand – Reducing overtime – Work hour flexibility © Care IQ Group BV 20
- 21. How predictable is OR production? 11000# 11500# 12000# 12500# 13000# 1# 2# 3# 4# 5# 6# 7# 8# 9# 10# 11# 12# 13# Number'of'procedures' Number'of'OR'procedures'per'year' © Care IQ Group BV 21 ?! = = ?!96%=predictability=
- 22. How predictable is acute admission? © Care IQ Group BV 22 Fri:=GP=weekend=closure= ! number=of=paEents= =====(year=average)= Eme=of=day="= Tue:=sick=children,=GP=awaits=a=day=
- 23. How do doctors impact acute admission? 23 9=Regular=producEon=(outpaEents)= 9=MD=presence=(6=of=8=absent)= 0% 5% 10% 15% 20% 25% 30% 35% 40% 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 9=RaEo=acute/regular=producEon=
- 24. The essence of a weekly monitor Weekly monitor: • Shows more detail on production patterns • Enables analysis of process variations • Allows to adjust more quickly and see its impact. • What if you could have real time data? © Care IQ Group BV 24 more=predicEve!=
- 25. More recently… Translation to new hospital projects • First design new processes, then design new building around that! • Maximize flexibility through modular design (future proof) • Design interior to meet patient and staff experience demands © Care IQ Group BV 25
- 26. 26 David-Ruben Thies (CEO): “In 2014 we were designing our new nursing center, but costs were higher than budgeted. Care IQ helped redesign our processes and plan capacity, while using the existing facility. This proved to be effective.” February 2013 © Care IQ BV 21 ?" Care IQ services: • Optimising patient pathways to reduce workload and length of stay • Centralising admissions to improve patient experience and efficiency • Reorganising nursing centre to enhance staff satisfaction and service levels • Introducing capacity management and staff planning to minimise operating costs • Revising architecture to fit budget restrictions • Designing open offices for physicians and management • Work in progress: business controls, staff training, day care centre, “staff flex pool” • 270 bed multi-speciality hospital • Largest academic orthopaedics dept. in EU • 45,000 patients per year • €40 million construction budget
- 27. 27 • Next steps & conclusion
- 28. Next steps… from anticipating to regulating demand 1. Internal data for sustainable quality improvement (e.g. planning, volumes) – Current limitations: cost detail registration do not support pathway based costing, material use per individual medical professional, risk profiling, profile matching 2. External data (e.g. demographics, traffic, disease prevalence) – Investigating broader causes: disease prevalence, cost deviations, waiting times, infection control, disease spread – Anticipating circumstances beyond control: epidemics, weather, traffic jams, influx of refugees © Care IQ Group BV 28
- 29. Towards predictive analytics • “But many providers are still not leveraging the vast amounts of data that they are collecting to improve the quality of care, increase patient satisfaction, and reduce costs. Indeed, most information available is still retrospective. For instance, it is common for organizations to produce reports on infections and patients falls on a monthly basis and those reports only reflect what has already occurred, not what is happening now or is expected to occur in the future. In this regard, health care is way behind manufacturing, consumer products, and financial services companies” Recommended building blocks: • Change leaders’ mind-set • Standardize data, real time data • Build a culture of transparency © Care IQ Group BV 29 h"ps://hbr.org/2014/11/hospitals9are9finally9starEng9to9put9real9Eme9data9to9use=
- 30. Concluding words 30 Data= InformaEon= Knowledge= Understanding= Wisdom= AcEon= experience= applicaEon= Data is not information, Information is not knowledge, Knowledge is not understanding, Understanding is not wisdom.= Clifford=Stoll= += ==+=