Texas Childrens Hospital SharePoint Server 2010 Case Study - ROI and Business Intelligence (BI) SharePoint Consulting, SharePoint 2010, SharePoint Case Study, SharePoint Consulting Services, EPC Group, Errin O'Connor, Top SharePoint Firm, Top SharePoint Consulting Firm, SharePoint BI, SharePoint Healthcare, SharePoint Hospital, SharePoint 2010 Healthcare, PHI, SharePoint PHI

1. Customer Solution Case Study
Hospital Uses Business Intelligence to Trim
Patient Waiting Time by up to 51 Percent
Overview ―No other hospital we know delivers this data to
Country or Region:United States
Industry:Healthcare administrators on a 15-minute basis, the way we do
with the Microsoft BI solution—that‘s the ‗wow‘ factor
Customer Profile
Texas Children's Hospital, located in when we show this to other administrators.‖
Houston, Texas, is known worldwide
Matt Sides, Manager, Enterprise Applications, Texas Children‘s Hospital
for its expertise and breakthrough
developments in pediatric clinical care When you are located in the fastest-growing state in the United
and research. It has 7,000 employees.
States, customers have a way of finding you—but can you boost
Business Situation your efficiency enough to serve them all without massive
The hospital wanted to remove
bottlenecks to the flow of patients
increases in your facilities and staffing? That was the happy
through its facility, so that it could challenge facing Texas Children‘s Hospital, one of the top
treat more of Houston‘s growing
population with its current resources
pediatric hospitals in the U.S. Its solution: Adopt a Microsoft
and personnel. Business Intelligence solution to find and resolve bottlenecks in
Solution
the flow of patients through the hospital in near-real time. As a
The hospital adopted a Microsoft result, the hospital has reduced delays by up to 51 percent,
Business Intelligence solution based on
Microsoft SharePoint Server 2010 and
shaving a full day off the typical hospital stay and making it
SQL Server 2008 R2, which it uses to possible for the hospital to see as many more patients in a year
find and address patient-flow issues in
near-realtime.
as it could if it had added and staffed another hospital floor. And
because the solution relies on familiar Microsoft technology, it
Benefits
Bottlenecks in patient flow trimmed
was easily adopted by the IT department and clinical staff.
by up to 51 percent
Data updated every 15
minutes,spurring better, timelier
decisions
Familiar technology adopted easily

2. ―I‘m one of the people Situation Over the course of a year, the impact of
Houston‘s Texas Children‘s Hospital was the census alerts was the equivalent of
responsible for assigning growing as fast as it could. It just the hospital not admitting new patients
couldn‘t grow fast enough. for a month. Executives realized that
nurses to the EC and improving the flow of patients through
other areas of the Fast enough, that is, for a state that saw the hospital would reduce wait times and
its population grow by more than 20 minimize, if not eliminate, the census
hospital. That was tough percent over the past decade. As people alerts. Improved patient flow would free
streamed into Texas from across the hospital resources to serve more of the
to do when we didn‘t United States, Texas Children‘s Hospital pediatric population without additional
know what was not only grew–it grew smarter, adding facilities or staff. Improved patient flow
facilities and programs designed to could increase the quality of care and
happening in those reduce children‘s needs for emergency lead to saving more lives.
or inpatient care in the first place. For
areas.‖ example, it opened a community The hospital assembled a clinical team
Jennifer Sanders, Assistant Director of pediatric hospital facility and expanded from throughout its various departments
Nursing, Texas Children‘s Hospital the number of its primary care pediatric to investigate the issue of patient flow.
clinics throughout the city. Now, it is That team identified key targets that
preparing to open a hospital dedicated required greater efficiency and
to prenatal care for high-risk developed measurements by which to
pregnancies. evaluate progress, including the time
from EC arrival to EC discharge, EC arrival
Still, sections of the hospital regularly to hospital admission, hospital admission
went on ―census alert‖—meaning that to arrival in hospital room, pending
they were operating at capacity. When discharge to actual discharge, and
that happened, additional patients could discharge to preparation of the bed for
not be seen until current patients were the next patient.
discharged and their beds became
available. These bottlenecks could create As part of this process, the clinical team
delays that were felt throughout the identified a new challenge: The hospital
hospital, much as a traffic jam at one lacked a consistent, comprehensive, and
intersection can grow to stall traffic for timely way to aggregate, analyze, and
blocks. display patient flow measurements. This
was a very practical challenge for the
Once doctors had cleared patients to go hospital‘s staff.
home, it took three hours to actually
discharge them. And then, it took almost ―I‘m one of the people responsible for
two hours to get their beds ready for assigning nurses to the EC and other
new patients. That in turn increased the areas of the hospital,‖ says Jennifer
time that emergency center patients Sanders, Assistant Director of Nursing at
waited to be admitted to the hospital by Texas Children‘s Hospital. ―That was
two or three hours, on top of a five-hour tough to do when we didn‘t know what
wait to be seen and treated by an was happening in those areas. I spent
emergency center (EC) doctor in the first too much of my time going through the
place. hospital, trying to figure out where the
problems were at any one time.‖

