Customer Spotlight: Gaylord Hospital Executives Gain Insight with MEDITECH Healthcare Dashboards

With the growing adoption of EMR & CPOE, MEDITECH community hospitals face reporting challenges when shifting from a single ERP system to multiple data systems.

Administrators at Gaylord Hospital (Gaylord) know that its overarching goal of providing safe, effective, efficient patient care requires careful attention to data management, quality measures, and national healthcare standards. As national reporting demands increased and the number of the hospital's data sources grew, Gaylord sought a business intelligence solution to streamline and enhance both internal and external reporting and analysis. Using tools from Business Objects, database and reporting experts at Golden Consulting (Golden) helped Gaylord implement an efficient, flexible, and user-friendly reporting and dashboard system. The hospital's goal is to develop executive dashboards to monitor their quality performance and ultimately improve quality patient care.

The Hospital

Located in Wallingford, Connecticut, Gaylord Hospital is a long-term acute care hospital (LTAC) specializing in the care and treatment of medically complex patients, rehabilitation and sleep medicine. Gaylord is staffed and equipped to handle the specific needs of acutely ill or chronically disabled patients whose average length of stay is at least 25 days. The hospital is also able to treat those who need rehabilitation for illnesses or injuries related to the brain and nervous system, bones and joints, lungs, and other conditions. Licensed as a 109-bed chronic disease hospital, Gaylord admits more than 1,000 inpatients each year and offers over 50 outpatient services.

The Challenges

Gaylord was on the verge of deploying two distinct EMR applications to meet the clinical documentation needs of both its inpatient and outpatient services. Consequently, Gaylord faced the challenge of integrating two distinct billing systems. The finance staff sought a solution that would integrate these disparate data sources in order to provide a unified picture of Gaylord's patient population data that would transcend the artificial segmentation created by the two EMR systems. Financial managers needed to analyze, track and report on patient utilization, revenue, quality, and costs across the entire continuum of care, and to communicate that information effectively to hospital executives, payors and providers.

Like many small- and mid-sized community hospitals, Gaylord had used MEDITECH as its primary hospital information system (HIS). MEDITECH had dedicated modules to meet much of the hospital's needs — clinical, billing, GL, Accounting, human resources — in one centralized data system. Crystal Reports was the primary tool used to produce reports from the MEDITECH repository.

The deployment of electronic medical records (EMR) meant that Gaylord's data was now generated from multiple data sources. Business Analyst Randy Whelan recalls that executives were trying to make decisions based on data from three or four different data sources, each using a different report writing tool. "The reports were all trying to look at the same information, but they would generate different numbers" Whelan explains. "We needed a tool to nail down the correct information."

This proliferation of data sources came at a time when increasing national reporting requirements were making accurate, comprehensive reporting more critical than ever before. The Centers for Medicare & Medicaid Services (CMS) compels hospital administrators to report CORE quality measures, and the National Association of Long Term Hospitals (NALTH) now requires quarterly CORE measure and financial data submissions in an effort to benchmark hospitals against one another. "Under a Value Based Purchasing model, CMS is transitioning their "pay for reporting" initiative to a "pay for performance" plan. In the future, hospitals will receive a financial incentive for meeting or exceeding quality benchmarks," explains Pat Salem, Golden's Vice President for Healthcare Planning and Business Intelligence.

Gaylord administrators anticipate that their hospital's Medicare and Medicaid reimbursements will soon be tied directly to its CORE measure performance. Furthermore, much of the NALTH quality data was housed in stand-alone Access databases and Excel files throughout the organization, which made it a nightmare to collect, analyze and report.

Behind the scenes, Whelan was manually compiling, customizing, and distributing over 300 Crystal Reports within the hospital each month. This effort left him little time to manage the EMR implementation or develop a better data management system in order to comply with the new NALTH reporting requirements.

Golden's Smart Solution

Gaylord needed a comprehensive business intelligence tool from a vendor who understood the unique needs of healthcare organizations. As a Business Objects Platinum Partner, Golden offered a dedicated team of dashboard designers, database experts, and report developers with both managerial and technical hospital-industry expertise.

To integrate Gaylord's disparate data sources, Golden deployed BusinessObjects Edge Professional, a comprehensive business intelligence platform designed for mid-sized organizations. By creating a metadata layer, Edge Series connects source data from multiple systems like MEDITECH and eClinicalWorks. Eventually, this solution will allow Gaylord to create interactive dashboards that will take the integrated data to the next level, i.e., near real-time visual representations of key quality, financial and operational performance indicators, like the CORE measures, charges, and percent occupancy.

"During the initial proof-of-concept meeting — even before the actual implementation began — Golden's consultants presented an initial dashboard which raised a 'red flag' regarding an important aspect of our data collection," Whelan recalls. "Our executives were impressed, and as we saw more and more of the solution, they were even more enthused."

The Results

Interactive tools like Gaylord's new census and patient occupancy dashboard put critical operational metrics at executives' fingertips. They are now alerted when the patient census reaches a critical threshold, which provides an opportunity to take action before reduced patient flow creates major bottlenecks. Data which formerly updated only at midnight now updates automatically every five minutes, and management no longer spends time manually manipulating spreadsheets and PowerPoint slides just to get a visual representation of data.

Golden's deployment also streamlined Gaylord's Crystal Report distribution. "I used to spend half a day each Monday just distributing reports," Whelan recalls. Now the production reporting features of BusinessObjects Infoview — scheduling, publishing, security — mean that weekly, monthly and quarterly reports now run automatically, and the information is more accurate than before.

In the near future, Gaylord is preparing to launch a NALTH quality dashboard to integrate all of the hospital's quality indicators to allow for core measure reporting directly into the NALTH submission file. "These dashboards will empower users with time-sensitive information required to make critical decisions that will impact patient care and the bottom line," notes Salem. "BI tools that were once used only by large academic medical centers are now packaged for the mid-market community hospital, clinic or physician practice."

Later phases of the implementation will compile EMR from all three areas of the hospital — inpatient, outpatient, and sleep medicine — for a more complete understanding of the patient utilization and outcome data. Since different areas use different data systems, physicians are unable to get a comprehensive picture of a patient who had transitioned through multiple service areas. "Our source data is all over the place," explains Whelan, "but the metadata layer will allow the different systems to 'talk' to each other."

With help from Golden and Business Objects, Gaylord will continue to remain at the forefront of quality patient care. Whelan has already received requests for business intelligence functionality from other hospital departments, and he anticipates eventually rolling out solutions to the marketing and human resources departments. "Compared to the rest of the IT world, hospitals are typically not up to speed," remarks Whelan. "This Business Objects implementation is a proactive step that will keep Gaylord ahead of the curve."

To learn more about Gaylord Hospital, visit them online at www.gaylord.org.

To learn more about Golden Consulting Group, visit them online at www.goldencg.com.