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Executive Dashboard Development Guide - Amazon S3s3. · PDF fileExecutive Dashboard...

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  • Table of Contents

    Executive Dashboard

    Development Guide

    April 2009

    2009 Healthcare Information and Management Systems Society (HIMSS)

  • 2009 Healthcare Information and Management Systems Society (HIMSS)

    2

    Table of Contents

    Overview.......................................................................................................................................3 Defining the Need .........................................................................................................................4 Using Information within the Dashboard .......................................................................................6 Defining the Key Performance Indicators and Metrics................................................................11 Defining the Infrastructure...........................................................................................................16 Transforming Data ......................................................................................................................19 Presenting the Data in an Executive Dashboard ........................................................................22 Environmental/Cultural Factors in Your Organization.................................................................24 ROI/Organization Benefits ..........................................................................................................26 Lessons Learned ........................................................................................................................28 References..................................................................................................................................30 Contributing Authors ...................................................................................................................32

  • 2009 Healthcare Information and Management Systems Society (HIMSS)

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    Overview Executive dashboards come in all shapes and sizes. They serve many different purposes and audiences, and use various infrastructures as their foundations. Due to variability, it is not uncommon for an organization to overlook key aspects when beginning to establish a dashboard. In simple terms, an executive dashboard is an electronic display comprised of key performance indicators (KPIs). Yet, who or what determines the KPIs to be used and what needs to be considered? How is the electronic display developed and who determines the amount of information, the level of detail or the display components? Where should this information be stored and what are the options available? This document will try to answer many of these questions. An executive dashboard goes through a lifecycle as it is a project all its own. The following outlines the key steps and as in any lifecycle, the project moves in a continuous loop.

    1. Project Initiation Establish governance and decision-making boards Establish change control processes

    2. Design Phase Identify the target audience (address executives, managers, clinicians) Determine potential KPIs Evaluate data sources for the KPIs (Do you have the data for your KPIs?) Evaluate current and potentially required software/hardware for the dashboard Address workflow considerations and associated training approaches

    3. Build Phase Develop mechanisms for getting the data from the sources (systems, paper, etc.) Set up selected ETL (Extract, Transform, Load) tools and other 3rd party specialty tools

    (SAP/Crystal/BO, etc.) Build training materials

    4. Test Phase Ensure all the tools work to get accurate results Ensure the updated workflow processes work with the new dashboard

    5. Rollout Phase: Conduct training and begin production use 6. Monitor Phase: Review and monitor the dashboard are the results actionable? Does

    the workflow continue to work with the dashboard? Measure and trend data from the dashboard evaluate impact on the organization. Determine if there are other KPIs that need to be measured.

  • 2009 Healthcare Information and Management Systems Society (HIMSS)

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    Defining the Need

    Before making a decision, something inside of us convinces our brains of a desire or a need to take an action. Need is defined as A condition or situation in which something is required or wanted. That something can be the hiring of a new nurse FTE due to patient volume increases or the expansion of a clinical service to serve an aging population. In both instances need may be generated and influenced by a multitude of internal and external influences, some not in our own ontrol. c

    Once we identify the need, we are often faced with many decision points. The process through which we generate conclusions can be described as follows: we collect information, process the data we have available, take a course of action, and then hope for the best. If we are lucky enough, we can quickly evaluate our decisions, collect more information and modify our course. In this section of this resource tool kit, we are considering those factors that create the need for hospital organizations to consider the purchase of Business Intelligence (BI) tools. Without first considering the need for these tools and their importance in guiding us to make decisions, the rest of the content in this resource tool kit loses its relevance. As the healthcare industry begins to build the case for the purchase of BI tools, one only needs to look at internal organizational and external pressures that exist within our space. Listed below are some

    xternal factors that may drive your organizations need to invest in BI tools. e Economic Factors Changes that negatively impact the revenue generated by the healthcare institution/provider for patient care services:

    Changes in payer mix with a movement away from higher paying payers. Growing number of patients seeking care who do not have insurance. Closing of hospitals in poorer areas. Domination by one or a few payers that reduce the reimbursement rate Process bottlenecks and other workflow impediments impacting cost and timelines of billing.

    Governmental Factors Restrictions and/or demands placed on healthcare institution/provider by government agencies:

    Increased CMS reporting demands on quality. Changes in reimbursement tied directly into quality indicators. Elimination of payments for care delivered as a result of medical errors.

  • 2009 Healthcare Information and Management Systems Society (HIMSS)

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    Environmental Factors Other external changes that place pressures on local healthcare systems:

    Increases in malpractice costs causing many physicians to leave the area. More demands by local employers for hospitals and physicians to reduce medical errors. Smarter patients who use the Internet before seeking care. Increase in immigrant population to a geographic area who have had little historical preventive

    care. Each one of the above external factors places pressures on internal operations within healthcare entities to adjust. These adjustments may come from:

    Elimination or creation of service offerings. Re-structuring of payer contracts. Re-distribution or elimination of staff. Investment in technology or other capital.

    However, in order to approach the right adjustment strategy, tools capable of capturing, analyzing and reporting clinical, operational, financial and satisfaction data are required to guide in the decision-making process. It is clear that many external factors are now placing pressure on healthcare professionals to make internal organizational decisions. To make well-informed decisions, healthcare organizations need the tools to help them with these choices. Once the need for BI has been established and reaffirmed, the next steps include executive sponsorship and an evangelist capable of convincing others of this need and its benefits through out the enterprise.

  • 2009 Healthcare Information and Management Systems Society (HIMSS)

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    Using Information within the Dashboard

    As noted within the lifecycle, the first step you take in defining an executive dashboard is to identify the target audience and what the information from the dashboard is going to do for these groups. It is important to think about tying back quantifiable business benefits to requirements you would put into a dashboard. An organization may have multiple audiences it is trying to serve, which would result in multiple dashboards. However, before you can begin, it is critical to develop a clearly defined scope document and ask yourself the following:

    Who are the intended users? What are you trying to show, learn or understand through the dashboard? What is the soft and hard return on investment (ROI) for the hospital for having a dashboard

    with KPIs? Which departments and which stakeholders stand to gain the most with an initial dashboard

    deployment? What is the frequency of the updates? What is the intended lifecycle of the dashboard?

    In healthcare, most dashboards display three kinds of indicators. These indicators are financial, clinical, and operational indicators. The financial indicators address the financial health of the organization while the clinical indicators speak to both quality care and the operational aspects of a clinical department. For consideration, we have provided background information on how an organization may use a dashboard for both financial and clinical information. Financial Information An organization can use a dashboard (or multiple dashboards) to monitor its financial health on an ongoing basis. The dashboard should convey fundamentals about the business, pinpoint are

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