3. 15 min flat file extract
picked up by SQL Server
Integration Services
SQL Server Reporting Services
Electronic Medical SQL Server 2008 R2 PerformancePoint Services
Record System Data Mart Excel Services for SharePoint
(Cache Database)
SharePoint Server 2010
Enterprise
SQL Server
Analysis Services Cube
Figure 1. The solution pulls Solution comfortable,‖ says Matt Sides, Manager,
information from an EMR What the hospital needed, executives Enterprise Applications at Texas
system, processes it into decided, was a centralized business Children‘s Hospital. ―It meant staffing IT
reports and an analysis cube, intelligence (BI) tool, accessible to for another system and incurring the
and makes the information allstaff, that would provide data on and continuing management costs for that
accessible to users through a analysis of patient flow measurements. system.‖
portal and dashboard. Another requirement was that data and
analysis had to be provided quickly Time was also a consideration: The
enough for administrators and others to hospital had given Sides and the IT
resolve patient-flow bottlenecks as they department just four months to put the
were occurring. Next-day reports would BI solution into production. ―This was
not be of much use. uncharted territory for us,‖ says Sides.
―We‘d never tried to pull real-time or
Some departments already used BI tools, near-real-time data out of our
although inconsistently and mostly for multidimensional array EMR system. To
clinical research. The hospital considered simplify the challenge, we needed
using Business Objects reporting, something with which our DBAs
primarily because the tool was included [database administrators] were already
with the electronic medical record (EMR) familiar.‖
system that the hospital already used.
That EMR would provide most of the raw The hospital‘s 13,000 workforce
data for the new BI solution. But the members—7,000 employees and 6,000
hospital had concerns. associates (mostly affiliated with Baylor
College of Medicine)—were already
―We‘d have to roll out this BI solution to familiar with a centralized tool to access,
all users—which meant training 13,000 use, and share information: Microsoft
people in an unfamiliar system with Office SharePoint Server 2007. The
which they were unlikely to be hospital‘s DBAs were already familiar

4. with a powerful data management tool, been using an expanded, full-feature
Microsoft SQL Server 2008 R2 Enterprise. version since January 2011 (see Figure 1).
The missing piece was BI. Then Sides and That solution uses Microsoft SQL Server
his colleagues took a close look at Integration Services to pull flat-file data
Microsoft SharePoint Server 2010 and its from the EMS system every 15 minutes,
service application PerformancePoint convert the data to a relational format,
Services in Microsoft SharePoint Server and deliver it to a SQL Server data mart.
2010. ―The integrated business The SQL Server technology also pulls
intelligence tools in SharePoint Server data from a custom bed-management
2010 were exactly what we needed. And database built on Microsoft .NET into the
it only made sense to continue with the data mart with the same frequency.
same Microsoft tools that we already had
Figure 2. All 13,000 hospital
and knew. We decided to use Microsoft The data then flows into a Microsoft SQL
workforce members have
technology.‖ Server 2008 Analysis Services cube.
access to patient-flow data
Microsoft SQL Server 2008 Reporting
through the SharePoint
In May 2010, four months after making Services uses the cube and the data mart
intranet portal, here showing that decision, the hospital went live with to create 36 graphical reports. Hospital
EC arrivals per hour. a preliminary version of its patient-flow personnel view these graphical reports
reporting and analysis solution. It has on a patient-flow dashboard that runs in

