While these hospitals are evolving as world-class care providers, not many of them are able to evolve as profitable and sustainable businesses. This can be prevented so that the investors and the managers of the hospital are able to build a sustainable industry while continuing to offer affordable care as well as run a sustainable business. This is not a hypothetical situation– it is indeed possible to be successful on both the counts if appropriate monitoring and management of the hospital’s KPI’s and KRA’s are conducted rigorously.

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Business Cleverness in Hospitals
By Dr.Mahboob Khan Phd
The private hospital sector boom, thanks to world-class patient
management, clinical outcomes, infrastructure services and
management has been enabled due to the implementation of excellent
IT systems, the backbone of monitoring and managing financial,
operational and clinical performance, points out Dr.Mahboob Khan
Phd renowned healthcare quality and strategic legal consultant at
Saudi aramco.
The investment in IT systems by many hospitals has been in multiples
of millions of rupees. The primary aim of implementing these systems
was to facilitate ease of administration of admissions, discharges and
transfers (ADT), hospital enterprise resource management and staff HR
management. As these hospitals started implementing more
sophisticated IT systems for labs, radiology and clinical management,
they have been collecting and collating a significant amount of
demographic and clinical data.
While these hospitals are evolving as world-class care providers, not
many of them are able to evolve as profitable and sustainable
businesses. This can be prevented so that the investors and the
managers of the hospital are able to build a sustainable industry while
continuing to offer affordable care as well as run a sustainable
business. This is not a hypothetical situation– it is indeed possible to be
successful on both the counts if appropriate monitoring and
management of the hospital’s KPI’s and KRA’s are conducted
rigorously.
The way to build a sustainable and profitable hospital business as well
as provide affordable care lies in the ability of the hospital to leverage
all its assets and optimise the use of all of them constructively.
Constructively is a key and operative word here since sustaining an
operations means that you do not wear the assets out and run them to

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the ground, but utilise them optimally, plan well for their continued
quality of output and plan for appropriate maintenance and repair and
replacement too. What that means is that not only does a hospital have
to run like a well-oiled machinery but also function as a well managed
financial enterprise.
All of the above can be achieved if the entire enterprise marches to one
set of truth with respect to operations, administration and financial
metrics. This would additionally mean that these metrics are not only
available to all the key stakeholders bus is also available in an
actionable format. Actionable format means that the executive is not
only able to review the metrics but also able to simulate multiple 'what-
if' scenarios and act on the metrics immediately so that any negative
trends are neutralised and positive trends are enhanced. This would
mean that executives at every level are able to review, drill-down and
then analyse and react to the outcomes or be pro-active to the trends or
prospective outcomes.
First Step to Business Intelligence
I think With increasing use of records in electronic form where the data
is available in electronic form by more and more care delivery
institutions, the increased use of Business Intelligence tools is bound to
happen. The knowledge culled through extensive use of these tools will
greatly impact the top line of the institution that use them. The primary
foundation for business intelligence is knowing where the source of
truth exists within the various data and information systems and
bringing this truth to the fore. This act of separating the source of truth
from all the rest of the data converts the data to information. This is the
first step in the process of business intelligence i.e identifying and
determining what is good and useful information and what is plain and
simple peripheral data.
Creating Value
Then we have to apply our understanding of healthcare as a business

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and develop equations and algorithms to leverage this information and
get additional knowledge out of this information – this is where
business intelligence is being performed using analytics. The
knowledge that will emerge will be in a very raw format which is then
left to the determination of the trained and specialised users and
practitioners. It is these practitioners who create value out of this
knowledge. Creating value in a hospital consists of following from the
three primary areas:
Administrative
 Efficiency of discharge , billing, collections and admission of
next patient
 Appropriate allocation of staff during peak usage
 Inventory and leverage all assets appropriately and ensure
availability at all times of need
Financial
 Ensure that all receivables are paid on time
 Leverage assets to maximise ROI and Return on Assets
 Minimise the non-revenue components of assets and services
Operational
 Provide services at lowest asset utilisation without compromise
on outcomes and quality
 Leverage cost benefit analysis and practice preventive practices
 Monitor and manage compliance and adherence to all best
practices to minimise operational effectiveness
Benefits of Business Intelligence
Business Intelligence and analytics implementation allows hospitals
and organisations to create canned and ad-hoc reports which can be
used to measure and monitor the metrics around the above areas. The

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creation of the reports and leveraging the output of these reports is
value creation. The ability to draw inferences from these reports, seek
additional data-points and conduct what-if analysis are the key
capabilities of a good business intelligence system.
Good executives and managers are able to constantly be on top of these
metrics and take corrective action immediately. These constant
measuring and managing and constant hands-on course correction by
vigilant managers will ensure that hospitals are productive, cost-
effective and provide excellent quality of care.
Clinical Effectiveness and Outcome Management
As these metrics are measured and managed on an ongoing basis – it
will be realised that the best care and outcomes can evolve from
hospitals which had very poor performance in the past. The reason is
that when you cannot measure– you do not know where you stand and
where you have to go! Many hospitals have either implemented such
systems or are evaluating the implementing of the same to achieve
operational, financial and administrative effectiveness. But, there is
one area which is clearly the core realm of the hospitals ie clinical
effectiveness and outcomes management.
Among the many applications in the healthcare IT space the two most
likely to impact on care delivery over the next decade are clinical
decision support systems and clinical analytics applications. With
increasing volumes of health data available it is now possible to look
for patterns in the clinical data, pick up disease trends faster and use
these systems at the point-of-care to enable them to have the maximum
impact on improving patient outcomes.
Hospitals realise that if they want to have a satisfied customer – they
have to have successfully treated a patient optimally and built faith in
the cured patient that if she or her relatives or friends need medical
care she will feel completely comfortable recommending the same
hospital – and so effectiveness of outcomes is a key customer

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satisfaction index for the hospital. This is where the overall outcome of
all the BI systems in the hospital plays an integral role and thus ensures
that the best care and thus the optimal outcome was provided at the
best cost without compromise on quality of care for the patient and
operational realisation for the hospital. This is how the business of care
becomes the value creation for the investors rather than a social cause.
Hospital and clinical information provides valuable insights into the
causes of disease and the effectiveness of treatment, interventions and
health care services. BI solution integrates clinical / non clinical patient
data from disparate systems thus providing a centralised global view of
information for various clinical and non-clinical researches. This data
is then put to meaningful use for medical research by BI techniques
such as data mining for evidence based decision support (which can
also be used to uncover trends and patterns in clinical errors),
predictive modeling and advanced analytics.
BI has shown a marked improvement in operational efficiency, quality
of care, process improvement in hospitals. BI is also used for
supporting high-throughput phenotyping of diseases and medically
relevant traits. BI analysis of clinical information would reduce the
time, effort, and cost involved in conducting genomic, biomarker, and
pharmacogenomics studies. In summary I think, “The use of BI in the
analysis of patient data and study of clinical trials will contribute
significantly to research leading to discoveries that will advance the
diagnosis and treatment of diseases, and will help reduce human
suffering and contribute to the advancement of medical knowledge.”