The purpose of analytics in a healthcare organization is to gain insights to improve a process to address an issue such as, improving clinical quality and patient safety or improving the health of a particular patient population. Analysts are responsible for gathering disparate data from different functional areas and develop a narrative so those driving change can take the information and make it actionable. Organizations generally build one of two analytic reporting structures. One is a centralized model, where the analytics group is its own entity, independent of any particular group. The second is a decentralized model where the analysts work directly for the different groups or departments. In this way, the group does not have to compete for the attention of the analysts and the analysts’ sole focus is to serve those “customers” well. There is a third way, as well, that optimizes the strengths of both centralized and decentralized.

1. Healthcare Reporting:
Centralized vs. Decentralized

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Healthcare Reporting
One of the questions that often
comes up as healthcare
organizations look to get more
deeply into data analytics is
whether their reporting
functions should be centralized
or decentralized.
The answer I usually give is:
YES!!

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Healthcare Reporting
At Health Catalyst we believe in
a concept touted by Reed
Hastings, co-founder and CEO
of Netflix, refers to as “highly
aligned, loosely coupled.”
Highly aligned means everyone
shares the same strategic
goals–team interactions are
focused on strategies.
Loosely coupled means different
groups have the flexibility to
approach tactics differently as
needed.

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Healthcare Reporting
The approach is much like the
offense on an NFL team.
The coaching staff develops a
game plan and the overall
strategic approach the team
will take to win the game.
However, during the game, the
offensive and defensive
coordinators call the plays
according to the game plan.
That is highly aligned.

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Healthcare Reporting
Suppose at the line of
scrimmage the quarterback
sees a certain defensive
formation and realizes there is
a better opportunity available.
He has the freedom to call an
audible and make a tactical
decision that is still highly
aligned with the team’s overall
strategy.

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Healthcare Reporting
The purpose of analytics in a
healthcare organization is to
create insights that help achieve
strategic goals.
Analysts are the conduits that
collects various data points from
different sources that allows non-
analysts understand and act on it.
The tactics they use depend on
the organizational structure.

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Basics of Centralized vs. Decentralized
Organizations generally take
one of two approaches to
analytics and reporting.
One is a centralized model,
where the analytics group is its
own entity, independent of any
particular group.
In a decentralized model, the
analysts work directly for the
different groups or
departments.

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Basics of Centralized vs. Decentralized
Each of these models has its
pros and cons; the pros of one
are usually the con of the other.
Let’s look a little more deeply at
each to see where their
strengths and weaknesses lie–
and why a hybrid of the two
tends to work best.

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Centralized Reporting Pros
The centralized model has
many advantages.
Overall, if you had to choose
a single approach, this
would be recommended
based on our experience
with both.
The strengths of the
centralized model follow:

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Centralized Reporting Pros
Standards and best practices vs. a maverick approach
This begins with standard tools.
If everyone is sharing the same
tools, the analysts are able to
share their knowledge about
those tools as they learn.
Having a standard set of
reporting tools ensures it can
be done almost instantly.

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Centralized Reporting Pros
Flexibility
Organizations that use a
centralized approach can shift
resources where and when
they’re needed; those with a
decentralized approach cannot.

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Centralized Reporting Pros
Ability to support individuals with different skillsets
In a centralized model, the
organization can have a mix of
skill levels since the junior or
mid-level people can always go
upstream to get questions
answered or learn new skills.

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Centralized Reporting Pros
Spot analytics trends vs. analytics islands
In a decentralized model; what
is learned in the domain tends
to stay in the domain.
When reporting is centralized
the organization can aggregate
reports from multiple areas and
build customized dashboards
that enables executives to get
ahead of trends.

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Centralized Reporting Pros
Better management of resources
In a centralized model,
management is provided
by experts in analytics who
know how long a particular
task should take–and when
a heroic effort is needed to
deliver a particular report.

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Centralized Reporting Cons
Specific departments do not control their destiny
In many cases departments or
higher-level initiatives usurp the
needs of another department.
A dissatisfied department Might
say, “Fine, if IT can’t help me, I
will go hire my own people.”
This common attitude is typically
what drives organizations to go
to a decentralized model.

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Play to Organizational Strengths
Centralized vs. decentralized
reporting doesn’t have to be an
either/or choice.
Organizations with the most
success are the ones that
combine the two to keep their
reporting processes highly
aligned yet loosely coupled –
giving them the best of each
while overcoming each model’s
negatives.

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Play to Organizational Strengths
The primary benefit is that
analytic efforts are focused on
a specific need.
With a lot of low-hanging fruit
out there it’s easy to take
advantage of immediate
opportunities.
If their work aligns with the
overall organization’s strategy
they don’t need to follow the
formal processes that are part
of the centralized model.

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More about this topic
Hospital Data Warehouse: The Best Tool for Efficient Hospital Reports
Bobbi Brown, Vice President of Financial Engagement
Physician Reporting: The Secret to Useable, Engaging Reports
Dr. Ed Corbett, Medical Officer
Data Analyst Saves Hospital Millions
John Wadsworth, Vice President, Client Engagement
4 Ways Healthcare Data Analysts Can Provide Their Full Value
Russ Staheli, Vice President, Analytics
Self-Service Hospital Reporting Possibilities
Brian Eliason, Vice President, Client Engagement and Kristi Mousel, Business
Intelligence and Data Warehousing Professional
Link to original article for a more in-depth discussion.
Healthcare Reporting: Centralized vs. Decentralized

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For more information:

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Other Clinical Quality Improvement Resources
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Russell Staheli joined Catalyst as a data architect in October 2011. He started his
career as an Intern and later Outcomes Analyst at Intermountain Healthcare in the
Institute for Health Care Delivery Research supporting the Advanced Training
Program for Executives & QI Leaders (ATP) and the Primary Care Clinical
Program. Before coming to Catalyst he worked as a Management Engineer
Programmer Analyst for the Duke University Health System in their Performance
Services department supporting their Infection Control and Epidemiology efforts.
While there, he also worked as an external consultant to advance the analytical work of the Duke
Infection Control Outreach Network (DICON), a collaborative of over 30 community hospitals. Russ
holds an Master of Public Health in Health Policy and Administration from University of North
Carolina Chapel Hill and a Bachelor’s degree in Health Services Research from the University of
Utah.