5. a SharePoint intranet portal. The portal is need to see an organization-wide picture
part of each employee‘s personalized of the data, to compare historical and
intranet home page and remains visible current data, and to identify and resolve
on select computers throughout the systemic issues.
hospital (see Figure 2). Employees who
want to explore and work with detailed Benefits
patient-flow data do so by querying the Texas Children‘s Hospital adopted a
cube and conducting ―what-if‖ analyses Microsoft BI solution based on
using PerformancePoint Services and SharePoint Server 2010 and SQL Server
Excel Services in SharePoint Server2010. 2008 R2 Enterprise to treat more of the
area population without having to build
Three key groups of employees use the and staff new facilities. It succeeded. By
patient-flow portal, each in different using the BI solution, administrators now
ways. Most are employees, from janitors can make better and timelier decisions.
to administrative and clinical assistants, The solution was also easy for the IT
who need to know how well their areas department to adopt, because it fit in
are performing at any given time, so that well with the technology that the
they can adjust their individual efforts as hospital already used.
required.
Patient-Flow Bottlenecks Trimmed by
A second group consists of unit up to 51 Percent
managers such as Sanders, who can After less than a year using the full
Figure 3: Key patient-flow
make real-time decisions about version of its Microsoft BI solution, the
measures, showing
reallocating personnel to improve project to improve patient flow, reduce
improvements with the use
patient flow. A third group consists of wait times, and treat more children
of the BI solution. business analysts and executives who successfully is itself a success. The
average 6.6-day hospital stay has been
trimmed by about 15 percent, or one
Measurement Baseline Result Percent day. Census alerts have been eliminated,
Improvement which executives calculate has enabled
EC Arrival to EC 5 hours 3.5 hours 30 percent the hospital to see as many more
Discharge children as it could if it had added and
staffed a new hospital floor.
EC Arrival to 8.3 hours 6.7 hours 19 percent
Hospital ―Our mission is to treat sick children,‖
Admission says Sanders. ―We want sick children to
go to the right area of the hospital, get
EC to Hospital 130 minutes 75 minutes 42 percent the right treatment, and return home as
Bed soon as it‘s appropriate. By using the
Microsoft BI solution, we‘re more
efficient and effective at this—seeing
Pending 360 minutes 176 minutes 51 percent
more children, providing full access to
Discharge to
care, and maintaining the quality of care,
Actual Discharge
without expanding the hospital or staff.
There couldn‘t be a bigger benefit than
Discharge to Bed 113 minutes 68 minutes 39 percent
that.‖
Ready

6. ―The information I need The hospital has eliminated census alerts ―No other hospital we know delivers this
by minimizing potential bottlenecks—by data to administrators on a 15-minute
is right in front of me on 19 percent to 51 percent—in all of its key basis, the way we do with the Microsoft
measures of patient flow (see Figure 3). BI solution—that‘s the ‗wow‘ factor when
the SharePoint we show this to other administrators,‖
dashboard. Instead of The hospital has achieved these says Sides. ―Most institutions deliver this
reductions while keeping a careful eye data to administrators the next day—
trying to figure out what on the quality of care, to help ensure that when it‘s too late to do anything with it.‖
none of the hospital‘s new efficiencies
the problems are, my job has come at the expense of its core Administrators make decisions on the
has become trying to mission to serve children. Clinical basis of this information to address both
outcomes such as infection rates are temporary and systemic issues. As an
figure out the solutions.‖ closely monitored. So is a measure called example of the former, Sanders uses the
―bounce-back‖—the measure of how patient-flow data to note when specific
Jennifer Sanders, Assistant Director of
Nursing, Texas Children‘s Hospital many patients return to the hospital with measurements in her areas exceed
the same complaintafter discharge. approved thresholds and to adjust
These measures confirm that the hospital staffing levels until the measurements
is seeing more patients and operating again fall within approved parameters.
more efficiently while maintaining its
high level of patient care. As an example of addressing systemic
issues, Sanders noted that it was
―Our efficiency improvements in no way consistently taking a relatively long time
affect the treatment that our patients for patients to transferfrom the EC to one
receive,‖ Sanders says. ―Patients are only of her units. Investigating the workflow
moved, say from the EC to a bed, or process, she discovered that the staff was
discharged, when a doctor says the relying on a push model in which EC
patient is ready, based on medical nurses waited for a call from the unit
criteria. Our patient-flow procedures only before they took patients there. She and
become relevant in implementing the her colleagues developed a pilot test
doctor‘s instructions.‖ that changed the process to a pull model
in which nurses in the unit retrieve the
Data Updated Every 15 Minutes, patient as soon as a room is ready,
Spurring Better, Timelier Decisions minimizing the EC wait. The preliminary
Better data, by itself, doesn‘t produce the result: transfer times have declined by 42
results that the hospital is now seeing. percent.
What does produce those results is the
use of data to make better and timelier That is not the only measure that has
decisions. Hospital administrators are declined for Sanders—so has her time
making those better and timelier spent walking around the hospital to get
decisions by taking advantage of the a sense of the problem areas at any one
near-real-time, updates produced by the time. ―My work is much more data-
system every 15 minutes, and by using driven with the Microsoft BI solution,‖
the highly intuitive dashboard, which is says Sanders. ―The information I need is
based on PerformancePoint Services and right in front of me on the SharePoint
hosted in the SharePoint portal. dashboard. Instead of trying to figure out
what the problems are, my job has

7. For More Information become trying to figure out the Microsoft SharePoint Server 2010
For more information about Microsoft solutions.‖ Microsoft SharePoint Server 2010 is the
products and services, call the business collaboration platform for the
Microsoft Sales Information Center at Familiar Technology Adopted Easily enterprise and the web.
(800) 426-9400. In Canada, call the Meanwhile, the Microsoft BI solution has
Microsoft Canada Information Centre fit easily and cost-effectively into the For more information about Microsoft
at (877) 568-2495. Customers in the hospital‘s infrastructure. ―Because this SharePoint Server 2010, go to:
United States and Canada who are solution is based on SharePoint Server www.microsoft.com/sharepoint
deaf or hard-of-hearing can reach and SQL Server, we already knew almost
Microsoft text telephone (TTY/TDD) everything we needed to know to make
services at (800) 892-5234. Outside the it work,‖ says Sides. ―We didn‘t have to
50 United States and Canada, please hire a consultant to design and build this,
contact your local Microsoft subsidiary. and we don‘t need additional people to
To access information using the World manage it. We can be flexible in how we
Wide Web, go to: staff it, because our IT staff already
www.microsoft.com understands .NET. Spinning up a new
database instance is a familiar task in our
For more information about Texas organization.‖
Children's Hospital, call (832) 824-1000
or visit the website ―While we went with what we knew, the
at:www.texaschildrens.org BI capability in SharePoint Server 2010
gave us the opportunity to provide value
to the organization at every level,‖ says
Sides. ‖Now, that's a cool feeling.‖
Software and Services − Microsoft SQL Server Integration
Microsoft Server Product Portfolio Services
− Microsoft SharePoint Server 2010 − Microsoft SQL Server 2008
− Microsoft SQL Server 2008 R2 Reporting Services
Enterprise − PerformancePoint Services
Technologies forMicrosoft SharePoint Server 2010
− Excel Services in Microsoft
SharePoint Server 2010 Hardware
− Microsoft SQL Server Analysis HP ProLiant BL460c
Services HP ProLiant DL580c
This case study is for informational purposes only.
MICROSOFT MAKES NO WARRANTIES, EXPRESS OR
IMPLIED, IN THIS SUMMARY.
Document published November 2011